One of the top reasons people come to see me is for help with anxiety. In fact anxiolytics, the class of drugs used to treat anxiety, are some of the most prescribed drugs in America. Unfortunately these prescriptions tend to be very addictive and, since they are not meant to be used long term, can present a challenge when trying to wean patients off of them.

Anxiety can be paralyzing – it can keep you from making important decisions or it can keep you from getting out and enjoying life. It can also be self-perpetuating. I often have patients who express that they know that they are “doing it to themselves,” but get so focused on the fact that they are anxious, they are unable to think about anything else. It can truly be a vicious cycle.

To evaluate a patient who presents to my office with anxiety, I look for nutritional deficiencies, hormone imbalances, and gastrointestinal disorders. Low levels of iron, folate or vitamin D can trigger anxiety. Hypoglycemia can elicit panic attacks in some people. Compromised adrenal function has also been shown in people who feel overwhelmed or feel they are unable to handle certain situations. In men, low levels of testosterone, as well as too much testosterone, can cause anxiety and depression. In women, low levels of progesterone and high levels of estrogen can cause anxiety and depression.

Gastrointestinal disorders are often at the center of nutritional deficiencies and hormone imbalances. Healthy bodies start with healthy guts. This is where we assimilate nutrients from our food and any supplements or medications we might be taking. If our GI tract is inflamed from consuming foods we are allergic to, then we might not be absorbing nutrients the way we should. Using Nexium or Prilosec to treat a “nervous stomach” can block the body’s ability to break down food and utilize its nutrients.

Physical symptoms can trigger mental/emotional symptoms just as mental/emotional symptoms can trigger physical symptoms. Have you ever gotten so nervous or scared that you felt like throwing up? GERD or gastritis can cause pain/pressure in the chest or an uneasy feeling in the gut. Patients may describe the discomfort as anxiety. I recently treated a patient for SIBO, or Small Intestine Bacterial Overgrowth. Her primary symptom was diarrhea but she noted that 80% of her anxiety was gone after the bacteria was eliminated.

If you are feeling anxious or overwhelmed, please talk to your doctor. Anti-anxiety medicine is good for short term relief, but do not plan to spend the rest of your life managing your symptoms. Make sure you get a thorough work up and walk away with a plan to correct imbalances and wean off of the medications. Life is a lot more fun when we can relax and enjoy it!