Franziska Geiser, MD
Franziska Geiser, MD, psychiatrist, department of psychosomatic medicine and psychotherapy, University Hospital Bonn, Bonn, Germany.
Medical research shows that anxiety may increase your risk of death by heart disease two to three times over, and now researchers at the University of Bonn in Germany think they know one of the reasons why. Their research discovered that people with an acute anxiety disorder tend to have higher levels of blood clotting activity than psychologically healthy people. Blood clots, we know, can cause blockages in coronary arteries, leading to heart attack.
The researchers studied 29 people suffering from panic disorder with or without agoraphobia (a fear of open spaces), social phobia or both conditions. “We chose patients with these two disorders because of their high prevalence and clear diagnostic criteria,” says lead researcher Franziska Geiser, MD, a psychiatrist in the department for psychosomatic medicine and psychotherapy at University Hospital Bonn. A blood analysis concluded that, compared with a control group of 29 psychologically healthy people, the anxiety patients showed significantly more coagulation (blood clotting) and less fibrinolysis (a process that keeps blood fluid and breaks down clots). The researchers designed the study to control for other factors, including medication and smoking.
Why does the body’s coagulation system become impaired in people with an anxiety disorder? “Anxiety activates the sympathetic nervous system with the release of catecholamines (hormones released by the adrenal glands in situations of stress). By binding to special receptors in blood vessels, catecholamines influence the concentration and activity of clotting factors in the blood,” explains Dr. Geiser.
The study results should not be interpreted to mean that people with anxiety disorder should be really worried about having a heart attack. Anxiety is a factor that increases probability of heart disease, but is not a prediction. In fact, says Dr. Geiser, “none of the patients in the study were in acute danger.”
A follow-up study shows that coagulation activation subsides in patients who have completed successful therapy for their anxiety disorder. Dr. Geiser and her colleagues treated their patients with a combination of psychodynamic and cognitive-behavioral psychotherapy (CBT). Both treatments were effective, although there’s more evidence of success with the cognitive approach.
Dr. Geiser advises anyone who thinks he/she may suffer from an anxiety disorder to seek help. “Early intervention is important because the illness impacts quality of life,” she said. The longer you live with an anxiety disorder, the less likely therapy is to help. Learning how to manage your anxiety productively will not only make life better, it may also make it longer.