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ANXIETY: A SOCIETAL DIS-EASE by Tatiana Beatriz
Worry and anxiety are feelings accumulated by not being in the present moment. They present as an attachment to a trauma or thought pattern that has become habit. The mind runs faster than rationality and one begins to feel the mental and physical stress. “Generalized Anxiety Disorder (GAD) is characterized by persistent and excessive worry about a number of different things.” (1) This feeling of worry reaches an irrational extent where one believes disaster to occur and anticipates worst case scenarios repeating in the mind related to life: health, family, work, money, stability, socializing and doing day to day tasks. With the fast pace of life generally demanded by our current society, our thoughts are presumed to race as well. This leaves us ungrounded in the present moment and in a loop of illusion.
Ayurveda is the science of life. Veda means knowledge or wisdom in Sanskrit, as Ayur means life. Life is considered the essence of combining the body, mind, soul and sense organs. (2) Thus, our senses play an eternal role in the expression of our health – physically, spiritually and mentally. With this awareness, we are granted the power of discernment and are able to decide what we let into our energetic field. What we experience and are exposed to affects our whole wellbeing. An accumulation of unwholesome factors leads to anxiety. Anxiety is thus treated through many sensory therapies in Ayurveda, working at many angles to heal as a whole.
HOW COMMON?
Anxiety is something that nearly every human experiences. The difference is in how often, how severe and how debilitating the effects are. Anxiety affects 40 million adults in the United States and 18.1% of the population every year. This is considered the most common mental illness in the United States in clear, reflective correlation to our culture. (3) The illusion of anxiety in one’s mind is debilitating; it worsens or leads to: “Depression, substance misuse, trouble sleeping (insomnia), digestive or bowel problems, headaches and chronic pain, social isolation, problems functioning at school or work, poor quality of life, suicide, …trouble concentrating” (4) and a lack of energy. Here we can see the important correlation of mental and physical health. The mind and body speak to each other as they share the same pathways of information. When we experience the loss of someone dear, the information enters the mind and is felt instantly in the heart. The pain of being left behind by loved ones in our lives causes an effect in our whole being. Within the first year of bereavement, a spouse is at higher risk for heart disease and mortality. (5) The feeling of loss repeats in the mind and ripples into the whole body leading to dis-ease if left unacknowledged and not intentionally healed.
With so many people experiencing anxiety and mental health illnesses, it is easy for symptoms to go untreated. Only about 40% of adults with mental illness conditions seek to receive treatment annually. (6) The way that the media and social media infiltrate our homes and our minds is easily overwhelming. Over stimulation of our senses leads to overwhelm in the mind. Social media specifically keeps us living in a world that is overanalyzed, thus we overanalyze ourselves. The ability to practice healthy boundaries with social media use can be the pivotal point in which we are addicted and affected versus inspired and connected. The people most associated with social media use are the youth, which in hand are predominantly at risk for mental health illness. (7) Addiction leads to anxiety and the more we train the brain to rely on something, the more dependent we are. The more time people spend on social media, the more they experience depression from living in an illusion of measurable comparisons.
BRIEF HEALING MODALITIES
In western society, the most common treatments of anxiety include psychotherapy and pharmaceutical medications. According to the Mayo Clinic, “Cognitive behavioral therapy is the most effective form of psychotherapy for generalized anxiety disorder”. (8) Beck Institute defines CBT as, “a time-sensitive, structured, present-oriented psychotherapy directed toward solving current problems and teaching clients skills to modify dysfunctional thinking and behavior.” (9)
Ayurvedic counseling helps the patient to have awareness as a student. They will gain insight to the patterns of their behavior by observation and be guided to heal these mentalities through physical, psychological, social and spiritual factors. Thus, gaining the personal power to guide their own life in a positive direction. Ayurvedic counseling gives insight on how the sensory impressions we experience completely affect our well being. Through guidance, the patient will learn about healing through food, eating guidelines, aromas, colors, gems, herbs, awareness and spiritual practice. Yoga being the union of body and mind with divine source energy, has a positive healing impact for the case of anxiety. In relation, practicing twice a week for 8 weeks, patients experienced improved moods, physical functions and higher energy levels. (10)
WHAT HAPPENS IN THE BODY WHEN ANXIOUS ?
It begins to be noticed with a shortness of breath. The focus of the mind has gotten lost in its own created world of negative stories and scenarios. One feels anxiety from many different causes yet it comes across as a state of panic & mental attack on oneself. Our brains are the command center for our bodies. The brain receives stimuli and tells the body what to do and the mind how to feel. When triggered, people with Generalized Anxiety Disorder have exaggerated amygdala activation. The amygdala retains the response and memories of emotions, fear especially. (11) When triggered, we are creating a pattern of recognition for the experience of fear. This pattern speaks to our body and translates to emotions and experiences. This is an automatic process and takes conscious action with intention to rewrite our fear triggers. The feelings of anxiety, fear, worry and overwhelm are debilitating as they keep us in a fight or flight mentality. The experience is also held onto in the mind for it is traumatic.
Physical signs and symptoms may include:
Fatigue
Trouble sleeping
Muscle tension or muscle aches
Trembling, feeling twitchy
Nervousness or being easily startled
Hyperventilation
Sweating
Nausea, diarrhea or irritable bowel syndrome
Irritability
Increased heart rate
Common anxiety signs and symptoms include:
Feeling nervous, restless or tense
Having a sense of impending danger, panic or doom
Trouble concentrating or thinking about anything other than the present worry
Having difficulty controlling worry
Having the urge to avoid things that trigger anxiety
Overthinking plans and solutions to all possible worst-case outcomes
Perceiving situations and events as threatening, even when they aren't
Difficulty handling uncertainty
Indecisiveness and fear of making the wrong decision
Inability to set aside or let go of a worry
Inability to relax, feeling restless, and feeling keyed up or on edge
Difficulty concentrating, or the feeling that your mind "goes blank"
Persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events
AYURVEDA: ANXIETY = VATA VITIATION
The elements are the building components of all physical creation. They are the natural qualities that we recognize in matter; a source of recreating balance and harmony from the excess or deficiency that we acquire in life. From most subtle to dense they are: Ether, Air, Fire, Water and Earth. These elements are the world we experience as well as our internal environment and functioning. The traits of the elements are used to harmonize each other, as like increases like and opposites create balance.
The elements have a tendency to combine in pairs to create doshas. Vata dosha is Air and Ether. Pitta dosha is Fire and Water. Kapha dosha is Earth and Water. Each element has qualities such as hot or cold, dry or moist, light or dense, flowing or stable, sharp or dull, cloudy or clear, and rough or smooth. The dosha’s qualities are reflective in our bodies and our minds. Vata’s combined qualities of Air and Ether are cold, dry, light, flowing, sharp, hard, rough & clear. Now applying these qualities to the mind in excess, translates thoughts to be frantic, unfocused, insecure, indecisive, worried, confused, passive, overwhelmed, uncertain, unrealistic, dramatic, impulsive, ruminative, and anxious.
Vata’s qualities become accumulated and the dosha is vitiated by many excessive factors: (12)
Dry, light, raw, hard, cold foods
Exposure to the cold
Iced/ cold drinks
Irregular routines
Travel
Caffeine, stimulants, drugs
Fast paced lifestyle
Sexual indulgence
Fasting
Awake late at night
Suppression of natural urges
Physical exertions
Overactive lifestyle
MIND/BODY EXPERIENCE IN AYURVEDA OF VATA VITIATION
One experiences anxiety by living in the created illusion of panic, attack and a lost sense of power. This reality infiltrates the mind and quickens the pace of life & thoughts. A fast pace reality is ungrounding and takes away a person’s ability to intentionally guide their own life. The place where we set intentions, connect to the beauty of life & humanity, and stand with confidence in who we are…is not under our feet when we are going too fast with worry hovering over our essence.
Experiencing Air and Ether qualities feels vacant, hopeless, insecure, worthless, problematic and confusing. It feels as if nothing will ever get better and one is doomed to this fate of isolation in experiencing this illness. In order for healing a Vata imbalance, one must cultivate faith. Healing the root of doubt in this experience of anxiety provides a foundation for growth and feeling secure. This security will translate to the foundation of rationality, where one will not automatically focus on possible negative outcomes or expect scrutiny.
The mind is within us, a part of us. Healing it requires coping skills to alleviate repetitive feelings of past traumas. Coping skills allow us to function beyond traumas and acknowledge the power within us to move on. A study to test the frequency of different coping mechanisms was done using the 28-item Brief COPE inventory. Out of 162 people, 34% proved to have anxiety and depression where the cross-section survey was conducted between three different health care centers to represent semi urban & rural settings of Karachi & Pakistan. Out of the 14 styles of coping mechanisms, religion (faith) was the most frequently used strategy. (13)
Dr. David Frawley explains Vata as “the basic sensitivity and mobility of the mental field. It energizes all mental functions from the senses to the subconscious. It allows us to respond mentally to external and internal impulses. Fear and anxiety are its prime emotional derangements, which occur when we feel our life force is somehow threatened or jeopardized.” (14) Stress in the mind manifests as stress in the body. With stress, we become filled with worry that inhibits our functionality.
To balance the lightness of Vata, stability is needed to bring the fleeting energy down to earth in the physical body. Here, Ojas is introduced as the “essence that gives tissues strength and endurance.” (15) This creates a protective container for the body and mind to experience optimal functioning. Immunity down to the cellular level is reflective of the health of ojas. Stability is a positive force that allows us to resist stress physically and mentally. Living with stress for a prolonged time leads to the inhibited functioning of the immune, neuroendocrine, nervous, and cardiovascular systems. (16) Rebuilding ojas is how one can overcome and heal stress, anxiety, excess sensitivity to environment (conflict, other’s emotions, intense circumstances), mental fatigue, discontent and overwhelm. Ojas is rebuilt through nourishing, calming, compassionate practices as mentioned below. Since ojas is reflective of the intake of food, it is essential to have proper digestion of these nutrients – pay special attention to the eating guidelines. With good digestion, ojas is unctuous, warming, moist, oily and stabilizing. Cultivate enough fire within to digest these heavier qualities.
SENSORY THERAPY HEALING
Just as the body is fed and releases waste, the mind requires the same treatment and nourishment. The digestive fire of the mind transforms sensory impressions into thoughts and emotions. What we take in through sight, sound, touch, taste and smell is what we become as it affects our whole essence. To heal over accumulation of harmful sensory impressions, we must first become aware of their presence in our lives. Then we begin to take action of not surrounding ourselves in harm just like one would avoid junky processed food to better their diet. To rebalance the cold, dry, etheric, mobile qualities of Vata – we must incorporate the opposite qualities of warmth, stability, nurturing, softness, smoothness, density and moisture through the senses:
Abhyanga: self or administered application of warm oils ( sesame or almond ) in a downward motion to ground energy.
Meditation:bring calmness into the mind. Use guidance to help with focus.
Connect to divinity in a way that cultivates faith and self love.
Sound: listen to calming, optimistic music or enjoy the peaceful songs of nature. Immerse in a sound bath to align with the frequency of healing.
Sight: soothing, positive visual impressions such as art, movies, nature, and environmental settings (especially one’s home).
Aromatherapy: send relaxing signals to the brain with grounding, calming scents as:
* Sandalwood, Rose, Lavender, Jasmine, Cinnamon, Chamomile, Rosemary
in the form of essential oils, flower essences, incense, fresh/ dried plant
Gems: warming, grounding, moist qualities of: Citrine, Yellow Sapphire, Yellow Topaz, Yellow Tourmaline, Pearl, Moonstone, Quartz,
Opal, Ruby, Garnet, Rose Quartz, Emerald, Jade, Green Agate
Colors: warm, soft tones of: Gold, Orange, Yellow, Green, Brown, Pink
Avoid expansive colors like: white and blue (Air & Ether)
Herbs: sweet, warming, moist, rejuvinative = Cinnamon, Ashwagandha, Brahmi, Ginger, Clove, Nutmeg, Black pepper, Cardamom,
Licorice, Marshmallow Root, Slippery Elm
Eating Guidelines:
Eat while grounded, seated and present – not while rushed, upset or stressed
Eat in peaceful settings without distractions – not while watching anything
Chew food slowly and completely to fully savor and ease digestion
Feel gratitude for the energy your food provides you
Eat complete meals rather than snacking or grazing
Tastes: Sweet = heavy, nourishing, grounding: grains, dairy, nut milk, fruit, meat, root veggies, warming spices
Sour = set stage for digestion: fermented foods
Salty = increase appetite / nutritious: oceanic foods, healthy natural salts
Pranayama: breathing to balance the channels of energy
Anuloma – Viloma (alternate nostril breathing) = use thumb and pinky to hold alternate nostrils. Inhale through one side, plug both & hold gently as a beginner, release through alternate nostril. Pause, inhale through same release nostril, gentle hold, then release through alternate nostril once again. Continue for a few minutes until the desire to build time continues. (17)
Ashwagandha is one of the most popular herbs for healing Vata in the mind. The roots are used to treat all that may be depleted in Vata vitiation: muscle, fat, bones, marrow and the reproductive, nervous and respiratory systems. The nervous system is extremely connected to the mind. The actions of Ashwagandha are tonic, rejuvinative, aphrodisiac, alterative, diuretic, nervine sedative & tonic, as well as astringent. (18) Its power to tonify and sedate the nervous system correlates directly to healing Vata in the mind.
To balance the depletion of Vata, one must nourish their body, which feeds the mind and soul. The most nourishing of substances is ghee: the product of cooking milk and water solids out of butter. It is the best substance to make herbal medicine with to heal Vata, for it has the power of taking on and enhancing the herbal qualities without losing its own. (19) Ghee itself has the ability to increase intellect, memory, digestion, eyesight, strength, semen, vitality and cure insanity in a depleted person. (20)
POSITIVE INFLUENCES OF VATA ENERGY
We are divine spirits living as humans in bodies. This simple breakdown is a reminder to breathe in our own magical essence. When we forget our own divinity and birthright to live in peace, we get caught up in the technicalities of life. We fall into the trap of overworking & over worrying. This leads us to dis-ease, illness & a negative vibration filled with many emotions. When in this state, we act against our own best interest - taking on too much, eating unhealthy, consuming substances, avoiding self-care and cultivating unrest in the mind.
The classical Ayurvedic text, Caraka Samhitā, states that the “mind and body have been described as receptacles of diseases. The soul is however, absolutely detached of all the bodily or psychological ailments. It is only when the soul is associated with the body or mind, he suffers from diseases or enjoys happiness. “ (21) As we align with our most natural spirit, we begin to guide our lives positively in the highest virtuous direction.
Although an over accumulation of Vata energy causes fearful anxiety and a debilitating reality – a balance of Vata energy expresses itself as the gift of creativity. People with Vata energy usually change interests with passion quickly, they are talkative and intellectually inclined to innerstand various points of view. They are sociable, musically / artistically / performance inclined, flexible, easily adaptable and energetic. They are creators and with the right focus and support, their greatest dreams fruit into reality.
REFERENCES:
1. Anxiety and Depression Association of America, ADAA Staff, Anxiety https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad
2. Sarah Khan & Rafeeq Alam Khan, Chronic Stress Leads to Anxiety and Depression (2017) SciMed Central, Ann Psychiatry Mental Health 5 (1): 1091
3. ADAA, ADAA Staff, Anxiety Statistics
https://adaa.org/about-adaa/press-room/facts-statistics
4. Mayo Clinic, Clinic Staff, Anxiety Symptoms & Causes
https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc20350961
5. Research Gate: Chan, Chow, Ho, A body-mind-spirit model in health: an Eastern approach (2001) https://www.researchgate.net/publication/11148479_A_body-mind-spirit_model_in_health_an_Eastern_approach
6. Bashir H, Bhat S A (2017), Effects of Social Media on Mental Health: A Review, International Journal of Indian Psychology, Volume 4, (3)
7. IBID
8. Mayo Clinic, Mayo Clinic Staff, Anxiety Treatment
9. Beck Institute, Beck Institute Staff, Cognitive Therapy
https://beckinstitute.org/get-informed/what-is-cognitive-therapy/
10. Dr. Christina Tarantola, PharmD, CHC, CHt, (2018) The Proven health benefits of Yoga and Meditation, PharmacyTimes
11. US National Library of Medicine, Staff, (2009): The Neurocircuitry of Fear, Stress, and Anxiety Disorders 19625997
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3055419/#__sec12title
12. R.K. Sharma & Bhagwan Dash, Caraka Samhita Vol V, (Maidagin: Chowkhamba Sanskrit Series Office, Varanasi -1, 2001) pg 23-24
Bhagwan Dash & Lalitesh Kashyap, Materia Medica of Ayurveda (New Delhi, India: Ashok K. Mittal Concept Publishing Company1980) 173
13. US National Library of Medicine, Staff, (2012): ISRN Psychiatry. 128672.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3658553/
R.K. Sharma & Bhagwan Dash, Caraka Samhitā Vol I (Varanasi, India: Chowkhamba Sanskrit Series Office, 1995) 41
14. Dr. David Frawley, Ayurveda and the Mind: The healing of Consciousness (Twin Lakes, WI: Lotus Press, 1997) 13
15. Dr. Marc Halpern D.C., C.A.S., P.K.S., Principles of Ayurvedic Medicine, Eleventh Edition, (2016) 111
16. Sarah Khan & Rafeeq Alam Khan, Chronic Stress Leads to Anxiety and Depression (2017) SciMed Central, Ann Psychiatry Mental Health 5 (1): 1091
17. Sahara Rose Ketabi, Idiot’s Guide to Ayurveda (Indianapolis, Indiana: DK Publishing, 2017) 114
18. Dr. Gyanendra Pandey, Dravyaguna Vijñāna Vol 1, (Varanasi, India: Chowkhamba Krishnadas Academy, 2005) 246
19. R.K. Sharma & Bhagwan Dash, Caraka Samhitā Vol I (Varanasi, India: Chowkhamba Sanskrit Series Office, 1995)
20. Dr. Christina Tarantola, PharmD, CHC, CHt, (2018) The Proven health benefits of Yoga and Meditation, PharmacyTimes
21. US National Library of Medicine, Staff, (2009): The Neurocircuitry of Fear, Stress, and Anxiety Disorders 19625997
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3055419/#__sec12title
ABSTRACTS
5. Under the division of labor of Western medicine, the medical physician treats the body of patients, the social worker attends to their emotions and social relations, while the pastoral counselor provides spiritual guidance. Body, mind, cognition, emotion and spirituality are seen as discrete entities. In striking contrast, Eastern philosophies of Buddhism, Taoism and traditional Chinese medicine adopt a holistic conceptualization of an individual and his or her environment. In this view, health is perceived as a harmonious equilibrium that exists between the interplay of 'yin' and 'yang': the five internal elements (metal, wood, water, fire and earth), the six environmental conditions (dry, wet, hot, cold, wind and flame), other external sources of harm (physical injury, insect bites, poison, overeat and overwork), and the seven emotions (joy, sorrow, anger, worry, panic, anxiety and fear). The authors have adopted a body-mind-spirit integrated model of intervention to promote the health of their Chinese clients. Indeed, research results on these body-mind-spirit groups for cancer patients, bereaved wives and divorced women have shown very positive intervention outcomes. There are significant improvements in their physical health, mental health, sense of control and social support.
11 Anxiety disorders are a significant problem in the community, and recent neuroimaging research has focused on determining the brain circuits that underlie them. Research on the neurocircuitry of anxiety disorders has its roots in the study of fear circuits in animal models and the study of brain responses to emotional stimuli in healthy humans. We review this research, as well as neuroimaging studies of anxiety disorders. In general, these studies have reported relatively heightened amygdala activation in response to disorder-relevant stimuli in post-traumatic stress disorder, social phobia, and specific phobia. Activation in the insular cortex appears to be heightened in many of the anxiety disorders. Unlike other anxiety disorders, post-traumatic stress disorder is associated with diminished responsivity in the rostral anterior cingulate cortex and adjacent ventral medial prefrontal cortex. Additional research will be needed to (1) clarify the exact role of each component of the fear circuitry in the anxiety disorders, (2) determine whether functional abnormalities identified in the anxiety disorders represent acquired signs of the disorders or vulnerability factors that increase the risk of developing them, (3) link the findings of functional neuroimaging studies with those of neurochemistry studies, and (4) use functional neuroimaging to predict treatment response and assess treatment-related changes in brain function.
13 Different individuals use different coping styles to cope with their problems. In patients with anxiety and/or depression, these have important implications. The primary objective of our study was to estimate the frequency of different coping mechanisms used by patients with symptoms of anxiety and depression. A descriptive, cross-sectional survey was conducted and patients with symptoms of anxiety and depression were identified using the Aga Khan University's Anxiety and Depression Scale (AKUADS). Coping styles were determined by using the 28-item Brief COPE inventory. We were able to recruit 162 people. The prevalence of anxiety and depression was found to be 34%. Females were more than 2 times likely to have anxiety and depression (P value = 0.024, OR = 2.62). In patients screening positive for AKUADS, “religion” was the most common coping mechanism identified. “Acceptance”, “Use of instrumental support”, and “Active coping” were other commonly used coping styles. Our findings suggest that religious coping is a common behavior in patients presenting with symptoms anxiety and depression in Pakistan. Knowledge of these coping styles is important in the care of such patients, as these coping methods can be identified and to some extent modified by the treating clinician/psychiatrist.
14 Effects of Social Media on Mental Health: A Review
From past two decade social media beheld a sporadic enhancement in quantity, quality and utility. As the body of an individual is nourished by the intake of necessary mineral elements obtained through nutrition, likewise human mind is nurtured by the availability of nutrition for thoughts. Now a day’s which is readily available through the advancement of technology, thereby opening a platform for discussion between social media and mental health of present era. From the dawn of internet and social networking sites human resources of contemporary world have become more social virtually but less practically. This virtual life is isolating present man from other fellow beings thereby affecting his health (mental & physical) and overall balance. Increased usage of social networking among adults of the present era is a matter of concern for the parents, society & researchers, as there are always two sides (positive & negative) of every innovation. The aim of present research is to explore the effect
of social media on mental health. To achieve said purpose, the investigator reviewed and synthesized available related literature. Literature summed so far reveals that younger generation operates susceptibly. As a confronting population of the present era, younger generation is experiencing embryonic stage of life and is at higher risk of serious mental health problem. Younger generation of present era is acting as active users of social media which has affinity towards the problems of mental health. The present perilous situation requires more understanding, to know relation between social media and mental health problems is just a kick off point. Exploring and understanding the means with the help of which social media is affecting mental health of present younger generation is succeeding step which can illuminate the connections which are at play among these variables of young generation.
19 Studies have found a link between chronic stress and anxiety disorders as well as major depressive disorder. This article reviews literature based on that keeping in view the physiology of stress and its consequences on psychological well-being of a person. If untreated, stress however downplayed at times, could be hazardous.
