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Posts Tagged ‘Anxiety and dementia’

A study by Baycrest’s Rotman Research Institute in Toronto, supported by the United States National Institutes of Health, found that there might be a link between anxiety and dementia. The study analyzed data from the Alzheimer’s Disease Neuroimaging Initiative that documented changes in cognition, brain structure and mental health in 376 adults, from age 55 to 91, all of whom had mild cognitive impairment related to mild memory problems such as forgetting why you went to the kitchen or forgetting where you put your keys. Over a three-year period, patients reported whether they felt anxiety, or experienced symptoms of anxiety such as shortness of breath, nervousness, shakiness or trembling. The Baycrest study found that in patients with mild, moderate or severe anxiety the risk for developing Alzheimer’s increased by 33%, 78% and 135%, respectively. The suggested reason is the higher levels of the stress hormone cortisol in people with anxiety disorders. A steroid hormone released in response to stress and low level of blood glucose, cortisol is known to damage the hippocampus that is important for memory processing and emotion.

It is already understood there is a link between depression and Alzheimer’s and the study was able to separate the effects of anxiety from those of clinical depression as they only studied patients with low depression scores. In patients whose condition deteriorated into Alzheimer’s disease, magnetic resonance imaging (MRI) detected structural changes such as atrophy in brain regions involved in creating memories and in processing emotions. It was considered unlikely the patients’ anxiety was only an emotional response to cognitive decline. Previous research on depression and emotional stress also points to shared mechanisms that could lead to or exacerbate Alzheimer’s disease.

Since anxiety medications for patients with mild cognitive impairment could interfere with sleep and dull cognitive function, researchers are suggesting lifestyle changes. Better sleep, learning a new language or dance to stimulate the synapses and mindfulness-based stress reduction. Basically to try to live in the present moment and enjoy things is what they recommend. [1] Try being the key word.

Medical Outcomes Surveys

A Medical Outcomes Survey deals with three levels of human experience and how they tie into our health and well being.

  1. Physical Health: Physical functioning, satisfaction with physical ability, mobility, pain effects, pain severity, role limitations due to physical health
  2. Mental Health: Psychological distress (anxiety and depression), psychological well-being (positive affect and feelings of belonging), cognitive functioning, role limitations due to emotional problems
  3. General Health: Energy/fatigue, sleep problems, psychophysiological symptoms, social functioning, role functioning (eg, unable to work), current health perceptions, and health distress

But how capable are we to ensure all these factors stay in a healthy range, all the time? We can see that psychological distress refers to anxiety and depression. Here are some facts on anxiety and depression from The Canadian Mental Health Association.

  • 20% of Canadians will personally experience a mental illness in their lifetime.
  • Approximately 8% of adults will experience major depression at some time in their lives.
  • Suicide is one of the leading causes of death in both men and women from adolescence to middle age.
  • Anxiety disorders affect 5% of the household population, causing mild to severe impairment.
  • Almost one half (49%) of those who feel they have suffered from depression or anxiety have never gone to see a doctor about this problem.

According to the Anxiety Disorders Association of Canada anxiety disorders are the most common mental illness affecting Canadian adults. More facts:

  • One in four Canadians will have at least one anxiety disorder in their lifetime.
  • 4% of the Canadian population experiences anxiety disorders at serious and chronic levels.
  • 58% of OCD clients experience academic underachievement.
  • 47% report occupational impairment.
  • 40% are unable to sustain long term employment.
  • The presence of an untreated anxiety disorder in youth is a risk factor for the development of depression and substance abuse in early adult years.
  • Anxiety disorders are also more chronic than other groups of mental disorders, including affective disorders and substance use disorders.
  • They disproportionately affect individuals from lower social classes.
  • Anxiety disorders are associated with a ten fold increase in suicide risk.

Stress, anxiety and our bodies

So we have large numbers of people experiencing depression and anxiety and the health, financial and social issues they can cause yet many are not seeking help. I would extrapolate that this is not just a Canadian problem. In an interesting experiment involving two silhouettes of bodies alongside emotional words, stories, movies, or facial expressions in order to see how emotions are felt in the body people were asked to colour the bodily regions whose activity they felt increasing or decreasing while viewing each stimulus. The significance of this work is in how emotions coordinate our behavior and physiological states during survival-salient events and pleasurable interactions.

The tiger strikes

Recent research is shedding some light on what stresses are doing to the body. We are not so evolved from the Hunters and Gatherers that were our ancestors, although our lives are so very different. In his article Stress -and Allostasis- Induced Brain Plasticity, Dr. McEwen explains how the brain is the key organ of stress processes. The brain has a dynamic and plastic neural circuitry that coordinates, monitors, and calibrates behavioral and physiological stress response systems in order to meet the demands imposed by particular stressors. These processes can be adaptive in the short term (allostasis -the process of achieving stability, or homeostasis, through physiological or behavioral change) and maladaptive in the long term (allostatic load -“the wear and tear on the body” which grows over time when the individual is exposed to repeated or chronic stress).

“Stress and stressful experiences have long been implicated in the etiology and pathophysiology of chronic physical and mental health conditions that now pose a great threat to public health. Historically, disciplinary variation in defining and studying stress and stressful experiences posed both methodological and conceptual challenges to the medical community’s understanding of how an individual’s health status could be affected by such complex processes over the life course. These challenges have been addressed by current perspectives, which build on recent advances in translational animal and human research and emphasize that the relationships between stressful experiences and health status depend on a dynamic interaction between genetic liability and exposure to environmental factors. This interaction begins in utero and continues until death.”

Although we are rarely trying to outrun a tiger, or take down a bison to feed the family, we still live in a state of stress based on what we perceive as dangers or as threatening. We maintain homeostasis through the allostatic adaptation to the external and internal demands that are registered by the brain.  This allodynamic adaptation comes at a cost of the wear and tear on the body and brain, which is termed the allostatic load. The allostatic responses to stressful experiences are best when they are also rapidly employed and then terminated. You climbed the tree to escape the tiger and now you can appreciate the clouds in the distance while you wait to descend. Or, the bison has launched off the cliff and you can now celebrate with your hunting comrades while your heart rate slows and you catch your breath. When the allostatic responses are prolonged and not terminated promptly, the allostatic systems undermine mental and physical health. [2]

“An important aspect of allostasis and allostatic load is the notion of anticipation…psychological states, such as apprehension, worry, and anxiety, as well as cognitive preparation for a forthcoming event. Anticipation arising from neural activity within the brain can drive the output of allostatic biomediators, and it is likely that states of prolonged anxiety and anticipation can result in allostatic load. Other important aspects of individual responses to stress in relation to allostasis and allostatic load are health-damaging and health-promoting behaviors such as smoking, alcohol consumption, sleep, diet, and physical activity, collectively called lifestyle behaviors. These may be embodied within the overall notion of allostasis—i.e., how individuals adapt to and cope with a challenge—and they also contribute to allostatic load.”

Screen shot 2014-11-14 at 9.58.59 PM

Conventional holistic view of pathogenesis showing
contributing factors of chronic disease (Dr. McEwen)
Judyann K. McNamara © 2014

Wiki defines anxiety as an unpleasant state of inner turmoil, often accompanied by nervous behavior, such as pacing back and forth, somatic complaints and rumination. It is the subjectively unpleasant feelings of dread over anticipated events. Fear is a response to a real or perceived immediate threat; anxiety is an overreaction to a situation that is only subjectively seen as menacing. Anxiety can be appropriate, but when it is too much and continues too long, the individual may suffer from an anxiety disorder. Anxiety disorders are partly genetic but may also be due to drug use including alcohol and caffeine, as well as withdrawal from certain drugs. They often occur with other mental disorders, particularly major depressive disorder, bipolar disorder, certain personality disorders, and eating disorders. Common treatment options include lifestyle changes, therapy, and medications.

How to outrun a tiger?

Again, a suggestion of lifestyle changes to remedy anxiety. I would argue who does not want to feel happy, healthy and calm! If it were as simple as making choice, would we not all just do it? Would it not be wonderful to be lit up like an orange Christmas tree as the above diagram suggests happiness feels like? Ok, so you make the choice to be happy and not anxious, yet nothing happens. So the next best idea is to seek out help. We have a problem when we go to the doctor complaining of anxiety however. How can the root cause be determined? It is obvious the cause would vary from individual to individual and it is not likely to found by blood tests, MRIs or other scans and tests when we ourselves feel that something is not quite right. So how can we help someone suffering from anxiety? It was already made clear from Baycrest’s study that treating it when a person is young can avoid serious health complications such as Alzheimer’s, atrophy in the brain, and studies suggest you could also avoid social problems, lost income and substance abuse issues. Certainly, it needs attention before it reaches the level of serious depression or of suicide. Too many people wait until there is disordered functioning of the affected organs and systems and the problem of allostatic load sets in. Then the problem is on an unconscious loop and starting to affect all parts of our life. At the very late stage when signs and symptoms indicating structural alterations in the tissues and organs appear, the doctor can finally give a definite diagnosis. [2]

Yet, what is their treatment at that late stage point? Medication or lifestyle change. So going back to the big argument, medication is their answer because most of us don’t succeed in making a lifestyle change big enough or sustained enough to save us from our own thoughts and perceptions. Yes, the tiger will likely eat me, I know it is around the corner and it probably, oddly, looks just like my boss, so I run into that scary monster five times a week. This means we are kind of up shit creek as my mother would say, since we can’t think our way out of a problem that our thoughts got us into.

Albert Einstein quote

Homeopathy can help with anxiety

In her article, the Noumedynamic Human, Judyann McNamara explains the problem of stress and anxiety and how homeopathy can help. Stress is essentially the application of or resistance to a force. “Stress, by definition, is the process through which adaptation and evolution occur in response to externally and internally driven forces. Life is movement, a dynamic interaction of forces. Stress can be environmentally induced or self-induced. Self-induced stress can be experienced as two forms: a force pushing the individual or a force resisting change or life.” [2] This comes from a homeopathic understanding of disease and health. In order to help someone with chronic disease states such as anxiety or depression, a homeopath needs to understand an individual’s processes of adaptation and susceptibilities. The causes are often found to be self-induced stress and what current research also shows is that the discrepancy between the real and the perceived in a stressed individual causes stress-related consequences on a very subtle level of biological organization. [2] This is the allodynamic component of an individual where the balance is now tipping from happy allostasis to miserable allostatic load.

Modern research now shows that mitochondria are also susceptible to physical, mental and emotional states in the person. When the individual perceives challenges beyond his or her reach, perceptions are altered, stress responses become fixed, or there is a dichotomy between the real external environment and what the individual perceives, this shows up in how the mitochondria organize themselves. [2]

Mitochondria as bioenergetic portals (McNamara)

Mitochondria as bioenergetic portals (Judyann McNamara)

“The top section of the chart illustrates a situation of optimal health and susceptibility. When the difference between the external and perceived realities are somewhat consistent, the mitochondria can coherently channel the vital field to enable to cell and the organism to adapt to changing conditions, and evolve. In this scenario, the mitochondria show themselves to be fusional, in close contact and together, as a group forming a coherent image of an underlying electromagnetic field through the alignment of their cristae. When the difference between perception and reality increases, this coherency is lost. Perhaps with this loss is the loss of adaptation, freedom of response and the possibility of evolution. When the difference reaches a certain threshold, the mitochondria change shape (balloon out) and become dysfunctional. If environmental factors are too extreme, they lose their shape completely, become pale and anemic, and begin a process that will lead to the death of the cell in which they are enclosed.” [2]

With the help of homeopathy we are able to fill in the source of both what inspires the individual and of the unhealthy delusional state that leads to disease. In order to decipher the true root cause to be addressed in chronic disease, a homeopath must understand the individual’s processes of adaptation and evolution. This is the beauty of it, the healing process can help in cases of depression, anxiety and stress without causing further harm, and all without or in conjunction with medications. The state of having the discrepancy between the real and the perceived reduced by homeopathy is difficult to describe unless it has been experienced. Einstein knew what he was talking about when he said that we can only solve our problems with a different level of consciousness than where we started with it. It requires an evolution and the mitochondria play a role in that, so does homeopathy.

~

[1] Article resource.

[2] Judyann McNamara. Montreal Institute of Classical Homeopathy

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