The Common Cold of Mental Health
We all likely know someone who suffers from anxiety – a friend or coworker or relative. It affects different people to different degrees. Maybe one person can’t leave the house while another is dealing with a panic attack sitting in traffic. Others feel uncomfortably anxious in social situations.
What you might not know, however, is that anxiety disorders are the most common mental disorders plaguing the U.S., according to facts and statistics by the Anxiety and Depression Association of America. Anxiety affects 18% of the population – that’s almost two people in every ten. And that number just includes people 18 and over. It doesn’t account for teens suffering from anxiety.
Anxiety can also manifest in a myriad of different forms including but not limited to OCD, panic disorder, generalized anxiety disorder, and specific phobias. The need for anxiety reduction in our society is great.
What Causes Anxiety?
There is a component in our brain called the amygdala that is responsible for the regulation of many of our emotions, our motivation, and empathy. It is also well known for being heavily incorporated in our “fight or flight” response. Some scientists think that excess panic attacks can come from irregular activity in this bundle of nerves.
But knowing whether the panic causes the irregularity or the irregularity causes the panic is hard to do. In a review of existing research published in 2012, Dr. Jieun E Kim and his colleagues cited several animal studies that show a correlation with the amygdala and behavior analogous to human panic attacks.
Another area, the periaqueductal gray, is also believed to be involved. Found in a summary on Science Direct, studies involving injections of benzodiazepines or GABA receptor agonists into this area of the brain showed anxiolytic effects.
When investigating how to address your anxiety, it’s good to search for that root cause. It varies depending on the individual.
Pharmaceutical Options for Anxiety Reduction
If you suffer from anxiety, you are probably familiar with the common drugs used to treat it. Xanax is a household name in America. But, according to info gathered from drugs.com, there are actually 57 medications associated with the treatment of anxiety. Most of them are benzodiazepines. Some are selective serotonin reuptake inhibitors (SSRIs) more commonly prescribed for depression. And some are beta blockers, often prescribed for heart arrhythmias or tachycardia but occasionally prescribed for the off-label use of anxiety reduction.
Benzodiazepines, the most common medication, work by boosting the effects of GABA, your brain’s primary inhibitory neurotransmitter. GABA transmits a message between your neurons, effectively telling them all to calm down or decrease their firing rate.
Also, according to benzo.org, a website endorsed by the Institute of Neuroscience at Newcastle University, about 40% of your brain’s millions of neurons will respond to GABA. This is why the effect of benzodiazepines can sometimes be widespread rather than localized to one thing. Benzos function by allowing extra chloride ions to enter the neuron responding to GABA, thereby further decreasing the neuron’s excitability.
The Downside: Down Regulation
The problem with these medications, particularly benzos, is covered by the same source at benzos.org. They have been responsible for many issues, including…
- aggression and assault;
- driving accidents;
- memory problems; and
- withdrawal fatalities from unsupervised withdrawal.
Of course, these side effects and problems are completely dependent on dose and on the duration or regularity of consumption.
Let’s focus on addiction. Addiction to benzos occurs because of something called “down regulation.” Here’s what Heather Ashton, DM, FRCP, said in a paper published in New Scientist:
People become tolerant to benzodiazepines probably because their nerve cells respond by producing fewer receptors for GABA/benzodiazepines. This phenomenon, known as “down regulation,” means that the number of “high affinity” GABA receptors decreases in response to the enhancement of GABA caused by the drug. […]
Whatever the mechanism, the development of tolerance sets the scene for withdrawal effects. At this stage, the removal of benzodiazepines, or even a reduction in dosage, exposes the altered state of the brain, with fewer “higher affinity” receptors for GABA to act upon.
For the reasons she outlined, many people might prefer something other than this pharmaceutical option. Of course, I need to stress this, do not stop your medications without first speaking to your doctor about weaning and what can be done to help the weaning process. There are withdrawal processes for SSRIs and beta blockers as well. Some people undergo hospital care to come off of certain medications.
Make sure you do whatever is safest if you wish to replace your regimen with something else.
Tell Us Your Story
Now that you understand a bit more about anxiety, tell us a bit about your anxiety story in the comments. You are not alone. Sometimes simply knowing that and seeing the stories of others can alleviate some of our anxieties.
Also, have you encountered positive or negative experiences with your current medications? What coping mechanisms, if any, are you practicing? It is good to dialogue with other sufferers.
Lastly, feel free to contact us with any further questions. We hope to provide the relief you are seeking.