Anxiety and Nutritional Help

Photo by Tanja Heffner on Unsplash

We all know that what we eat can influence our overall health and risk factors in fairly straightforward ways. We are beginning to learn that what we eat can influence our mental health as well. Most of this research is fairly new, and there will definitely be more developments in the years to come, but I wanted to share some of it with you.

In this post, I will be specifically focusing on anxiety. In my next few posts, I will also cover bipolar disorder and depression. If there is another mental illness you would like me to cover let me know in the comments!

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I do not believe that nutrition/diet change is a replacement for medicine and counseling.  This information is not to be viewed as medical treatment or diagnosis.  Please do not change or stop any medication you are taking without consulting a doctor first. But I do believe that most people can benefit with a decrease in symptoms and an increase in functionality with nutritional changes/supplementation.

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Anxiety is the constant feeling of something being wrong, or about to go wrong. You may feel on edge the majority of the time, and small changes may severely upset you. Anxiety has fastly become the worlds most prevalent diagnosed mental illness. It is estimated to affect 40 million American adults.

Common treatments for anxiety disorders are medication and therapy. These are the only studied treatments that have been proven to decrease anxiety symptoms.

But food and it's relationship to our brain is starting to be more understood as we continue to research different nutrients and their potential impact on our brains, moods and various illnesses. While nothing I mention here has been proven beyond a shadow of a scientific doubt there are promising observational studies and small case studies.

My post will focus on specific nutrients, but I want to be clear that supplementation is not necessary for everyone. Supplementation is necessary if you are found to be deficient (which can be done with tests at your doctor's office) or if your diet does not provide you with certain nutrients (such as vitamin B12 supplementation for vegans and some vegetarians).

You do not have to stop your medication before changing your diet, and many studies show a beneficial effect when combining an improved diet with just about any issue. No matter who you are, what medication you take, or what illnesses may affect you improving your diet in general, should help you feel better, function better and have a higher quality of life.

I wanted to focus on the nutrients that most people have a higher chance of being deficient in that may help towards managing anxiety symptoms.

Calcium

Calcium is the most prevalent mineral in the human body. It is stored in bones & teeth not only to keep them strong but also to provide your body with calcium when you diet becomes low in the mineral. Calcium is needed for important electrical impulses throughout your body to help muscles and blood vessels to contract and expand, and it also plays a role in helping to secrete hormones and enzymes throughout the day. 

When calcium deficiency is present chances of irregular moods and anxiety attacks can increase significantly. We are still not sure as to why this may occur though we can speculate that it may be linked to calciums role of electrical impulses, and hormones.  If these are not "firing off" correctly the brain may not function as well. 

Most calcium deficiency occurs due to lack of calcium-rich foods in the diet. Too much protein and sodium in the diet can also cause your body to excrete calcium. And as we age or body's ability to absorb calcium lowers naturally. Protein is acidic mainly in the forms of phosphates and sulfates. When the blood is becoming too acidic the body will "buffer" this effect by telling your bones/teeth to release calcium to bring the blood back to a neutral pH. The average American diet is quite high in protein and low in fruits and vegetables which would cause a constant "leak" of calcium from the bodies stores. If this loss of calcium is not being replaced by calcium in the diet we are met with calcium deficiency!

Roughly 50% of American adults are not getting enough calcium in their diet. 

Many of us recognize milk and dairy products as a source of calcium but there are many different sources such as:

• Kale, arugula, broccoli
• Bony fish (ex: salmon, sardines)
• Soybeans and tofu
• White beans
• Almonds
• Sesame and sunflower seeds

Potassium

Potassium works closely with chloride in regulating blood pressure and pH balance. It is necessary for the heart to beat, for kidneys to filter blood and for our muscles to move. Low levels of potassium have been associated with greater risk for mood disturbances. 

The average American gets almost half the recommended intake of potassium daily. This is mainly due to lack of potassium-rich foods in the diet. Other causes can be antibiotics, diarrhea, and sweating. It can also be caused by bulimia, diuretics, Crohn's disease and excessive consumption of soda. Excessive soda consumption (in this study the man was drinking 4 liters of cola a day) can cause osmotic diarrhea due to the high amount of fructose being processed which can cause a potassium deficiency)

Potassium also helps to regulate serotonin (a neurotransmitter that helps you to feel happy). Potassium appears to act as a facilitator in ensuring the brain's ability to properly utilize serotonin. It is also required to activate neurons involved in positive thinking and feelings. A decrease in potassium (even slightly) can result in significant feelings of anxiety.

Foods high in potassium include:

• Beans
• Dark leafy greens
• Sweet potatoes
• Winter Squash (acorn, butternut)
• Salmon
• Avocados
• Mushrooms
• Bananas
• Raisins
• Dates

Note: Potassium is a very delicate balance in the body. Too little and the heart can give out, too much and the heart can stop. Supplementation should not occur without talking to your physician. If you want to increase your potassium levels, I recommend just starting by including potassium-rich foods into your diet. 

Non-deficient Vitamins of Interest

Selenium

Selenium is a trace element that plays a critical role in reproduction, thyroid hormone metabolism, DNA synthesis and protection from oxidative damage and infection. The majority of selenium is stored the skeletal muscle tissue in the human body. It is one of the most researched minerals in regards to its relation to depression and anxiety. 

Selenium deficiency is quite rare in the United States, but low levels of selenium have been associated with anxiety (1). 

A double-blind study in 1991 showed that subjects consuming the highest amounts of selenium had the highest elevation of mood and lower anxiety. The subjects with the lower level of selenium in their diet had more reports of anxiety, depression, and fatigue. But these were all revered following 5 weeks of selenium therapy. This study only had 50 subjects, so it is a very small pool, but the research is promising. 

A study of 475 pregnant women found that prenatal supplementation with selenium decreased the risk of postpartum depression. And a study of the elderly found that depression was improved by an increase of selenium in their diet. 

Foods high in selenium include:

• Brazil Nuts (1 oz contains over 100% of your daily requirement)
• Tuna
• Turkey
• Beef
• Eggs
• Brown Rice

Vitamin B12 (Cobalamin)

Vitamin B12 supports the brain and central nervous system by assisting in normal nerve growth and development, improves communication between nerve cells, promotes stable adrenal function, provides emotional and mental energy, helps with the ability to concentrate, bolsters memory function, and has calming effects to balance moods. 

It is generally believed that one of the pathways that B12 uses to get important work done is through the process of myelination. The myelin sheath is an insulating coating that covers all cells in the nervous system. It is made up of protein and fatty substrates which helps electrical signals to transmit quickly and efficiently between cells. B12 helps to build and maintain these covers. When there is a lack of B12 the myelin coating is compromised, which can lead to slow, sporadic nerve signaling which can lead to cognitive and mood changes. 

B12 is also important in the production of neurotransmitters that help communicate emotional information throughout the brain and the body. Without enough B12 this production system can falter and neurotransmitters will no longer be released at appropriate rates. As levels of neurotransmitters fall symptoms of mental health disorders can arise. 

A randomized, double-blind, placebo-controlled clinical trial lasting 60 days compared a group of adults given a mixture of mixture of B-Vitamins (Thiamine (B1), Riboflavin (B2), Niacin (B3), Pantothenic Acid (B5), Pyridoxine (B6), Biotin (B7) and Cobalamin (B12)) folate, PABA and inositol versus a group of adults that were given a placebo. Both groups of adults were diagnosed with depression, but this study compared their scores on the Becks Anxiety Inventory (BAI) as well as the Becks Depression Inventory II (BDI) so I felt it would be helpful to include in this post. 

The "Max Stress B" group (the one given the mixture of the B-Vitamins, etc) showed greater improvement on the BAI versus the placebo group. And they achieved a more continuous decrease of symptoms throughout the 60 days, whereas the placebo group had less or no improvement from 30-60 days. 

While this study has a lot of different nutrients that could be an explanation for this (or the combinations given) B12 has been the most studied of the B-complex for its role in anxiety relief. So this study helps to show the promise in this little vitamin. 

Vitamin B12 sources include: 

• Clams
• Fortified Cereals that list 100% DV for vitamin B12 in one serving
• Sockeye Salmon
• Tuna Fish (preferably canned in water)
• Haddock
• Top Sirloin
• Swiss Cheese
• Cured Ham
• Chicken Breast

Most B12 sources are meat based. As shown above, though, you can find cereals and non-meat options that have been fortified with B12. It is generally recommended that if you follow a vegan diet or certain vegetarian diets that you take a B12 supplement, as a deficiency in B12 can cause cognitive issues. 

Putting It All Together

So what to do with all this information? The first thing I would recommend is to evaluate your eating patterns. Do they include a variety of fruits and vegetables? Is it high in processed foods? Do you think you may have a caffeine problem? 

The best way to make sure that you are getting the vitamins you need is to maintain a diet rich in vegetables, fruits, a variety of proteins (meat or plant), with some healthy fats and whole grains thrown in.  The lists of foods above can be used to help you add new foods to your diet, or to see if you are lacking in certain areas. Maybe not enough vegetables, or not enough sources of B12? 

It is also recommended to consume foods that supply not only calcium and potassium but magnesium and phosphorus as well since these nutrients can be depleted due to stress. These foods include:

• Apricots
• Avocados
• Broccoli
• Dried Fruits
• Garlic
• Legumes
• Soy Products
• Yogurt

Small frequent meals, avoiding refined sugars and caffeine-containing products, regular exercise, and adequate rest can also be helpful towards those with anxiety (1). 

As always remember that a balanced diet is helpful for everyone, regardless of your medication or mental illness everyone can benefit from better eating habits. This is considered a complementary approach for symptoms and is NOT a treatment for anxiety. 

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If you need help with finding resources for handling your anxiety please check out these resources. 

If you are feeling suicidal or violent please call: 1-800-273-8255

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Do you feel that your anxiety symptoms have improved with certain foods? Let me know in the comments below!

1) Prescription for Nutritional Healing, Fifth Edition: A Practical A-to-Z Reference to Drug-Free Remedies Using Vitamins, Minerals, Herbs & Food Supplements