What is anxiety?

Anxiety disorders are one of the most common mental health conditions affecting 1 in 4 New Zealanders at some point in their lives. It’s highly likely that you know someone that suffers from anxiety, and if so, you’ll be aware of how debilitating this condition can be. After depression, anxiety is the leading cause of unhappiness, life dissatisfaction and suffering, yet 40% of people with anxiety do not seek treatment.

Anxiety is triggered by different things for different people and can be categorised as –  generalised anxiety disorder, social anxiety, post-traumatic stress disorder, panic disorder, obsessive compulsive disorder and specific phobias. This group of disorders is more common in women and can be exacerbated during different phases of the menstrual cycle and life stages like menopause, indicating the impact of hormones.

What does anxiety feel like?

Anxiety often presents as a range of mental, emotional and physical symptoms. Many people describe anxiety as a bubbling of nervous energy or an amplified version of butterflies in your stomach. Common manifestations of anxiety include:

• Feeling nervous or on-edge

• Fearful of the future/the unknown

• Difficulty controlling feelings of worry

• Unable to concentrate on anything other than the present worry

• Having a sense of impending danger, panic or doom

• Irritability and restlessness

• Headaches, muscle aches or unexplained pains

• Sleep problems – difficulty falling or staying asleep

• Feeling fatigued and weak

• Gastrointestinal symptoms – abdominal pain, loose stools

• Increased heart rate

• Heart palpitations

• Breathing more rapidly (hyperventilation)

• Shortness of breath

• Sweating

• Trembling

What are some causes of anxiety? 

The mainstream view of anxiety is that it is purely to do with a chemical imbalance in the brain. Too much of the excitatory neurotransmitters including glutamate, adrenaline and noradrenaline and too little of the inhibitory neurotransmitters like GABA, serotonin and dopamine are linked to anxiety.

Pharmaceutical drugs have been created that target these neurotransmitters. This includes benzodiazepines (e.g. valium) which increase GABA levels in the brain, producing a sedative action that helps reduce anxiety or SSRI’s that increase serotonin levels by targeting their receptors. Although these medications can be effective in alleviating anxiety for some people, they are not addressing the root cause of the problem.

A more holistic approach to anxiety can provide sustainable shifts by going deeper into the root cause/s of anxiety. This approach looks at anxiety on a mental, emotional, physical and spiritual level, whilst also addressing these neurotransmitter imbalances. Here are some examples of imbalances that contribute to the onset of anxiety.

Anxiety and gut issues

It is likely that you have heard that ‘the gut is our second brain’. The gut-brain axis is the connection between the central nervous system in our brain with the enteric nervous system in the gut. Another way these two systems are connected is through the gut microbiome (bacterial composition), which produces a large amount of our brain’s neurotransmitters, including serotonin implicated in depression and anxiety.

An increasing amount of research is being produced exploring the link between our gut health and mental health disorders like anxiety. Gut dysbiosis (an imbalance in the microbial composition) due to antibiotic use, chronic stress, toxin exposure and poor diet can impact the production of neurotransmitters and nutrients required for brain health and function.

Dysbiosis causes inflammation of the gut lining, which increases gut permeability (‘leaky gut’). This can lead to the infiltration of bacterial endotoxins (lipopolysaccharides or LPS) into our circulation and inflammation in the brain. Inflammation is one of the leading causes of depression and there is increasing evidence for its link to anxiety. Overgrowth of certain histamine-producing strains of gut bacteria can also cause high histamine levels that contribute to anxiety in some people.

HPA dysfunction

The HPA (hypothalamic-pituitary-adrenal) axis is a network of hormone-secreting glands that functions as the body’s stress response system. This system is designed to switch on when we are under threat (e.g. bear attack), helping to mobilise energy to enable our escape.

In the world we live in today however, these ’threats’ are everywhere – they are the work deadlines, financial stress, relationship difficulties and traffic jams. And so this stress response system that is evolutionarily designed for an environment with acute stressors, becomes chronically activated.

A chronically activated HPA axis results in changes to the release of our stress hormones cortisol, DHEA and pregnenolone. This impacts the production of other hormones and brain chemicals, resulting in mental health imbalances like anxiety and depression. Things that impact the HPA axis include:

~ What a person perceives as stressful – this varies from person to person and may be dictated by past trauma, upbringing and life experiences. It is also often exacerbated by situations where there is a lot of uncertainty.

~ Inflammation levels – Inflammation is a stressor brought on by poor diet (see below), gut infections, gut dysbiosis and leaky gut.

~ Disruption of the circadian rhythm due to overexposure to blue light from screens and lack of natural sunlight first thing in the morning contributes to HPA dysfunction.

Poor diet

A typical western-style diet that is high in refined carbohydrates, sugar, processed food, preservatives and vegetable seed oils negatively impacts our mental health, increasing the likelihood of anxiety for a number of reasons.

Firstly, this diet is typically nutrient deplete and leads to deficiencies, including some of the key nutrients required for the production of our neurotransmitters like zinc, vitamins B6, B12, choline and folate. The glycemic highs and lows (blood sugar dysregulation) produce energy fluctuations and mental health symptoms like anxiety and low mood.

This diet is inflammatory, especially the industrialised vegetable seed oils that are high in omega-6 fatty acids. It also lacks anti-inflammatory omega-3 fatty acids found in fatty fish that aid fluidity of the cell membrane of neurons in the brain. An increase in inflammatory cytokines in the brain is associated with anxiety and depression, due to the effect these chemicals have on neurotransmitter systems.

How do we support anxiety holistically?

Eating an anti-inflammatory nutrient dense whole foods based diet: 

• Reduce your intake of refined sugar and refined carbohydrates that cause blood sugar dysregulation and inflammation.

• Eliminate industrialised vegetable seed oils (e.g. canola, sunflower, safflower, soybean) that are chemically processed and cause inflammation.

• Choose complex carbohydrates like kumara, pumpkin, carrots, quinoa, buckwheat and millet that provide fibre to balance blood sugars.

• Eat a palm-sized portion of protein with each main meal to provide the amino acids required for neurotransmitter production. This is especially important at breakfast time as it helps to regulate blood sugars for the remainder of the day and supports the HPA axis.

• Include protein and healthy fats with carbohydrate rich foods and snacks, to stabilise blood sugars e.g. nut butter on apple slices.

• Have fatty fish like salmon, sardines and anchovies in your diet regularly (2-3 times per week).

• Eat eggs from pasture raised hens (2-3 per day if you can tolerate them). Eggs provide B vitamins, choline and omega-3 fatty acids for neurotransmitter production and brain health.

• Fill your plate with colourful vegetables and fruit to provide antioxidants that lower inflammation and prebiotics to support a healthy gut. Including green leafy vegetables like spinach, rocket and Brussels sprouts for their folate, to support methylation required for neurotransmitter production.

• Include organ meats in the diet, especially liver which is nutrient dense and provides micronutrients required for neurotransmitter production such as folate, vitamin B12, choline and zinc. Liver also supplies vitamin D3 which is anti-inflammatory and implicated in anxiety.

• Limit intake of caffeine as this is a stimulant that increases stress and exacerbates anxiety.

• Limit alcohol intake as this is inflammatory and affects the gut, acts as a stimulant and can impact our neurotransmitters.

Spend time outdoors daily:

• Sunshine exposure throughout the day provides an array of wavelengths of light that are beneficial for our mental health including inflammation-lowering red light and vitamin D producing UVB.

• Grounding/earthing by placing your bare feet on the earth’s surface in nature allows the absorption of negative ions, helping to neutralise the artificial positive charge our body has absorbed through urban living (electricity, EMF) that increases stress and exacerbates anxiety.

• Shinrin-yoku or forest bathing, which involves immersing yourself in nature and paying attention to your senses, has been shown to reduce stress levels and anxiety. There is also evidence that the feeling of awe derived from being in nature has the ability to reduce symptoms of PTSD.

Adopting a regular mind-body practice: 

• Mind-body practices like meditation, mindfulness, yoga, tai chi, qi gong and others reduce anxiety by focusing attention on your bodily sensations and breath, rather than the fearful thought that is triggering the anxiety. With regular practice, the parasympathetic nervous system (PNS) becomes activated, which is the “rest-and-digest” calming branch of the autonomic nervous system. This in turn quiets the sympathetic nervous system (SNS) responsible for the “fight-or-flight” stress response.

• Diaphragmatic breathing which is a form of slow and deep breathing, with a lengthening of the exhale breath, engages the vagus nerve and the parasympathetic nervous system to bring calmness and alleviate anxiety.

We are releasing a new blog post in a few weeks on ways to stimulate the vagus nerve to alleviate stress, anxiety and improve your overall health – watch this space!


Written by Shaz Andrew, Naturopath and Holistic Nutritionist