What Everyone Should Know About Stress & Anxiety

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We’ve all experienced it: a pounding heart, tensed muscles, a slight flush, a surge of adrenaline, throbbing head, and a feeling of impending doom. It is your stress response reacting to a perceived threat. Our ancient ancestors relied upon their stress response to quickly get them out of harm’s way of predators or enemies. And, if you’re reading this, it worked very well for them. The stresses we experience today are benign by comparison. Bills and deadlines have replaced prowling predators and enemies. And, although they may not pose a threat to life or limb, our perception of modern stresses still elicit a life or death response. The stress response meant to last just long enough to get us out of danger now remains activated longer. The prolonged activation of our stress response produces several impediments to our health and well being. These are the tools you can use to keep stress and anxiety from consuming you.

What is Stress?

Stress is the perceived disconnect between a situation and the resources needed to manage that situation. Our response depends on our perception of how bad the problem is and how well prepared we are to deal with it. In other words, stress is subjective.

Our reaction is often disproportionate to the stressor. Whether activated by a letter from the IRS or a hungry lion, our stress response reacts the same way. The hypothalamus signals the pituitary gland, which secretes a hormone that, in turn, signals the adrenals to produce adrenaline and cortisol. Cortisol signals the body to make every ounce of stored energy available while sharpening awareness and deactivating non-essential systems like digestion and reproduction so that the body can focus solely on the threat. After all, you’re not likely going to want to eat or have sex when a lion or the IRS is charging at you.

Adrenaline increases heart rate and blood pressure, expands air passages of the lungs, and triggers blood vessels to redirect blood towards major muscle groups to facilitate the movement needed to run from the IRS or confront the lion. The entire process occurs in less than a second and is aptly named the “fight or flight” response.

Stress and the ECS

Our stress response is intimately connected to the endocannabinoid system (ECS), a collection of specialized neurotransmitters and neuroreceptors located throughout the body and brain. Although research is limited, evidence suggests that the ECS also regulates many other bodily processes, including the immune system, communication between cells, mood, sleep, appetite, and memory.

After a stressful event passes, the ECS signals the stress response to stand down by inhibiting the production of an enzyme that degrades anandamide, an endocannabinoid fittingly nicknamed the “bliss molecule”. As cortisol and adrenaline levels drop, blood pressure and heart rate return to baseline, and all other systems resume normal function. In short, the human body can mitigate the effects of acute short-term stress and calm itself naturally.

Chronic or long-term stress from increased workloads, financial troubles, or family issues results in the extended release of cortisol. The stress response intended to save your life works to shorten it. It keeps blood pressure elevated, taxes the cardiovascular system, weakens the immune system, impairs digestion, and disrupts sleep patterns. Chronic stress also downregulates the ECS. So the systems that generally oppose or buffer stress responses stop responding (deRoon-Cassini et al., 2020). When the ECS is downregulated, fatty acid amide hydrolase (FAAH) — the enzyme that degrades anandamide — persists unabated. The uninhibited production of FAAH creates a deficiency of anandamide, which prevents the body from calming itself. According to recent research, anandamide deficiency contributes to anxiety. (Bluett et al., 2014).

Anxiety

Anxiety is the unpleasant feeling of apprehension, tension, nervousness, overwhelm, and worry usually caused by anticipation of risk, danger, or unknown situation (de Mello Schier et al., 2014). It is the feeling of dread that keeps our minds racing and prevents us from falling asleep. Nearly 20% of the U.S. population suffers from anxiety disorders (Facts & Statistics, n.d.).

Anxiety and anxiety disorders are typically treated with a combination of psychotherapy and medications. Despite being treatable, many individuals with anxiety disorders do not seek treatment or, worse, self-medicate (Papagianni & Stevenson, 2019). The most common challenge is compliance — the patient’s ability to continue treatment. Health insurance rarely covers the full amount of mental health copays or prescription drugs, making treatment cost-prohibitive. Additionally, some anti-depressants leave patients feeling “dull” or “flat” while benzodiazepines cause sedation and lethargy. Instead of feeling relief from anxiety, many patients don’t feel at all. Benzodiazepines also carry the risk of dependency, and weaning is a very long and deliberate process that must be supervised by a physician. Simply quitting cold turkey can be fatal.

Ways to Reduce Stress and Anxiety

One of the best ways to mitigate anxiety is by exercising. Your body created the energy and prepared itself to use it in the most efficient way possible. Why not use it?

Engaging in exercise creates both physiological and psychological reactions. Exercise diverts your mind from the very thing that was causing you anxiety. After extended periods of exertion, the body releases hormones called endorphins that act as pain killers to quickly calm the body and mind while also creating a sense of euphoria. Athletes refer to it as “Runner’s high.” Experts say that the therapeutic benefit of exercise to treat anxiety is better than anxiety medication. A simple bike ride, dance class, or even a brisk walk can be a powerful tool for those suffering from chronic anxiety (Ratey, 2019).

Although exercise may be as good as or better than anti-anxiety medications, constraints imposed by jobs, health, family responsibilities, or other obligations might make it impossible. Military and law enforcement personnel face the same challenge while holding one of the most stressful jobs. Repeated and sustained activation of the stress response is frequent, and triggers are anything but benign. Soldiers and officers alike face life or death situations almost routinely. Even when the threat passes, a state of hypervigilance prevails, and the stress response remains activated. Few have the luxury of exercising to reduce stress and anxiety on a whim. Most practice a form of meditation called “tactical breathing” as a practical alternative.

Tactical breathing is a fantastic way to remain grounded and forced amid stressful situations. The straightforward approach to mindfulness draws from yoga but lacks any intentional movement. And it is easy. These are the steps:

• Breathe in slowly through your nose for a count of four.
• Hold your breath for a count of four.
• Exhale slowly through your mouth for a count of four.
• Hold for a count of four.
• Repeat 3–5 times, visualizing each number as you count.

Meditation carries the added benefit of improving focus and concentration, raising self-awareness, reducing negative emotions, and increasing imagination and creativity. With practice and repetition, meditation also enhances awareness of the situations that cause stress or anxiety. Mid-day meditation is also a great way to combat the afternoon slump. Instead of having another cup of coffee, take a meditation break.

Leave My Coffee Alone!

Many of us would wander aimlessly through the day without our morning cup of coffee. Thankfully, a cup of coffee offers many health benefits. Caffeine, in moderate quantities, stimulates the central nervous system. It boosts the production of serotonin, dopamine, and noradrenaline, which elevate mood. However, caffeine in excess can also be detrimental to your mental health. It increases anxiety by inhibiting the effects of adenosine and promoting adrenaline. Adenosine is a chemical produced by the body that regulates digestion and energy production. During digestion, food breaks down into glucose and adenosine triphosphate (ATP). ATP is the energy we use for synaptic signaling and muscle contraction. Your heart, the muscles around your eyes, arms, and fingers are using ATP to read and scroll through this article right now. Once used up, ATP breaks down further to adenosine, which serves as a chemical signal for our body to sleep and restore energy reserves. Blocking adenosine prevents you from feeling tired and significantly slows the replenishment of ATP energy reserves.

Minor changes in diet can also substantially reduce anxiety, especially long term. Specific ingredients in various foods and drinks can both positively and adversely stimulate your endocannabinoid system. For example, Echinacea, most commonly used to fight the common cold, contains cannabinoid-like compounds that interact positively with our endocannabinoid system to inhibit the production of FAAH (Sarris et al., 2013). Chocolate high in cacao may also inhibit the production of FAAH. But keep an eye on the sugar content since processed foods and refined sugars are internal stressors that stimulate FAAH production (Martin et al., 2012).

With the rising cost of prescription medications and their potential side effects, individuals who suffer from anxiety often explore herbal alternatives and other natural remedies to manage and treat psychological conditions. Most patients appreciate the opportunity to try something natural and avoid psychiatric medication use (Shannon et al., 2019). Recent research into plant-derived cannabinoids shows the potential for relieving anxiety. For example, CBD works with the ECS to ease chronic stress symptoms and anxiety by inhibiting the release of FAAH (Mechoulam et al., 2007). Some research even suggests that given the relatively safe profile of cannabis-derived compounds compared to conventional medication, CBD and specific terpenes found in cannabis may serve as a potential complementary treatment or even replacement for traditional anxiety medications (Leu, 2020). More research is needed to clarify possible long-term risks and harms. But CBD appears to be better tolerated than common psychiatric drugs (Shannon et al., 2019). As with any change to your health routine, it’s always wise to consult with your physician or healthcare provider before making any changes.

Stress and anxiety are a normal part of life. However, our health depends on how well we manage stress. Regular exercise remains the best treatment for stress and a natural preventative to anxiety. Meditation, breathing exercises, diet changes, and natural remedies are also useful in mitigating the effects of stress. But, unmanaged stress can lead to anxiety. And, just like a hungry lion, anxiety can interfere with living an everyday, happy, healthy life.

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Citations

Bluett, R. J., Gamble-George, J. C., Hermanson, D. J., Hartley, N. D., Marnett, L. J., & Patel, S. (2014, July). Central anandamide deficiency predicts stress-induced anxiety: behavioral reversal through endocannabinoid augmentation. Translational Psychiatry, 4(7), e408. 10.1038/tp.2014.53

de Mello Schier, A. R., Oliveira Ribeiro, N. P., Coutinho, D. S., Machado, S., Arias-Carrión, O., Crippa, J. A., Zuardi, A. W., Nardi, A. E., & Silva, A. C. (2014). Antidepressant-like and anxiolytic-like effects of cannabidiol: a chemical compound of Cannabis sativa. CNS & neurological disorders drug targets, 13(6), 953–960. 10.2174/1871527313666140612114838

deRoon-Cassini, T. A., Stollenwerk, T. M., Beatka, M., & Hilliard, C. J. (2020, October). Meet Your Stress Management Professionals: The Endocannabinoids. Trends in Molecular Medicine, 26(10), 953–968. https://doi.org/10.1016/j.molmed.2020.07.002

Facts & Statistics. (n.d.). Anxiety and Depression Association of America. https://adaa.org/about-adaa/press-room/facts-statistics

Leu, R. (2020, July 16). Exploring the Role of Cannabidiol-Monoterpene Formulations in Modulating Anxiety Symptoms.” Electronic Thesis and Dissertation Repository, (7090). https://ir.lib.uwo.ca/etd/7090

Martin, F.-P. J., Antille, N., Rezzi, S., & Kochhar, S. (2012, June 20). Everyday Eating Experiences of Chocolate and Non-Chocolate Snacks Impact Postprandial Anxiety, Energy and Emotional States. Nutrients, 4, 554–567. doi:10.3390/nu4060554

Mayo Clinic. (2019, March 19). Chronic Stress Puts Your Health at Risk. Mayo Foundation for Medical Education and Research. www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037

Mechoulam, R., Peters, M., Murillo-Rodriguez, E., & Hanus, L. (2007, September). Cannabidiol — Recent Advances. Chemistry & Biodiversity, 4(8), 1678–1692. PubMed. 10.1002/cbdv.200790147

National Institute of Mental Health. (n.d.). 5 Things You Should Know About Stress. U.S. Department of Health and Human Services. Retrieved September 14, 2020, from www.nimh.nih.gov/health/publications/stress/index.shtml

Papagianni, E. P., & Stevenson, C. W. (2019, April 27). Cannabinoid Regulation of Fear and Anxiety: an Update. Current Psychiatry Reports, 21. https://doi.org/10.1007/s11920-019-1026-z

Ratey, J. J. (2019, October 24). Can exercise help treat anxiety? Harvard Health Publishing. https://www.health.harvard.edu/blog/can-exercise-help-treat-anxiety-2019102418096

Sarris, J., McIntyre, E., & Camfield, D. A. (2013, May 8). Plant-Based Medicines for Anxiety Disorders, Part 2: A Review of Clinical Studies with Supporting Preclinical Evidence. CNS Drugs, 27, 301–319. DOI: 10.1007/s40263–013–0059–9

Shannon, S., Lewis, N., & Hughes, S. (2019, January 7). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente Journal, 23(18–041). 10.7812/TPP/18–041

Zuardi, A.W., de Souza Crippa, J.A., Hallak, J.E.C., Campos, A.C., & Guimarães, F.S. (2017). Chapter e13 — The Anxiolytic Effects of Cannabidiol (CBD). In Handbook of Cannabis and Related Pathologies: Biology, Pharmacology, Diagnosis, and Treatment (pp. 131–139). Academic Press. https://doi.org/10.1016/B978-0-12-800756-3.00097-1