ARCHIVE

 Can Anxiety Cause Dementia?

woman with head in her hands
A growing body of research suggests that anxiety experienced earlier in life might have a causal effect on the development of dementia later in life.

Is there a link between anxiety and dementia? The answer appears to be a resounding yes. Anxiety is commonly seen in individuals with certain types of dementia. However, researchers are increasingly studying anxiety as a potential risk factor for dementia.

Indeed, a growing body of research suggests that anxiety experienced earlier in life might have a causal effect on the development of dementia later in life. Individuals with mild cognitive impairment may have a higher risk of developing dementia, which is relevant to the discussion about anxiety as a potential risk factor.

Anxiety disorders are the most common mental disorder affecting more than 40 million U.S. adults. Considering just 43.2% get proper treatment, the implications for dementia risk are significant. Here’s what you need to know about anxiety and its potential role in the development of dementia. Plus, you’ll discover ways to keep your anxiety levels in check.

WHAT IS CLINICALLY SIGNIFICANT ANXIETY?

General anxiety disorder (GAD) is characterized by persistent feelings of fear, worry, and unease. An individual’s anxious feelings are uncontrollable, and they are typically out of proportion for a particular situation or stressor.

This is different than the transitory anxiety we all experience. This type of anxiousness is usually related to an event or situation, such as the first day on a new job, a first date, or an exam.

People who have general anxiety disorders worry and feel nervous most of the time about everyday activities that do not pose a threat. Anxiety is disproportionately more common in women, teens, and those affected with attention-deficit hyperactivity disorder (ADHD), also known as attention-deficit disorder (ADD).

Common physical symptoms of anxiety include insomnia, heart palpitations (panic attacks), trouble concentrating, and dizziness. Anxiety disorder symptoms can run the gamut from mild (such as nervous feelings, tending to imagine the worst, or feeling tensed up) to severe (such as suicidal thoughts).

When anxiety goes untreated, it can wreak havoc in your life. It can put an individual at risk for other mental health conditions and physical health issues such as:

Mounting research suggests that untreated anxiety may impact your brain in such a way that it also sets you up for dementia later in life.

BASICS ABOUT DEMENTIA

Dementia is defined as a general and pervasive deterioration of memory, as well as at least one other cognitive ability, such as language and executive function. This can be due to various causes. The loss of cognitive function is pronounced enough to negatively impact an individual’s normal daily functioning, work, and social life.

Alzheimer’s disease is the most common form of dementia, accounting for 60-80% of memory loss cases. Ongoing research has shown connections between Alzheimer’s disease and various factors, such as stress and emotional dysregulation, indicating the complexity of its development and progression. But there are many other types of dementia, including:

  • Vascular dementia
  • Frontotemporal dementia (FTD)
  • Alcohol-related dementia

Regardless of the type of dementia, memory loss is not normal, even for aging people.

WHAT CAUSES DEMENTIA?

There are multiple dementia causes or risk factors that lead to its development. In addition to the recent study findings suggesting anxiety as a risk factor, other common causes may include any of the following:

  • Depression
  • ADD/ADHD
  • Posttraumatic stress disorder (PTSD)
  • Alcoholism and substance abuse
  • Traumatic brain injury (TBI), including mild concussions
  • Family history of Alzheimer’s disease or other types of dementia
  • Infections that can affect the brain, such as Lyme disease
  • Heart health issues
  • Type-2 diabetes and prediabetes
  • Genetic factors such as APOE4
  • Altered microbiome
  • Gum disease
  • Gender
  • Obesity and eating a poor diet
  • Untreated sleep apnea
  • Certain medications
  • Cancer/chemotherapy
  • Exposure to toxins
  • Underactive thyroid
  • Hypertension or prehypertension
  • Chronic inflammation

ANXIETY’S LINK TO DEMENTIA

A marked association between anxiety and dementia has been noted in multiple studies over the past decade. However, until recently, researchers were not sure if anxiety was an early symptom of dementia or an independent risk factor.

Research findings indicate that individuals with mild cognitive impairment may have a higher risk of converting to dementia compared to those who are cognitively intact. This is relevant to the association between anxiety and dementia, as studies have included cohorts of participants with mild cognitive impairment to examine this link.

A systematic review published in the January 2022 issue of BMJ Open points to the latter. The review included four reliable studies involving close to 30,000 participants. All four studies indicated a positive connection between moderate to severe anxiety and the development of dementia later in life.

The researchers concluded, “Clinically significant anxiety in midlife was associated with an increased risk of dementia over at least 10 years.”

What’s more, the review’s authors noted that the findings indicate anxiety may be a risk factor for late-life dementiaand not a symptom. The authors additionally suggested that the link may be explained by the excessive stress response triggered by the anxiety.

Indeed, chronic stress and anxiety can cause ongoing suppression of the prefrontal cortex, as well as hippocampus atrophy, research has noted. These actions contribute to the development of dementia.

Another study found that chronic phobic anxiety may shorten telomere length in middle-aged and older women. Telomeres are structures found at the ends of chromosomes made from DNA sequences and proteins. Like the end of a shoelace, telomeres cap and protect the end of a chromosome from getting tangled or frayed.

Telomere length shortens with age. Shortened telomere length is associated with a greater likelihood of disease and poor survival. The study indicated that untreated chronic phobic anxiety is a possible risk factor for accelerated aging. Other research shows that short telomeres are associated with a greater risk of neurological and psychiatric disorders including dementia.

Emotional dysregulation, which is common with anxiety disorders, may also play into the development of dementia recent research indicates. It appears that emotional dysregulation can adversely impact the posterior cingulate and the amygdala—areas heavily involved in autobiographical memory and regulating emotions.

Regardless of the specific cause, anxiety is undoubtedly linked to an increased risk of developing dementia, especially as we grow older.

ANXIETY’S IMPACT ON COGNITIVE FUNCTION

Anxiety can have a profound impact on cognitive function, particularly as we age. Research has shown that anxiety can impair attention, memory, and processing speed, leading to cognitive impairment. This can make everyday tasks more challenging and affect an individual’s ability to maintain independence.

Anxiety often reduces the ability to focus and pay attention, making it difficult to concentrate on tasks. This can be particularly problematic for older adults, who may already be experiencing some degree of cognitive decline. Additionally, anxiety can affect memory, making it harder to learn new information and recall existing memories.

Chronic anxiety can also lead to structural changes in the brain. Studies have shown that prolonged anxiety can reduce the volume of the hippocampus, a region critical for memory and learning. This reduction in hippocampal volume is associated with cognitive decline and an increased risk of developing dementia.

Moreover, anxiety can exacerbate existing cognitive decline, creating a vicious cycle where anxiety and cognitive impairment feed into each other. This highlights the importance of managing anxiety to protect cognitive function and reduce the risk of dementia.

THE ROLE OF STRESS IN DEMENTIA DEVELOPMENT

Stress is a well-known risk factor for dementia, and chronic stress can significantly accelerate cognitive decline. When we experience stress, our body’s “fight or flight” response is triggered, releasing stress hormones like cortisol. While this response is beneficial in short bursts, chronically elevated cortisol levels can be detrimental to the brain.

Chronic stress can lead to structural changes in the brain, including reduced volume in the hippocampus and prefrontal cortex. These areas are crucial for memory, learning, and executive function. Prolonged exposure to high levels of cortisol can damage these brain regions, leading to cognitive impairment and increasing the risk of dementia.

Additionally, stress can promote inflammation and oxidative stress, both of which are linked to cognitive decline and dementia. Inflammation can damage brain cells and disrupt neural communication, while oxidative stress can lead to the accumulation of harmful molecules that further damage brain tissue.

Research has shown that managing stress through relaxation techniques, regular exercise, and social support can help mitigate the risk of dementia. By reducing stress levels, we can protect our brain health and potentially delay or prevent the onset of cognitive decline.

ASSESSING INDIVIDUAL RISK

Assessing individual risk for dementia is crucial for identifying those who may benefit from early intervention and prevention strategies. Several factors can increase the risk of dementia, including age, family history, and lifestyle choices.

Age is the greatest risk factor for dementia, with the risk increasing significantly after the age of 65. However, it’s not the only factor to consider. Family history also plays a role, particularly if a first-degree relative has been diagnosed with dementia. This genetic predisposition can increase an individual’s risk of developing the condition.

Lifestyle factors are also important to consider. Physical inactivity, social isolation, and a poor diet can all increase the risk of dementia. Engaging in regular physical activity, maintaining social connections, and following a healthy diet can help reduce this risk.

By assessing individual risk factors, healthcare providers can identify those who may benefit from early intervention and prevention strategies. This proactive approach can help delay the onset of dementia and improve the quality of life for those at risk.

In conclusion, understanding the impact of anxiety and stress on cognitive function, as well as assessing individual risk factors, is essential for mitigating the risk of dementia. By addressing these factors early on, we can take steps to protect our brain health and maintain cognitive function as we age.

REDUCE ANXIETY TO MITIGATE DEMENTIA RISK?

You may wonder, “If anxiety is to blame for accelerated cognitive decline, does this mean that alleviating anxiety would minimize the risk of dementia?” It’s an excellent question that remains unanswered by science.

That said, there are many lifestyle actions you can take that can relieve anxiety. This can make you feel better in the short term and may possibly protect you against memory loss issues in the future.

5 WAYS TO LESSEN ANXIETY

Here are five natural ways to reduce your anxiety levels.

1. Try psychotherapy.

Cognitive behavioral therapy (CBT) helps to address negative self-talk and is the most effective therapy for reducing anxiety. Eye movement desensitization and reprocessing (EMDR) therapy helps reduce stress and anxiety related to trauma.

2. Avoid foods that can increase anxiety.

For example, coffee is associated with higher levels of anxiety as are many inflammatory foods. Consider a calming alternative to coffee like green tea, which still promotes alertness and mental clarity. You can also take nutritional supplements with calming ingredients like l-theanine (extracted from green tea), GABA, saffron, or magnesium.

3. Try holistic and natural solutions.

Yoga, tai chi, biofeedback, and meditation have been shown to provide relaxation benefits according to research. Of course, a simple walk in nature can help alleviate anxiety too.

4. Practice diaphragmatic breathing.

Anxiety can constrict your breathing to rapid, shallow breaths, which may impact your blood’s oxygen levels and increase anxiety further. Calm your nervous system by repeating 10 cycles of deep breathing. Research shows that diaphragmatic breathing practices may help bring down stress and anxiety levels.

5. Try alternative calming methods.

Research indicates acupuncture may help to alleviate anxiety. Also, hypnosis, guided imagery, listening to soothing music, or progressive muscle relaxation may help to lessen anxiety and even offer additional benefits like better sleep.

If you struggle with anxiety, it doesn’t mean that you will develop dementia. But it is a warning signal to address it right away. Don’t hesitate to reach out to a mental health professional for help.

Reviewed by Amen Clinics Inc. Clinicians

We’re Stronger Together

Anxiety, dementia, and other mental health issues can't wait. At Amen Clinics, we're here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

Gimson A, Schlosser M, Huntley JD, et al. Support for midlife anxiety diagnosis as an independent risk factor for dementia: a systematic review. BMJ Open 2018;8:e019399. doi: 10.1136/bmjopen-2017-019399

Ávila-Villanueva M, Gómez-Ramírez J, Maestú F, Venero C, Ávila J and Fernández-Blázquez MA (2020) The Role of Chronic Stress as a Trigger for the Alzheimer Disease Continuum. Front. Aging Neurosci. 12:561504. doi: 10.3389/fnagi.2020.561504

Okereke OI, Prescott J, Wong JYY, et al. High phobic anxiety is related to lower leukocyte telomere length in women. PLOS ONE 2012;7. doi:10.1371/journal.pone.0040516

Topiwala A, Nichols TE, Williams LZJ, et al. Telomere length and brain imaging phenotypes in UK Biobank. PLOS ONE 2023;18. doi:10.1371/journal.pone.0282363

Baez-Lugo, Sebastian, et al. “Exposure to negative socio-emotional events induces sustained alteration of resting-state brain networks in older adults.” Nature Aging, 12 January 2023.

Related Posts

7 Differences Between Male and Female Brains

people looking at brain
In one of the largest functional brain imaging studies ever, Amen Clinics compared the brain SPECT scans of 46,034 female and male brains, and it

Does your toddler or preschooler struggle with hyperactivity, impulsivity, or inattention? Are they prone to tantrums or appear overly sensitive? If so, you may wonder if these are just normal phases of childhood, or if they indicate attention deficit hyperactivity disorder (ADHD), also known as attention deficit disorder (ADD).

Many children can demonstrate the early signs of ADHD, such as restlessness, outbursts, or lack of concentration. Parents may expect them to “grow out” of these tendencies by their later years. But if they do have the neurodevelopmental condition and carry it into adulthood—especially if they remain undiagnosed and/or untreated—it can negatively impact their entire lives.

Today, we have more knowledge than ever about this common mental health condition, which affects 7 million (11.4%) children ages 3-17, according to the Centers for Disease Control (CDC). Children who are found to meet the criteria for ADHD can be diagnosed as early as 4 years old.

Recognizing the earliest warning signs of ADHD is key to getting kids the help they need. In this blog, you’ll discover seven ADD symptoms every parent needs to know.

EARLY-CHILDHOOD RISK FACTORS FOR ADD/ADHD

A retrospective study of risk factors for ADHD in different stages of infancy found that eight elements were significantly associated with the condition’s later development. At 0-1 month old, these factors were:

  • Advanced maternal age
  • Lower maternal education
  • Family history of ADHD
  • Social problems (such as divorce, socioeconomic difficulties, and parental illness)

At 3 and 18 months, a decrease in head circumference growth was associated with later ADHD. And, at 9 and 18 months, there were correlations found between ADD, delays in motor and language development, and having a difficult temperament.

A 2023 systematic review of 48 articles also found that temperament in infancy or toddlerhood could indicate an early risk for childhood ADHD. Moderate associations were found with activity level, negative emotionality, and sustained attention.

The first two of these were found to be “predictive of all three symptom dimensions (i.e., inattention, hyperactivity/impulsivity, and combined).” The third, sustained attention, was associated only with combined symptoms.

Further research will help explore the links between ADHD’s development and sustained attention and inhibition in a child’s earliest months and years.

Finally, in an overview published in Health Psychology Research, a variety of genetic, neurobiologic, and neurochemical factors were explored as contributors to ADHD in young children. These include:

  • Heredity and genetics
  • Brain structure, neurobiology, and neuropsychology
  • Cognitive dysregulation
  • Pregnancy or birth complications
  • Exposure to environmental toxins
  • Parenting styles
  • Diet

EARLY SIGNS OF ADD/ADHD

What does this mean for parents who are concerned about possible early symptoms of ADHD in their child? Here are some early signs of ADHD to look out for in your toddler or preschooler:

  1. Poor coordination and a tendency to be accident-prone.

The overview mentioned above notes that ADHD in children can manifest with poor motor coordination or motor performance and balance.

These children are also more prone to accidental injuries and physical trauma, including head trauma, which itself can lead to or exacerbate ADHD symptoms.

  1. Impulsivity.

One of the hallmarks of ADHD, impulsivity in a preschooler or toddler may present itself as speaking before thinking, impatience while waiting, or interrupting others.

An impulsive child may also yell or scream when they’re frustrated, get physical with other kids, or run into the street without looking for oncoming vehicles.

  1. Impaired academic performance.

Once a child reaches preschool, their performance may already be compromised by the academic challenges associated with ADHD. One of the early signs of ADD in preschoolers, trouble with paying attention, impacts their ability to learn in a traditional classroom.

Parents working with their child’s teachers may be instrumental in helping children with ADHD perform better, which is one benefit of early diagnosis.

  1. Sleep disruption.

A 2022 study published in Frontiers in Pediatrics noted that children with ADHD are more likely to have sleep disorders.

This association works in both directions. Not only does the degree of ADHD symptoms correlate with sleep disorder severity, but sleep disorders can trigger or worsen the symptoms of ADHD.

  1. Sensitivity and intense emotions.

In the retrospective study mentioned above, researchers found that temperamental and behavioral problems in children 9 and 18 months old are “an important predictive factor for the development of ADHD.”

This may take the form of excessive crying during infancy. Later, these children displayed issues with sensory integration, attention, and behavioral development.

Emotional hyperarousal, emotional dysregulation, and rejection sensitive dysphoria are some of the common emotional issues faced by those who have ADHD.

Parents may notice that their child has intense reactions or stays “stuck” in emotions for longer periods than would be expected. Or perhaps their child has more, or longer-lasting, tantrums and outbursts, or frequently shows signs of frustration.

  1. Behavioral issues.

A 2021 study reported that 40% to 60% of children with ADHD also have oppositional defiant disorder (ODD). Another behavioral disorder that may overlap with ADHD is conduct disorder. Harming oneself and/or others (with behaviors such as biting) may also become an issue in children with ADHD.

  1. Constant movement.

Young children with ADHD can be excessively restless or fidgety, with difficulty sitting still and paying attention. They may be constantly in motion and excessively talkative. Parents may have trouble getting them to sleep, eat a meal, or focus on tasks.

TREATING ADHD IN TODDLERS AND PRESCHOOLERS

According to the American Academy of Pediatrics’ (AAP) Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents, ADHD criteria can be applied to children as young as ages 4-6. The guidelines advise medical professionals to note symptoms across multiple settings, such as home and preschool.

The most common treatment prescribed at these early childhood ages is parent training in behavior management (PTBM). The AAP explains that this consists of helping parents learn:

  • What to expect in terms of age-appropriate development
  • Behaviors that will help strengthen the parent’s relationship with the child
  • Useful skills to help manage problem behaviors

Parents who have spent time implementing and incorporating these strategies at home can then report their results to the medical professional, as well as provide a picture of the child’s persistent symptoms and struggles. This enables a more accurate ADHD diagnosis.

Brain SPECT scans can also help in the diagnosis of ADHD in toddlers and preschoolers. Because there are seven different types of ADD/ADHD, it’s crucial to pinpoint which type is interfering with a child’s development. With brain scans, clinicians can then determine an effective and personalized treatment plan.

Many doctors rely on prescription medications for childhood ADHD, and they can be highly beneficial for some kids. However, stimulant medications are not effective for all ADD types—and they may even cause harm. In addition to ADHD medication or in lieu of it, children can reap significant benefits from all-natural lifestyle changes, including:

  • An elimination diet that removes sugar, gluten, dairy, corn, soy, and artificial dyes and sweeteners from the diet (to rule out potential allergies)
  • A higher-protein, lower-carbohydrate diet
  • More exercise
  • Sleep hygiene and increased sleep duration
  • Less screen time
  • Supplements such as omega-3 fatty acids

Parents can also help by rethinking traditional discipline measures, which may not be helpful for children with ADHD. Instead of yelling, threats, and anger, these children tend to respond to different strategies. Remaining calm and positive will help better guide their behavior.

Finally, because there is a genetic component associated with the condition, parents of children with attention problems may want to undergo screening for ADHD themselves. At Amen Clinics, many adults with ADHD only learn about their condition after bringing in their child for an evaluation.

HELPING ADHD TODDLERS, PRESCHOOLERS, AND PARENTS

It’s never easy to be a parent. But it can be even more challenging when you’re parenting a child who shows the early signs and symptoms of ADHD.

Fortunately, we know more than ever about what to watch for in our toddlers and preschoolers—as well as the benefits of early diagnosis. With vigilance, patience, and understanding, we can help ensure that they are given the best chance of success in life.

Reviewed by Amen Clinics Inc. Clinicians

We Are Here For You

Brain and mental health conditions can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

Amen, Daniel G et al. “Gender-Based Cerebral Perfusion Differences in 46,034 Functional Neuroimaging Scans.” Journal of Alzheimer’s disease : JAD vol. 60,2 (2017): 605-614. doi:10.3233/JAD-170432

Nishizawa, S et al. “Differences between males and females in rates of serotonin synthesis in human brain.” Proceedings of the National Academy of Sciences of the United States of America vol. 94,10 (1997): 5308-13. doi:10.1073/pnas.94.10.5308

Related Posts

The Long-Term Impact of Adverse Childhood Experiences (ACEs)

When your childhood years are marked by abuse, neglect, or trauma, it can have a negative lasting impact with serious consequences. In fact, adverse childhood

Our childhood experiences have a powerful influence on the rest of our lives. When those early years are marked by abuse, neglect, or trauma, it can have a negative lasting impact with serious consequences. In fact, adverse childhood experiences, or ACEs, can set the stage for long-term physical and mental health problems.

A 2024 neuroimaging study published in Frontiers in Psychiatry and conducted at Amen Clinics confirms that having more ACEs is closely associated with heightened risk of mental health conditions, such as anxiety, depression, post-traumatic stress disorder (PTSD), and substance use disorders.

In this blog, you’ll learn more about adverse childhood experiences, how they impact brain development as well as physical and mental health in adulthood, and how to overcome childhood trauma for better brain health and mental wellness.

WHAT ARE ADVERSE CHILDHOOD EXPERIENCES (ACEs)?

For decades, researchers have been looking into the many possible consequences of adverse childhood experiences. Experts have been studying how traumatic events in childhood impact people not only during their early years but also in adulthood.

Research shows that ACEs are very stressful and traumatic and can interfere with normal developmental processes. They also increase the risk for health problems and psychiatric disorders.

In 1995, the Centers for Disease Control (CDC) and Kaiser Permanente undertook a large-scale study to identify the extent of ACEs in a group of 17,337 adult participants. This study also looked at the long-term effects of ACEs.

Adverse childhood experiences were surveyed using eight specific questions that covered neglect, abuse, and household dysfunction, such as witnessing domestic violence.

The results of this research found that nearly 25% of those in the study had been exposed to three or more of the eight ACEs that were being studied at that time. The fact that the participants were primarily middle-class Caucasian adults was a clear indication that ACEs can happen in almost any household.

However, it is now well-known that chronic poverty, community violence, and racism can also negatively impact a child’s physical and mental health and development.

WHAT IS THE ACEs QUESTIONNAIRE?

Since the time of that groundbreaking study, the ACEs questionnaire has had some minor modifications. The latest version is comprised of 10 questions that cover adverse and traumatic experiences a child could be subjected to or witness while growing up. The categories include:

The scores on the ACE questionnaire range from 0 to 10, with zero meaning no exposure and 10 indicating a person was subjected to significant—if not profound—levels of trauma before age 18. The higher the score, the higher the long-term health consequences a person can be at risk for.

Of note, the ACE questionnaire is not a stand-alone diagnostic assessment. It specifically addresses only negative experiences, not positive ones. It’s not necessarily predictive of future problems, although those correlations exist.

 

Rather, it’s intended to be used as a guide for clinicians and community health workers to identify services that can benefit the child and family.

For a deeper understanding of the ACEs questionnaire, tune in to the Change Your Brain Every Day podcast, where hosts Dr. Daniel Amen and his wife Tana Amen break down each question.

HOW CHILDHOOD TRAUMA IMPACT THE DEVELOPING BRAIN

The development of a child’s brain is very sensitive to the environment in which they are raised. A loving, supportive, and predictable home environment bodes well for the brain to organize and function in developmentally appropriate ways as the child grows up.

However, for children who are repeatedly subjected to trauma, chaos, abuse, and/or neglect, healthy brain development is often obstructed. When a child is chronically exposed to adverse and traumatic experiences, the brain’s stress activation system—which impacts immune, metabolic, and cardiovascular functioning—is constantly in overdrive.

As the brain develops, the delicate balance of neurotransmitters (brain chemicals) that are necessary for healthy brain function can be disrupted due to the constant flood of stress hormones. This process can also stunt the development of certain areas of the brain, such as the hippocampus, which is important for memory formation.

When enduring toxic levels of stress, it’s as though the child’s brain is stuck in fight-or-flight mode. This can lead to problems with self-regulation, learning, and social interactions, as well as trouble controlling emotions, aggression, and nightmares. Another long-term consequence involves difficulty forming and maintaining healthy attachments later in life.

The negative effects of the adverse experiences can even alter a child’s genes and be passed along to the next generation. 

In a fascinating episode of the Change Your Brain Every Day podcast, Dr. Amen talks in detail about the results of the Amen Clinics study mentioned earlier. The largest brain-imaging study ever conducted on ACEs, it involved over 7,000 participants and used brain SPECT imaging and clinical evaluations to map how childhood trauma affects brain activity.

As he reveals on the episode, the results indicate that higher ACE scores are tightly linked to an increased risk of mental health conditions. The study underscores the importance of brain-focused treatment approaches to mitigate the long-term effects of ACEs.

ADVERSE CHILDHOOD EXPERIENCES: IMPACTS ON PHYSICAL AND MENTAL HEALTH

Not everyone with a high ACE score will develop health problems later in life. Some children have natural strengths that can help them navigate the turmoil that surrounds them in a way that other children may not be able to.

 

In addition, having a close relationship with one or more caring adults can help buffer the adversity at home. For example, a teacher may provide extra support for the child. In other instances, a loving relative who cares for the child may provide a temporary refuge from the trauma. These adults can promote a sense of safety that helps the child become more resilient.

However, adults who had multiple ACEs and did not have healthy connections to people around them—nor strengths that were nurtured—can be at an increased risk for physical and mental health problems in adulthood, including:

The connection between high ACE scores and substance abuse is especially strong. In fact, more than 25% of people with addictions report childhood trauma, according to a 2022 study in General Psychiatry. This study also found that higher levels of ACEs was associated with greater severity of mental health disorders.

ADVERSE CHILDHOOD EXPERIENCES (ACEs) AND EMOTIONAL BIAS

Neuropsychological testing also shows that individuals who have experienced high levels of childhood trauma have difficulty with emotional awareness and emotional bias.

Emotional awareness and emotional bias tests involve having a person look at images of facial expressions and categorize them as happy, neutral, angry, or disgusted. On these tests, people with high scores on the ACE Questionnaire typically respond slower to happy faces and more quickly to disgusted faces. They also identify fewer neutral faces correctly while recognizing more angry faces correctly.

This contributes to an emotional bias known as a conscious negativity bias. Ultimately, this means people with higher levels of adverse childhood experiences are more likely to have a negative view of the world.

TREATING ADVERSE CHILDHOOD EXPERIENCES (ACEs)

Fortunately, certain mental health therapies and lifestyle changes can help mitigate the onset or reduce the severity of ACEs consequences, such as:

  • Address the adverse childhood experiences with a trained psychotherapist to help work through the emotional trauma.
  • Consider Eye Movement Desensitization and Reprocessing (EMDR), which is a powerful treatment for trauma survivors.
  • Seek treatment for alcohol, drug, and/or food addiction.
  • Switch to a healthier diet with lots of fresh produce and omit fried foods, sugar products (including soda), and ultra-processed foods.
  • Exercise regularly and spend less time on the couch.
  • Volunteer in your community to build positive social connections.

On the Change Your Brain Every Day podcast episode about ACEs, Dr. Amen and Tana discuss several other beneficial strategies to help overcome childhood trauma for better mental health.

If you’re an adult who endured the trauma of adverse childhood experiences, start taking good care of yourself now. Incorporating healthier habits and seeking treatment for your physical and mental health issues can open up greater possibilities for your life as you go forward.

We Are Here For You

Emotional trauma, substance abuse, depression, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

Keator DB, et al. Adverse childhood experiences, brain function, and psychiatric diagnoses in a large adult clinical cohort. Frontiers in Psychiatry, Volume 15 (2024). https://doi.org/10.3389/fpsyt.2024.1401745

Anda, Robert F et al. “The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology.” European archives of psychiatry and clinical neuroscience vol. 256,3 (2006): 174-86. doi:10.1007/s00406-005-0624-4

Gu, Wenjie et al. “Impact of adverse childhood experiences on the symptom severity of different mental disorders: a cross-diagnostic study.” General psychiatry vol. 35,2 e100741. 22 Apr. 2022, doi:10.1136/gpsych-2021-100741

Related Posts

Coping with a PTSD Episode: Effective Strategies and Support Options

Coping with a PTSD Episode: Effective Strategies and Support Options
The amygdala (the brain’s fear center) doesn’t forget anything that it has deemed as dangerous and doesn’t discern whether the threat is real or imagined.

Throughout their lifetime, at least half of all people will experience a traumatic event of one kind or another. For some, trauma begins early in life with the devastation of childhood abuse and other maltreatment, including neglect.

Beyond this, there are many other types of events that are inherently traumatic, such as military combat, sexual violence or other physical assaults, serious injury, motor vehicle accidents, being stalked or in a natural disaster as well as surviving a mass shooting or living in a war zone.

Essentially, any event during which a person experiences the fear of actual or threatened death can trigger PTSD symptoms. Some mental health experts suggest that living through the COVID-19 pandemic was yet another event that triggered trauma in some people.

It’s normal for anyone who has endured or witnessed experiences like these to have a strong emotional response that could last for days or weeks.

However, some people have a delayed and/or prolonged reaction to the traumatic event which can lead to post-traumatic stress disorder (PTSD), a serious mental health condition.

This blog will explore what happens during a PTSD episode, offering insights and coping strategies to help you deal with it.

Prevalence and Symptoms of PTSD

According to the Department of Veterans Affairs National Center for PTSD—the mental health services administration for veterans—approximately 7-8% of people in the U.S. will develop PTSD during their life—10% of women and 4% of men.

To be diagnosed with this condition, a person will have some specific PTSD symptoms, including several of these:

  • Recurrent and distressing memories or dreams of the traumatic event that cause severe anxiety

  • Prolonged or noticeable psychological and/or physical reactions, such as extreme fear, to cues resembling the experience

  • Flashbacks of the event or emotional/psychological dissociation during PTSD episodes

  • Avoidance of thoughts, feelings, people, places, or any reminders of what happened, often referred to as avoidance symptoms

  • Difficulty remembering details of the event

  • Changes in memory or thinking patterns or the development of mood symptoms and difficulty experiencing positive emotions and possibly feeling emotionally numb

  • Hypervigilance, trouble sleeping, anger outbursts, trouble concentrating, and suicidal thoughts as well as unhealthy coping strategies such as substance abuse and other self-destructive behaviors

While all these post-traumatic stress disorder symptoms can cause significant impairment, some are more challenging to manage than others.

PTSD AND THE BRAIN

Studies show that PTSD symptoms are largely related to the amygdala, a structure deep in the brain that is best known for our fight-or-flight response.

When in danger, the amygdala assigns an emotional tag to any experience that could be life-threatening. Its function is automatically prioritized over other areas of the brain, including those that govern reasoning and memory.

Not everyone who experiences a traumatic incident will develop post-traumatic stress disorder, but for those who do, seeking treatment with a licensed mental health professional to help you reduce or manage PTSD symptoms can make a world of difference.

Fortunately treating PTSD is possible and mental health services that do this are widely available.

PTSD Episodes: Flashbacks and Dissociation

The amygdala doesn’t forget anything that it has deemed as dangerous and doesn’t discern whether the threat is real or imagined. This plays a big role in untreated post-traumatic stress disorder, especially when these symptoms occur:

  • Flashbacks are a nightmarish and intense reliving of traumatic events. Whether it is momentary or lasts a few minutes, hours, or even days, someone going through a flashback is unable to distinguish intrusive memories from reality.

    Flashbacks are uncontrollable and very vivid, likely evoking strong sensory memories associated with the trauma that was endured and the environment in which it happened.

    Someone experiencing a PTSD trigger and flashback might have heightened anxiety and other reactivity symptoms.

  • Dissociation occurs when a person feels separate or disconnected from their body and surroundings as though they are observing things from outside of themselves.

    This tends to occur automatically as a coping mechanism to manage traumatic memories and the emotions and sensations associated with them in those who develop PTSD. Like flashbacks, dissociative episodes can be fleeting or last for a long time.

The amygdala (the brain’s fear center) doesn’t forget anything that it has deemed as dangerous and doesn’t discern whether the threat is real or imagined. This plays a big role in untreated PTSD. Share on X

Flashbacks and dissociation are often unpredictable and are caused by triggers in the environment that are reminders of the traumatic event. Such cues can be sights, sounds, odors, objects, people, places, or any number of things that are somehow associated—even unconsciously—with the fearful experience and lead to traumatic stress reactions.

During PTSD episodes, the brain responds by activating the amygdala as though real danger is imminent. This in turn causes an increase in heart rate, shallow rapid breathing, perspiration, and panic as the fight or flight system kicks in.

For Steven, an Amen Clinics patient who witnessed a horrific accident that killed 10 people, his hands would start shaking.

“Grounding” to Offset a PTSD Episode

Although they come on quickly, a person will usually have a little bit of warning prior to a flashback or dissociation. For example, they may feel they are losing their connection to reality or things may start to look blurry.

One method for managing PTSD symptoms and not completely losing touch with reality is through a technique known as “grounding,” which is similar to mindfulness.

Just as it sounds, grounding can help a person stay present so that they recognize their oncoming PTSD symptoms for what they are. This technique involves strategies such as these:

  • Engaging each of the senses by identifying things in the immediate environment they can see, smell, touch, taste, and hear

  • Moving around—whether by walking, running, or jumping—to help disrupt the body’s stress response

  • Breathing deeply and slowly to help calm themselves

Mental Health Treatment for PTSD

It is possible to recover from PTSD symptoms, and there are many PTSD treatment options that can be beneficial, including:

1.Talk therapy: Some mental health professionals offer talk therapy treatments, such as cognitive behavioral therapy (CBT), which addresses ongoing negative emotions and negative thought patterns.

2.Exposure therapy: Another type of treatment, known as exposure therapy, incorporates present-moment relaxation techniques to help reduce symptoms of PTSD in the presence of a trigger.

Another form of this technique is called prolonged exposure therapy. This allows people to gradually face their feelings related to past traumatic events.

3.EMDR: According to research, one of the most effective treatments for post-traumatic stress disorder is called eye movement desensitization and reprocessing (EMDR). This type of psychotherapy is done with a licensed mental health professional or other healthcare provider who is trained and certified in it.

After some sessions for EMDR preparation during which a client will identify triggers, accompanying physical sensations and distressing symptoms, a process called bilateral stimulation (BLS) is used. This involves having clients move their eyes side-to-side as they follow the therapist’s finger, having the client hold a small device in each hand that alternately vibrates.

At the same time, a traumatic memory and associated bodily sensations are recalled simultaneously with the BLS. The distraction of the BLS along with emotional support from the healthcare professional makes thinking and talking about the experience less terrifying or overwhelming.

This method helps the memories of traumatic events get “unstuck” so they can be more fully processed in the brain. This in turn opens the door to greater coping skills and emotional management and fewer negative thoughts related to the trauma or oneself.

4.Antidepressant medications: Mental health professionals may also recommend selective serotonin reuptake inhibitors (SSRIs) to help reduce day-to-day symptoms. It’s important to understand that antidepressant medication alone is unlikely to fully treat PTSD symptoms.

In general, doing therapy in conjunction with medication is usually recommended to overcome symptoms of PTSD.

CONSEQUENCES OF UNTREATED PTSD

Sadly, without treatment, many people won’t fully recover from PTSD. In this case, PTSD episodes are likely to continue or worsen with time. For some people, this can aggravate symptoms and may even lead to suicidal thoughts.

The stigma attached to mental disorders holds some individuals back from seeking help. Because of this, it’s important to know that reaching out to a mental health professional for help is a sign of strength, not weakness.

Understand that the road to recovery from PTSD and other types of trauma may not be a linear one. You may experience setbacks on your healing journey.

However, continued progress can lead to an improvement in mood symptoms, healthier coping strategies, and a greater ability to manage symptoms. Overall, this fosters a greater sense of well-being and more fulfillment in life.

Reviewed by Amen Clinics Inc. Clinicians

We Are Here For You

PTSD and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

U.S. Department of Veterans Affairs. PTSD: National Center for PTSD. How common is PTSD in adults? https://www.ptsd.va.gov/understand/common/common_adults.asp

Zotev V, et al. Real-time fMRI neurofeedback training of the amygdala activity with simultaneous EEG in veterans with combat-related PTSD, NeuroImage: Clinical, Volume 19,2018, Pages 106-121, https://doi.org/10.1016/j.nicl.2018.04.010.

Medical News Today, Step-By-Step Guide on Grounding Techniques, https://www.medicalnewstoday.com/articles/grounding-techniques

Rothbaum, Barbara Olasov, and Ann C Schwartz. “Exposure therapy for posttraumatic stress disorder.” American journal of psychotherapy vol. 56,1 (2002): 59-75. doi:10.1176/appi.psychotherapy.2002.56.1.59

Wilson, Gemma et al. “The Use of Eye-Movement Desensitization Reprocessing (EMDR) Therapy in Treating Post-traumatic Stress Disorder-A Systematic Narrative Review.” Frontiers in psychology vol. 9 923. 6 Jun. 2018, doi:10.3389/fpsyg.2018.00923

Related Posts

13 Positive Affirmations to Boost Moods and Build Mental Strength

45 Positive Affirmations to Overcome Uncomfortable Emotions
Daily affirmations can be a powerful way to heal and build emotional and mental health when you’re feeling bad.

If you’ve ever felt held back by anxiety, anger, or self-doubt, or you’ve been haunted by past trauma you can’t seem to shake, you’re not alone. The brain holds onto these memories and thought patterns, which makes it challenging to move forward.

Emotional issues are tightly linked to brain function, according to over 250,000 brain scans at Amen Clinics. SPECT scans reveal abnormal activity in various brain regions—such as the basal ganglia and limbic system—in people who struggle with anxiety disorders, anger issues, post-traumatic stress disorder (PTSD), and other mental health conditions.

Positive affirmations offer a practical way to ease the hold of negative thoughts, calm anxiety, and strengthen mental resilience. And scientific research shows that they can help rewire the brain in beneficial ways.

Daily affirmations can be a powerful way to heal and build emotional and mental health when you’re feeling bad. In this blog, you’ll discover 45 affirmations you can say to enhance your brain and help you cope with 10 of the most common negative emotions.

HOW POSITIVE AFFIRMATIONS HELP OVERCOME NEGATIVE EMOTIONS

1. When You’re Feeling Anxious

Anxiety often presents itself when past fears or trauma resurfaces. Oftentimes, it’s triggered by familiar sights, sounds, or social interactions. There are simple anxiety-soothing techniques to help you calm your mind. Pair these with daily positive affirmations to help calm anxiety and enhance your sense of safety.

Positive Affirmations:

  • I am safe.
  • I am secure.
  • I am calm.
  • I am protected.
  • I focus on my breathing and centering myself.

2. When You’re Feeling Angry

Old wounds or disappointments can be triggered by previous shame, guilt, bullying, abuse, or resentment. Anger can be constructive; however, in excess and unchecked, it is incredibly destructive.

Learning healthy ways to release your anger helps build resilience and strengthen cognitive well-being throughout your life.

Positive Affirmations:

  • I express my anger in ways others can hear.
  • I accept responsibility if my anger has hurt someone.
  • I direct my anger appropriately.
  • I do not use anger to intimidate.
  • I express anger in words, not actions, unless in protection.

3. When You Feel Invisible

If you tend to feel unnoticed or unimportant, you may feel the weight of abandonment. When you’ve experienced a lack of parental presence or emotional support, this can impact your self-worth and purpose to deepen your sense of self.

Positive Affirmations:

  • I am loved.
  • I am unique.
  • I am significant.
  • I am seen by the people who see me (name them out loud).
  • I am making a difference in the lives of my loved ones.

4. When Past Trauma Is Haunting You

Lingering memories of past trauma—whether from an accident, relationship, or significant life event—often make you feel vulnerable. Recite positive affirmations to help ease painful memories and encourage mental wellness.

Positive Affirmations:

  • I am safe within this moment.
  • I have everything I need at this moment.
  • I release trauma, turmoil, and grief.
  • Asking for help is a sign of strength.

5. When You Feel Inferior

“Comparison is the thief of joy.” A truer statement has never been said about what you can stop doing right now to feel happier. When you find yourself comparing your achievements or appearance with others, it’s easy to feel inferior.

It’s a common struggle, but positive affirmations can help redirect your focus to accept and love who you are right now.

Positive Affirmations:

  • I will refrain from comparing myself to others.
  • I am a strong, independent person.
  • I will be my best, not someone else’s best.
  • I work hard.

6. When you Feel Shame

Studies show that shame and regret can be some of the most powerful forces when it comes to your emotional health. While excessive shame can be harmful to your mental health, a moderate amount may motivate you toward more positive behavioral change.

Letting go of negative self-talk is possible with the intentional practice of self-compassionate affirmations.

Positive Affirmations:

  • Each day I feel more at peace with my past mistakes.
  • I work to learn the lessons of my past.
  • I can and will let go of any shame that haunts me.
  • That was then; this is now.

7. When You Feel Overly Responsible

Feeling overly responsible for other people’s happiness can lead to imbalanced relationships, emotional exhaustion, resentment, and long‐term stress.

Giving yourself as much compassion as you give others is essential in living a happier and more purposeful life. You can start by establishing boundaries and reminding yourself that you’re not alone in caring for others.

Positive Affirmations:

  • Loving others as myself means taking care of myself so I can love others.
  • I help others as long as it helps them become independent.
  • It’s better to give than to receive—if it doesn’t create dependency.
  • I share the load, so I don’t become overburdened.
  • I do what I can and trust others to God’s care.

8. When You’re Feeling Overwhelmed

Thoughts of aging, mortality, and the fleeting nature of life can feel overwhelming at times. This has been especially prevalent in the past decade. A 2024 study in Frontiers in Psychology shows that things like global political discourse, natural disasters, and a pandemic on top of personal life events can compound certain anxieties.

Positive affirmations encourage living fully and without fear by learning to cope by grounding yourself in the present moment.

Positive Affirmations:

  • I will live a life that matters.
  • I live fully and fearlessly.
  • I am present in all I do.
  • If something is meaningful, I pursue it; if not, I let it go.

9. When You’re Grieving   

Loss can leave a lasting impact, but healing is possible. Grief is often the last act of love you can express in the wake of losing of a loved one. Findings in a 2024 study suggest that affirmations can help you grieve and offer hope through the healing process.

It’s not about moving on from your loved one—it’s about having the courage to move forward with their memory.

Positive Affirmations:

  • I feel my feelings and cry when needed.
  • I choose to heal and move forward.
  • I hold on to love and let go of grief.
  • Seeking help is a sign of strength.
  • Even though I’ll never be the same, it’s OK to be someone new.

10. When You’re Feeling Hopeless

If you’re feeling hopeless, please know that you don’t have to feel alone. Some situations can feel impossible to change which, over time, can lead to a mindset of learned helplessness.

Start saying these phrases to help reframe your thoughts and renew hope for a better future that you control.

Positive Affirmations:

  • I am worth it.
  • I can ask for help when I need it.
  • I have hope for the future.
  • Today is going to be a great day.

THE POWER OF AFFIRMATIONS

By practicing these affirmations, you’re empowering yourself with simple yet powerful tools. When repeated regularly, it can help shift your brain chemistry and boost your mood to break patterns of negativity and embrace positive thinking.

We Are Here For You

Anxiety, depression, stress, and other mental health conditions can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

Cascio, Christopher N et al. “Self-affirmation activates brain systems associated with self-related processing and reward and is reinforced by future orientation.” Social cognitive and affective neuroscience vol. 11,4 (2016): 621-9. doi:10.1093/scan/nsv136

Budiarto Y, Helmi AF. Shame and Self-Esteem: A Meta-Analysis. Eur J Psychol. 2021 May 31;17(2):131-145. doi: 10.5964/ejop.2115. PMID: 35136434; PMCID: PMC8768475

Gérain P, Zech E. Do informal caregivers experience more burnout? A meta-analytic study. Psychol Health Med. 2021 Feb;26(2):145-161. doi: 10.1080/13548506.2020.1803372. Epub 2020 Aug 20. PMID: 32816530

Gabriela, M., Laurențiu, M., & Camelia-Iulia-Maria, V. (2024). The relationship between critical life events, psycho-emotional health and life satisfaction among youths: Coping mechanisms and emotional regulation. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1288774

Baiu, B. (2024). Self-affirmation Shortens the Grieving Process after Romantic Abandonment and can Increase Self-esteem. International Journal of Indian Psychology, 12(4), 577-589. DIP:18.01.052.20241204, DOI:10.25215/1204.052

Nickerson, C. (2024, May 2). Learned Helplessness. Simply Psychology. www.simplypsychology.org/learned-helplessness.html

DeAngelis, T. (2019, February). The legacy of trauma. APA Monitor, 50(2). www.apa.org/monitor/2019/02/legacy-trauma 

Yehuda R, Lehrner A. Intergenerational transmission of trauma effects: putative role of epigenetic mechanisms. World Psychiatry. 2018 Oct;17(3):243-257. doi: 10.1002/wps.20568. PMID: 30192087; PMCID: PMC6127768.

Related Posts

The Pill’s Surprising (and Scary) Effects on the Brain

Research shows that taking birth control pills causes structural changes in the brain, alters neurotransmitter function, and messes with mood regulation.

“The pill” is the most popular form of contraception prescribed in the U.S. with 14% of women aged 15-49 using it. That adds up to over 10 million women. What many of these women don’t know is that in addition to pregnancy prevention, birth control pills can have negative impacts on brain function and mental health.

In fact, a lot of women have misconceptions about how these hormonal contraceptives affect the brain and body and how they influence overall health. It’s time to clear up the confusion.

WHAT ARE ORAL CONTRACEPTIVES?

Oral contraceptives are most commonly associated with preventing pregnancy. However, they are also frequently used to reduce PMS symptoms and other issues that may occur with menstruation, such as:

  • Irregular periods

  • Premenstrual syndrome (PMS)

  • Premenstrual dysphoric disorder (PDD)

  • Painful periods

  • Heavy flow

  • Endometriosis

  • Polycystic ovarian syndrome (PCOS)

  • Fibroids

Because the pill can effectively decrease symptoms of these conditions, it is commonly prescribed.

HOW BIRTH CONTROL PILLS WORK INSIDE THE BODY

Most oral contraceptive pills (OCP) are made with combinations of synthetic estrogen and progestin, a synthetic form of the hormone progesterone. The main goal is preventing ovulation. They have key effects on menstrual cycles.

After taking a birth control pill, these synthetic hormones enter the brain and hijack your cyclical hormonal process. They act as endocrine disruptors, interfering with the signaling process that is necessary for ovulation.

In particular, they prevent the hypothalamus from signaling to the pituitary gland (which regulates your hormones) to release hormones that cause an egg to be released. In the unlikely event ovulation does occur and an egg is fertilized, the synthetic progestin thins the uterine lining, making it more likely that the egg will be shed.

Many birth control pills include a week of placebo pills that induce monthly breakthrough bleeding, but this is not a real menstrual period. It is an artificial pattern that eliminates the natural ebb and flow of estrogen and progesterone throughout the cycle.

You may already be aware that OCPs have been shown to cause problems with blood pressure and blood clots and nearly doubles the risk of strokes, especially if you smoke or have a history of migraine headaches.

But did you know that OCPs also affect your brain and mental wellbeing?

HOW HORMONES WORK IN THE BRAIN

In order to feel happy and healthy, you need to have balanced hormones. Here is some important information to note about the differences between natural and synthetic hormones.

Natural hormones bind to specific receptors and keep your body in balance:

  • Estrogen binds to the estrogen receptor.

  • Progesterone binds to the progesterone receptor.

  • Testosterone binds to the testosterone receptor (yes, women produce testosterone, just not as much as men).

There is no cross-reactivity.

Synthetic progesterone (progestins) acts differently on the body:

  • Progestins do not limit binding to just the progesterone receptor, rather, they bind to many other receptors as well.

  • When a synthetic hormone binds to the wrong receptor, that receptor may convey inaccurate signals, which throws the body off balance. 

Because synthetic hormones may bind to the wrong receptors, birth control pills may cause hormonal imbalances and detrimental side effects. Not all women experience these problems, but for those that do, side effects can be quite miserable.

THE HEAVY TOLL OF THE BIRTH CONTROL PILL ON THE BRAIN

Research shows that taking birth control pills causes structural changes in the brain, alters neurotransmitter function, and messes with mood regulation.

Brain structure: A 2019 study found that the hypothalamus in women taking oral contraceptives was about 6% smaller than in women who weren’t on the pill.

 Impacts neurohormones: Birth control pills also elevate cortisol levels (hello, stress!) and lower testosterone levels (goodbye, sex drive!). And low-testosterone problems can remain even after stopping oral contraceptives, putting you at increased risk for long-term sexual, brain health, and psychiatric disorders.

Microbiome disruption: Synthetic birth control can also disrupt the gut microbiome.

The gut—your gastrointestinal tract (GI)—is often called the second brain because it is lined with about 100 million neurons. That’s more neurons than you have in your spinal cord or in your peripheral nervous system.

Research has shown that gut health problems, such as leaky gut, are associated with mood and anxiety disorders, as well as attention deficit hyperactivity disorder (ADHD), also called attention deficit disorder (ADD).

Micronutrient depletion: Birth control pills interfere with the absorption of essential vitamins and minerals, which can lead to nutritional deficiencies, according to one study.

In particular, key nutrient depletions have been seen in folic acid, B vitamins (B2, B6, and B12), vitamins C and E, and the minerals magnesium, zinc, and selenium—micronutrients that are important for healthy brain function. If you’re taking oral contraceptives, it’s a good idea to take supplements to avoid deficiencies.

SYMPTOMS OF HORMONE IMBALANCES

Often women have no idea that their birth control pills may be causing the following issues:

  • Low moods

  • Mood swings

  • Anxiety

  • Fatigue

  • Low libido

  • Insomnia

  • Weight gain

To find out if your birth control pills are contributing to your symptoms, it’s important to get tested. However, simple standard blood tests will rarely detect this problem.

A better option is a 24-hour urine hormone collection, which is the gold standard for looking at all the hormones and their metabolic byproducts.

An integrative medicine physician, also called a function medicine physician, can be helpful in assessing hormone levels, nutrient deficiencies, and other issues related to hormonal birth control.

THE PILL AND EMOTIONAL HEALTH

For decades, many women have complained the OCPs cause such extreme moodiness and other emotional issues that they quit taking them. Studies back up their claims.

In some women, taking the pill is associated with a wide range of psychiatric issues, including mood disorders like clinical depression, as well as anxiety, fatigue, compulsive behavior, anger, and neurotic symptoms.

Scientists from Denmark found that women ages 15-34 taking OCPs were 23% more likely to start taking antidepressants for the first time than non-OCP users. In fact, studies have shown that bouts of depression have been reported by 16-56% of women on hormonal birth control, which depletes serotonin.

Oral contraceptives also affect mental health indirectly. They put you at greater risk of autoimmune diseases and elevated cortisol levels, both of which are associated with an increased incidence of anxiety and depression.

And as mentioned above, they have also been linked to lower levels of testosterone, which is associated with depression, low libido, and memory problems. And low-testosterone issues can persist after stopping OCPs, meaning you could be facing long-term sexual and mental health problems.

ARE YOU READY TO STOP TAKING BIRTH CONTROL PILLS?

Going off a birth control pill isn’t necessarily a quick-fix solution. Some women experience a rash of symptoms—including mood swings, anxiety, and depression—in the months following cessation of hormonal birth control. Some hormone experts have started calling this effect “post-birth control syndrome.”

In addition, it’s important to remember that if you started taking the pill because you were experiencing irregular periods, fibroids, endometriosis, or other symptoms, the pill doesn’t actually address those issues. It only masks the problem. When you stop taking oral contraceptives, that original issue may return with a vengeance.

If you were experiencing irregularities in your menstrual cycle, note that taking natural progesterone can be quite effective for some women—without any of the side effects of synthetic progestin in hormonal contraceptives.

If you’re taking an oral contraceptive pill to prevent pregnancy, there are other non-synthetic, non-hormonal forms of birth control available that you can discuss with an integrative physician.

HOW TO GET BACK INTO HORMONAL BALANCE 

If you’re taking the pill, here are three strategies to help you regain balance:

1. Take nutritional supplements.

Because OCPs can deplete nutrient absorption, it’s important to supplement your diet with B vitamins (folate, B6 and B12), vitamin E, and magnesium.

2. Don’t stop cold turkey.

Be aware that stopping OCPs isn’t necessarily a quick-fix solution. Some women experience “post-birth control syndrome.” which can cause an array of symptoms—including mood swings, anxiety, and depression—in the months following cessation of hormonal birth control.

If you want to get off OCPs, investigate other types of birth control, such as an intrauterine device (IUD) or barrier methods like condoms or a diaphragm.

3. Test your hormone levels.

If you’re experiencing emotional, psychological, or cognitive symptoms while taking OCPs or after quitting, it’s critical to get a full evaluation that includes testing for any hormonal imbalance. Brain imaging tests can also help determine the root cause of your issues.

If you’ve been taking birth control pills for many years, it can take several months to rebalance your natural hormone levels. This is due to the chronic suppression of your own hormone production. It is often helpful to supplement hormones during this recovery period.

If you must stay on the pill for any particular reason, consider asking your physician about using natural progesterone and/or testosterone to improve quality-of-life issues while taking the pill.

We Are Here For You

Depression, anxiety, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

CDC/National Center for Health Statistics. Contraceptive Use. https://www.cdc.gov/nchs/fastats/contraceptive.htm

Loyola University Health System. Increased Stroke Risk From Birth Control Pills, Review Finds. ScienceDaily. October 27, 2009. www.sciencedaily.com/releases/2009/10/091026152820.htm

Williams C. The Pill’ Might Shrink Certain Brain Regions Among Women Taking It. Live Science. December 4, 2019. https://www.livescience.com/birth-control-brain-hypothalamus.html

Skovlund CW, et al. Association of hormonal contraception with depression. JAMA Psychiatry. 2016. 73(11):1154–1162. doi:10.1001/jamapsychiatry.2016.2387

Slap GB. “Oral contraceptives and depression: impact, prevalence and cause.” Journal of Adolescent Health Care: Official Publication of the Society for Adolescent Medicine. 1981. 2(1):53-64. doi:10.1016/s0197-0070(81)80087-3

Hamed K. Risk of inflammatory bowel disease with oral contraceptives and menopausal hormone therapy: Current evidence and future directions. Drug Safety. 2016. 39(3):193-7. doi:10.1007/s40264-015-0372-y

Clapp M, et al. Gut microbiota’s effect on mental health: The gut-brain axis. Clinics and Practice. 2017. 7(4):987. doi:10.4081/cp.2017.987

Palmery M, et al. Oral contraceptives and changes in nutritional requirements. European Review for Medical and Pharmacological Sciences. 2013. 7(3):1804-13. https://pubmed.ncbi.nlm.nih.gov/23852908/

Williams WV. Hormonal contraception and the development of autoimmunity: A review of the literature. The Linacre Quarterly. 2017. 84(3):275-295. doi:10.1080/00243639.2017.1360065

Hertel J, et al. Evidence for stress-like alterations in the HPA-axis in women taking oral contraceptives. Scientific Reports. 2017. 7:14111. https://doi.org/10.1038/s41598-017-13927-7

Related Posts

10 Scary Ways Social Media is Changing Your Brain

Just as with substance addictions, users develop a tolerance to the dopamine surges that social media triggers. They’ll eventually require more frequent or prolonged

Social media has become a normal part of life for people of all ages. But, as a relatively recent addition to our modern world, researchers are still uncovering all the ways it’s affecting our brains, bodies, and behavior.

These changes are even more alarming among children and young adults, who have grown up with round-the-clock exposure to smartphones—not to mention computers, televisions, tablets, and video games.

Technology overuse, especially early in life, can lead to long-term addiction. But that’s just the tip of the iceberg.

Let’s take a look at 10 surprising ways social media and devices like smartphones are altering our lives.

10 DANGERS OF SOCIAL MEDIA

  1. Impacts Dopamine Pathways and Reward System

It’s no surprise that both kids and adults become addicted to social media—these platforms are designed to trigger the brain’s reward system. Users get hooked on the constant dopamine release that accompanies a “like” or a positive comment online

Dopamine, a neurotransmitter associated with pleasure and reward, helps reinforce the behavior, which leads to repeated use of social media. This phenomenon is known as the dopamine loop.

One Turkish study found that social media users exhibited biological and psychological symptoms similar to those addicted to alcohol, cigarettes, and other drugs.

Because the brain becomes conditioned to associate social media use with positive feelings, users seek out more social media interactions to experience those pleasurable dopamine surges.

Furthermore, social media is particularly effective at exploiting the brain’s reward prediction error system. This happens when unexpected rewards (such as an unexpected “like” or comment) trigger even more significant dopamine releases. Such unpredictability can increase compulsive use.

  1. Changes Brain Structure and Brain Function

Some studies have shown that heavy social media and smartphone use can lead to reductions in gray matter volume in areas of the brain. Affected regions include the anterior cingulate cortex (ACC) and the prefrontal cortex (PFC).

The ACC is involved in emotional regulation and impulse control. Changes in this region have been associated with increased susceptibility to addiction and difficulty managing emotions.

The PFC is responsible for decision-making, impulse control, and focusing attention. It can become less effective through excessive screen time, leading to impaired judgment and self-regulation.

Indeed, studies have noted that excessive smartphone use is associated with difficulties in cognitive-emotion regulation, impulsivity, and impaired cognitive function. All of these also contribute to the likelihood of addiction.

  1. Weakens Attention and Cognitive Control

With a constant influx of notifications and a compulsive need to check social media, heavy users often struggle with short attention span. When the brain is continually shifting focus, its ability to concentrate on tasks that require sustained attention weakens.

Multitasking is often believed to improve productivity. But research suggests that multitasking with digital media actually decreases overall cognitive performance. The brain also suffers from reduced ability to filter out irrelevant information, which can lead to cognitive overload.

Over time, the brain may adapt to frequent social media use by becoming less efficient at controlling impulses and focusing attention. The prefrontal cortex, which governs these functions, can be overwhelmed by the constant demands for attention from various apps and platforms.

  1. Distorts Social and Emotional Processing

Research has linked social media with altered social cognition because it can distort how individuals perceive social interactions.

The curated and often idealized nature of online content can lead to unrealistic expectations and comparisons, which may contribute to self-esteem issues or feelings of inadequacy or depression among young users.

In addition, the amygdala (the brain region involved in processing emotions like fear and anxiety) can become more sensitive due to the constant exposure to emotionally charged content on social media. This heightened sensitivity may contribute to anxiety disorders and heightened stress responses.

Some studies have suggested that excessive use of social media, particularly when it replaces face-to-face interactions, may even reduce empathy. This is because the brain’s mirror neuron system, which is involved in understanding others’ emotions, is less engaged during online interactions than face-to-face ones.

  1. Leads to Addiction-Like Behaviors

Various changes within the body and brain create the potential for addiction to social media. The compulsive need to check these sites is driven by the concept of intermittent reinforcement. Just as with gambling, the brain is rewarded inconsistently, which strengthens the habit and makes it difficult to break.

And, just as with substance addictions, users develop a tolerance to the dopamine surges that social media triggers. They’ll eventually require more frequent or prolonged use to achieve the same effect.

If they try to give up or reduce their social media usage, they can even experience withdrawal symptoms. These side effects can include irritability, anxiety, or depression.

  1. Contributes to Sleep Disruption

The Sleep Foundation warns that excessive social media use before bedtime can reduce sleep quality and increase the risk of numerous sleep issues.

The blue light emitted by cell phones and other screens suppresses the production of melatonin, a sleep-regulating hormone. This can delay the onset of sleep and reduce sleep quality, leading to chronic sleep deprivation.

Even when users are asleep, screen time may impact REM sleep. These disruptions, particularly in the REM stage, can impair memory consolidation and emotional processing.

Over time, poor sleep can exacerbate mood disorders and cognitive decline, making it more challenging to regulate emotions and maintain optimal mental health.

One 2024 study found a distinct relationship between the duration of sleep, social media usage, and brain activation across regions that are key for executive control and reward processing.

Other studies have noted the correlation between sleep disturbance and serious effects such as suicide and mental health problems in adolescents.

  1. Ramps Up Stress and Anxiety

Studies have shown that social media and device usage can cause various stress and anxiety symptoms.

For example, many users have reported experiencing “phantom vibrations”—the sensation that their phone is vibrating when it isn’t. This occurs when the brain develops a heightened state of vigilance and anxiety about missing a notification.

Meanwhile, the constant stress of being connected and fear of missing out (FOMO) can lead to chronically elevated cortisol levels. High cortisol can impair cognitive function, reduce immune response, and contribute to the development of anxiety and depression.

The American Psychological Association has cited research that there’s even a correlation between stress and the frequency of attention switching that’s necessary online.

Stress, measured by heart rate monitors, was shown to rise in correlation with faster attention switching. Users are then more likely to make errors, which adds to stress. Simultaneously, performance slows, so each task requires more mental effort.

Finally, many users struggle with social comparison online. With social media showing carefully edited images and videos, users often unfavorably measure their lives against the seemingly “perfect” lives of others.

This can increase stress, anxiety, and depression, as users may feel inadequate or unsuccessful after viewing such content.

  1. Interferes with Adolescent Brain Development

As a period characterized by high neuroplasticity, adolescence is a critical time for brain development. That’s why excessive social media use in a child’s younger years can so drastically shape the developing brain in disturbing ways.

For example, a child may learn to prioritize instant gratification while having a reduced attention span and impaired emotional regulation.

At the same time, peer influence is at an all-time high in adolescence, so a child’s brain is particularly sensitive to peers’ opinions. Social media amplifies this trait by providing immediate feedback through likes, comments, and shares, which can influence behavior and self-concept in ways that may be unhealthy.

Finally, heavy social media use has been associated with delayed emotional and social maturity. Adolescents may struggle to develop the skills needed for in-person social interactions, leading to difficulties in forming and maintaining real-life, off-screen relationships.

  1. Causes Neurochemical Imbalances

Research suggests a link between neurotransmitter levels and Internet and smartphone addiction. Excessive screen time may alter the balance of neurotransmitters like GABA, which has inhibitory effects, and glutamate, which has excitatory effects. An imbalance in these neurotransmitters can contribute to mood disorders, anxiety, and cognitive dysfunction.

Social media addiction may also affect levels of serotonin, a neurotransmitter associated with mood regulation. Low serotonin levels are linked to depression, anxiety, and other mood disorders, which may be exacerbated by the stress and social comparison inherent in social media use.

  1. Leads to Long-Term Consequences

While any single consequence listed above is alarming, overuse of social media and smartphones may have further serious long-term effects over time.

For example, prolonged and excessive use may lead to brain atrophy, particularly in areas responsible for cognitive control, emotional regulation, and attention. This could contribute to long-term cognitive deficits and increased susceptibility to mental health disorders.

Meanwhile, the behavioral conditioning effects of social media can lead to lasting changes in behavior, making it challenging for individuals to break free from the cycle of addiction.

As with any addiction, this can impact every aspect of a person’s life: personal relationships, academic or professional performance, and overall well-being.

REDUCING SOCIAL MEDIA AND SMARTPHONE EXPOSURE

The introduction of technological advancements like the Internet, smartphones, and social media in recent decades has turned modern human beings into proverbial guinea pigs. And experts are still investigating the full implications of these developments.

As we learn more about tech’s effects, it’s best to limit screen time to daily recommended amounts, which range from 2 hours max for adults to less than 30 minutes for preschoolers.

Minimizing screen time will help maximize your—and your child’s—brain, body, and mental health, both now and for the future.

We Are Here For You

Addiction and other mental health conditions can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

Macit, H. B., Macit, G., & Güngör, O. (2018). A RESEARCH ON SOCIAL MEDIA ADDICTION AND DOPAMINE DRIVEN FEEDBACK. Journal of Mehmet Akif Ersoy University Economics and Administrative Sciences Faculty, 5(3), 882-897. https://doi.org/10.30798/makuiibf.435845

Shanmugasundaram Mathura, Tamilarasu Arunkumar. The impact of digital technology, social media, and artificial intelligence on cognitive functions: a review. Frontiers in Cognition, VOLUME 2, 2023, https://www.frontiersin.org/journals/cognition/articles/10.3389/fcogn.2023.1203077. DOI 10.3389/fcogn.2023.1203077.

 

Wacks Y, Weinstein AM. Excessive Smartphone Use Is Associated With Health Problems in Adolescents and Young Adults. Front Psychiatry. 2021 May 28;12:669042. doi: 10.3389/fpsyt.2021.669042.

Uncapher MR, Lin L, Rosen LD, Kirkorian HL, Baron NS, Bailey K, Cantor J, Strayer DL, Parsons TD, Wagner AD. Media Multitasking and Cognitive, Psychological, Neural, and Learning Differences. Pediatrics. 2017 Nov;140(Suppl 2):S62-S66. doi: 10.1542/peds.2016-1758D.

Doheny Margaret M., Lighthall Nichole R., Social cognitive neuroscience in the digital age, Frontiers in Human Neuroscience, VOLUME 17, 2023, https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2023.1168788. doi:10.3389/fnhum.2023.1168788.

Social Media and Empathy Around the Globe, by Alison Jane Martingano, The Society for Personality and Social Psychology, https://spsp.org/news/character-and-context-blog/martingano-social-media-use-lower-empathy

Sleep and Social Media, Rob Newsom and Dr. Anis Rehman, Internal Medicine Physician, Sleep Foundation, https://www.sleepfoundation.org/how-sleep-works/sleep-and-social-media

American Academy of Sleep Medicine. (2024, May 30). Social media use and sleep duration connected to brain activity in teens. ScienceDaily. Retrieved September 9, 2024 from www.sciencedaily.com/releases/2024/05/240530132713.htm

Pirdehghan A, Khezmeh E, Panahi S. Social Media Use and Sleep Disturbance among Adolescents: A Cross-Sectional Study. Iran J Psychiatry. 2021 Apr;16(2):137-145. doi: 10.18502/ijps.v16i2.5814.

 

American Psychological Association, Speaking of Psychology: Why our attention spans are shrinking, with Gloria Mark, PhD, Episode 225, https://www.apa.org/news/podcasts/speaking-of-psychology/attention-spans

Lara N. Wolfers, Sonja Utz, Social media use, stress, and coping, Current Opinion in Psychology, Volume 45, 2022, 101305, ISSN 2352-250X, https://doi.org/10.1016/j.copsyc.2022.101305. https://www.sciencedirect.com/science/article/pii/S2352250X22000070

Seo HS, Jeong EK, Choi S, Kwon Y, Park HJ, Kim I. Changes of Neurotransmitters in Youth with Internet and Smartphone Addiction: A Comparison with Healthy Controls and Changes after Cognitive Behavioral Therapy. AJNR Am J Neuroradiol. 2020 Jul;41(7):1293-1301. doi: 10.3174/ajnr.A6632.

Related Posts

5 Ways Your Body Tells You That You Have Anxiety or Depression

Anxiety and depression are best known for causing mental distress are also associated with a host of physical symptoms.

Headaches, a queasy stomach, muscle pain—is it time to reach for the aspirin or ibuprofen? Or is it anxiety or depression causing your symptoms?

Anxiety and depression are best known for causing mental distress—making you feel nervous, worried, sad, or numb. But these common mental health conditions—anxiety disorders affect an estimated 40 million Americans and major depressive disorder affects approximately 17 million—are also associated with a host of physical symptoms.

According to Amen Clinics, a global leader in brain health that has treated tens of thousands of people with mental health issues over the past 30-plus years, here are five of the most common physical signs of anxiety and depression.

5 COMMON PHYSICAL SYMPTOMS OF ANXIETY AND DEPRESSION

  1. Headaches

Research has found that chronic daily headaches are common in people with clinical depression and anxiety, especially in people with generalized anxiety disorder or panic disorder.

Some people experience tension headaches that can cause mild to moderate pain and may involve stiffness in the neck and shoulders. Others suffer from migraine headaches, which are associated with more severe pain and can interfere with daily activities.

A 2018 study in the journal Headache found that people with frequent migraine headaches are more likely to experience anxiety and depression.

  1. Muscle Tension, Soreness, or Chronic Pain

Muscle tension is often seen in people with anxiety disorders, such as panic disorder, and chronic pain is frequently seen in depressed people. Research in the Journal of the Neurological Sciences shows that people with depression tend to have a lower tolerance for pain.

At Amen Clinics, brain imaging studies using single photon emission computed tomography (SPECT) scans show that people who experience chronic pain often have too much activity in an area of the brain called the thalamus.

This brain region is part of the deep limbic system, which is the brain’s emotional centers. On brain scans, overactivity in the limbic system is often associated with depression. This suggests that chronic pain and depression may activate the same brain systems.

  1. Nausea, Upset Stomach, And Digestive Distress 

Everyone knows that anxiety about a big life event can trigger a nervous stomach, but the connection between the digestive tract and mental health goes even deeper. Feeling nauseous, having stomach cramps, or experiencing constipation or diarrhea are all associated with anxiety and depression.

Findings from a study appearing in Advanced Biomedical Research showed that people with irritable bowel syndrome (IBS) have higher anxiety and depression symptoms compared with people who don’t have IBS.

Researchers have also found that people with anxiety or mood disorders are more likely to have constipation compared with the general population.

  1. Fatigue or Lack of Energy

When you have anxiety, you may worry incessantly, which can be exhausting. Similarly, having depression is strongly linked to fatigue. Being depressed can lead to a physical lethargy, a sense of apathy, and a loss of mental energy.

However, the fatigue you feel may also be related to sleep troubles. Anxious thoughts may make it difficult to fall asleep or may cause you to wake up in the middle of the night when worries start spinning in your mind. According to scientific evidence, over half of all people with anxiety have trouble sleeping.

 

Depression and poor sleep also go hand in hand. Research in Dialogues in Clinical Neuroscience shows that about 75% of people with depression also have insomnia. Early awakening is also common among depressed people.

A smaller percentage of people with depression sleep more than usual but still feel daytime sleepiness. If you aren’t sleeping well, get an evaluation before taking sleeping pills, which may be hard to stop.

  1. Chest Pain or Rapid Heartbeat

Feeling your heart start to race or experiencing tightness in the chest can be symptoms of panic attacks. After the panic attack subsides, heart rate usually returns to normal levels and any chest pain goes away.

In some people with depression or anxiety, however, chest pain can become chronic. A 2023 study explores the bidirectional relationship between heart disease and depression and anxiety.

According to this study, the prevalence of people with depression who have cardiovascular disease is 20%–40%, far higher than the rate among healthy individuals. At the same time, people with heart disease are more likely to develop depression compared to the general population.

These findings also indicate that people with cardiovascular disease are more likely to have anxiety. In fact, they have a 26% increased risk of anxiety.

Because of this, if you’re experiencing any form of chest pain, it’s critical to see a doctor to determine what’s causing it.

WHAT TO DO WHEN PHYSICAL SYMPTOMS PERSIST

You may not realize that the recurring aches and pains, digestive issues, or fatigue you experience are related to mental health problems. Many people simply head to their primary care physician or another traditional medical professional in an effort to treat the physical issues without considering the possibility of underlying anxiety and depression.

However, this can lead to treatments that don’t solve the underlying issue. For example, taking medication for physical symptoms without treating the anxiety and depression won’t provide the lasting relief you want. Getting to the root cause of your physical symptoms is the key to feeling better.

To help you understand what’s causing your issues, pay attention to when your physical symptoms arise. Is it during times of increased stress, nervousness, or sadness?

Becoming aware of an increase in pain, more frequent headaches, or an uptick in digestive problems or other physical symptoms may be a clue that anxiety or depression may be to blame.

If you aren’t getting relief, it may be time to seek help from a mental health professional who understands the connection between the brain, body, and mind.

Getting a brain SPECT scan allows psychiatrists to identify brain activity patterns associated with anxiety and depression, as well as other brain and mental health issues. With a more accurate diagnosis, you’ll be on your way more quickly to feeling better both mentally and physically.

We Are Here For You

Anxiety, depression, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

Wei, Cui-Bai et al. “Overlap between Headache, Depression, and Anxiety in General Neurological Clinics: A Cross-sectional Study.” Chinese Medical Journal vol. 129,12 (2016): 1394-9. doi:10.4103/0366-6999.183410

Chu HT, Liang CS, Lee JT, et al. “Associations Between Depression/Anxiety, Headache Frequency In Migraineurs: A Cross-Sectional Study.” Headache. 2018, 58(3):407-415. doi: 10.1111/head.13215.

Zambito Marsala, Sandro et al. “Pain perception in major depressive disorder: a neurophysiological case-control study.” Journal of the neurological sciences vol. 357,1-2 (2015): 19-21. doi:10.1016/j.jns.2015.06.051

Roohafza, Hamidreza et al. “Anxiety, depression and distress among irritable bowel syndrome and their subtypes: An epidemiological population based study.” Advanced biomedical research vol. 5 183. 28 Nov. 2016, doi:10.4103/2277-9175.190938

Hosseinzadeh, Sahar Tahbaz et al. “Psychological disorders in patients with chronic constipation.” Gastroenterology and hepatology from bed to bench vol. 4,3 (2011): 159-63.

Nutt, David et al. “Sleep disorders as core symptoms of depression.” Dialogues in clinical neuroscience vol. 10,3 (2008): 329-36. doi:10.31887/DCNS.2008.10.3/dnutt

Harvard Health Publishing. “Sleep deprivation can affect your mental health,” August 17, 2021, https://www.health.harvard.edu/newsletter_article/sleep-and-mental-health

Li, Xinzhong et al. “Cardiovascular disease and depression: a narrative review.” Frontiers in cardiovascular medicine vol. 10 1274595. 21 Nov. 2023, doi:10.3389/fcvm.2023.1274595

Related Posts

Are you someone who struggles with anxiety and depression inwardly, but outwardly presents a happy persona to the world? Do you worry that your anxiety symptoms or depressive symptoms will scare people away or jeopardize your career? Do you feel there’s something weak or shameful about having mental health issues? If you answered yes to any of these questions, you’re not alone. It’s not uncommon for individuals with anxiety disorders and clinical depression to hide their conditions from others. In fact, a recent survey by Kantar research, commissioned by the mental health organization See Change, found that more than half (53%) of young people would contemplate hiding a mental health disorder from family or friends. More than half (53%) of young people would contemplate hiding a mental health disorder from family or friends.
Click to tweet
Sometimes an individual struggling with depression symptoms will appear outwardly cheerful, smiling often, thus masking the condition from others. This is termed “smiling depression,” which can exacerbate depression and associated anxiety and even lead to suicidality. Indeed, the cost for hiding anxiety and depression is great. Mental health experts have found that there are significant reasons why people conceal mental health disorders. Here’s what may be driving smiling depression and hidden anxiety in you or a loved one.

ABOUT ANXIETY AND DEPRESSION

Not everyone who has depression fits the stereotype of being sad, isolated, and unable to get out of bed. In fact, brain scans using a technology called single photon emission computed tomography (SPECT) at Amen Clinics have revealed there are 7 types of depression. Smiling depression may be considered a form of “high-functioning depression.” Individuals who exhibit smiling depression may inwardly experience some of the core symptoms of depression, such as: Despite their internal symptoms, these people appear “normal” to the outside world. Often co-occurring with depression, an individual hiding anxiety may inwardly experience some of the less visible symptoms of anxiety: Outwardly, they try to appear calm, although that can be difficult if they experience more visible core symptoms of anxiety such as being easily startled, rapid breathing, sweating, or trembling.

7 REASONS WHY PEOPLE HIDE ANXIETY AND DEPRESSION

There are many understandable reasons why you might hide symptoms of anxiety and depression. Gaining insight, empathy, and acceptance about what drives this behavior will help you or your loved ones seek help and treatment.

1. Fear of burdening others

Guilt is a major feature of depression. This tends to create a feeling of being burdensome in those who are struggling inwardly with the pain of depressive or anxious symptoms. If you have a caretaking personality, it can feel especially wrong to ask for help. If you appear to have a great life, you may additionally feel guilty about not being happy. Instead, you silently struggle while outwardly acting as if everything is okay or by appearing happy.

2. Shame or embarrassment

Internalized stigma about mental illness, called “self-stigma,” may lead some individuals to think depression and anxiety are signs of weakness or a moral failing. This is very common for people who grew up in a family that did not talk about mental health openly or maintained a “stiff upper lip” approach to psychological pain. This type of individual may feel tremendous shame about not being able to handle their depression and/or anxiety. Pretending they are okay and appearing outwardly “normal” is their solution. Additionally, perfectionists—often driven by shame—may find a mental health disorder intolerable and unacceptable, preferring to appear fine at all costs.

3. Denial

We all have a psychological defense mechanism called denial. It’s a protective tool the mind reverts to when things get difficult or overwhelming. On the one hand, it allows us to have time to adjust to a difficult or disturbing change in our reality. With depression and anxiety, smiling or acting calm serves to keep the reality of potentially having a mental health condition at bay. Yet, it also inhibits us from acknowledging there’s a problem and making a needed change by getting treatment. Some people struggle to admit that there might be something wrong with them. Pretending like they’re fine is a better choice than being vulnerable and opening up about how they really feel. The protective shield of denial may be strong in individuals who came from families where denial was modeled. Mental health issues can be a big trigger for denial, experts report. Denial can also stem from fear about side effects of medication, cost of treatment, or mistrust of medical doctors due to past experiences.

4. Negative feedback

Mental health experts have observed that individuals who struggle with anxiety and/or depression may unconsciously learn to hide their symptoms when they receive negative feedback from others in response to their depressive symptoms, negative thinking, or anxious thoughts and behaviors. Sometimes it’s a conscious decision to smile and act “okay” to protect themselves from rejection or pain. People with anxiety and depression may worry that they’ll overwhelm friends, partners, or family members or they will be judged The negative thoughts and paranoia that are symptomatic of depression and anxiety can make you feel hypersensitive to criticism from others furthering the desire to conceal your inner struggle.

5. Stigma

Although public understanding of mood disorders like anxiety and depression has increased in recent years, stigma still exists. Mental health stigma has existed for centuries and has been reinforced by Influences such as inaccurate portrayals of mental health disorders in media, our country’s history of institutionalizing individuals with mental illness, our former criminalization of suicidality, and more. Too often, public stigma causes individuals with mental health conditions to think of themselves as defective or having caused their illness. The cultural stigma becomes self-stigma, as mentioned above, where an individual carries a negative perception and internalized shame about their own mental health disorder. Unfortunately, our culture doesn’t fully understand that depression and anxiety are illnesses with neurobiological underpinnings caused by a number of factors, including brain function and genetic predisposition. As a result, you may hide your depression and anxiety symptoms from others or yourself, or both.

6. Fear of discrimination

People with anxiety and depression will go to great lengths to keep their symptoms hidden in the workplace out of fear of being passed over for a promotion or worse, being fired. Of course, this causes tremendous stress as they struggle to focus and perform while privately grappling with low energy, fatigue, concentration, worries, low mood, and other symptoms. These fears are not unfounded. Even though people with mental health disorders are supposed to be protected under the law, discrimination does exist.  Recent data shows that complaints in workplace discrimination based on mental health disorders have increased. A large portion of these complaints are related to anxiety disorders. That said, disclosing a mental health disorder with an understanding employer or supervisor can be very beneficial. Many informed employers/bosses will readily make accommodations to support the well-being of employees struggling with depression and/or anxiety.

7. Unaware of being anxious/depressed

Here’s a surprising reason: Some people don’t realize that they’re anxious or depressed! They may have less recognizable symptoms of depression or anxiety. Or, in some cases, their symptoms may increase slowly over time, making them harder to notice. According to a report from the National Alliance on Mental Illness, there are hard-to-identify symptoms of depression, such as: There are some surprising physical signs of anxiety too, including dental health issues, poor libido, brittle nails, inflammation, and a more pronounced stress response.

ANXIETY AND DEPRESSION TREATMENT

Smiling and pretending to be fine are ultimately a risky way to respond to feelings of depression and anxiety. Untreated depression and anxiety increase your chances of developing other mental disorders and health issues, substance abuse, eating disorders, panic attacks, relationship problems, work problems, suicide, and more. The great news is that anxiety and depression are treatable with psychotherapy, medication (when necessary), and lifestyle changes such as meditation, healthy diet, nutritional supplementation, restorative sleep, exercise, and social connections. If you suspect you or a loved one might be hiding depression or anxiety, don’t continue to suffer. Reach out to a qualified mental health professional for help. Anxiety, depression, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Do you constantly worry about having a serious health issue. Do you frequently check your body for signs of illness, such as lumps, skin changes, numbness, tingling, irregular heart palpitations, or pain? Do you often call or see your primary doctor due to these concerns? Or, alternatively, do you avoid your doctor, afraid of what he or she might discover? If so, you may have a condition called health anxiety disorder. Patients with health anxiety will use health care services frequently, sometimes seeking treatment from multiple providers at once. However, they don’t often feel reassured and more commonly doubt that their medical care is adequate.
Click to tweet
Health anxiety can be debilitating—negatively impacting work, personal relationships, basic daily functioning, mental health, and even longevity. Actress/producer Tish Cyrus, mother of pop singer/songwriter Miley Cyrus, suffered for many years from health anxiety. In a segment of Scan My Brain with Dr. Daniel Amen, Cyrus opened up about her experience.
“I was just always worried about my health,” she says. “And that happened for a long time until my mom literally forced me to go see a doctor and get on some medication.”
Indeed, health anxiety can be managed by medication, different types of therapy, and actions that reduce anxiety. Here’s what you need to know about health anxiety and how to manage it.

WHAT IS HEALTH ANXIETY?

Health anxiety is a mental health condition that involves excessive worry about specific symptoms or fears that you are or may experience a serious illness. This condition was formerly known as hypochondriasis, or hypochondria. If you’ve ever expressed worry about a symptom, injury, or illness being something bigger or more serious than it actually was, you may have been called a “hypochondriac.” This casual term is dismissive and borders on disparaging. That’s one reason the diagnosis hypochondriasis was replaced with the two new, more specific diagnostic terms: The terms hypochondria and hypochondria symptoms may still be used, but not diagnostically. They are both forms of health anxiety.

WHAT IS SOMATIC SYMPTOM DISORDER?

SSD involves one or more chronic somatic (bodily) symptoms that cause excessive concern, preoccupation, or fear. This can lead to significant distress and trouble functioning in daily life. Usually, one symptom remains constant, but other symptoms may come and go. People with SSD feel concerned that their mild symptoms (such as minor pains, weakness, shortness of breath, etc.) are signs of serious conditions. Patients with SSD will use health care services frequently, sometimes seeking treatment from multiple providers at once. However, they don’t often feel reassured and more commonly doubt that their medical care is adequate. These individuals can spend exorbitant amounts of time and energy dealing with health worries. Sometimes they may be unusually sensitive to drug side effects. They may become demanding or dependent on others for help and emotional support. And they may feel angry when they feel unsupported.

WHAT IS ILLNESS ANXIETY DISORDER?

IAD is a mental health disorder characterized by excessive worry about having or developing a debilitating life-threatening illness, such as cancer, stroke, or heart disease. People with IAD may have no symptoms or only mild symptoms, which are not overly distressing. However, if an individual with IAD has a medical condition or an increased risk for developing a medical condition (due to family history), the anxiety surrounding the medical condition or potential medical condition is abnormally high. Even when physical examination and laboratory testing results are normal, people with IAD continue to have intense anxiety or fear of having or developing a serious medical issue. Their health anxiety symptoms may include repetitive behaviors related to their fears like compulsively checking their body for bumps or other signs of disease. For a clinical diagnosis of IAD, the preoccupation with illness must last for 6 months or longer and cannot be better explained by another mental health condition. Other signs of IAD may include: Although it’s common for people with any type of health anxiety to see their doctors frequently, some individuals may be completely care avoidant. This may be due to fear that seeing a doctor will reveal a life-threatening illness.

THE NEGATIVE IMPACT OF UNTREATED HEALTH ANXIETY

Untreated health anxiety can impact an individual in profoundly destructive ways. As mentioned, it can significantly interfere with a patient’s personal life and relationships, as well as normal functioning in their daily life. It can also cause severe psychological disability, according to the latest research. People with health anxiety are at greater risk of other psychiatric disorders, such as: But there’s more. A 2023 Swedish study has found that people with illness anxiety disorder tend to die earlier than individuals who don’t obsess about their health. People with IAD die at a mean age of 70 while those without the condition pass away at a mean age of 75. In this study, having health anxiety was linked to increased risk of death from both natural and unnatural causes, such as suicide. Data from this study indicate that those with IAD are four times more likely to die by suicide compared to the general population. In short, one’s overall quality of life—and even longevity—can be dramatically decreased.

WHAT CAUSES HEALTH ANXIETY?

Experts are not entirely clear about what causes health anxiety, but there are a number of factors associated with SSD and IAD. Contributing factors may include: For Cyrus, a few of these causes likely played a role in her health anxiety. While growing up, she was faced with the traumatic experience of slowly losing her father to throat cancer.
“Between 7 and 19, I saw a lot. He had his voice box removed, and he couldn’t talk for a year and a half before he died,” she says. “And he was also diabetic.”
Although medication initially helped with her symptoms, its effectiveness diminished over time. Her health anxiety resurfaced after a number of stressful life circumstances occurred, including the passing of her mother.
“I always knew when something happened to my mom, it would probably be the hardest day of my life,” she says.
She eventually visited Amen Clinics for help. As part of her evaluation, Cyrus underwent brain SPECT imaging, which measures blood flow and activity in the brain. Her SPECT scan revealed overactivity in the region of the brain known to control anxiety and body sensations. This may, in part, explain her health anxiety.

11 WAYS TO MANAGE HEALTH ANXIETY

If you believe you may have health anxiety, it’s important to reach out to a mental health professional for an evaluation. Here are 11 ways to manage health anxiety: 
  1. Consider psychotherapy, especially cognitive behavioral therapy (CBT).
  2. Talk to your doctor about antidepressant medication, such as SSRIs and SNRIs, which have been shown to help the condition in research.
  3. Get tested (and treated if tests are positive) for hypoglycemia, anemia, and hyperthyroidism, which are associated with increased anxiety.
  4. Try prayer, meditation, and hypnosis, which are associated with stress and anxiety reduction.
  5. Practice diaphragmatic breathing, which may reduce anxiety.
  6. Learn to eliminate automatic negative thoughts (ANTS).
  7. Practice calming exercises such as yoga, qi gong, or tai chi.
  8. Take calming nutritional supplements such as l-theanine, GABA, and magnesium (glycinate, citrate, or malate) with vitamin B6.
  9. Take probiotics. Gut health is important to keeping stress and anxiety levels low.
  10. Try neurofeedback which can alleviate anxiety, according to research.
  11. Consider eye movement desensitization and reprocessing (EMDR), which involves moving the eyes in a specific way. EMDR has been shown to be an effective trauma therapy in You can watch Tish Cyrus engage in EMDR with Dr. Amen in this video segment.
By putting one or more of these strategies into practice, you will be better able to get health anxiety under control. This can be beneficial in your daily life and can help you achieve a greater sense of calm and happiness. Healthy anxiety and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 855-508-1316 or visit our contact page here.