Are you feeling anxious? More anxious than normal? Or dogged by a pervasive feeling of anxiety?
You are not alone.
Autumn is a season of change—and not just because of cooler temperatures, shorter days, foliage, and a faster pace. For many people, fall is also a time of adjusting to changes in life circumstances, both great and small.
Transitions can include the start of a new school year, busier work schedules, demanding project deadlines and/or more travel. Life transitions can include the purchase of a new home, becoming new parents, death of a loved one, job loss, moving to a new city, or retirement, all of which can feel more intense in a season with less daylight and chillier nights.
Humans are creatures of habit. Situations that involve transitions or which introduce change, uncertainty, or disruption of a regular routine, can trigger anxiety.
What is anxiety?
Anxiety is the body’s response to a stressful situation—real or perceived.
For example, going on a first date, anticipating an important job interview, or public speaking can trigger anxiety. Anxiety is associated with feelings of tension, distress, nervousness, fear and/or apprehension and is characterized by worried or intrusive thoughts.
That said, anxiety is not the same as fear.
Anxiety is considered a future-oriented, long-acting response broadly focused on a diffuse (non-specific) threat, whereas fear is an appropriate, present-oriented, and short-lived response to a clearly identifiable and specific threat (1).
Physical symptoms of anxiety can include:
–Restlessness
–Racing heart or increased heart rate
–Sweating
–Shaking or trembling
–Nausea
–Feeling faint or light-headed
–Changes in body temperature (too hot, too cold)
–Digestive issues (e.g., diarrhea, constipation, indigestion)
–Changes in appetite
–Shortness of breath
–Headache
–Dry mouth
–Sleep problems or insomnia
Anxiety disorders affect 19.1% of the population, or 40 million American adults, aged 18 or older (2).
I find it fascinating the extent to which Western medicine has “medicalized” anxiety. Now, your family doctor or PCP (primary care physician) can prescribe anti-anxiety medication for “moderate” anxiety. Really?!
In our convenience-oriented, one-click culture, taking a pill for every perceived ill seems like an easy, quick fix. However, many people are seemingly unaware of the wide range of potential (and common) side effects of taking anti-anxiety medications.
Depending on the type of anti-anxiety medication you take, side effects can include—and are not limited to—weight gain, sleep problems/insomnia, dizziness, changes in blood pressure (higher or lower), memory issues, confusion, increased agitation, headache, gastrointestinal issues (e.g., constipation, diarrhea, stomach upset), tremors, dry mouth, increased feelings of anger, hostility and irritability, addiction, depressed mood….and, oh…increased anxiety (3, 4, 5)!
Anxiety is not caused by a Xanax deficiency. Anxiety can have many root causes, including poor gut health, nutritional deficiencies, blood sugar imbalances, sleep deficiency, hormonal imbalances that occur during post-partum, perimenopause, menopause or andropause (male menopause), overexposure to blue light and unaddressed trauma.
What is often overlooked is that our food choices and lifestyle habits—areas of our life where we can make different choices—can cause or worsen anxiety.
Here are six common culprits:
1. Sugar
With my clients, I always emphasize that optimizing blood sugar is the cornerstone of good health. And this includes mental health! Food or drink with a high glycemic index (e.g., high fructose corn syrup, sugar in any of its 57 forms, wheat) and/or high sugar foods—including sweetened beverages, sodas, refined carbohydrates, refined grains (e.g., breakfast cereals, crackers, etc.), flour-based foods (e.g., bread, pastas, pizza, sandwiches, etc.) and processed foods—cause a rapid rise in blood sugar.
Your body then compensates by releasing excess insulin to help lower too-high levels of blood sugar. This, in turn, causes your blood sugar to plummet (too low, too fast), triggering hypoglycemia, or a “sugar crash”, which is often experienced as a sudden drop in energy levels or fatigue.
This sudden lowered blood sugar state causes your adrenal glands to release stress hormones—like cortisol, norepinephrine, and epinephrine. These same hormones, which are released when you are in an “emergency” fight-or-flight mode (e.g., metaphorically being chased by a tiger), can cause or contribute to feelings of anxiety, irritability and/or hunger (6, 7).
Before you start an anti-anxiety medication, consider your food choices. Keep in mind: The symptoms of reactive hypoglycemia, which can be triggered by consumption of high sugar foods, including simple sugars (e.g., candy, sodas, sweetened beverages) and refined or simple carbohydrates (e.g., fruit juice, milk and milk products, white flour, white rice, bagels, pizza, pasta, etc.), are similar to symptoms of anxiety (8).
What you can do: Be mindful of eating whole food-based meals. Eat protein, especially at your first meal of the day; animal protein is ideal because it can help stabilize blood sugar. Include fiber (a.k.a. vegetables) and a source of healthy fat at every meal. Consider getting support from a functional health coach and schedule a free 15-minute consultation. Start your journey with a Food & Lifestyle Review. Or, order your own labwork to stay on top of blood sugar management, nutrient status and metabolic health.
2. Caffeine
Caffeine is the most widely used—and socially acceptable—psychoactive drug in the world. Approximately 90% of adults in North America consume coffee every day (9).
A study, specifically focused on U.S. caffeine consumption, and published in Food and Chemical Toxicology, surveyed 37,602 consumers who completed a comprehensive beverage survey regarding their consumption of caffeinated beverages. Results showed that 85% of the U.S. population consumes at least one caffeinated beverage every day. Approximately 96% of caffeinated beverage intake is from coffee, soda and tea. Among children, carbonated soft drinks were a main source of caffeine compared to coffee in adults. For US consumers, coffee remains the top choice of caffeinated beverage. (10).
While the benefits of caffeine have long been touted, caffeine intake has also been associated with anxiety, headache, nausea and restlessness (11). Caffeine can trigger anxiety symptoms, especially in those who have pre-existing anxiety disorders (12).
Caffeine affects how we think and how we feel. It is speeds up our breathing, heart rate and blood pressure, and is associated with increased alertness, motivation, focus and productivity.
However, as a central nervous system stimulant, caffeine use has also been linked with anxiety disorders, sleep disorders and eating disorders and a possible association with schizophrenia (13).
Why can caffeine significantly contribute to anxiety? Because:
–Caffeine increases heart rate, blood pressure and stress hormones, like cortisol and adrenaline, which can worsen feelings of stress and overwhelm (14, 15).
–Caffeine disrupts sleep, and a common side effect of caffeine consumption, especially among those who are prone to anxiety, is insomnia. Many people struggling with anxiety experience sleep problems. Getting restorative sleep is essential for balanced mood and overall mental health.
–You may be sensitive to caffeine—and not realize it. It is important to understand: caffeine can be experienced differently at different stages of life and depending on your hormonal balance, overall health status and whether you have the genes to efficiently metabolize caffeine—or not (16). I have personally experienced a shift in caffeine tolerance over time. For me, drinking espresso was a once much-anticipated daily ritual. I could even drink an espresso at 11PM and fall asleep immediately! Now? I still enjoy espresso, but only as an occasional “treat”.
Overall, studies suggest that caffeine sensitivity tends to increase with age. Research indicates that caffeine has a greater impact on calcium metabolism and bone in older people (17).
Taking synthetic hormones (e.g., oral birth control pills or conventional HRT) can slow down how you metabolize and eliminate caffeine from your system (18).
If you are perimenopausal, menopausal or post-menopausal, caffeine can worsen vasomotor symptoms, such as hot flashes and night sweats, as well as worsen sleep problems and increase frequency of urination (19).
Taking certain medications can slow the breakdown of caffeine in your body and increase the negative side effects of caffeine. These medications include—but are not limited to—some antidepressants, antipsychotics, cardiovascular drugs, anticoagulants and NSAIDS (20).
Even if you don’t drink coffee per se, keep in mind that the caffeine in energy / sports drinks, energy shots, sodas, caffeinated teas and iced teas can also cause or worsen anxiety.
What you can do: Be mindful of when and how much caffeine you consume throughout the day; what food(s) you may have with your caffeine (e.g., cookies, chips, candy, breakfast sandwich, etc.) and its effect on your blood sugar and energy levels. Depending on the extent of your caffeine dependency (none, mild or severe), taper off gradually or just take a break altogether. Swap out coffee and colas for green tea (stimulating without the jitters), decaffeinated green tea or calming herbal teas. Schedule a free 15-minute functional health coaching consultation. Consider doing a 7-Day whole foods-based Fall cleanse to reset your system.
3. Alcohol
Unlike sugar and caffeine, which are stimulants, alcohol is a depressant. For those who are socially anxious or feel anxious in general, alcohol is an attractive antidote to anxiety; its ability to slow down processes in your brain and central nervous system, can make you feel—at least initially—less inhibited and more relaxed (21).
However, if you are prone to—or regularly experience—anxiety, alcohol can actually increase anxiety levels. How?
A 2019 study, published in Alcohol and Alcoholism, explains that the initial stimulatory feel-good effects we can experience after drinking alcohol is caused by temporary changes to chemical messengers in the brain called neurotransmitters. GABA is the brain’s natural calming neurotransmitter.
Drinking alcohol temporarily increases GABA while blocking glutamate, a neurotransmitter associated with excitability. The brain then tries to compensate for these effects by decreasing GABA production and increasing glutamate. However, once alcohol leaves the body, the brain is an overactive state, causing anxiety and/or other symptoms of a hangover (22).
It can become a vicious circle to break (23):
–You drink alcohol to cope with anxiety.
–You feel calm from alcohol’s initial relaxation-promoting effect on the brain.
–You feel anxious as a symptom of alcohol withdrawal.
–You then feel compelled to drink again to relieve your anxiety.
Sure, there are general guidelines for how much alcohol consumption is considered “normal” or “safe”. In reality, however, alcohol tolerance is unique to an individual, depending on their gender, race, overall health status, hormonal balance and age, as well as genetic factors or predispositions.
What you can do: Pay attention to how much you drink on a daily / weekly basis. When and how frequently do you drink? Do you absolutely “need” alcohol to unwind or cope with stress? Are you able to take a break from alcohol? Are you able to soothe your anxiety in ways other than alcohol? Consider seeking support from a CBT therapist or CBT-trained coach, like myself, to identify triggers for anxiety, to develop adaptive coping strategies and to cultivate / prioritize self-care. Schedule a free 15-minute phone consultation here. Consider doing a Comprehensive Wellness Assessment to better understand where to make lifestyle changes first.
4. News Consumption
Many of us seek certainty in uncertain times. One of the ways that many people try to feel more “in control” of their lives is by overconsuming “news”, whether through mainstream media (e.g., CNN) or social media feeds (e.g., Twitter).
Focusing all of your energy and attention on “the news”, whether on television, online, or via our phones, actually increases anxiety levels in the long run because it feeds the false belief that if you have enough information, you can remain in control (24).
I have worked with many clients who grapple with anxiety. *Beth (not her real name), who was in her mid-60s, intelligent, articulate and highly anxious, expended all of her mental and emotional energy obsessing about the war in Ukraine, the current US political environment, people who did not wear masks, and she expressed great fear about getting C*V*D. (Ironically, she came down with a severe case of C*V*D, rife with adverse health complications, despite being “up to date” on her shots). Energetically, we attract what we most fear, especially if we live in—and act from—a place of fear.
Beth was so consumed by external events beyond her control that she was absent from her own life. Staying glued to the news kept her distracted from dealing with a deteriorating marriage, myriad health problems, out-of-control clutter, dysfunctional “friendships” and unresolved trauma. One of the first things we worked on was limiting her news and social media consumption.
Keep in mind: today’s 24/7 news cycle literally assaults viewers with a barrage of negativity, fueling anxiety, fear, overwhelm and feelings of powerlessness. Even if you don’t turn on the television, you are served up “the news” on your phone, elevators, medical offices, and taxis. Like processed foods, news headlines are click bait, designed to keep you hooked and wanting more.
Humans naturally have a negativity bias; meaning, the human brain is wired to detect threats, so it will pay more attention to negative or scary information that could potentially help avoid a harmful situation (25). However, overconsuming gloom-and-doom news stories can take a toll on your mental and physical health.
In a study published in the British Journal of Psychology, researchers found that participants who were only exposed to negative television news bulletins experienced greater levels of anxiety and sadness; this translated to these same participants experiencing a significant increase in worrisome thoughts about their own lives (26).
What you can do. Managing anxiety is like a meditation practice. Many meditation practices advise bringing your attention back to your breath when your thoughts wander. Likewise, when you feel anxious, gently bring your attention back to the present moment; this can include engaging in relaxation or deep breathing practices. Ground yourself, literally, by walking barefoot on dirt or grass, to release oxidative stress and tension. Notice sensory details of your environment; for example, the sun is shining; birds are singing; it feels cold; or a dog is barking in the background.
The best way to deal with uncertainty is to practice acceptance of what is beyond our control and to refocus our attention on things that we can control, like our own self-care—getting enough sleep, eating unprocessed whole foods, hydrating well, moving our bodies, and spending time in nature. For guidance and support, schedule a free 15-minute functional health coaching consultation. Consider doing a Comprehensive Wellness Assessment for an objective perspective about areas where you may have blind spots.
5. Sleep
Which comes first…sleep problems or anxiety? Actually, both are intertwined.
Sleep problems, including insomnia, are a common symptom of anxiety disorders. People who ruminate tend to have obsessive thoughts about their problems or fears. Rumination often leaves the ruminator in a negative emotional state and, consequently, less able to come up with good solutions to problems or concerns. As a result, rumination is associated with anxiety (27).
Rumination, described as “racing thoughts”, “overthinking” and “unable to shut my mind off”, can instill a feeling of dread about going to sleep or prevent a ruminator from falling asleep (28).
Mental hyperarousal, triggered by worry, has been identified as a key factor behind insomnia. This means that if you frequently feel anxious, you are more likely to have sleep problems under duress (29).
On the other hand, not honoring your sleep needs can cause anxiety—even if you do not experience anxiety regularly.
Sleep is vital for optimal physical, mental and emotional health. As a functional health coach and CBT coach, I can attest that sleep deficiency in my clients is highly prevalent—and a major factor that contributes to the intensity of anxiety they experience.
Sleep deficiency occurs when (30):
–You don’t get enough sleep (a.k.a., sleep deprivation or sleep debt).
–You sleep at the wrong time of day (e.g., you work the night shift and sleep during the day.)
–You get poor quality sleep or have disruptions in your sleep cycles (e.g., no REM sleep)
–You have a sleep disorder (e.g., sleep apnea) that prevents you from getting enough sleep or causes poor sleep.
Depriving your body of sleep is a physiological, mental and emotional stressor.
Sleeping—at the right time—enables the body to heal and repair itself. When you sleep too little, poorly, or against circadian rhythm, stress builds up in the body.
Sleep affects brain health. Getting enough sleep enables your brain to properly detoxify by removing cellular “trash”—metabolic waste proteins, like beta amyloid (its accumulation in the brain is associated with Alzheimer’s) that build up in the brain throughout the day). This brain-cleaning process may reduce the risk of Alzheimer’s (31).
Sleep deficiency makes us less stress-resilient and more emotionally reactive to perceived stressors. A 2013 study found that sleep deprivation intensified reactions in the amygdala, the area of your brain responsible for emotional processing, especially anxiety and fear.
Sleep deficiency also impacts the anterior insula, the part of the brain that seeks cues for certainty and is also associated with anticipatory anxiety (32). A 2020 study found that poor sleepers and those who experience insomnia are more vulnerable to generalized anxiety disorder (GAD) during periods of chronic stress (33).
Bottom line: whether or not you are prone to anxiety, it is highly likely that not getting enough sleep or poor quality sleep will trigger or intensify feelings of anxiety.
What you can do:
–Create a bedtime routine. Plan in advance when you go to bed and give yourself an hour to wind down; e.g., brushing teeth, washing face, reading a book.
–Take a 10 to 30 minute walk outside—if you feel safe enough to do so—after dinner. This helps lower blood sugar, blood pressure and exposure to natural darkness increases melatonin production which can help with sleep.
–Maintain good sleep hygiene. Make sure your room is dark, cool and quiet. Keep all electronics, including the television, out of the bedroom.
–Keep a worry journal to counter rumination. Spend 5 to 20 minutes writing out all of your worries and concerns as a way to release repetitive thoughts.
–Consider working with a therapist or coach, such as myself, trained in CBT (Cognitive Behavioral Therapy) approaches to identify negative thought patterns, develop adaptive mindset strategies and create healthy sleep habits. Schedule a free 15-minute coaching consultation here.
6. Movement
Did you know: people with anxiety disorders are at greater risk for heart disease and premature death (34)?
Previous studies have linked sedentary behaviors, such as sitting for work or travel and screen-based activities (e.g., online engagement via computer or phone, television viewing and electronic gaming), with increased risk of chronic diseases in adults and children.
Researchers have also found a positive association between sedentary behavior and anxiety risk. That is: the more you sit, the greater likelihood you will experience anxiety (35).
One 2015 study found that people with mild to moderate symptoms of anxiety disorders were sedentary most of their waking time (about 9.1 hours) and engaged in low-intensity physical activity—if at all (36).
Physical activity appears to have a protective effect against anxiety; aerobic exercise, in particular, has been shown to significantly reduce symptoms of anxiety (37).
To be clear, exercise is a subset of physical activity. Though the terms are often used interchangeably, they are not the same. Physical activity is any activity that requires an expenditure of energy, like walking up the stairs, walking the dog, gardening, or raking leaves. On the other hand, exercise is physical activity that is planned, structured, repetitive, and purposeful in its intent to improve one’s physical fitness. Examples of “exercise” include biking, swimming, brisk walking and running (38).
Why is exercise so effective in reducing and preventing anxiety?
–Exercise is present moment-oriented and can provide a healthy distraction from what you are feeling anxious about (39).
–Moving your body releases muscle tension. As a result, you feel less tense and less anxious (40).
Exercise, especially vigorous exercise, produces endorphins, which act as “feel good” neurotransmitters. Endorphins have natural pain-killing, anti-inflammatory and anti-stress effects on the body. Endorphins also trigger the release of dopamine, another neurotransmitter associated with feeling pleasure and reward (41).
–Regular exercise improves sleep, which is key to good mental health, including the prevention and reduction of anxiety (42).
–Exercise can help the body better cope with stress. When we have greater stress resilience, we feel less anxious overall. One study revealed that those who engaged in regular, vigorous exercise were 25 percent less likely to develop depression or an anxiety disorder over the next five years (43).
What you can do: I have coached many people who felt overwhelmed trying to find time to “go to the gym”. You don’t have to “go to the gym” to move your body! If you spend a lot of time sitting, the first step is to simply find ways to incorporate physical activity into your day. For example, walk wherever you can instead of driving; take the stairs instead of the elevator; or make a date to go walking with a friend. When it comes to exercise, engage in exercise that feels good to you: spinning, kickboxing, swimming, biking, doing the elliptical or brisk walking. Keep in mind: exercising longer and harder is not necessarily better. It depends on an individual’s state of overall health, mobility, and fitness. Studies suggest a 10-minute walk can be just as effective for some people in relieving anxiety as a more intense 45-minute workout (44). Looking for support, guidance and a “partner” to help you achieve your health goals? Schedule a 15-minute free functional health coaching consultation here. Consider getting your health back on track with a Food and Lifestyle Review.
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