Hi, I'm Dr. Tracey Marks, a psychiatrist and I make
mental health education videos. Some people will use stress
and anxiety interchangeably, but stress and anxiety are not the same. There are some distinct
differences between the two. Why does this matter? Well, one reason is because
there's an herbal remedy that's gaining a lot of
attention that works for stress, but not so much for anxiety. First, let me explain the difference between stress and anxiety from a biological perspective.
Stress can cause feelings of angst, usually triggered by a circumstance. The circumstance can
be financial pressures, the pandemic, having too
many responsibilities, relationship conflicts, et cetera. The circumstances, called stressors, can trigger you to have
an anxiety reaction, such as chest pain, trouble
breathing, or worrying. You can be stressed
emotionally or physically. And there's a specific biological response to both of these kinds of stress. Having surgery, spraining your ankle, or getting the flu are
examples of physical stressors. All of these situations increase cortisol, which is one of the
body's stress hormones. Your stress hormones serve the purpose of preparing your body for
a fight or flight response.
Cortisol is a steroid that
increases your blood sugar and suppresses your immune system. It does this by blocking
chemicals in the body that create inflammation. And by the way, just as an aside, you may be familiar with
hydrocortisone creams. Hydrocortisone is a version of cortisol that you can buy as an
over the counter medication to treat allergic reactions or inflammatory skin conditions. So cortisol is a chemical
that the body needs for certain functions, but having excessive amounts of it and persistent amounts of
it cause problems for you.
Your cortisol levels
fluctuate throughout the day and you tend to have your highest level first thing in the morning. And then the level falls
off as the day progresses, with the lowest levels occurring
in the middle of the night. Then it increases again as your body prepares you to wake up. If you are under a lot of stress, you can have higher than
normal cortisol levels in the morning called the cortisol awakening response. If this happens to you, you can wake up with a
lot of anxiety symptoms, like feeling tense, nauseated, or panic. Some people can wake up feeling chest pain and this feel very jarring because you expect to wake up
feeling relaxed and refreshed in the morning.
And here you are already in a panic. Then your cortisol levels are supposed to drop during the day. But if it doesn't drop enough because, let's say, it started out really high in the morning or you're stressed state produces surges of cortisol during the day, the high level in the
evening can make it hard for you to fall asleep
or even stay asleep. Your morning cortisol
levels can vary depending on what's going on in your week. One of the studies that I reference in the description found that test subjects had higher
morning cortisol levels on work days than they did on the weekends when they didn't have to work.
So that's stress. It can be mental or physical and result in elevated cortisol levels. Anxiety, on the other hand, is affected by a different
part of the brain. Your amygdala, which is
located in your temporal lobes, detects threats even before you're consciously aware of them. Your prefrontal cortex
is the part of the brain that processes threats and fears. Anxiety is different from stress because it's generally based on fear or worry about a threat. You may say, well if I feel overloaded
with responsibilities, the stress makes me fear that
I'm on the verge of failure. Well, yes, stress can trigger anxiety or make preexisting anxiety worse. But with true anxiety, you don't need a trigger
to experience the symptoms. And your fears and worries don't have to be based on real threats. For example, here are some of the fears with common anxiety disorders.
With social anxiety, you fear being humiliated or embarrassed, whether that's a real probability or not. You assume whenever you're around others or in a performance situation that humiliation is
the inevitable outcome. With panic disorder, you may fear that you're dying or having a heart attack. Even if you've had 50 other panic attacks that were never heart attacks, each attack you have
presents a new possibility that this time may be different. With generalized anxiety disorder, you worry about worst case
scenarios for any situation. And with separation anxiety, you fear losing people close to you. So can you see the difference between being consumed
with these kinds of fears versus having a negative response
to situational stressors? Situational stressors,
especially if they're prolonged, can cause you to have
persistent anxiety symptoms, like the morning panic, sleeping problems, or trouble thinking and
processing information.
Prolonged stress can also
cause physical problems like high blood pressure, insulin resistance, and weight gain. And you can experience all
of these stress problems even if you don't already
have an anxiety disorder. If you have an anxiety disorder, becoming overwhelmed with stress makes your anxiety more unmanageable. There's lots of things that you can do to reduce your stress. But one intervention that
falls under the category of complementary and
alternative medicine is the herb ashwagandha. Ashwagandha is an evergreen herb in the nightshade family
that grows in India, the Middle East, and Africa. It's been used in Indian
medicine for centuries as a medicinal herb that imparts intellectual
power, long life, and vigor. More recent research has looked into ashwagandha as an anxiety treatment. So far, the studies have
shown that it helps anxiety in people who were under a lot of stress. But it's not as good at relieving anxiety in people
with an anxiety disorder. Why? Because the way it works is
by reducing cortisol levels, especially morning cortisol levels. Herbs that improve your
body's stress response are called adaptogens. And they work by normalizing your body's physiologic
responses in times of stress, like in this case, reducing
high cortisol levels.
So far, I haven't seen
consistent recommendations as far as how much to take, but most studies that I've
seen use 250 milligrams to 600 milligrams taken in the morning. High doses greater than 1,000 milligrams have been associated with side effects of nausea, vomiting, and diarrhea. And there's also been a few reports of liver injury at the higher doses. So if you're feeling
overloaded with stress, ashwagandha may be worth a try, especially if you're having
intense morning anxiety or broken sleep. These are signs that you may have persistently
elevated cortisol levels as part of your anxiety and lowering your cortisol
may bring you some relief. Of course, things like
exercise, breathing, and meditation also help decrease
stress related to anxiety.
Take a look at this
video that I did talking about how exercise affects your brain. Thanks for watching. See you next time..