Anxiety in its mild form is a natural state associated with stressful situations, and is suffered by everyone at some time. The things people get anxious about include exams, interviews, relationships, finances, acts of violence and rabid dogs. Some degree of anxiety, which subsides after the event, would be considered to be appropriate, given the circumstances.
However, when the anxiety escalates and in some cases brings on panic attacks and palpitations (rapid or irregular heart beats), medical intervention is necessary. When severe anxiety is present the whole body feels ‘wired up’. The person finds it difficult to relax, over-reacts, feels tense, nervous, agitated and finds it difficult to concentrate. Sleep is likely to be disturbed, with periods of insomnia, and early-morning waking. The person may also experience a dry mouth, muscle tremors and diarrhoea, all of which are very distressing.
Heart: palpitations and awareness of missed heartbeats, discomfort in the chest
Chest: overbreathing, pain in the chest
Muscular: aches and pains, Nervous System, shakes, headaches, dizziness, tinnitus (ringing in the ears), prickling sensations, poor concentration and memory
Digestive: dry mouth, difficulty in swallowing, indigestion, excessive wind, diarrhoea
Bladder: frequent need to pass water
Uterus: amenorrhoea – lack of periods, period pains
There are three main types of anxiety which are quite distinctive:
General anxiety: which is continuous.
Phobic anxiety: which occurs from time to time, when in certain situations
or places.
Panic attacks: which occur from time to time, but are not related to a situation or place necessarily; the response is often out of proportion to the situation.
Plus: Premenstrual: anxiety which is experienced by some women.
The causes of general anxiety are not fully understood, but it is thought that it could be attributable to a combination of any of the following:
• genetic disorders
• insecure relationships in childhood
• stressful events in life
• nutritional deficiencies
• possible food allergies
Your doctor can carry out physical investigations to eliminate the possibility that the anxiety is related to a physical disease or problem. An overactive thyroid, hypoglycaemia (low blood sugar) and, rarely, tumours of the adrenal glands can all be accompanied by symptoms of anxiety, as can psychiatric disorders like depression, dementia or schizophrenia. Once pure anxiety has been diagnosed the treatment your doctor has to offer is mainly psychological:
• Setting your mind at rest is the first step, so that there is a clear understanding that the symptoms are not related to any major illness.
• Stress management advice, to help you to understand and recognise the trigger for your anxiety. • If you are hyperventilating (overbreathing), you should be given instructions about how to breathe, by re-breathing expired air from a paper bag to restore the normal concentrations of carbon dioxide.
• You may be offered drug treatment like Valium, which produces rapid relief of anxiety, but this should not be prescribed for more than three or four weeks.
• Alternatively, anti-depressants are used to control anxiety, but they are a longer-term treatment and should only be considered as a last resort.
The main symptoms of premenstrual anxiety are nervous tension, irritability and mood swings, beginning as early as two weeks before the period and becoming progressively worse as the period approaches. There are several possible factors, both hormonal and dietary, that might cause it.
• Some doctors think than an excess of the hormone oestrogen or an increased sensitivity to it may trigger changes in brain chemistry, resulting in anxiety. The average diet, high in fat and relatively low in fibre, can increase the levels of this hormone.
• Also, high levels of oestrogen slow down the rate at which the stimulant caffeine is broken down by the liver. This is why some women become more sensitive to tea and coffee when they are pregnant or when taking the oral contraceptive pill.
• A lack of vitamin B and possibly the mineral magnesium can also cause changes in the chemistry of the nervous system, aggravating feelings of anxiety and irritability. Interestingly, it seems that some women and men who are prone to anxiety and panic attacks are more sensitive to caffeine and genuinely have a more sensitive body metabolism, which makes them very susceptible to the effects of a lack of vitamin B or magnesium.
• Kava kava is a herb renowned for its calming and sedative properties and has been used in traditional folklore medicine for centuries in the treatment of anxiety, depression and stress related disorders. The active components of kava are kavalactones, found in the fat soluble resin of the root of the plant. Whilst taking sedatives like Valium can induce unwanted side effects, including addiction, kava does not appear to present any such symptoms. However drowsiness has been reported in some studies. NB Although no side effects have been reported as a result of using standardised kava extract, research does show that it may interfere with levels of the neurotransmitter dopamine and worsen Parkinson’s disease. Therefore, until more sound research is published, it should not be taken by anyone with Parkinson’s.
• A comparison of caffeine consumption in Chinese nurses and workers in a tea factory revealed a strong association between increased caffeine consumption and the severity of premenstrual symptoms. We conducted our own survey in the United Kingdom with Fitness magazine, which was published in 1992. Three hundred and seventy-seven women took part. Caffeine consumption was nearly two and a half times higher in PMS sufferers compared with non-sufferers.
• A final and important factor is hyperventilation. This simply means over-breathing. Often when one becomes anxious it is natural to increase the rate and depth of respiration. This provides more oxygen to the bloodstream but also removes more of the waste gas carbon dioxide. This lack of carbon dioxide causes a change in the body chemistry which can actually aggravate or cause a variety of symptoms, including numbness and tingling in the fingers, hands and around the mouth, muscle cramps, headaches, light-headedness, increased anxiety, physical and mental fatigue, and confusion. The solution is to relax, reduce the rate and depth of breathing, and if symptoms are severe, to breathe in and out of a paper bag for several minutes. When these symptoms chronically occur, formal advice and breathing exercises may need to be given by a physiotherapist or psychologist.
Celia was a 31-year-old mother of two young children who had been suffering for years with mood swings that left her feeling frightened and depressed.
‘I’d be chugging along fairly normally, then, suddenly, I would burst into tears over nothing at all. My mood seemed to change from one hour to the next, and the frightening thing was that I had no warning it was about to happen – it was as if I just snapped. I went from feeling perfectly normal, to thoroughly depressed, and my patience threshold was non-existent. The slightest little thing would spark me off and I’d feel like thrashing out. I’d been suffering like this, three weeks out of four, for six years, since the birth of our first son, until I reached crisis point one morning whilst hanging out the washing. All I did was drop a sock on the floor, but I burst into tears. It felt like the end of the world and I was sure I was going mad. In desperation I opened up to my husband, who was always supportive. We decided that perhaps I needed to get a part-time job, as I hadn’t been out of the house whilst the boys were small. Now they were at school it seemed like a good idea, but I didn’t manage to get a job and nothing changed.
I went to visit my doctor and explained about my wild moods and tearfulness. He was very sympathetic, but said he only had antidepressants to offer me. I hate taking pills, but I was so desperate, I promised to try them for three months. I didn’t feel I had any choice as by this time I had reached the point where when I woke up each morning I knew I couldn’t face the day. The anti-depressants drained me and left me feeling completely zombified. My quality of life was non-existent and I didn’t even feel that I was fit to drive the children around. I tried to stop taking them, but my symptoms returned with a vengeance. Finally, I thought that my only hope would be to see a psychiatrist, which I did. He asked me all about my sex life, and my marriage. And, as I talked to him it dawned on me that he wasn’t going to be able to help me at all. The only thing wrong with my sex life and my marriage was that I was feeling ill. Sex hadn’t been that great whilst my moods had been so up and down, but I knew it was not the cause of my bad moods. And so I renewed the prescription for the anti-depressants, and carried on taking them, feeling like a washed-out zombie for the following year. If it hadn’t been for my husband and the boys I really think I’d have been suicidal. I can’t believe that my husband didn’t pack his bags and leave, I must have been so awful to live with.
My husband tried to cheer me up and found a dream house for us to move to, hoping it would pull me out of my problems. I thought long and hard about it, and told him I was going to throw the pills away, and somehow help myself. I booked some counselling sessions which helped a bit. But what really changed my life was an article I read in Family Circle magazine about a woman describing her mood swings. I read the article over and over again. I just couldn’t believe it. She was describing precisely what I had been going through, and had cured her problem, not with pills, but by changing her diet! I wrote to the organisation mentioned in the article, the WNAS, and I bought their book. They sent me a questionnaire asking me about my diet, lifestyle and moods. I was then provided with a special programme which involved changing my diet completely. I felt so awful the first week, which they said I would, I actually wondered if it was worth continuing. One morning at the end of the first week, I woke up feeling terrible, I made breakfast and crawled back in to bed. I stayed there all day, and when I woke up the next morning I felt fantastic. I hadn’t felt that good for ages. I couldn’t believe it. It was as if a dark cloud had been lifted from me. The longer I was on the programme the better I felt. It has been five years now, and I feel wonderful. I’m lively, energetic and those horrendous and unpredictable mood swings have gone completely.’
“The longer I was on the programme the better I felt. It has been five years now, and I feel wonderful. I’m lively, energetic and those horrendous and unpredictable mood swings have gone completely.”
Celia