Introduction to Anxiety and anxiety disorders
According to APA (American Psychological Association), anxiety can be defined as “an emotion which can be characterized as worrying thoughts, feelings of disturbance and tension, leading to physical changes which increase blood pressure or cause any other physiological change.”
In order to identify the difference between anxiety disorders and anxiety, it requires special attention to the medical record and condition of a patient for correct and precise diagnosis.
In this article, we will discuss anxiety, types of anxiety, causes, and treatment with inositol.
Anxiety is not always a medical condition unless it causes distress. When any individual potentially feels worrying or faces harmful triggers, in such cases, anxiety is not only normal but also vital for survival.
Since ages, a danger system inside the body alarms about the situation and lets a person take evasive action. These alarming signs become apparent when a rise is seen in a heartbeat, increased surrounding sensitivity, and increased sweating. When the body is in danger, it releases a rush of adrenaline, which is a chemical messenger present in the brain. The function of adrenaline is to trigger the anxious and conscious reactions in sympathetic processes as “fight or flight responses.” This process of consciousness helps in preparing a body to have safety from potential harms and confront the danger.
Anxieties can prevail anywhere, around work, in family life, money-related situations, health, and other important conditions which require the attention of individual without conscious (fight or flight) response.
In our daily life, we sometimes feel a nervous feeling or anxiety before any important event or any situation, which is a natural response to flight and fight reaction. This feeling is yet important for human survival.
What are Anxiety Disorders?
American Psychological Association described anxiety disorder as “recurrent episodes of intrusive concerns and thoughts.”
The duration of anxious feelings or severity of anxiety can sometimes get out of appropriate proportion to actual stressors or triggers. These triggers can end in the form of physical symptoms as nausea, hypertension, and other conditions. Once an episode of anxiety reaches to the stage of a specific disorder, then it can specifically interfere with daily life and functions.
Symptoms of Anxiety and Anxiety disorders:
Generalized anxiety disorders can constitute a variety of diagnoses, but generally, the symptoms associated with this disorder are:
• On-edge feeling and restlessness.
• Worried feelings
• Increase in behavioral irritability
• Difficulty in perception and concentration
• Difficulties with sleep as falling asleep or staying asleep.
Sometimes, these symptoms are normal to daily life experiences, but often, people can experience them to extremely persistent levels. Generalized anxiety can sometimes be vague, or cause severe and unsetting worries which can disturb the quality of daily life.
Types of anxiety disorders:
DSM-V (The Diagnostic and Statistical Manual of Mental Health Disorders – 5th edition) has classified anxiety disorders in various kinds.
Previously, in older versions of DSM, OCD (disorders), PTSD (post-traumatic stress disorder), and acute stress disorders were included. However, new editions or manuals no longer include mental health difficulties under the diagnosis of anxiety.
Following are the anxiety disorders which are now included in newer versions of definitions:
• GAD (Generalized Anxiety Disorder):
GAD is a chronic disorder that involves long-lasting anxiety, excessive worries about non-specific life events, situations, and objects. The most prevalent type of anxiety is GAD, and people suffering from generalized anxiety disorder are not always able to identify the exact cause of their anxiety.
• Panic disorders:
Sudden or brief intense apprehension and terror attacks characterize the panic disorders. These episodes of symptoms may lead to difficulties with breathing, nausea, dizziness, shaking, and even confusion. Panic attacks occur rapidly and can escalate instantly after reaching a peak within 10 minutes of the attack. In some cases, a panic attack can also last for a longer time from minutes to hours.
Usually, panic disorders occur post-traumatic or frightening experience, or it may occur as a result of prolonged stress even without any specific trigger. An individual suffering from panic disorder may misunderstand the attack as a life-threatening experience or illness, which can cause some drastic changes in behaviors leading to attacks in the future.
Avoidance of a particular situation or any particular object and irrational fear of something is referred to as a phobia. Phobia is not like anxiety and anxiety disorders; rather, they are associated with some specific trigger or cause.
An individual suffering from a specific phobia can perceive it as illogical fear or an extreme inability to control the anxiety or response when around the trigger. The triggers associated with phobias can vary or range from everyday objects, animals, and even different situations.
• Selective mutism:
A form of anxiety that can persist among children. Selective mutism refers to an inability to speak in the context of specific environments and places as schools or gatherings. Children suffering from these disorders may have excellent verbal communication skills in real life, but they can not express them in specific situations. Selective mutism can be a form of extreme social phobia.
• Separation anxiety disorder:
Type of anxiety disorder in which high levels of anxiety feelings prevail after separation from a specific situation, place, or person which used to provide a sense of safety or security. This type of separation can lead to different panic symptoms.
Causes of anxiety disorders:
Anxiety disorders can have a complicated network of different causes which include:
• Chemistry and reactions in the brain:
Different traumatic or stressful experiences, in combination with various genetic factors, can cause alterations in the structure of the brain and the case brain to react vigorously and cause anxiety. Neurologists and psychologists define the term anxiety as hormonal disruptions, disturbance in electrical brain signals, and mood disorders.
Individuals having a family history of anxiety disorders are prevalent for developing anxiety disorders in themselves.
• Medical factors:
Different medical conditions may lead to various anxiety disorders as some severe underlying pathology or medical condition, disease symptoms, and medications’ side-effects, which can or cannot directly trigger the changes associated with anxiety disorders and cause significant adjustments in lifestyle, restricted movements, and pain.
• Environmental factors:
Different factors or elements persisting in the environment can cause an increase in the anxiety of an individual. Stress coming from some specific personal relationship, financial difficulties, school, and jobs can significantly contribute to anxiety and different disorders. Low levels of oxygen in areas of high altitudes can add to symptoms of anxiety.
• Withdrawal from substance use:
In the period of rehabilitation from substance abuse can also lead to anxiety symptoms, which refer to withdrawal symptoms. These factors contribute to anxiety disorders.
Disproportionate anxiety may result from one or a combination of different causes, as mentioned above.
Treatment of anxiety and anxiety disorders with Inositol:
Inositol is a compound, commonly referred to as myo-inositol, which is found in many foods. Inositol is sometimes placed into the Pseudo vitamins category. These vitamins are vital for several functions of the body. Inositol is referred to as vitamin B8. Different biological processes support inositol. The main functions included are:
• Signaling of insulin
• Nerve functioning
• Fat metabolism.
Inositol can be used as a supplement or treatment for different mental health conditions as depression and anxiety. Inositol supplements are capable of enhancing the mood positively.
According to a study conducted for a period over 4 weeks, a connection was established between symptoms reduction (related to anxiety and panic disorders) and inositol. Another study also confirmed a decrease in anxiety and OCD symptoms in response to inositol supplementation. In the case of inositol supplementation, it is essential to notice that a high dose of inositol was used in these studies to achieve the required results.
One study conducted on comparison of inositol supplementation and fluvoxamine was done, which showed the results that larger dosages of inositol (18 grams) were found to be more effective in anxiety and panic disorders than commonly suggested medicine fluvoxamine for anxiety treatment.
Regarding anxiety and mood disorders, levels of serotonin are essential to be noted. Most of the people do not suffer from inositol deficiency as It is present in several food items as wheat, beans, nuts, and cantaloupe.
According to scientific research reported in The Journal of Clinical Psychology conducted by Ben Gurion revealed that inositol is useful for the treatment of anxiety disorders, which include panic disorders and OCD.
Dosage of inositol:
• Most often, the recommended dosage of the inositol is 500 mg, which is to be taken twice a day. For the treatment of anxiety, panic disorders, and depression, the dosage can increase to 12 to 18 grams per day. If an individual is suffering from anxiety and OCD, then he/she should refer to some consultant for inositol supplementation while taking SSRI anti-depressants.
• The standard dosage in dietary supplementation is 3 grams each day.
• For the treatment of clinical anxiety and depression, the standard dosage of inositol is 12 grams per day.
• For the OCD (obsessive-compulsive disorder), the dosage should be higher as 18 grams per day.
The type of inositol is also vital for the dosage.
Inositol is available in two forms:
• Powder inositol
• Soft gel inositol
Only 30% of the inositol dosage is required for achieving the expected results in comparison with the necessary dosage in powder form.
Dosage of inositol in gel form can reduce to 4.2 to 5.4 grams in soft gel form, from 14 to 18 grams of dosage in powdered form.
Mechanism of action of inositol:
Inositol is a non-essential vitamin that can be found naturally in the body. The structure of the inositol is the same as that of glucose, and it can usually be found in food.
According to statistical data and evidence, inositol plays a vital role in the neurotransmission of CNS (central nervous system). Studies show that inositol can help in increasing the function of GABA-A receptors, which can increase the sensitivity of serotonin receptors, which work similarly to those medications which are used for anti-anxiety purposes as anti-depressants SSRIs (selective serotonin reuptake inhibitors) and benzodiazepines.
Levels of inositol are comparatively less in people with neuropsychiatric conditions as compared to normal individuals. Researches have proved that an inositol increase in the brain can help with reducing the anxiety symptoms, which has made it an essential supplement for treating mental disorders.
According to a study published in The Journal of Clinical Psychopharmacology, inositol was found to be effective in reducing the symptoms of anxiety and panic disorders in the first month by 4 percent in comparison with fluvoxamine, which helped in reducing by 2.4 percent. However, fluvoxamine was found associated with tiredness and nausea in comparison with inositol, which has fewer side-effects, which makes it more feasible and attractive treatment as a psychiatric medication.
In a meta-analysis study published in The Journal of Human Psychopharmacology, inositol is found useful in the treatment of depression and anxiety disorders in comparison with other treatments or placebo.
Inositol; a widely recognized supplement:
Inositol supplements are proved to be having fewer side-effects and toxic effects. The reason behind this property is that inositol is a water-soluble component which makes it easily soluble in the body without producing the waste materials and causing toxicity in the body.
Foods that are rich in inositol are bananas, brewer’s yeast, wheat germ, brown rice, liver, vegetables, raisins, unrefined molasses, and oat flakes. Fruits that contain a high concentration of inositol are cantaloupe and oranges.
FDA (The Food and Drug Administration) in the US has tagged inositol as a safe supplement that is free from repercussions in comparison to other medications, which can cause lethargy and nausea.
According to the BHS (Baptist Health System), when the dosage of inositol supplements is eighteen times higher than the recommended intake, there are not still any severe side effects associated with it. In order to treat different bipolar disorders, a higher dosage of inositol is usually required.
In case of severe anxiety and anxiety disorders, supplementation with inositol is worth it. The current shreds of evidence suggest that inositol can help with illnesses that are curable with SSRIs and other anti-anxiety medications; therefore, it can be used as an alternative for the medicines. As medications have many side-effects, but safety profile of inositol is higher as compared to these drugs, which has made it a widely recognized supplement for different disorders as anxiety, depression, panic disorders, and mental health-related conditions.