I used to think I was just an anxious person - that was my cross to bear - but now I know it’s not as simple as that, and I really hope this will help someone. If you know someone who suffers from anxiety, please share this with them. It can’t do any harm but it might make all the difference. This post may seem long, but it’s a question that deserves to be addressed more than cursorily. I do tend to write rather too much rather unnecessarily, but here I have made sure to keep to the essential points. It’s all important.
This post is about demystifying the underlying causes of anxiety, and getting some control back. When you feel you understand the why, you cope better, you are less distressed because you know there is a possibility that you can address it.
You may be wondering what anxiety is doing on a food blog. Well it’s very simple. My blog is about healthy food choices, but also issues relating to healthy lifestyle choices. Your diet is one piece of the jigsaw that makes up your controllable health status, and my objective is to attempt to influence my health positively, using measures I can affect directly – diet, sleep, exercise, attitude and approach to life.
I would like to preface this post with an important point.
I have suffered from anxiety for about sixteen years. Actually, I could tell you to the nearest week, so engraved in my memory is the experience of my first panic attack. And here is something of which I am certain: the person best placed to understand and help an anxious person is another sufferer – but even then, no one has the right to tell you how you feel, and no one should pretend to fully understand the experience, or tell you they know how to fix it. It is as individual as the individual, and largely impossible to communicate. So I do not for one single second claim to have the only answer to this complex issue of anxiety. It takes many forms, it has many causes. But there are reasons why something provokes anxiety in one person and not the next, and I have got a clue to what that is over this past year, for me, and I think for others too. I would have liked someone to share this with me years ago. At least then I would have had the choice to listen or to ignore.
So I would like to share the things I have learnt, and know for a fact have a serious impact on my anxiety. These are things I have come to realise through the excruciating scrutiny to which I subject my health on an hourly basis, and the insights in the many books, articles and blogs I have read almost obsessively for two years.
I have never been satisfied with the support offered to me by doctors. From the first time I set foot in a GP’s office for anxiety at the age of 19 (at that time I had no idea what was happening to me) I have been offered anti-depressants, beta blockers, and then counselling and CBT sessions (cognitive behavioural therapy). I never took any drugs, despite extended periods of what I can only describe as sheer terror and abject distress. It’s a hell I wish on no one, and one for which all fellow sufferers of any mental illness have my unconditional, unquestioning sympathy.
I could write a book about the experiences I had, how it felt, how it has affected my life over the years. There’s no point. You must just believe me when I say that it is horrendous. I am not someone who is prone to depression, but I believe whole-heartedly that the devastation to the individual is probably equatable.
I felt my anxiety was chemical. I could feel that something was happening in my body. I didn’t want drugs that would mask a problem, or maybe make it worse, so I resisted. I knew it was not the right decision for me. You might say I wasn’t desperate enough, but my anxiety has always revolved around my health, and taking any kind of drug has always filled me with dread, so that never struck me as the solution. But doctors (only limited apology for the generalisation) do love a go-to drug. Got acid reflux? Let’s not ask ourselves why, let’s just take some pills with worrying side-effects we won’t think about too much. Same with MS, I have discovered. So you have to ask yourself why. Why are you anxious? Similarly, I have had to ask myself why I might have MS. The doctors aren't asking, but I have to.
Never did anyone suggest to me that it was a physiological symptom in a way I could affect, other than through talking therapy and relaxation techniques, and I think this oversight (read neglect) was catastrophic for my general health. I don’t think it’s going too far to say that some of the health issues I developed years later are ultimately attributable to the same things that I could have addressed had I had a clue: my lifestyle choices. No one asked me about how I was sleeping, if I was getting any fresh air and sunshine, if I ate any food other than pasta, cheese and chocolate. Why not? You might say I should have known, but I did not make the link. It wasn't like, eat a bar of Dairy Milk and have a panic attack. It was the cumulative effect of bad decision after bad decision.
Now please don’t misunderstand. I am predisposed to be an anxious person, of that I am certain. But when I was a teenager I was fine. I lived with my mum who fed me well and my rhythm of life was normal. When I went to university everything changed. I started eating badly. I ate the right things but I also ate the wrongs things, a lot. I did zero exercise. I stayed up all night eating, smoking and watching films with my friends. And that’s when the anxiety appeared. After a year of uni and this unhealthy mode of living I was a different person. I had never really been ill until then. Now I was generally unhealthier. I was overweight, and I was oblivious to the damage I was doing to myself with my sugar binging and all-nighters. I was upset that I was overweight – that was the only consequence I could see. I was utterly clueless about the most basic aspects of maintaining one's health. I took my functioning body for granted, like most young people. The anxiety was a whole separate thing as far as I was concerned, and it gradually, regrettably, became a part of who I thought I was. I was cursed with anxiety, something was wrong with the wiring in my brain, and I had to live with it.
Over the next fifteen years the anxiety came and went in phases. When it was there it was always crippling. I would learn eventually to manage it for a while, and have periods free of it, and so it felt it would just change shape, morph into something else, something I didn’t recognise, and the job of learning to cope with it would start afresh. It was like it was an intelligent demon that knew me, that knew how to tap into my fear. Being scared without knowing why is the scariest thing I have ever experienced.
About six months after my daughter was born it hit a peak. I was in a state of near-constant panic. My family were horrified and no one knew what to do. Everyone thought I was traumatised by the birth, sleep deprivation, and the mysterious and apparently inexplicable physical symptoms I developed – mostly swallowing problems. It is not helpful that this symptom is recognised as axiomatically anxiety-related. But that wasn’t what is was, although, as it transpires, it is indirectly linked.
I am going summarise and say that my body was deeply affected by a combination of factors which all resulted in poor gut health. If you eat rubbish and you don’t rest, and your body is pumping out cortisol non-stop, the balance of your bacteria is affected, which has a direct effect on every aspect of your physiology. Your immune system pretty much resides in your intestines, and your gut is directly linked to your brain via the so-called gut-brain axis. Not enough nutrients, deficiencies, subsequent hormonal imbalance – it’s a cascade of physiological processes which translate to different outcomes for different people, but can often be traced back to a common set of factors.
So I know what it was. Months of no sleep, medication for severe pregnancy sickness and acid reflux, pain medication after my C–section, months of eating badly, breastfeeding and being dehydrated, and of cortisol pumping, had left me depleted. It was a chemical issue affecting my mind and I was certain of it. I just didn’t know how to fix it, then.
And the problem is that in the moment that is not the answer you want. You just want to feel calm. But there is no quick fix. When you are having a panic attack there is no point in someone telling you that you need to adjust your lifestyle, and get more exercise. At my worst I couldn’t leave the house. I came out of that fog gradually, painstakingly, and this coincided with several things I am now convinced are related, and they are all to do with how my structured my life, and how I ate.
Because I have MS I have made major adjustments to my life which I think have affected my anxiety dramatically. I know they have. Certain factors work together to the detriment of your health, and it’s a slow burn. Having a damaged gut means that I am now much more sensitive to the things which affect me negatively. Poor dietary choices can paralyse me, for example. I think I took my body to breaking point, and now a few bad nights of sleep make my life unbearable. There is a link between my MS and my anxiety, and I think there is probably a link between mental health, lifestyle and many other diseases affecting all parts of the body. I’m certain my poor lifestyle choices cost me my resilience. That has been a breakthrough for me, in terms of understanding my body and why it behaves and responds the way it does. It has to be rebuilt, and that is what I am trying to do every day.
A quick aside to say that psychological trauma is commonly believed to be a factor in anxiety. I agree, but I also think there is a reason why we all cope with stressful triggers, grief and anger differently. We build our own ability to cope with these external factors by the way we landscape our internal universe. And the sad truth is that if you have suffered a traumatic experience you can't undo that, but there are some things you very much can affect. I am certain the causes for me are combination of many, but here are those I have identified, and that I can affect.
Sugar and junk food
Sugar is the devil’s work, it’s as simple as that, and I have a rather pronounced sugar addiction, read complete lack of discipline when it comes to limiting my intake, which is pathological. The repercussions on your entire system of sugar consumption are far too profound for my basic understanding, but please look here for a list of 130 ways in which sugar is bad for you. Also look at www.Iquitsugar.com.
One of the things sugar does for you – it exports minerals from your body at an impressive rate. Couple this with a diet low in vegetables and nutrient-rich foods, and you are certain to be deficient in magnesium, zinc, copper, iron, and other vital things too, such as B vitamins. In short, you need these for everything. I have been a pescatarian since birth, and although I don't think this is the cause, I don't think it helped, when you add it to all the other factors.
Low vitamin D
I have always been a bit afraid of sunburn and sunstroke, and not fussed about lying in the sun. I thought that was good – no skin cancer for me. How uninformed I was. Vitamin D deficiency is an epidemic in countries far from the equator. It’s thought to be a major factor in MS (and surprise surprise, mine was half the recommended level when it was checked this year), and I noticed that my anxiety was often worse in the spring, when our reserves are low. It has been observed that people who attempt suicide often have low vitamin D. We should not underestimate its importance for mood, among other things.
We don’t work outdoors anymore. We hide indoors, and you just can’t get enough from food. You can barely get enough from the sun. Think about a plant that sits inside and never sees the sun. It will wither. You need to be informed about how to get enough vitamin D, but essentially you need to get about half an hour of late morning or early afternoon sun every day, on as much of your bare skin as possible during summer months, and take a supplement in winter if it’s not enough.
Lack of sleep has affected me badly for years, but I didn’t join the dots. The day never feels long enough for me, and I have always stayed up late. I didn’t realise it had a more insidious consequence that making me tired all the time. When Flora was born I didn’t sleep for three days straight and had the mother of all panic attacks. It was no longer a slow burn. The reserves I had were used up, probably the pregnancy had taxed my dwindling stores of everything, and my brain went to a place I’d hadn’t seen before. It wouldn't surprise me if post-natal depression might sometimes be a chemical problem too.
Lack of exercise
There is a logical connection between all these things. They work together to cause a chain reaction of negative habits and then effects. You will not normally meet an exercise junkie who sleeps badly and eats only junk. When your lifestyle choices are poor, they feed more poor choices. Similarly, when you exercise, your appetite actually decreases, you sleep better, you spend more time outdoors. Activities for optimal health feed into each other. You need to try and start a positive chain. Exercise is meant to be the best remedy for mental illness and the reasons are legion. But essentially, when you exercise everything works better, because your body is meant to be used, and it needs physical activity.
How good does it feel to go to the seaside, or the wide-open spaces and breathe some fresh air? If you exist between the house, the car, the train, the tube, an office with strip lighting and the glow of your phone, how can you hope to feel ok? I feel myself physically longing for the outdoors often. They say that walking barefoot on the grass can have an instant effect on your mood, and that gardeners derive huge benefits from having their hands in the soil – not just good for the soul but also through the direct contact with the earth. Good for your microbiome, your immune system, and your brain.
Why were none of these ever broached by any doctors? I have absolutely no idea, but I suspect that when you go to the doctor about something intangible like anxiety or depression, the most logical things are neglected in favour of a faster route to relief.
But they really should ask, do you eat properly, do you sleep enough, do you get enough sunshine and exercise? Before prescribing anything, everyone should start there. We are not informed about the significant effect these simple things can have, so we go searching for something more subtle, more sinister. Before taking the pills, it just makes sense to address the obvious mistakes you are making on a daily basis. Sometimes other issues will obstruct our attempts to be healthy – work, family, money, problems. Start where you can. Anything to avoid pills you don’t need. These give you a self-image you may not need to have, of someone who is dependent on medication.
The doctors will say that we must take care of our general health, and we nod and we think we know what that means, but often we don’t really get it. We’re not really taking it on board, and perhaps it’s because it’s actually a huge effort to be healthy. There’s an album by Blur entitled Modern Life is Rubbish. I think about that frequently: nowadays it’s an uphill battle to dodge sugar and processed food, to go to sleep at a sensible time with the TV and the IPad luring you from your 8 hours, and to find time to exercise. So when the doctor says that what you can do, is to make sure you eat a balanced diet, and do some exercise, and get some rest, and you nod knowingly, do you really understand?
I don’t think my anxiety is gone, but now I understand it. I don’t think I will ever be truly free of it. Once you are susceptible, I believe that channel is open and it will probably always be open, even if it’s just a crack. You know how to be anxious and it’s a capacity you can’t forget you have. But now I’m wiser about my agency in my anxiety – about the role I play in my own health, both physical and mental. I no longer eat rubbish and sleep five hours and then wonder why I feel like hell. The link between those things has become more immediate for me, and thus more obvious. If I want to be well, I need to look after myself, and that’s hard work. It requires discipline, which frankly I lack. My husband read a quote somewhere, about how to achieve optimal health: eat less, move more, relax. I love it. Let’s just all do that.