A diagnosis of anxiety covers a lot of territory. Psychologists organize patients suffering symptoms of anxiety into groups that include generalized anxiety disorder (with or without panic attacks), obsessive-compulsive disorders, social anxiety disorders, post-traumatic stress disorders, and the various phobias (heights, snakes, germs, etc.).
However, the symptoms are all pretty much the same.
According to the National Institute of Mental Health approximately 40 million Americans, or 18% of the US population, suffer from some form of chronic anxiety. With numbers like this, odds are good that you’re either among them or you know someone who is.
Chronic anxiety sufferers can be pretty miserable. The most common symptoms include feelings of panic and fear, insomnia, cold/sweaty hands/feet, shortness of breath, dry mouth, muscle tension, repetitive (“ruminative”) thoughts, nausea, and an absolute inability to calm down.
Most of these symptoms are caused by an unchecked fight-or-flight response. This perfectly normal physiologic reaction should be temporary, a “for emergency use only” response to a sudden stressor (getting mugged, seeing your child heading for danger, etc). For the chronically anxious person, though, the fight-or-flight response remains locked in the on position, making life miserable.
People with chronic anxiety know intuitively this state of affairs simply can’t be healthy over the long haul and they’re correct, as a recently published research article has shown.
Anxiety and your telomeres
One way scientists can track how you age is by examining your chromosomes, the strands of genes inside your cells that define you as the unique individual you are. The protective tips of chromosomes are called telomeres, and as you age they shorten. If you think of your chromosomes as shoelaces, telomeres are the plastic tips at ends of the laces that protect them from fraying.
Ponder for a moment how people age, considering obvious signs like wrinkles, grey hair, and loss of height. What you can’t see is hardening of the arteries, arthritis, and a susceptibility to a variety of chronic illnesses. It’s now thought that the slow deterioration of telomeres triggers this widespread, age-related decline. Some lifestyle choices (healthful eating, physical activity) protect telomeres and slow the aging process while others (smoking, chronic inflammation) press the fast-forward button on everything associated with getting old.
Newly added to the bad-for-your-telomeres list is chronic anxiety. Decade for decade, the telomeres of people with untreated anxiety were shorter than those without anxiety. And while the exact reason for this shortening is uncertain, the best guess is that it’s a combination of cortisol, the stress-response hormone generated by your adrenal glands, and inflammation (both of which increase during periods of stress).
However–and this is extremely important–individuals with a history of anxiety who reported being successfully treated had telomere lengths that were completely normal for their age. In other words, the premature aging effect of chronic anxiety disorders is reversible.
Treating chronic anxiety and restoring telomeres
By far the most frequent method of treating anxiety in the US is a combination of counseling (to reduce stress) and prescription medications. The two groups of meds most often prescribed are the SSRI antidepressants, like Lexapro and Zoloft, to increase stress-buffering serotonin and anti-anxiety meds like alprazolam and clonazepam, which can calm anyone, anxious or not.
But as effective as pharmaceutical therapy has proved to be, just about everybody–patients, doctors, psychologists–believes psychopharmacology is overused. Too many people find themselves taking drug cocktails for decades with no end in sight.
Yes, the meds work. And yes, protecting your telomeres and avoiding accelerated aging are important, but you have options.
Alternative therapies for chronic anxiety
Let’s review the most promising alternative therapies for chronic anxiety, steps you can take immediately and just about anywhere you happen to live.
Nutritional supplements If you’re not taking an SSRI antidepressant, your best bet is St. John’s wort (450 mg twice daily), to boost your serotonin. This dose has been shown to be as clinically effective as a half-dose of Prozac, Lexapro, or Zoloft. Be sure to use a pharmaceutical-grade St. John’s and be aware that, like prescription antidepressants, St. John’s wort takes three to four weeks for its effect to be felt. While you’re waiting for it to kick in, for a more immediate reduction in anxiety take L-Theanine (100-200 mg three times daily). A good alternative is gamma amino butyric acid (GABA, 250-500 mg three times daily as needed).
Acupuncture Clinical studies have proven that acupuncture can be extremely effective in treating chronic anxiety, obsessive thinking, panic attacks, and insomnia. Although traditional Chinese medicine (TCM) takes a completely different view than Western medicine on anxiety, after just a few treatments most anxiety sufferers report a sense of calm and a marked improvement in their overall well-being. At WholeHealth Chicago, Mari Stecker, Cindy Kudelka, and Helen Strietelmeier all have considerable experience using TCM for anxiety disorders.
Other ideas If you don’t have a TCM practitioner in your area, consider a guided meditation CD by Belleruth Naparstek. Also very helpful are yoga and tai chi, either in a group or on your own with a DVD.
Don’t forget your telomeres
There are several anti-aging, telomere-protecting lifestyle choices you can make, starting today, starting now, and guess what? You know most of this already.
Healthy eating The best way to protect telomeres and slow down aging is the Mediterranean diet, which emphasizes concentrated nutrition and antioxidants. Eating Mediterranean does slow aging, period.
Regular exercise I know you’re tired of hearing this, but physical inactivity ages you and under a microscope leads to shortened and frayed telomeres. Exercise also helps anxiety by accelerating your own production of serotonin.
Nutritional supplements These can be useful but–fair warning–are not a replacement for exercise and high-nutrition eating. I think the research on this is very interesting and take all three of these supplements myself, but you’re kidding yourself if you think supplements without a healthful lifestyle will cover your telomeric ass, especially if you’re a binge-eating, anxiety-ridden couch potato. Studied most extensively are resveratrol, green tea extract, and the anti-inflammatory turmeric. Take one capsule of each daily.
Lastly, there are three relatively new psychotherapy techniques that have proven invaluable for generalized anxiety disorder: cognitive behavioral therapy, Emotional Freedom Technique, and EMDR (Eye Movement Reprocessing and Desensitization). Since all three are now available here at WholeHealth Chicago, I’ll save the full discussion of them for next week.
David Edelberg, MD