QUESTION

I have anxiety, and sometimes I get panic attacks. Could anxiety actually give me a physical illness?

ANSWER

Anxiety can indeed make you ill—literally ill, beyond the anxiousness that you feel. But you can take steps to keep that from happening. Of course, a certain amount of anxiety is normal—and useful. Being anxious before a job interview, when making an important decision or if you’re walking in an unsafe neighborhood is a good thing. It keeps you alert and makes you more careful. But chronic feelings of fear, nervousness or worry…dwelling on troubles or difficulties…and even frequent nightmares and other such symptoms can lead to serious health problems. That’s because those feelings create stress that affects your whole body physiologically—including your hormone levels, cardiovascular system, immune system, digestion and metabolism. For example, a chronically elevated heart rate and high blood pressure (both common effects of anxiety) increase your risk for heart attack and stroke. Chronic high levels of stress hormones such as cortisol suppress your immunity, making it easier to catch a cold or get an infection or even a serious disease such as cancer. Steady elevated cortisol also leads to reduced insulin sensitivity and perhaps eventually to diabetes. And it can affect thyroid hormone production, which can change your metabolism and lead to weight gain. In fact, people who have been diagnosed with an anxiety disorder have a higher risk for a physical illness—for instance, they can be as much as 44% more likely than people without an anxiety disorder to have irritable bowel syndrome. Research also shows that anxiety disorder frequently precedes the onset of migraines. Of course, the anxiety-physical ills connection is a two-way street—being diagnosed with a serious condition such as cancer, heart disease or diabetes can trigger an anxiety disorder. In fact, an estimated 40% of cancer patients develop anxiety, panic attacks and/or depression. Caretakers of people with serious illnesses are also at increased risk for anxiety and depression. The good news is that anxiety can be treated—and tamping down this mood disorder can also help you avert a physical health problem. One especially effective approach is cognitive behavioral therapy (CBT). CBT is a problem-solving approach that involves working with a trained therapist to identify particular patterns of anxiety and practicing ways to change thoughts and behavioral responses to the anxiety triggers. Most people see results in 12 to 16 weeks of weekly therapy sessions. Exposure therapy, a type of CBT, is very effective for people whose anxiety is caused by a specific fear or trauma. As the name suggests, patients are exposed at gradually increased levels and amounts of time to what frightens them while they are in a “safe” environment, which helps them to retrain their brains to not fear that something “bad” will happen. They also learn that because they are feeling the symptoms of anxiety—such as a racing heart and shortness of breath—doesn’t in reality mean that they are in actual danger. Other approaches to anxiety include biofeedback, meditation or even regular exercise. Of course, medications are a good option for some, so discussing concerns about anxiety with a health-care provider is always a good idea. Read Bottom Line’s “Beat Social Anxiety Disorder with Cognitive Behavioral Therapy”…“If Anxiety Interferes with Good Sleep, Consider L-Theanine”…and “Guide to Drug-Free Ways to Calm Anxiety” for more about anxiety and treatments that work.