Welcome to our second post in the anxiety series! In case you missed the first one, we went back to basics and covered these 4 areas:
➼ What is anxiety?
➼ How it manifests, either physically and/or in our thoughts and behaviours
➼ The anxiety alarm: fight-flight-freeze response
➼ Frequently asked questions about anxiety
For the current post, I’ve gone deep into the depths of Google to learn what people want to know about anxiety. The internet is often the first place we turn to for solutions to just about anything, even health issues. I know I’m not the only one who leaves an internet search with more questions than answers! And why oh why must everything point to an incurable disease?
Having said that, the internet can also be a wonderful place to learn about mental health, given that the information is accurate. In that spirit, I hope this post will help undo some of that internet trauma you and I have experienced.
This second post in the series will explore:
➼ Most commonly asked questions about anxiety
Our questions will take the form of “can/what/how anxiety…” (i.e. can anxiety be cured?). Kind of how I would type it in if I was doing a frantic Google search, you know?
Let’s jump in.
Frequently Asked Questions about Anxiety
If you have a question about anxiety, chances are that a couple thousand others have the same question as you! People may or may not be voicing them out loud, but they are certainly asking Google. Here is a list of questions people want to know about anxiety. I learned a thing or two while compiling this list (i.e. coffee is love, life, and maybe a source of anxiety). Hopefully, you will find it useful as well. Click on the questions that interest you, or scroll through!
Here are the some of the most frequently asked questions about anxiety:
Question 1: Can My Anxiety Be Cured?
A permanent cure for anxiety sounds like a tempting idea. However, its not as simple as yes or no. Anxiety can be managed with psychotherapy, medication, and lifestyle changes in diet, exercise, and stress levels. It is a work in progress for most of us.
By consistently practicing anxiety management strategies, some of us may be able to reduce anxiety symptoms and lead a very healthy lifestyle. Or, you may do all of the above and just get to a point where you can manage on most days.
Dealing with mental health issues is a highly personalized experience because every one of us has unique upbringings, coping styles, and exposure to adversity. Therefore, a one-size-fits-all formula simply will not do.
Here is something else to consider: anxiety is more than a list of symptoms. Its reoccurring nature tells us that the symptoms are red flags for underlying issues. Sometimes these take the form of natural changes over the course of the life span. Therefore, as we move through life, our anxiety levels may dip and rise accordingly.
Eliminating anxiety entirely may not be beneficial for us- it’s adaptive and helpful, sometimes even life-saving. Perhaps a ‘cure’ isn’t what we should be aiming for.
Managing your anxiety in a way that works for you is a healthier and more compassionate mindset to adopt in your mental health journey.
Question 2: How Do I Talk to My Family And Friends About My Anxiety?
It's important to have a support system you can lean on when managing your mental health, especially on challenging days. The first step is telling people you trust about your experiences and how they affect your life.
Here are 4 tips on how to make a conversation about anxiety a little easier:
- Talk to people you trust: Try and talk to people who you have seen respond to vulnerability with love, kindness, and acceptance in the past.
- Choose a comfortable setting: Our environment can influence how we feel. Choose a place that is friendly and familiar- and this does not necessarily need to be a public place.
- Think about what you want to say in advance: Planning what you will convey to a trusted friend or family member may help reduce any uneasiness you are feeling about the conversation.
- Write a letter or email if talking about it is too hard: We always have the option of doing this. It may also give the person time to send a thoughtful response.
The people in our lives may not always understand what our anxiety means or feels like. Our loved ones might need some time to process and do their own learning about the topic. Telling them about your unique experience of anxiety is something you can do over time.
Don't be surprised if they already know you have anxiety! Feeling anxious is a part of the human experience, giving most of the us the capacity to empathize.
Question 3: Can My Anxiety Cause Depression?
Anxiety and depression can very commonly occur together. They have also have similar treatment approaches and are both responsive to psychotherapy, medications, and lifestyle changes. Research tells us that co-occurring anxiety and depression may require closer management because it is associated with slower recovery and more frequent recurrence.
There is no conclusive evidence in the research that one causes the other, however. This concern makes sense because many of the symptoms of depression overlap with anxiety! We encourage you to talk to a health professional to discuss your specific symptoms.
Question 4: How Does Coffee Affect My Anxiety?
Ah, coffee. That sweet, sweet first sip is sometimes the only thing that gets me out of bed on a cold winter morning. But could that mid-afternoon double-shot be making you- and by you, I mean us- anxious?
Coffee, tea, and certain drinks contain caffeine, which is the most widely used psychoactive drug in the world. It's strange to think of caffeine as a drug, but it's true!
Caffeine is a central nervous system stimulant, meaning it reduces tiredness and drowsiness and causes us to be more alert and even perform better. Caffeine does this to our bodies by interrupting a chemical in the brain that causes tiredness (adenosine), while also increasing our levels of adrenalin.
Many people, myself included, can think of situations where caffeine accelerated our anxiety and made us feel worse.
There is, indeed, an association between caffeine consumption and anxiety.
In fact, the DSM-5 identifies caffeine-induced anxiety disorder under 'substance/medication-induced anxiety disorder'.
When you have way too many cups of joe, the symptoms feel like common anxiety symptoms:
- Fast heart rate
- Gastrointestinal (GI) distress (read the next question to learn more on this)
- Racing thoughts
This could be because caffeine and the fight-flight-freeze anxiety response both increase activity in the sympathetic nervous system! To simplify it, caffeine and anxiety both trigger a similar response in our bodies. Once you know this, it makes sense why drinking several cups of coffee triggers feelings of anxiety, or makes existing anxiety feel more intense.
Coffee is not exactly the enemy though. If you consume it in moderate amounts, the boost of energy and concentration may be worth some jitters. Some people do not experience any adverse effects of coffee at all, making it a true miracle in a mug!
It's all about knowing what your own threshold is and then consuming your caffeinated drink of choice strategically. For me, it's either 2 black teas, or 1 coffee- beyond this, I feel quite anxious and can no longer concentrate or be productive.
And I absolutely have to ask - leave a comment below telling me about your favorite type of coffee. I absolutely LOVE South Indian filter coffee, and the closest thing that does it for me in Toronto is BRU coffee. At the clinic, if I have ever made you a latte, I use scuro by Nespresso.
You know, I never started drinking coffee until 2 years ago?
TOTAL ◍ GAME ◍ CHANGER
Question 5: Can anxiety affect my gut health?
The language we use to describe feeling anxious and nervous often relates to our gut. Have you ever had “butterflies” in your stomach? Or experienced something that was just “gut-wrenching”? How about “going with your gut” when something feels right? This language makes it seem like our gut can gauge our feelings.
Researchers have found that a gut-brain connection exists. The body’s GI system and brain communicate with each other and this connection goes both ways.
For example, if you are experiencing any bloating, diarrhea, nausea or stomach cramps, it can affect your anxiety. The same is true vice versa- feeling anxious or stressed can lead to stomach issues. This may explain why we feel nauseous before a big speech or have stomach cramps during exam time.
Scientists call this system- your “gut brain”- the enteric nervous system (ENS). Your ''gut brain'' is unable to carry out complex thoughts or write a blog post like our large brain can.
That being said, scientists have found that irritation in the GI system may send signals to our brain, triggering mood shifts. This is a growing area of research that we may hear more about in the coming years.
Question 6: Can anxiety cause weight loss?
Mental health and physical health are closely intertwined. Have you ever heard someone describe themselves as an ‘emotional eater’? I am 100% guilty of it, and so are many others.
Anxiety can influence our eating behaviours, causing us to:
- Skip meals
- Forget to eat
- Crave sugary and comforting junk foods (you can read more on what sugar does to your anxiety)
All of these can influence weight changes and are also quite common responses to anxiety. I can think of specific situations where anxious feelings have led me to each of those eating habits!
Weight loss and anxiety can be explained by our body's anxiety response (fight-flight-freeze). When our bodies are mobilizing to respond to stress, they need extra energy. This may result in an increased metabolism, where your body processes what you eat quicker so it can be converted to fuel faster. I have personally lost count of the number of times my stomach has grumbled LOUDLY during a session, meeting, or presentation.
When anxiety is prolonged, our bodies are in flight-flight-freeze mode when they don't necessarily have to be. This is also why anxiety- and the resulting fast metabolism- causes weight loss in some people.
Question 7: Are Anxiety Medications Addictive?
Most physicians prescribe SSRIs (selective serotonin reuptake inhibitors) for anxiety, as this class of medication is effective for anxiety and has less potential for developing an addiction.
Benzodiazepines (more commonly known as “benzos”) are a category of medication that can be prescribed for several health issues, including anxiety disorders. You may even have heard of certain benzo brand names, such as Valium, Xanax, or Ativan. This class of medication does have a higher potential for tolerance and addiction. This is why they are usually approved for short-term use only and in more severe situations.
Question 8: Can my anxiety medication stop working?
Many different types of medications are used to treat anxiety, including anti-anxiety medications such as benzodiazepines (for short-term use) and antidepressant drugs (for longer-term use).
Sometimes medications for anxiety and depression become less effective with time. There is a medical term, tachphylaxis, for when this happens quite suddenly. You may have also heard it referred to as medication “poop-out”.
Some people may also develop a tolerance for their medication. This occurs when the biological response to a drug diminishes more gradually over time, and stronger dosages are needed to produce.
Scientists don’t entirely understand why this happens. Everyone has a unique combination of genetics, life experiences and stressors that can impact how effective a medication is and for how long.
So if your medication is no longer helpful, not to worry, these are common responses.
Question 9: Can My Anxiety Cause Heart Attacks?
The heart palpitations that go along with feeling anxious can feel overwhelming and scary. Panic attacks, which may occur in people who have panic disorder, are often mistaken for heart attacks. A panic attack can mimic a heart attack, with both causing dizziness, sweating, and shortness of breath.
Harvard Health Publishing provides a short guide on determining if what you are experiencing is a panic attack or a heart attack. However, always consult your doctor if you are concerned about your health.
If you are experiencing the following symptoms, it is more likely a panic attack:
➼ The pain is stabbing and “needlelike”
➼ The pain and discomfort tend to occur in the centre of the chest
➼ Chest pain and other symptoms decrease quickly
Question 10: Can anxiety kill me?
Anxiety can be a scary experience. It's an invisible issue because it does not have a physical marker that shows the world what you are going through. This is why it can seem like others are so much calmer, happier, and have a better life than you.
While anxiety can be uncomfortable, anxiety symptoms are not dangerous or life-threatening- even if they sometimes feel that way. Panic attacks, for example, create a sudden surge of fear that peaks within minutes and causes shortness of breath and heart palpitations. The loss of control at that moment can certainly feel life-threatening.
For some people, severe anxiety can lead to thoughts of suicide. Research has shown that there is a link between anxiety and suicide-related outcomes in adolescents and adults. While suicide is not always easy to discuss, it's important to make it a less taboo topic.
If you believe you are at risk of harming yourself, please reach out to a health professional or supportive person in your life.
Here is list of multilingual crisis phone lines in the Greater Toronto Area if you need someone to talk to:
- Suicide Prevention Lifeline: 1 (800)-273-8255
- Toronto Distress Centre: (416)-408-4357
- Naseeha Youth Helpline: 1 (866)-627-3342
- Crisis Text Line: Canada & UK
- Good 2 Talk Student Helpline: 1-(866)-925-5454
- Ontario Mental Health Helpline: 1-(866)-531-2600
- Gerstein Centre Crisis Line: (416)-929-5200
Question 11: Can Anxiety Raise My Blood Pressure?
Anxiety can increase or decrease blood pressure. When our heart rate goes up during an episode of high anxiety, the chambers of the heart contract more intensely. This results in an increase in blood pressure.
Conversely, anxiety symptoms can also decrease blood pressure. Sometimes anxiety makes it difficult to breathe properly, causing our blood vessels to widen so more oxygen can get in, which decreases blood pressure.
Researchers have demonstrated that a positive relationship between anxiety and hypertension exists and it goes in both directions. This means adults with anxiety are more likely to develop hypertension and adults with hypertension are more likely to have anxiety.
Keep in mind that a trend does not mean that one causes the other. Anxiety and hypertension are both complex issues that likely have multiple causalities. However, knowing the relationship between the two allows us to make more informed decisions about our health and well-being.
Question 12: Can My Anxiety Affect My Baby?
Our friends and family members often tell us to relax during pregnancy, because stress is not good for the baby. There is some degree of truth to this. Research has shown that high levels of anxiety in pregnancy can have adverse effects on the mother and baby. Earlier in pregnancy, very high levels of anxiety can increase the chances of fetus loss. In the 2nd and 3rd trimesters, the baby can experience a decrease in birth weight. Researchers say that it can also affect maternal-bonding when the baby is born.
Keep in mind that pregnancy is a time of remarkable physical and emotional changes. Some of these changes can be welcome, while others may be quite stressful and overwhelming. It is natural to have some worries during pregnancy. However, if these worries start to interfere with your ability to go about your day, there may be concerns with managing your anxiety. Once again, we encourage you to talk to a health professional if you are concerned about you and your baby’s well-being.
Question 13: Can anxiety affect my breastfeeding baby?
Breastmilk contains proteins, fats, sugars- all the nourishing things a growing baby needs. It also carries certain hormones from the mother to the baby. Cortisol, also known as the stress hormone, is carried from the mother’s system to the baby’s via breastfeeding. However, it is too simplistic to say that the cortisol in a mother’s milk causes a baby to be anxious.
There are several reasons why a baby may have higher cortisol levels. Researchers found that in the first year of life, salivary cortisol is higher in breast-fed infants, compared with formula-fed infants. To explain this finding, the researchers considered that breastfeeding requires more effort on the infant’s part than bottle-feeding. This extra effort (and stress) may at least partially explain the difference.
Despite the gaps in the research, it is well-known that cortisol exposure during infancy affects the development of the baby’s stress response system. In response to the cortisol, new receptors grow to detect the hormone. Some research has shown that these early disturbances in cortisol levels may affect brain development and influence a trajectory of psychopathology in young people.
Question 14: What Does Anxiety Look Like in Children?
Children can have anxiety too. It often presents as a constellation of behaviours, making it difficult to pin down the underlying problem as anxiety.
For example, a 6-year-old may cry before school every morning and beg to stay at home. A 12-year-old with straight A’s and a stellar extracurricular record may feel overwhelmed by the pressure and yell at her siblings. Both of these children may be experiencing anxiety.
Children these days experience stressors on multiple fronts: academically, socially, and developmentally. Adding to this are the unique challenges of navigating social media. Kids have a LOT on their plates! It’s no wonder they need some extra support.
Sometimes, however, anxiety can go undetected by parents or teachers if the child is quiet and well-behaved. Anxiety can also manifest in the form of disruptive behaviour and result in the child being labeled as the ‘bad kid’ in class. Neither of these outcomes are helpful to the child.
Children are not as skilled as making the connection between negative thoughts, physical sensations (i.e. racing heart, stomach ache), and the experience of anxiety. This is why it is important for adults to not only spot the overt behaviours but also recognize the underlying causes.
There are also anxiety disorders that occur predominantly in childhood. Selective mutism is a childhood anxiety disorder where a child is unable to speak in social situations that require them to speak, such as school, in rehearsals, or when talking to an adult. The child may speak openly in other situations. Selective mutism can prevent a child from engaging fully in their lives and affect academic performance and friendships.
Anxiety Canada provides some guidelines on how to know if a child has selective mutism. The child may:
- Speak in some situations and stops speaking entirely when other people are around
- Appears to be ‘frozen’ or upset when strangers speak to them or ask questions
- Uses gestures to get their needs met, despite knowing how to talk
In order to qualify as selective mutism, these speaking difficulties must occur for longer than one month (not including the first month of school) and cause some disruption in the child’s life.
I hope you found some useful answers in this post. Living with anxiety looks different for all of us. If you have concerns regarding management of anxiety symptoms for yourself or a loved one, book a free consult with anyone on my amazing team.
If you found that some of these questions did not capture your experiences, I am interested to know what other questions you have about anxiety!
Leave a comment, or flip me an email, I would love to hear from you.