What distinguishes anxiety from occasional nervousness?

Are you a Worrier or a Warrior?

In this country, so many people operate in an ever-present state of low anxiety or worry (also called generalized anxiety) that may grow into episodes of full-blown panic attacks, phobia or anxiety disorders during times of psychological stress (college, job, marriage, or parenting) or biological change (adolescence, pregnancy, or menopause).

A majority of my patients with chronic anxiety are so acclimated to living with it — often since childhood — that they do not even mention it until I ask or until their anxiety symptoms worsen.
Anxiety and worry are clusters of feelings birthed from both emotions and physiology. Most psychologists wrongly look at anxiety as solely emotional and as an outward sign of inner conflict and repressed negative feelings. Yet scientific research over the past twenty-five has proven that all anxiety, severe anxiety disorders, and panic attacks have real physiological causes that are just as important to treat. This is especially necessary for relief of anxiety related to hormonal imbalance, for example.

This is good news. It means that anxiety symptoms that were once dismissed as character flaws are not feelings you just have to live with or medicate when they get too severe for you to function. We know there is a lot more to the story — and a lot that you can do to end the problem.

What distinguishes anxiety from occasional nervousness?

Everyone experiences anxiety or feels panicky from time to time: the shaky hands and rapid heartbeat, the heavy breathing, and the mind accelerating to a hundred miles per minute. Part of what keeps us alive is our ability to feel fear. In fact, it is self-preserving that we have a built-in alarm system that brings the full scope of our mental and physical aptitude to bear in the face of peril — known as the fight or flight response.

The parts of the brain responsible for choreographing our emotions, including the fight or flight response, relies on a complicated interaction between neurotransmitters and hormones to ignite the body and mind to deal with a perceived enemy.

What is not acceptable is to feel afraid and upset most of the time without any palpable cause. Like our immune response, our fight or flight response is meant to snap into action in the face of a threat and then take it easy. But in our day and age, too many of us never get to relax. Our minds are continuously in crisis mode with the accompanying physical response.

Based upon the patients who visit me at Integrative Health Group, there is an epidemic of anxiety in our culture. Over 19 million American adults and millions of children have anxiety disorders ranging from mild to severe. And the statistics only count the people reporting their anxiety symptoms to doctors. I know from my practice that there are many more on the mild to moderate scale who feel reluctant or even ashamed to admit their anxiety.

Media promotes the message that feelings of fear, vulnerability, and even shyness are signs of weakness — which makes anxiety the fault of the victim. People are taught from childhood to disregard it and occupy themselves with some activity so you will not think about it. Telling people to suffer through anxiety is just as terrible as telling them that drugs are the only remedy for anxiety and panic attacks. Neither is correct.

At Integrative Health Group, we are succeeding in helping many patients with these problems because we have learned ways to find the particular solution to correct the particular type of problem. This happens because of three key reasons:

We know how to identify the major types of anxiety
We know the real roots of anxiety
We are astute at recognizing the symptoms (both subtle and obvious) that accompany anxiety.

Severe anxiety disorders

Severe anxiety and panic disorders like social phobias, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD) affect only a small minority of anxiety sufferers.
Many studies have been conducted to determine a connection between anxiety disorders and genetics because anxiety disorders clearly run in families. Genes are a factor in some anxiety disorders, but generally not the most important factor. More often than not, anxious people grew up in anxious households. Anxiety is usually a learned behavior that can be unlearned — even when it is severe.

Generalized anxiety disorder (GAD)

Mild to moderate anxiety is far more common but harder to identify than severe anxiety disorder. Called generalized anxiety disorder, or GAD, it is characterized by compulsive worrying and physical symptoms of anxiety which persist for more than six months. Often these individuals were anxious — and medicated — as children, suffered some form of childhood trauma, or grew up in anxiety-ridden households.

A majority of my patients are so accustomed to their anxious feelings that they often do not mention them until I ask them some key questions. That is because while anxiety can be incapacitating — and may increase progressively if left untreated — symptoms of mild to moderate anxiety may not clearly impact one’s ability to function.

In fact, quite the opposite may seem to be true. Often it is the high-achieving, seemingly productive achiever who finds it difficult to admit that he or she has chronic anxiety. Frequently I see dynamic, non-stop individuals who rarely felt anxious in their younger lives get blasted with anxiety and panic attacks as they enter their forties and fifties. These signs of anxiety can be misread at a strictly conventional doctor’s office precisely because these people appear to be such powerhouses.

Symptoms of anxiety and panic attack

While most of us will experience episodes in which we feel some or all of the symptoms of anxiety, what differentiates healthy anxiety and/or panic from chronic anxiety and panic attacks is the trigger. If you think you hear an intruder in the middle of a deep sleep, of course it is normal to wake with a start and go into high alert. But it is unhealthy to have these symptoms while sitting on the sofa reading a book.

Keep in mind that anxiety is a cluster of physiology and emotions. The root cause of the anxiety could arise on the emotional side or the physical side — or both.
The feeling of anxiety always begins with a trigger that begins a survival response from the brain. As a result of the first hint of apparent danger, your brain chemistry, blood hormones and cellular metabolism all whirl into action.

When you have chronic anxiety, this response may lessen but it never gets turned off, even when there is no obvious threat. Over time your anxiety symptoms may be sparked by less and less significant events because your brain has been sensitized to react in a highly anxious way.

The obstacle with anxiety is that it becomes so easily established that in a very short time it becomes your normal state. The network among your neurotransmitters, hormones and metabolism become fine-tuned to an equilibrium in which anxiety is sustained. That is the reason that relief from anxiety is dependent upon changing the physical and emotional causes of your anxiety and creating a new, healthier equilibrium.

There are three principal areas which must be carefully considered when one is plagued with constant nervousness.


The neurotransmitter imbalances that cause anxiety are related to those in children with ADHD and ADD (conditions also associated with high dopamine). In fact, what might look like ADD in some children may actually be related to severe anxiety.

At Integrative Health Group, we frequently test neurotransmitter levels.

Hormones – Sex hormones and Adrenal Hormones

Clearly sex hormones like estrogen play a critical role in anxiety. Women are more than twice as likely as men to feel anxiety, especially during the hormonal ups and downs of pre-menstrual symdrome, perimenopause, and menopause. Anxiety is often the first sign of perimenopause.  But I do not believe that menopause actually causes anxiety. I have observed that it simply amplifies what was already there. That is why relief from menopausal anxiety and panic attacks is found only after restoring hormonal balance.

At our office, we make available both hormone testing and adrenal stress index testing for questions related to sex hormones and the adrenals.

Nutrition and digestion

Most of the chronically anxious patients I see have some form of gastro-intestinal problem, whether it is nervous stomach, irritable bowel syndrome, diarrhea, nausea, bloating or bleeding. Usually, anxiety first attacks the gut. If your digestive tract is upset, it is almost impossible to feel well — which can add to the anxiety!

In some people, food allergies and food sensitivities trigger anxiety symptoms. It is not surprising that we do a lot of allergy testing, followed by allergy clearing, for many of our patients. Your nutrition heavily influences your mood. The gut is a source of serotonin, a major hormone for a happy and stable mood. Your digestive system is intricately tied into your hormonal balance, your brain chemistry, and your moods.

Can you now see how inadequate it is to solve the problem of anxiety, sleeplessness, and depression with prescription medications? I am greatly concerned about the widespread use of medication for generalized anxiety. Anti-anxiety medications are particularly habit-forming and they do nothing to reboot the neural and hormonal pathways for long-term mental health. They simply disrupt the pathway and mask the symptoms of anxiety so that one can barely function.

Relief from chronic anxiety comes from restoring your body’s natural, healthy equilibrium, and we are experts at helping people do just that.

Anxiety takes a lot of hard work. Imagine how powerful you could be if all that energy that has been consumed by anxiety and fear were released in a positive way so that you could fulfill all of your dreams – as a warrior instead of a worrier.

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