Adrenal fatigue

Are you wired to worry? Restoring adrenal balance to quiet your anxious mind

by Marcelle Pick, OB/GYN NP

• The physical basis of anxiety
• The vicious cycle of stress, anxiety, and worry
• Can women be born worriers?
• Turning anxiety and stress around

From what I see in my practice and from talking to people across the country, there is no shortage of anxious, worried women. And of course, we all worry — at least, from time to time. We may lose sleep over our own health or the well-being of loved ones. And it’s certainly easy to dwell on upsetting stories we see in the news.

Some worrying is okay — it helps keep you attentive and alert, and ready to tackle life’s little surprises. But if you worry obsessively and are plagued by fears and anxious feelings, everyday life can turn into a real struggle. It may even end up damaging your physical health.

Now, some compelling research suggests that certain people may even be “wired to worry” from birth, with a predisposition toward anxiety. While this is a fascinating hypothesis, what’s really exciting to me is that many women overcome this predisposition and transform their tendency to fret into a valuable asset. So let’s look at what happens in an anxious mind, and talk about ways you can calm — or re-channel — your worry.

The physiology of anxiety

All intense emotions can be hard for us to contain sometimes, and new evidence is revealing how emotions have real, physiochemical manifestations in our bodies. Fear and anxiety are central to a complex biochemical cascade known as the stress response. It starts simply enough: your brain registers a stimulus as a threat to your survival. That triggers your adrenal glands to release powerful stress hormones (adrenaline/epinephrine, noradrenaline/norepinephrine, cortisol, and others). These hormones then stimulate broad physical — and psychological — effects.

All this is only natural, and adaptive, too, as long as whatever stimulates us is resolved peacefully. But when your stress response is activated non-stop for long periods, your body will continue pumping out cortisol until it eventually spins into adrenal imbalance. I see every day how the effects of high cortisol unleash additional symptoms and related adrenal health concerns. Fortunately, we now know how to help restore healthy adrenal function, which relieves symptoms as your body returns to its natural state of balance.

It’s important to realize that anxiety manifests across a wide spectrum — as many as 40 million Americans may have anxiety disorders. But that number does not encompass the larger group of “garden-variety worriers.” For them, even though they may not have full-fledged anxiety diagnoses, life is still so fraught with fear that it affects their ability to lead happy, healthy, fulfilling lives.

Where do worry and anxiety begin?

Does our fear cause anxiety, or is it the other way around? The answer is hard to pin down because for many women these feelings create a self-perpetuating loop. We do know that both are traceable to the unknown or unfamiliar — we can have a range of responses to new or unexpected situations. A change of events that creates stress for me may never even register a blip on your worry scale. Biologists believe this variability is part of what allows populations to survive when the going gets rough. So again, the stress response is completely normal and fluctuates according to the seriousness and context of a threat.

We all know what it feels like to be frightened to death, and welcome the relief we experience as the perception of danger passes. For the chronic worrier, however, the menacing possibilities never take a holiday. By repeatedly triggering the adrenals to release stress hormones, an anxious mind keeps the body braced for peril — no matter how remote the possibility of real danger.

Some anxious women can push through their fears, though they still feel brittle, nervous, and unsettled. Other worriers find they can barely function, and are nearly paralyzed by their anxious thought patterns. When fear becomes so constant, the stress response remains stuck in the “on” position indefinitely.

Why some of us can’t “just relax!”

I’ve read some compelling research showing how, during pregnancy, stress chemicals may flood the uterine environment and influence fetal development. This means that a mother who worries throughout her pregnancy may bear a baby who’s a worrier, too. This can be a significant factor to understand and process later, when that baby grows up and wants to know why she has such an anxious mind.

There isn’t much you can do about what happened before you were born. But it’s quite clear to me that after birth, an array of post-natal factors — both internal and external — will affect your emotional “personality” and your general level of anxiety.

Friends and family may be tempted to tell a worrier to “calm down” or to “just get over it.” But a series of longitudinal studies — ones that follow people for years — imply that some people have brains that are wired to worry from birth. They experience life as a relentless stream of “fear gone wild,” with their minds pulsing out signals to the body to respond with the physical expressions of fear (see symptoms box). They’d probably like to stop feeling anxious, but feel as if they can’t escape the tendency.

Now certainly, even born worriers encounter real danger in their lives. But overwhelmingly, intensive worry springs from a perception that something is threatening.

Let’s say you’re invited to a fancy party, to be attended by dozens of important people you’ve never met before. Others might see this as exciting, or a challenging opportunity, or just plain fun. But for a woman with an anxious mind, such an invitation might bring on tremendous dread: How can I possibly make small talk with all those strangers? What if I say the wrong thing? What am I going to wear!? A born worrier might be so nervous and uneasy about this event that in the end, she won’t even go.

While some research helps explain why some of us worry more than others, related science shows how, remarkably, women with anxious minds are often able to turn what at first seems like a handicap into a strength. And I’ve seen myself how many worriers acquire strong coping skills that help them become productive and lead fulfilled lives.

Research that surprised even the scientists

Years ago, a noted developmental psychologist, Jerome Kagan, was intrigued by the idea that some babies seemed jumpier and more fretful than others from the minute they were born. So he set out to identify, measure, and chart the physical signs of anxiety in infants and children. Then his team followed these children into early adulthood, drawing links between the early findings and the participants’ grown-up behaviors and emotional quality of life.

Kagan hypothesized that those who were “highly reactive” as babies might have come into the world with exaggerated physiological responses to stress, caused partly by genetic influence or perhaps by exposures to large amounts of stress chemicals while in utero. These children could be born with lower thresholds for arousal in several areas of the brain, including the amygdala, the hypothalamus, and the cortisol-producing hypothalamic-pituitary-adrenal (HPA) axis. Significantly, the amygdala is often called the “nut of worry” because it’s the processing center for worry and fear, two of our most primitive emotions.

Studying babies and preschoolers, Kagan and his colleagues found that 40% were on one end of the scale: calm and low-reactive in response to new things. Another 40% fell somewhere in the middle of the spectrum, but 20% of the study subjects were “highly reactive” when presented with new stimuli. This group cried and fretted more, and had increased heart rate, respiration, and blood pressure.

Anxious temperament persists as subjects get older

Kagan kept checking in with the study participants until they were 15, and found that their original temperament patterns persisted as the kids got older. Other scientific studies had similar results. When Kagan’s study subjects turned 18, his research successor, Carl Schwartz, conducted MRI scans, which uncovered some interesting characteristics in the brains of the participants.

The “high reactors” had brains with prefrontal cortices that were significantly thicker than those of the “low reactors.” The prefrontal cortex has inhibitory qualities and also regulates emotion, so researchers thought these differences were important.

They theorized that the prefrontal cortex may have thickened as a result of, or in response to, hyperactive signaling from the amygdala. Or, perhaps the thicker cortex might be a sign of a tendency toward anxiety. But in the end, Schwartz proposed that the thicker prefrontal cortex might instead be a protective mechanism — an adaptation that helps some high reactors function better than others by blocking anxious emotional input.

When jittery babies grow up

Can early exposure to stress hormones shape your behavior and personality as an adult? Well, yes and no. There is a subset of people who grow up to have life-altering problems with anxiety. They may develop mental and physical health concerns such as addiction to alcohol, food or drugs; or engage in negative behaviors like denial and procrastination; or be inclined to blame others or “play the victim.” Other people gravitate toward stressful occupations or perilous pastimes because crisis has become the norm for them. They may be “hooked on adrenaline,” and only feel truly alive when their stress hormone levels are sky-high.

But a predisposition to hair-trigger adrenal glands doesn’t predestine a little girl to have an anxiety disorder when she grows up. Yes, early stress may “mark” our genes, programming us to release more stress hormones more easily. But fortunately, even the “born worrier” is influenced and shaped by a whole host of factors apart from genetics and hormones. The whole of your life experience — the hills and valleys you climb and cross — will act upon your temperament and shape your resilience. Some researchers believe “emotional intelligence” has tremendous influence as well.

Did you grow up in a stress factory?

Family environment can temper — or exacerbate — a child’s anxiety. Studies of children who have experienced neglect and high stress before adoption show the power of a positive relationship between a child and the adoptive parent. Calm, nurturing parents can make a worrier feel safe at home, and this may help offset a child’s worrying traits, behavior, and emotional health throughout life. But sometimes a patient will assure me that she had a happy childhood, while her obvious symptoms of anxiety — and her adrenal stress testing — suggest a different story.

Even loving parents may overdo it by fretting about every mundane detail of their children’s lives. Being overprotective or generally fearful of the world transfers any parental anxiety directly onto the child, which just magnifies the inborn tendency to worry. It also boosts adrenal output by overstimulating the stress response.

It may also color the child’s relationship with a parent by setting in motion unhealthy “negative love” patterns. In my experience, every anxious patient I have treated has had a childhood issue that needed to be resolved. So I encourage all women struggling with the tendency to worry to cast a long look into their upbringing, to acknowledge and heal any old wounds from childhood.

Turning an anxious mind into an asset

There is a decidedly bright side to the anxious mind. Worriers tend to lead examined lives, with keen insight into the way they think. If motivated to learn what sets them off, this awareness may help improve their ability to manage anxiety and stress. Once a worrier can step back and observe her thought patterns more objectively, she can often reframe negative self-perceptions as affirmative attributes.

Those who are “wired to worry” often develop unique and useful qualities that show up in the workplace. Worriers are usually conscientious, thorough, and well-prepared. They’re generally careful and thoughtful workers, with good planning skills, and sharp attention to detail.

Those with anxious minds often work well alone, and have a sense of inner-directedness that makes them good at jobs like writing, scientific research, and computer programming. Some employers actually seek out “worrying” personalities because they are usually deeply concerned about accuracy and following protocol.

Feeling better, feeling balanced

Even if you are wired to worry, you can learn not just how to cope, but how to make the most of your behaviors and traits. Appropriate emotional and physical support can help relieve the anxious feelings, perceived stress, and other symptoms of adrenal imbalance that can make it hard to complete everyday tasks.

When I notice anxiety in a patient, I always look at her adrenal function. If symptoms warrant, I may recommend treatments for adrenal imbalance, such as targeted nutrients and other measures to help her recover balance. When a woman realizes there may be an adrenal connection to her anxiety, she can let go of any guilt she may be dragging around. Then she can shift her focus toward feeling better and getting back into the swing of life.

Once a woman steps onto the path toward reducing anxious feelings, her body will respond in kind. Over time, as a woman learns to manage anxiety, stress, and worry, her adrenal glands won’t need to produce sustained, high levels of stress hormones. Her biochemistry will eventually return to a more balanced state, supporting her physical and emotional calm.

Nurturing and anxious mind, body and spirit

Because the body and mind are forever linked, physical wellness helps provide a firm foundation for your emotional health. Plus when you know you are healthy, you have one less thing to worry about, so healthy lifestyle and optimal nutrition play important roles. Nutrients are crucial to a body and mind under stress, so a high-quality multivitamin/mineral supplement and eating to support your adrenal health are indispensable for stabilizing adrenal function.

Some additional tried and true tips for “born worriers”

• Maintain supportive friendships— even if it’s just one or two.
• Find your niche. When you discover that one thing at which you excel, it’s incredibly satisfying and will do wonders to build your confidence. Feeling comfortable about what you do can help banish anxiety, fretting, and fear of failure.
• Your anxiety may be tangled up in old beliefs and feelings. Consider undertaking emotional work to help you identify and let go of any thoughts and perceptions left over from earlier days. (See our articles on emotions, health and stress to explore options).
• Practice deep breathing to calm your nervous system, especially when you first notice anxiety. Simply taking “five deep breaths” will help bring you back to center.
• I often recommend short, timed periods of meditation (even as little as 1-5 minutes, once or twice a day) to help restore peaceful balance to the nervous system. Try it!
• Take up regular exercise. Physical activity relieves tension and nervous energy and, regularly practiced over time, can lessen your tendency to be anxious. It can also ameliorate insomnia caused by adrenal imbalance — and a good night’s rest acts as an effective tonic for worriers.

Remember, even if you are someone who’s “wired to worry,” you’re not predestined to a life of high anxiety. Becoming more aware of situations and issues that cause you worry can help you head off stress and unpleasant symptoms of adrenal imbalance. Appreciating that your anxious mind might even be an asset could be your first step toward creating a calmer, more fulfilling life.

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References & further reading about women wired to worry

 

Original Publication Date: 10/19/2009
Last Modified: 02/16/2010
Principal Author: Marcelle Pick, OB/GYN NP