Anxiety is a very common mental health concern that can be mild or debilitating. It is on a spectrum just like other disorder, and treatment of it, in the conventional sense, can be a slippery slope. Often, conventional approaches include trying to fix a neurotransmitter imbalance, often using an antidepressant with an antianxiety component or even benzodiazepines (thus the slippery slope of addiction). While these approaches have their place and are sometimes needed acutely or long-term, there can be other- more root-cause solutions that can drastically shift these symptoms and improve overall health. While there is not a one size fits all answer, working with a functional medicine provider can help you find a new, more personalized answer.
Medication, as noted above, is sometimes necessary but this does not mean it can’t be supplemented with a functional medicine approach. And over time getting to the root cause could help you potentially taper off or lower the dose of these medications. You do not have to accept that medication is your destiny.
Anxiety can mean different mental or physical symptoms. In patients I have seen it mean palpitations, insomnia, picking at their skin, chest pain (even so bad as to bring them to the ER- thinking they are having a heart attack!), shortness of breath, brain fog, lack of concentration or racing mind, among other physical and mental complaints. In myself it feels like this tension in my chest- not pain but a twinge- telling me I need to be worried, to be on alert, I can’t relax…..it contributes to me ruminating on negative thoughts at times; even when everything seems like it should be just right! It’s really not fun- and it gets in the way of being a good mother, doctor, friend, wife…. But when it starts to come back it is a red flag to look at my self-care, diet, sleep, exercise choices, etc, and see where things are going astray.
The functional medicine approach to anxiety
In functional medicine we look to the root cause and start there. We will still need to work on the symptom and help you feel functional while we are digging deeper to find a more healing, holistic solution. We work on what may have caused the symptoms as well as what keeps feeding it. Common underlying causes of anxiety include: cortisol imbalance from the HPA axis (Hypothalmic-Pituitary-Adrenal), an imbalanced microbiome and/or inflammatory gut environment, nutrient imbalances- vitamins/minerals/macronutrients, or a toxic overload. A stressed HPA axis is a natural response to our overly stimulating society. Some can weather the storm better than others but in some, we don’t know how to shut down the fight or flight response. An imbalanced microbiome or inflammatory gi tract is also common due to our overly processed foods, high gluten grains, gmo foods and low nutrient soil. Our low nutrient soil can also lead to the next possible root cause- nutrient deficiencies- which often overlaps with the gi tract root causes. Toxins are also present in our food supply, air, and water- as well as possibly in our unique job settings or in our homes. Toxin overload can then burden our liver and mitochondria and use up many of our nutrients we need to drive other pathways- thus causing micronutrient deficiencies.
How can we figure out what might be driving our anxiety? For starters working with a functional medicine provider who asks alot of in depth questions about both present and past symptoms, health issues and family history. It would also be good to be open to additional tests- these are not always necessary but they can help individualize our approach and get to a more lasting, efficient healing plan. Another helpful tip in working with functional medicine for mental health- be willing to change your diet- be willing to cut things out that may be feeding your anxiety and working with your providers to be good detectives- noting your symptoms as you add back foods so that we can understand your unique food triggers. Also, pack your patience as these things do not disappear overnight- old habits and behaviors die hard! We also will likely add some supplements- these will help alleviate current symptoms and calm down the flame that might be igniting the anxiety. They are often temporary and can be tapered as the root cause is mended and healed.