Trapped In Fight or Flight: Anxiety

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In my office, I recently received a phone call from a woman with despair in her voice as she frantically shared her story. Her speech was pressured and racing. She seemed exhausted and frustrated to repeat her symptoms to one more doctor. She had been to several doctors over the years, she had been prescribed numerous medications, she underwent every test and she was then discharged by every clinic, no one was able to help her. She has been in fight or flight for 8 years. Life is a constant panic, terror, she can’t leave her home, function, hold a job or relationships. She is terrified all the time, shaking, tremulous with feelings of doom. Every medication has made it worse. Every supplement she tried, she did not tolerate. She has a strong desire to live, to get her life back and for her body to function normally. She is not alone. Many suffer with anxiety in silence and isolation. It is my intention to share our conversation about how anxiety affects the mind and the body in the hopes that it can also help someone else.

We were designed for survival. We are programmed to remember negative experiences in color and detail. When we are young these memories get embedded into our genetic code. They create neural pathways to heighten our ‘danger’ signals when we are intentionally or subliminally reminded of that experience. These experiences can be from a long time ago, maybe insignificant to those around us, but our perception triggered a ‘fear and danger’ response in our brain. When the body senses danger through our five senses (you see, hear, feel, smell, taste or experience a threat) or you have an internal trigger such as an infection, toxin or injury, your negative thoughts light a fire through the sympathetic pathways sending a “Fight or Flight” command waking up 50+trillion cells that make up your brain, heart, lungs, gut, muscles, immune system, blood vessels and skin, to stand guard and get ready for the ‘war’ or invasion about to ensue. This threat can be real or imaginary. The body reacts the same. Your brain may be revisiting an old memory of a threat and the body reacts the same. You can mistakenly perceive a conversation, a look or an event as negative and your body reacts the same.  Your cognitive thinking brain shuts down, you become irritable, unfocused, your mouth gets dry, heart races, breath becomes shallow, stomach turns in knots, hands become sweaty, muscles tense, blood vessels constrict causing blood pressure to rise, causing cold hands and feet, mind starts racing, insomnia ensues, thoughts become irrational and lead to feelings of doom.

When we get stuck in this place for years, chronic mental stress and activation of the sympathetic nervous system leads to physical changes to our brain which causes the sleep, mood and cognitive centers to atrophy leading to insomnia, depression, memory loss, headaches and worsening anxiety. The brain will seek maladaptive coping mechanisms to help rectify this imbalance. People quickly succumb to sedative drugs, recreational substances, tobacco, alcohol, caffeine, gambling and addictions to provide temporary relief.

Also, chronic stress causes inflammation in our vital organs and destruction of healthy tissues leading to weight gain, glucose intolerance, hormonal imbalances, fertility and libido issues, heart disease, kidney failure, arthritis, autoimmune conditions, high blood pressure, digestive issues, poor detoxification and decreased immune responses leading to chronic diseases, inflammation, infections, undernourishment, elevated toxic burden and even cancer.

The physical damage to the body by chronic stress creates another distress call to the brain trapping us in a vicious loop of ‘Fight or Flight’.  It is important to validate that the symptoms are real and the person with anxiety is truly experiencing all the physical symptoms that they express. Well wishers who expect them to ‘snap out of it’ or  tell them ‘it’s all in their head’ are not only wrong but they also make their loved one feel even more isolated and unheard. Also unfortunately for some, retelling the narrative or victim story that created the negative emotional response also resignals the brain to replay the event like a movie, this time in 3-D leading to more fear and threat signals strengthening the sympathetic tone and perpetuating more anxiety.

You want to change the genetic expression of your cells, you have to change your environment and your perception of stress. The brain reacts to what you see, feel, think, breath, sense, imagine, absorb, consume, touch and the energy from the people and things around you. When you change your surroundings and your thoughts, it changes the brain. The brain has a tremendous capacity for change, its called ‘Neuroplasticity’.

In an Integrative approach, the focus is helping the whole person by empowering them with knowledge about what is happening and why. Then guide them to becoming aware of how they perceive stress, how their body responds and their automatic reaction to that perception. Awareness is the path to wellness. Many studies support the use of mindful based stress reduction (MBSR) in patients suffering from anxiety. In addition, a focus on food as information and medicine, restoring gut health and the importance of the microbiome, modulating immune and hormonal balance, proper detoxification, a strong focus on sleep habits, time in nature and sun, regular movement and supplementation can be further steps to towards recovery. Recognizing harmful or self-sabotaging behaviors (sugar, processed salty foods, alcohol, caffeine, news media, substance abuse, sedentary behaviors, social media) and replacing them with meditation, body scans, progressive muscle relaxation, breath work, yoga, Tai Chi, finding passion & purpose, tribe, community and connection can create a life long journey to stress resilience. Persons with anxiety are more successful long term when they create a network of support through other modalities such as CBT, counseling, eye movement desensitization and reprocessing (EMDR), transcranial magnetic stimulation (TMS), mental health apps, telehealth providers, support groups, acupuncture, physical touch, hypnotherapy and bodywork. Conventional medicine is also key to the investigation of root cause. A thorough medical investigation of underlying triggers such as hormones, infections, toxins, nutritional imbalances, heavy metals, gut dysbiosis and genetic predispositions can help set the path to healing.

May is Mental Health Awareness Month. Anxiety disorders are the most common mental illness in the US and it affects 40 million Americans every year, but only a third receive treatment for their condition. Healing is a journey and proper treatment takes time, support, validation, medical therapy and resources which many with mental illness are unable to acquire in our current healthcare system.  We need to recognize health is not just the absence of disease and we need to work on building our physical, mental and spiritual wellness in a meaningful way.  We need to remove the stigma and treat anxiety as every other chronic disease such as heart disease and diabetes by providing the necessary resources, support, education, hope and empowerment to find and reverse the root cause, and then we can build healthier, productive and successful communities.

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The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Internist of the Year 2011 by the American College of Physicians Arizona Chapter and Women In White Coats Hero Award 2019.
She spearheaded a community garden in Fountain Hills, AZ and she was awarded the Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Volunteer of the Year Award 2018 by the Town of Fountain Hills. She is uniquely trained, triple board-certified and practices Integrative Pediatrics and Internal Medicine in Fountain Hills, Arizona. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

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