Jul
22
2016

Anxiety Is Common

Recently a review article was published that showed that anxiety is common. This research was conducted in England (Cambridge and London). 48 reviews about anxiety around the globe were examined. The results showed that anxiety in the world population fluctuates between 3.8–25%. Women (frequencies of 5.2–8.7%) and young adults (frequency 2.5–9.1%) are suffering from anxiety more. Among people with chronic diseases there is considerable variation in the frequency of associated anxiety (from 1.4% to 70%).

Variability of frequency of anxiety in different countries

The frequency of anxiety in various ethnic populations varies considerably around the world. For instance European and North American cultures have a relatively high anxiety rate in the population (3.8–10.4%) when compared to Indian and Asian cultures with only 2.8%. In Africa the rate is 4.4%, in Central and Eastern European countries the rate is 3.2%. In North Africa and the Middle East the anxiety rate is 4.9% while in Spanish/Latin cultures the rate is 6.2%.

Anxiety is common and there are subtypes

There are many subtypes of anxiety that have been researched. 

Generalized anxiety disorder (GAD)

This disorder affects 6.8 million adults, or 3.1% of the U.S. population. It seems like women get this condition twice as often as men. The risk for developing it is greatest between childhood and midlife. People with a mild case of GAD can cope and work. Severe cases can be disabling and may be difficult to treat.

Social anxiety disorder

About 15 million US citizens suffer from this. This equally affects women and men. Typically it starts at the age of 13, but 36% of people will not ask for medical help for 10 years or more. Symptoms of anxiety surrounding social situations are so intense that it interferes severely with making friends and having romantic relationships. They end up being alone, powerless against their anxiety.

Panic disorder

6 million US citizens or 2.7% of the population suffer from this. Women commonly are twice as often affected by it than men. Panic attacks develop in early adulthood. They often suffer in silence; distance themselves from friends, family and caregivers who could offer them help. Panic disorders often occur simultaneously with depression and medical conditions like asthma, irritable bowel syndrome and substance abuse.

Specific phobias

19 million or 8.7% of the US population suffer from this. It often starts in childhood and the median onset is at age 7. People affected by specific phobias may be afraid of high bridges, of animals like spiders or mice, of thunder, of flying and a myriad of other things. It disrupts daily routines, causes limitations of work efficiency and reduces self-esteem. It also places a strain on relationships because people afflicted by this problem will do whatever they can to avoid the uncomfortable or terrifying feelings of phobic anxiety.

Obsessive-compulsive disorder

2 million or 1% of the population in the US suffer from this form of anxiety. Onset is in the teenage years, although 1/3 of adults with obsessive-compulsive disorder experienced symptoms already in childhood.

Posttraumatic stress disorder (PTSD)

7 million people or 3.5% of the US population are suffering from PTSD. Women are much more affected by PTSD than men. But a lot of soldiers who were involved in direct combat situations will suffer from PTSD. Rape can be a source of PTSD. Most people who experience traumatic events and develop PTSD will be affected by it for months or even years, but eventually recover from them; a minority will not recover. Often therapy is helpful for these individuals.

Major depressive disorder

8 million American adults or about 6.7% of the U.S population will suffer from depression between the ages of 15 and 44 years. It is more common among women. A certain percentage of depressed people commit suicide. Anxiety is often mixed in with depression.

Persistent depressive disorder

This is a form of depression that persists for at least 2 years. 1.5% of the US population or 3.3 million adults suffer from this condition. The median onset is at age 31. Like with depression, so also with persistent depressive disorder, anxiety is very common.

Anxiety is common; related illnesses

There are many medical diagnoses where anxiety is often part of the symptom complex. The medical profession often talks about psychosomatic diseases. This means that these diseases have an anxiety overlay, which is part of the condition.

  • For instance, bipolar disorder is a condition where extreme mood swings are common, often between elation and mania, but then switching to deep depression with suicidal thoughts. Mixed into this condition is often a certain degree of anxiety, which can be very overwhelming.
  • Irritable bowel syndrome is a psychosomatic disease of the gut with bowel cramps and frequent bowel movements, in others there are periods of constipation. But irritable bowel syndrome often has anxiety attached to it. They are often inseparable.

Eating and sleep disorders

  • Eating disorders: here the person has an intense fear of turning fat. Persons with eating disorder often restrict their calories severely, even when they are underweight. They may exercise for hours with the hope to lose weight. Perhaps the most striking condition among eating disorders is anorexia nervosa, which often affects teenage females, but adult women are affected as well. Sadly many of these women die from starvation or starvation related diseases.
  • Sleep disorders: more than 40 million Americans suffer from chronic, long-term sleeping disorder. Another 20 million suffer from occasional sleep disorder. In addition, often there is stress and anxiety that interferes with the normal sleep cycle.

Chronic pain and fibromyalgia

  • Chronic pain: Pain is a common symptom; if it is associated with a surgical procedure or with an injury it is short lived and eventually goes away. With chronic pain, the pain is present all the time. People with arthritis or nerve injuries that did not heal often have this type of pain. Fibromyalgia sufferers also have this type of pain. When a person has an underlying anxiety disorder and gets chronic pain on top of this, the pain is amplified and becomes even more chronic. On the other hand anybody with chronic pain will suffer from a certain amount of anxiety just because of the chronicity of the pain.
  • Fibromyalgia: this chronic musculoskeletal pain disorder is a special form of chronic pain. About 20% of fibromyalgia sufferers have either chronic depression or chronic anxiety, which certainly complicates the condition.

Substance abuse, stress and headaches

  • Substance abuse: about 20% of people with chronic anxiety disorders have an alcohol or substance abuse disorder; and 20% of people abusing alcohol or having a substance abuse disorder have a chronic anxiety disorder.
  • Stress: too much stress can turn into distress. Distress is an overdose of stress where the stressed person loses control of the situation. This can cause depression and anxiety. It can also cause physical illness.
  • Headaches: migraines, anxiety and depression seem to affect the same population group. Stress and anxiety can cause muscles around the neck to get into spasms and cause tension type headaches. But any headache can be brought on by anxiety.

Anxiety is common; biochemical brain abnormalities

Dr. Kharrazian has summarized in his book that Gamma-aminobutyric acid (GABA), which is a by-product of the brain cell metabolism is responsible for calming the brain (Ref.1). Most noteworthy, this mechanism is not working properly in people with anxiety. In many people with anxiety GABA is simply not produced enough to calm the brain or it gets inactivated too fast resulting in a lack of GABA with anxiety. Consequently, the end result is the same: when there is a relative lack of GABA in the brain the person develops symptoms of anxiety.

Disbalances in neurotransmitters

Disbalances in other neurotransmitters can also contribute to anxiety. As a matter of fact, serotonin is a neurotransmitter that is essential to have for a stable mood and to prevent depression. It is produced in the mid brain. Furthermore, the pineal gland stores serotonin and makes melatonin out of it, which is essential for a normal sleep pattern. When serotonin is low, a number of things can happen. Anger and increased aggressiveness are associated with a lack of serotonin. But depression, obsessive-compulsive disorder, migraines, fibromyalgia, irritable bowel syndrome, bipolar disorder and anxiety disorder are also frequently observed. Many of these illnesses have been noted above to be associated with anxiety. Ref.1 also describes that stress inhibits the conversion of serotonin into melatonin, which therefore explains sleep problems in persons who are exposed to chronic stress.

Anxiety is common; treatment options

In particular, what are the treatment options for a person with anxiety?

Treatment with anxiolytics

It is tempting to just treat the symptoms in an anxious person. But just prescribing anxiolytics like benzodiazepines (like Xanax) will not cure anxiety, just relieve the symptoms for a while. Eventually the body gets used to benzodiazepine and requires higher doses to suppress the anxiety. This can be the beginning of drug dependency, which is not what the health professional or the patient wants. As mentioned above alcohol and substance abuse is already a problem for 1 in 5 people with anxiety.

Treat sleep deprivation

An alternative is to concentrate on treating sleep deprivation in order to help the person to get a good night’s sleep. Melatonin at a dose of 3 mg at bedtime is a reasonable dose to help a person to fall asleep. If during the night the anxious person wakes up again, another dose of 3 mg of melatonin can be given. In addition, if an anxious person lies in bed and ruminates about various things that have happened during the day, a dose of valerian root (500 mg or even 1000 mg) can be useful.

Brain hormone effects

Dr. Datis Kharrazian describes in Ref.1 that valerian root increases GABA at the GABA receptor site. Research has also shown that valerian root slows down the breakdown of GABA. Although GABA is available in health food stores, GABA does not get absorbed through the blood/brain barrier easily. Only patients with autoimmune problems have a leaky blood/brain barrier and GABA can get through, but this is not a good approach to take for treating GABA deficiency. When you take GABA as a supplement, it wears off after a few days and loses its effect. It is wiser to stay away from GABA.

Cognitive therapy and behavioral therapy

This has been proven to help the person with anxiety. Often psychologists specialize in these treatment methods. Meditation and counseling therapy will also help.

Antidepressant therapy

In anxiety cases where depression is part of the psychological make-up antidepressants may have a place for a period of time. The FDA issued a warning in October 2004 about antidepressant medications, including SSRIs. These may lead to suicide and suicidal behavior in a small number of children and adolescents. But there is no way of predicting who will be affected this way. The antidepressant medications are still available and many physicians still prescribe them.

A balanced diet

A balanced diet like a Mediterranean diet provides the nutrients necessary to make GABA. People should avoid sugar in any form as it contributes to anxiety from blood sugar fluctuations.

Yoga and biofeedback

Yoga with an emphasis on breathing techniques can also be useful. Biofeedback methods are useful as well.

Anxiety Is Common

Anxiety Is Common

Conclusion

Anxiety is common, but also very complex, as explained above. 74.8 million Americans suffer from the various forms of anxiety mentioned. Psychosomatic disease often involves anxiety as well and it can be difficult to sort out the symptoms of patients afflicted with physical illness and anxiety. Repeat visits to the treating doctor will eventually help sort these problems out. The physician will rule out any physical problems first by doing lab tests and imaging studies.

Treating anxiety should focus on reestablishing a healthy sleeping pattern. Self-hypnosis tapes or discs are useful. Melatonin and valerian root have their place. Cognitive-behavioral therapy will help the patient to reestablish clear thoughts and minimize the anxiety symptoms. With this approach the patient will often be able to overcome anxiety. There are no instant solutions, but with time and persistence the patient will be able to take back control of his or her life.

Reference

Ref. 1: Dr. Datis Kharrazian: “Why Isn’t My Brain Working?” © 2013, Elephant Press, Carlsbad, CA 92011

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Jun
01
2003

Genetic Link Found For Bipolar Disorder

A staff psychiatrist at the Dalhousie Medical School in Halifax (Novia Scotia, Canada) has gathered 1100 DNA samples and psychiatric histories from patients with bipolar disorder and family members who do not have this psychiatric disease. Dr. Martin Alda, The Medical Post reports on page 46 of the May 20, 2003 edition, and his medical team were able to identify 4 areas of interest on chromosomes 15, 7, 6 and 21 where molecular markers for bipolar disease were located.

Two additional tools, namely responders to lithium (common bipolar disease stabilizer) and certain ethnic group differences, are being utilized as well. Dr. Alda has already found that unstable genes can be stabilized in the presence of lithium. By studying the genes involved in the expression of bipolar disorder and defining what triggers a depressive response and what triggers a manic episode, the researchers hope to unravel the mysteries that still surround this intriguing disease. Dr. Alda is also studying the connection of diabetes and biploar disease. Patients with biploar disease are 3 times more prone to diabetes than the general population. As these patients (bipolar patients with diabetes) are poor responders to lithium, there is a suggestion that perhaps the newly defined genetic loci are blocked in some way by the hormone changes in diabetics. Further investigations in this direction are planned by the research group.

Genetic Link Found For Bipolar Disorder

Genetic Link Found For Bipolar Disorder

Link to bipolar disorder: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/bipolar-disorder/

Link to diabetes:

http://www.nethealthbook.com/articles/hormonalproblems_diabetesmellitus.php

Last edited October 26, 2014

May
01
2003

Bipolar Disorder In Children And Teens Different From Adults

Bipolar disorder used to be called “manic-depressive illness” in the past, now it is termed “bipolar disorder”. It is a multifaceted mental illness where subtle changes in the mix of brain hormones can lead to periods when the patient is euphoric, manic or even psychotic (manic episode), but at other times it seems that someone “pulled the plug”, so to speak, and the patient is depressed, lethargic and perhaps even suicidal.

To complicate matters even further,and this was the subject of a recent seminar at the Child and Health Resource Institute in London/Ontario, symptoms in children and teens are often completely different from symptoms in adults. This can be very misleading to the healthcare workers and the immediate family members. It can also delay the diagnosis and appropriate treatment of bipolar disorder. The Medical Post in its April 1, 2003 edition (page 54) published a review of this topic, based on a presentation by Dr. Margaret Steele at this seminar in London/Ont. Dr. Steele is a child psychiatrist of the University of Western Ontario.

Dr. Steele explained that bipolar disorder is relatively rare in children and adolescents. About 0.5% or less of children in pre-puberty and about 1% of adolescents are affected. But these children/adolescents usually have a family history of either bipolar disorder or depression. 20% of adults with bipolar disease experienced their first episodes of the disease during the teen years.

Bipolar Disorder In Children And Teens Different From Adults

Bipolar Disorder In Children And Teens Different From Adults

Below is a summary of her findings with regard to depressive symptoms in children/teens when compared to adults in tabular form.

Comparison Of Symptoms Of Depression In Bipolar Disorder Patients Depending On Age
Adult Symptoms:
Symptom Presentation In Children/Teens:
depressed mood irritability is more common; normally easy-going, but suddenly being oppositional and grouchy
anhedonia (difficulty to think positive and enjoy living) “I am bored” may be the only comment, retreating into a shell
sleep disturbance, mostly insomnia (problems sleeping) they may have the opposite, namely hypersomnia (sleeping too much and too long); this may cause problems when they sleep in during the week or they fall asleep in school
appetite disturbance (usually associated with weight loss) young children fail to grow and gain weight; adolescence may crave junk foods (sugar and starch) and overeat
lethargy in children a decrease in concentration may only become evident as a decrease in school performance (slipping marks)
psychomotor agitation or retardation these symptoms are similar in both adults and children, may be evident as pacing, fighting (agitation) and as “laziness”, moving slowly (retardation)
Suicidal thoughts
or behavior
similar in adults and children, but could be more concealed at a younger age (see below)
hopelessness when asked “what do you see in the future?” an answer like “I see nothing at all, I have no goals” could indicate hidden suicidal thoughts
masked depressive symptoms younger children may have temper tantrums, which would be out of character from their normal behavior; adolescents may “act out”
somatic complaints adolescents present with headaches and other physical symptoms (e.g. abdominal pain etc.) meaning a “screen of mood” should be done

The other part of the equation of bipolar disorder is mania. Different names are used for this hyperactive state of the mind depending on how severe it is: ‘hypomania’ for the lower end, ‘mania’ for an abnormally elevated and expansive mood lasting for at least 1 week. The most severe form of mania is a ‘manic psychosis’ where the person is “completely out of it” and needs to be hospitalized. Again there are some differences of how a manic episode is expressed in children/teens when compared to adults. Dr. Steele covered this in the seminar mentioned above as well and I have summarized the findings in tabular form again as follows.

Child psychiatrists are most familiar with assessing whether a child or adolescent has bipolar disorder. Apart from symptoms being quite variable as mentioned above, there are also lower-key versions of bipolar disorder.

A milder, scaled down version of a manic episode is called ‘hypomania’ as explained above and when expressed in bipolar disease this can lead to ‘bipolar II disorder’. In 60% of adolescents with bipolar disease a ‘mixed bipolar episode’ can be diagnosed. Typically, in these cases the teenager would have depressive symptoms in the morning (feeling low energy, feeling terrible etc.), but later in the day after school would get revved up having problems winding down at night. Often such behavior is very stressful for the parents, particularly as bipolar disorder is running in families and one of the parents may have established bipolar disorder that is being treated.

The reason for including this overview here is that many parents may recognize some symptoms in their offspring that warrant a closer look by a child psychiatrist. By diagnosing this condition early and treating it, these children and teens can have a normal life and prevent a lot of needless suffering and danger.

Click for links about bipolar disorder , depression and watch for suicide.

Manic symptoms in bipolar disorder patients depending on age
Manic symptoms in adults: Manic symptoms in children/teens:
inflated self-esteem elevated, irritable mood; it is beyond being giddy and silly, which many teens normally display; children may say that they are ‘Spiderman’, it can be difficult to separate from normal play, but on further questioning manic children have racing thoughts and hear voices (delusions), which normal children do not have
racing thoughts, often detected in conversation as ‘flight of ideas’ racing thoughts express themselves more as ‘distractibility’; a child might pick up a toy, drop it after a short time and suddely play with something else
pressured speech increased chattiness
excessive pursuit of activities that are potentially harmful (speeding in car, excessive drinking or drugs, risk taking in the stock market, etc.) risk taking expressed differently: kids might steal despite never having done this before; manic children may exhibit sexual behavior such as flirtatious behavior, etc.
medical conditions may mimic symptoms of mania (e.g. diabetes out of control) side-effect of oral corticosteroid therapy for asthma can lead to a psychosis and mimic a manic episode

Child psychiatrists are most familiar with assessing whether a child or adolescent has bipolar disorder. Apart from symptoms being quite variable as mentioned above, there are also lower-key versions of bipolar disorder.

A milder, scaled down version of a manic episode is called ‘hypomania’ as explained above and when expressed in bipolar disease this can lead to ‘bipolar II disorder’. In 60% of adolescents with bipolar disease a ‘mixed bipolar episode’ can be diagnosed. Typically, in these cases the teenager would have depressive symptoms in the morning (feeling low energy, feeling terrible etc.), but later in the day after school would get revved up having problems winding down at night. Often such behavior is very stressful for the parents, particularly as bipolar disorder is running in families and one of the parents may have established bipolar disorder that is being treated.

The reason for including this overview here is that many parents may recognize some symptoms in their offspring that warrant a closer look by a child psychiatrist. By diagnosing this condition early and treating it, these children and teens can have a normal life and prevent a lot of needless suffering and danger.

Click for links about bipolar disorder , depression and suicide prevention.

Last edited October 25, 2014