We've
all experiences moments of stress and anxiety in our everyday lives. Every
one of us has been late for an appointment, had arguments with loved ones,
or been anxious to find out what grade we received on a test. Brief moments
of anxiety are a normal part of life that has been bred into us by millions
of years of evolution. The “Flight or Fight” response as it is called
serves us very well in life or death situations, and has done so for eons.
Picture
what happens in a stressful situation. Let’s say you’re an early human
living a few hundred thousand years ago. You’re walking through the forest
minding your own business and suddenly you hear a twig snap. You turn
to investigate and immediately realize that a tiger has singled you out
for lunch; as you stand there deciding whether to stay still or run, your
body has already begun the “Fight or Flight” response. Your adrenal glands
are now flooding your body with adrenaline, epinephrine, and steroid stress
hormones, thus heightening your senses and giving you near super human
abilities. Surface blood vessels constrict allowing more blood to be pumped
to vital organs and less blood to be lost in the event of injury. Blood
pressure rises, and you are now ready to either stay and take your changes
with the tiger, or run. Well hopefully you outrun or outsmart the tiger
and live another day to do whatever it is that cavemen do.
Now
let’s advance a few hundred thousand years to today. Your stuck in traffic,
just had an argument, and also late for an appointment, so what happens?
Your body immediately says “tiger!”, and goes into survival mode, the
fight or flight response. Unfortunately, your body has no way to distinguish
between actual life threatening events and the rigors of modern living;
and these modern “tigers” are not rare events, they're around every corner.
Given the right circumstances, whether chemical or environment, a person
can find themselves in a state of constant “Fight or Flight”.
What
level of anxiety is normal?
One
question you probably have is what level of anxiety is normal and at what
point should you seek treatment? While there is no clearly definable threshold
for anxiety disorder, a basic rule of thumb for "normal anxiety" is the
ability to recover once the stimulus is removed. When ruminating thoughts
and anxiety exist in the absence of any definable stimulus it may be time
to seek treatment.
Anxiety
Hormones:
Glucocorticoids:
Glucocorticoids
serve to increase the level of glucose in the bloodstream for an added
boost of energy as well as decrease inflammation. The most famous
of which is cortisol.
Catecholamines:
Catecholamines
include norepinephrine and epinephrine. These hormones serve to increase
heart rate, blood pressure, cardiac output, and muscle tension. They
also decrease blood flow to the extremities and gut so that the blood
can be temporarily used for more vital organs.
Endorphins:
Endorphins serve
to decrease sensory awareness including the perception of pain, and
also cause a feeling of euphoria.
Health
effects of long-term stress and anxiety
We know that anxiety
and stress makes us feel horrible. We know that it can cause us to loose
friends, lash out at family, and live life in a confused mental fog; but
what does it actually do to our body? Studies have found that groups of
people subjected to large amounts of stress have generally poorer health
later in life. For Example, air-traffic controllers at busy airports generally
have a higher incidence of high blood pressure, ulcers, and diabetes,
than the general population.
High
blood pressure - Anxiety can cause large spikes in blood pressure
which generally return to normal levels after the episode. If the anxiety
is frequent or chronic it can have the same damaging affects on blood
vessels and organs as if the person had chronic high blood pressure.
Diabetes
- Chronic stress and anxiety has been linked to a reduction in insulin
sensitivity. It is believed that elevated levels of cortisol and other
hormonal imbalances related to stress and anxiety cause an excitement
of the hypothalamo-pituitary-adrenal (HPA) axis and insulin resistance.
Suppression
of the immune system - The same stress induced hormonal imbalances
which lead to diabetes can cause damage to the immune system and slow
the healing of wounds.
Hippocampal
damage - learning and the laying down of new memories can be
adversely affected by damage to the hippocampus caused by anxiety and
stress.
Research
has found that many of the adverse health effects from stress are caused
by a class of hormones known as glucocorticoids. These include the well
known steroids Cortisol and Aldosterone. Glucocorticoids have profound
effects on glucose metabolism by breaking down fats and protein and making
them available as energy. Glucocorticoids also decrease the sensitivity
of the gonads to luteinizing hormone (LH), which thus decreases the production
of sex hormones, including testosterone.
Types
of anxiety disorders
Generalized
Anxiety Disorder (GAD) - Generalized
Anxiety Disorder is the most common of the anxiety conditions; it is characterized
by chronic feelings of anxiety even in the absence of any definable stressor.
A person with GAD may wake up anxious, spend the entire day anxious, and
retire to bed still anxious. These anxious feelings may be the result of
ruminating over various life factors including career status and performance,
social or marital relationships, and financial troubles. GAD causes significant
distress which is capable of impairing ones ability to function in social,
occupational, and other areas of life.
Panic
Disorder - Panic disorder sufferers experience episodes of
acute anxiety lasting anywhere from a few seconds to a few hours. Panic
disorder is characterized by reoccurring attacks of extreme fear and the
urge to flee the situation. People with Panic Disorder often experience
anticipatory anxiety, fearing that an attack may come at any time, even
in public. For this reason, Panic sufferers are also at high risk for
developing agoraphobia; the fear of being in a situation from which they
cannot escape or where there will be no help in the event of an attack.
Posttraumatic
Stress Disorder (PTSD) - Posttraumatic Stress Disorder is
a condition brought on by an intensely traumatic experience that had the
potential of threatening your life or the life of those around you. This
disorder was first discovered in wartime, particularly combat situations,
and was known as “Shell Shock”. DSM IV characterizes PTSD as a disorder
caused by an event where a person "experienced, witnessed, or was confronted
with an event or events that involved actual or threatened death or serious
injury, or a threat to the physical integrity of self or others".
Obsessive
Compulsive Disorder (OCD)
- Individuals with OCD have reoccurring obsessions and compulsions which
they cannot control. An obsession is defined as a recurring thought while
compulsions are ritualistic behaviors performed over and over. OCD affects
as much as 3% of the general population and symptoms usually appear in
childhood. While specific causes of OCD remain unknown, there seems to
be a genetic link; roughly 25% of OCD patients have a family member with
OCD.