Anxiety is common enough that I’d venture to guess you at least know someone who has dealt with it, or maybe still is dealing with it. Or maybe that someone is you and you’re trying to understand if there is any chance of healing your anxiety. Functional medicine may just be that step for you.
The conventional perspective on anxiety is simplistic really—you have a neurotransmitter imbalance and you need a medication to re-establish that balance. Sometimes it works. Sometimes it doesn’t. But either way, that medication does nothing to re-establish balance, It’s job is to suppress those uncomfortable (and yes, they are uncomfortable) symptoms.
This model assumes you are broken and the only fix is a pharmaceutical…a lifelong pharmaceutical.
You are not broken.
And if you’ve chosen a medication to manage your symptoms—you have done nothing wrong.
Today I want to share with you the functional medicine approach to anxiety and offer you some tools to help you manage your symptoms…and maybe even kick the anxiety for good. This is how I approach anxiety in my clinic.
Anxiety is the Worst.
When I was in medical school we were taught about anxiety as if it was this fleeting uncomfortable feeling. Never having experienced anxiety, I gave little thought to what a person might actually feel when in the midst of panic attack, let alone the daily anxiety.
Not to fear! The universe was more than happy to give me a healthy dose of anxiety to teach me a thing or two about the patient experience.
That’s not really what I think happened. Instead, I was a new mom with undiagnosed autoimmune thyroid disease and one of my body’s best communication tools became anxiety. Boy, let me tell you how fun that was!
But in all seriousness, I became acquainted with anxiety on the most intimate of terms and had a newfound respect for those functioning in this world with this “panicked monkey” on their back.
I could see how anxiety could drive people to reach for a Xanax…in my case, Passionflower (more on this soon).
Healing Anxiety with Functional Medicine
While one school of thought is that your body is misbehaving and you need a medication to shut down all that bad behavior, there is another school of thought that instead looks at what your body is trying to communicate.
Anxiety is a symptom—a symptom that has a root cause.
In functional medicine we seek to unearth the root cause and address the system at that level. It’s like having a splinter in your foot—do you remove the splinter or just take the painkillers to shut the body up?
Now if you are living with anxiety then you might be thinking you’d take a thousand splinters in the foot than one more debilitating episode. I hear that!
But treating the root cause doesn’t mean ignoring symptoms or leaving you to deal with them.
Healing anxiety with functional medicine means figuring out why you have the symptoms in the first place, while also offering you some relief and tools to manage the anxiety in the day to day.
3 Common Root Causes of Anxiety
In my Root Cause Women’s Medicine clinic we see a lot of women who are concerned about their anxiety. What we see is that anxiety affects all women. Some of our patients are mothers, others are young college women, and still others are transitioning into menopause. Anxiety spares no one.
But well you may be inclined to call out hormones as the common denominator, it is important that we examine the other big root causes that may be at play. Hint: It’s rarely just one cause.
#1 HPA Dysfunction & Adrenal Mayhem
The hypothalamic-pituitary-adrenal axis (HPA) is what controls our response to stress and is why we fight, take flight or freeze when threatened with danger. It is a very good system for evading tigers, but in today’s modern world we have what is called an evolutionary mismatch. Basically, your brain and body evolved to survive in very different times.
This is where the body and your environment can collide to create anxiety. Modern stressors aren’t typically the kind to kill us, which kind of freaks your brain out more. It is getting the signal of danger (every single day), but it can’t see a tiger, or smell a tiger, or hear a tiger. So what does your brain do? Freaks out more! Because being told you’re in danger, but having no tangible evidence of danger is a really scary thing.
So in this modern world we stress over things like whether we made a fool of ourselves while speaking up in an office meeting, or whether we will be able to pay our bills, or if we’re doing a good enough job as a parent. All legitimate causes of stress.
But pile that on top of driving a car, living in neighborhoods that constantly expose us to light, the billions of noises and chemicals your body has to process every day, and a food system that does a better job at sabotaging us than nourishing us and it is easy to see that your body is handling a lot of stress…and like a champ I must say.
Sure, you may get anxious, but is it any wonder we aren’t completely debilitated?
But we’re not. And it is all because your body is set on survival.
But what happens when there is chronic activation of the stress system?
We see a change in the production of cortisol, DHEA, pregnenolone and even progesterone. This in turn alters our neurotransmitters. For example, stress hormones like cortisol, epinephrine and norepinephrine light the brain up, which progesterone supports GABA, a neurotransmitter that puts a stop to the panic. This is one scenario that can lead to anxiety.
But it isn’t just mental or emotional stress that can disrupt the HPA axis…
Inflammation stemming from chronic disease, hormone imbalances, infections and more can cause a disruption in the HPA axis. And as the system becomes more and more imbalance, inflammation climbs, creating a vicious cycle that can keep you in a state of panic.
Common Hidden Causes of Inflammation:
- Autoimmune disease
- Gut infections
- Chronic viruses
- Blood sugar imbalances
- Estrogen dominance
- Insomnia and sleep disruption
- And other sources…
How to Heal the HPA Axis with Functional Medicine
Work with an Expert
If you’ve got serious HPA dysfunction then you’re going to need to partner with an expert to treat the root and rebalance the system. It is completely possible to heal your adrenals and you mood, but it takes a bit of finessing and you’ll do best to have an expert assisting you.
You do not need to practice yoga or even have a mat. Just close your eyes for 5-10 minutes daily and focus on your breath. Feel yourself inhaling and exhaling completely. Relax in your chair and let yourself spend a few minutes away from whatever is bringing you stress.
For next level support, consider a Muse meditation device. This device helps you master meditation in a fraction of the time so that you begin reaping the benefits quickly.
Take a moment to look around you and without judgement, take it all in. This is the practice of mindfulness. Being present in moment can help decrease anxiety, stress and depression. Try to spend at least 5 minutes a day just observing the life that surrounds you.
Move Your Body.
Even if it is a walk around the office. Movement will allow you to release tension from the body, increase oxygen to your brain and counter what that nasty stress hormone, cortisol, is doing to your body.
Reinforce Circadian Rhythm
This is the natural sleep/ wake cycle that your adrenals and mood love. Do this every day!
- Expose yourself to natural light upon waking. You live in a place with little sunlight in the morning? (Trust me, I’m in Portland so I get it.) Then you may need to get yourself a natural light alarm clock.
- Wear amber glasses 2 hours before bed. This will drop cortisol and raise melatonin…what your body should be doing at this time.
- Sleep in a completely dark room. No light. No exceptions.
#2 Gut Health & Your Mood
In functional medicine there is a saying, “fire in the gut means fire in the brain.” Or in other words, if your gut is inflamed then you better believe your brain is too.
Infections like SIBO, bacterial dysbiosis, parasites, yeast overgrowth, and H. pylori can be one cause of inflammation. Intestinal hyperpermeability (leaky gut) and food sensitivities can also be a source of inflammation.
As you can imagine, having your brain on fire is not a good thing. In fact, when inflammation hits the brain it makes us irritable, angry and anti-social—a perfect mechanism for quarantining you in the event that you have a communicable illness. But all the calm and happy inducing neurotransmitters are compromised in this process leaving you to feel anxious, depressed, and at the mercy of stress.
Your Gut Makes Serotonin
About 400 times more serotonin is found in your gut than your brain to be exact.
So it would appear that your gut may be the hub of neurotransmitter synthesis and not your brain. Which makes sense why when you heal someone’s gut their mood gets better.
On a side note: Did you know that Parkinson’s, depression and Alzheimer’s are all now thought to originate in the gut? To me, this is a really good reason to figure out why a patient has depression in the first place and ensure brain health for the long run.
How to Heal Your Gut with Functional Medicine
As a natural medicine and lifestyle doctor, I work with women in developing a treatment protocol that is specific to their individual needs. It is also important to begin with lab testing to create a more targeted treatment plan, which can also ensure healing is not delayed. I recommend working with a licensed practitioner who understands the importance of conventional and functional lab testing and can interpret them in conjunction with your story.
Have Lab Testing Completed
- Comprehensive Stool Analysis
- Parasitology (O&Px3)
- H. pylori breath test
- Lactulose breath test (evaluate SIBO)
- Intestinal permeability (evaluate Leaky Gut)
- Food sensitivity testing
Once you’ve determined the health of your gut you can understand which therapies are necessary to help you heal.
Identify and remove any stressors that could be contributing to poor gut health. Here are two big areas I recommend you start with.
Remove NSAIDs, proton pump inhibitors (PPIs), unnecessary antibiotics, and birth control. Talk with your doctor before discontinuing meds.
Like we mentioned above, chronic stress can actually change the makeup of your microbiome. It also disrupts the HPA-axis (hypothalamic-pituitary-adrenal), which affects pretty much all the hormones in your body.
Add Fermented Vegetables to Your Diet
This is a great way to begin getting some beneficial bacteria going in your gut! Raw, cultured, organic vegetables like pickles, sauerkraut, and other fermented vegetables like beets and carrots can promote the growth of good bacteria in the gut.
In the case of SIBO or yeast overgrowth, we avoid these foods until infection is resolved.
#3 Nutrient Deficiencies
Nutrient deficiencies are much more common than you might think.
If you have a digestive issue that is compromising your ability to absorb nutrients then you’re at higher risk.
Adhering to a restrictive diet of any kind for too long, be it veganism, vegetarianism, keto, or autoimmune protocol, for example, can put you at risk for deficiencies. If you have anxiety it is always important to examine if your diet is working for you or if your diet is in need of some fine tuning to meet your current needs.
If you’re taking a nutrient depleting medication like the birth control pill then you’re at an increased risk for nutrient deficiencies. Medication that block acid, like PPIs and Tums, as well as those used in diabetics can create nutrient deficiencies that can manifest as anxiety and depression as well.
Nutrients like omega-3 fatty acids, EPA and DHA, B6, Inositol, folate, B12, copper, zinc, magnesium, and vitamin D are have a direct impact on mood and happen to be common deficiencies in people.
Additionally, if you have any issues with protein absorption then you're going to be deficient the amino acids your body needs to make neurotransmitters
How to Heal Nutrient Deficiencies with Functional Medicine
The first question is do you have nutrient deficiencies…with the obvious follow up being why.
Have Appropriate Lab Testing
I recommend an Organic Acids or NutrEval test for patients who I suspect nutrient deficiencies in. I prefer this test because it also provides a ton of data on neurotransmitter and mitochondrial function.
I also order blood work which often includes the following:
- Vitamin D
- And others as needed
Adopt a Whole Foods Diet
On top of optimizing gut health and absorption, you’ll also need to focus on a nutrient dense diet. I recommend starting with my hormone balancing meal plan and recipe guide. You can download it here for free.
How to Manage Anxiety Now
Green Tea Instead of Coffee
L-theanine is an amino acid that promotes a sense of calm and happens to be high in green tea. If you feel more anxious with coffee or between meals, ditch the coffee (I know, I love it too) and opt for some green tea instead.
L-theanine is typically taken at 200 mg twice daily in supplement form
Taurine is a precursor to GABA, an inhibitory neurotransmitter than most people with anxiety are low in. The general starting dose is about 500 mg daily. If you feel you need to go higher then I recommend speaking with a doctor first.
Put a Flower in Your Pocket
Passionflower that is! Passion flower encourages healthy levels of GABA and can help ease the anxiety. Most women do well with 2-3 droppers full when they feel the anxiety bubbling up.
I keep Passionflower in my travel bag in the event I find myself feeling a bit off. It’s also great to use before a presentation or talk!
Reframe Your Mindset
Watch this video by my dear friend Dr. Joan Rosenburg on the Rosenburg Reset. Do this now. It’ll be the best 15 minutes you’ve taken towards healing your anxiety.
And I highly recommend her book, Ease Your Anxiety, which is the best $10 you can spend if you're dealing with anxiety!
No, this will not get you high. Instead, it has been shown to drop inflammation and anxiety. If you’re starting CBD then the dose should be low. Some argue the frequency and consistency is more import than achieving high doses of CBD, but there are those who report improved symptoms with high single dose CBD.
The takeaway—find what works for your body.
I recommend working with a doctor to discuss if CBD therapy is right for you.
Helping You Heal Your Anxiety with Functional Medicine
Healing anxiety and depression through functional medicine removes the need for pharmaceutical management of your mood. Finding and treating the root cause can take time, but hopefully with some of the suggestions I provided you with today you will be able to find relief sooner than later.
If you’re looking for more help in healing your anxiety, please consider meeting with one of my skilled practitioners today.
KEEPING IT REAL, WHILE KEEPING YOU EDUCATED
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