Introduction to the Holistic Treatment of Anxiety
The Resilience Medicine Approach to the treatment of Anxiety with holistic, integrative and cannabinoid medicine.
The Resilience Medicine Approach to the treatment of Anxiety with holistic, integrative and cannabinoid medicine.
Anxiety is one of the most common issues affecting wellbeing at every stage of life. There are many different types of anxiety disorders, but the most common one is GAD, or generalized anxiety disorder. Other forms of anxiety include OCD, PTSD (a complex form of anxiety and trauma) and specific phobias. Often, anxiety is suffered in secret and may also be accompanied by low moods and sleep disturbances and can sometimes include panic attacks in some forms.
Two people with the same diagnosis of anxiety may respond to different things and different types of anxiety disorders also need a different treatment plan to heal. A holistic approach recognizes that treatment for anxiety should be personalized, especially since many people find that standard medication alone isn’t effective or has unwanted side effects.
The Resilience Medicine Holistic approach to treating anxiety incorporates cannabinoid (cannabis-based) medicines, specific mindbody techniques, therapeutic diets, prescribed combinations of nutraceuticals & medications, passion and connection and creating a resilience environment using evidence-based and evidence-informed interventions stacked together for greater healing to help you feel better faster.
In this article you are going to learn about each of these holistic approaches in detail, how to use them for your healing journey as well as the latest research evidence, case studies, clinical trials and resources for anxiety to help remove the confusion and help provide a path to feeling better.
Everyone has their own unique experience with depression but symptoms can include:
In addition to these symptoms, many patients also suffer from anxiety alongside depression, since anxiety and depression are not completely separate in the brain. In fact, most people with
depression, especially with chronic depression also has an element of anxiety.
Anxiety has what is known as ‘multifactorial’ causes. The exact mix of factors is slightly different for different people and involves:
Chronic illness, especially chronic pain conditions and neurological conditions as well as connective tissue disorders, hypermobility syndromes like hEDS and also chronic fatigue and long covid can also cause or worsen anxiety.
Some patients often experience anxiety years before the onset of another chronic condition while other people have never felt anxious until they got sick with something else, but have been struggling now with both conditions, anxiety worsening other symptoms or pain making anxiety worse in a vicious cycle.
Hormone changes like going through perimenopause can also cause or worsen anxiety. It can be a very frustrating lonely journey since when you suffer from anxiety, your life often gets smaller as you cut more and more things out in an attempt to maintain a calm nervous system and avoid triggers. Other chronic symptoms also impact anxiety levels in the brain and so must be treated together since they are often connected instead of just treating the symptoms of anxiety in isolation.
Diagnosing anxiety disorders necessitates a comprehensive and empathetic approach to ensure accurate identification and appropriate intervention. Mental health professionals, such as general practitioners, psychiatrists, and clinical psychologists, play a crucial role in this process.
The diagnostic evaluation begins with an in-depth exploration of an individual’s personal history, including their symptoms, experiences, and any potential triggers contributing to their anxiety. Standardized assessment tools, such as the Generalised Anxiety Disorder Assessment (GAD-7) are often employed to measure the severity of anxiety symptoms. Furthermore, it is essential to rule out any underlying physical conditions or other mental health disorders that may contribute to or exacerbate the individual’s anxiety.
Timely diagnosis and tailored treatment plans, encompassing cognitive-behavioural therapy, medication, or lifestyle modifications, can significantly improve the quality of life for those living with anxiety disorders.
The Resilience Medicine holistic approach involves incorporating interventions from 6 main categories: Cannabinoids & Power Plants, Diet + Microbiome, Mindbody, supplements & botanicals, Passion and connection & creating a resilience environment.
In the clinic, we also use functional medicine tests and approaches to further personalise treatment based on biomarkers, gut markers and genomics in some cases. We also, where needed, use medications, often with prescribed combinations of nutraceuticals.
These categories were chosen based on Dr Dani’s 15 years of experience using this holistic treatment framework with her patients. Often it is when things from different categories are ‘stacked’ on top of each other to create a unique integrative plan or ‘stack’ that gives the most benefit in anxiety, since everyone’s illness is slightly different.
It’s also worth remembering that even if you have tried some of these things before on your own, it is often getting the right combination of things done at the right time that makes a big difference even when meditating or changing the diet has failed in the past.
It can be very overwhelming and confusing trying to navigate all of the pieces of a holistic treatment plan on your own. Having expert guidance helps remove this confusion and overwhelm and makes sure you are on the best treatment path for your individual needs.
Power plants are potent plant and bio chemicals that have the ability to quickly shift our state and often temporarily alter our state of consciousness. These include the cannabis sativa plant as well as other compounds collectively known in medicine as ‘therapeutic psychedelics’ such as psilocybin now being used and researched as novel medicines for anxiety disorders and PTSD as well as other mental health conditions that often co-exist with anxiety, such as depression
Long before their use in modern medicine, many of these compounds have been used in different cultures around the world since ancient times to help reduce suffering and to facilitate personal transformation and healing. Many of the power plants were considered sacred by the cultures that utilized them, and still are today.
Medical cannabis is the most accessible power plant used as a medicine in the UK, where it is legal on private prescription from a specialist doctor. Medical cannabis are whole plant medicines which contain over 100 active cannabinoid compounds, which are thought to work together to deliver the medicinal effects although the main cannabinoids used for dosage currently are CBD and THC. The different strains or chemovars, can produce different therapeutic effects for anxiety, making it a highly personalized medicine.
Often people have tried recreational high doses of THC and found that this worsened anxiety or caused a panic attack. That is because THC does opposite things in the brain at different dosages and with vs. without CBD. Medical cannabis for anxiety is very different to recreational cannabis.
Medical Cannabis can often help patients those who have failed other approaches, to get a quick win in terms of anxiety symptom relief and starting of a
positive neurological ‘cascade’ leaving them more able to engage with other aspects of a holistic treatment plan.
Most patients see a significant improvement within the first month of therapy across multiple symptom clusters that often go along with anxiety including improved mood, fatigue, stress, pain, sleep and mental function.
Hemp CBD oil wellness supplement products available over the counter at health shops are not the same as medical cannabis. Hemp CBD oil non-medical products do not contain any measurable THC and are not made as medicines. However, for mild stress, they can be helpful for some people. However, for more severe anxiety or PTSD, medical cannabis which contains other plant cannabinoids including small doses of THC may be needed to get the medicinal effect that is needed. In PTSD for example, slow release medical cannabis oils containing more THC may be helpful for sleep.
Medical cannabis can be incredibly helpful for anxiety, including GAD, OCD, PTSD, phobias and other forms of anxiety like panic disorder especially where the standard medications and/or Psychotherapy approaches have not been effective on their own. Medical cannabis can be combined effectively with brain relaxation and brain training simple techniques to make them ‘stick’ faster and provide more relief while changing brain anxiety networks.
Medical cannabis can also help with more global mood and sleep disturbances, including trouble falling asleep and staying asleep (not waking up in the night) even when sleeping pills have not worked or made you feel hungover.
Medical Cannabis works on our endocannabinoid system (ECS) dysregulation, our HPA axis stress response system as well as our serotonin system and inflammation pathways. All of these mechanisms are involved in anxiety according to the latest research.
For anxiety, specific strains and types of medical cannabis are chosen for day vs nighttime, based on minor cannabinoid and terpene profile and the mode of delivery into the body so it is most effective for the anti-anxiety effect without making you feel sleepy during the day and then able to get a deep restful sleep at night.
This is because some types of cannabis can have the opposite effect and make fatigue or anxiety worse or not be helpful before sleep. Dr Gordon is the most experienced cannabinoid medicine physician in the UK, has trained the first UK psychiatrist physicians in the prescribing of medical cannabis for anxiety and has treated thousands of patients with medical cannabis first in Canada and in the past few years in the UK since it has become legal. She also uses a more holistic individualized approach to cannabinoid therapy due to her background in Integrative & botanical medicine.
Currently, there are clinical trials and studies ongoing for the use of psilocybin and other plant compounds for the treatment of anxiety, OCD, end-of-life anxiety and PTSD with promising early results, but they are not yet available outside of a research study in the UK.
Certain types of diets may influence and improve anxiety, due to the effects on factors such as the microbiome, affecting neurotransmitter levels and hormone pathways including insulin and stress hormone regulation. It’s often important to tailor the diet based on things like symptom cluster profile, anxiety type, gut and blood biomarkers and other factors which are assessed as part of the treatment plan.
However, starting by balancing blood sugar and insulin levels by reducing ‘free’ sugars in the diet, eating low glycemic index whole foods and dramatically reducing processed foods and processed carbohydrates is a good starting point if you suffer from anxiety.
Relaxation response techniques can lower stress, stimulate the vagus nerve and reduce brain ‘noise’ levels substantially to lower baseline anxiety levels. Techniques to activate the Relaxation Response, based on Dr Gordon’s experience studying these techniques at Harvard University with Dr Benson who discovered the Relaxation Response nearly 50 years ago, can make a huge difference. Other specific techniques such as mindfulness-based programs and techniques to reduce ‘body noise’ such as PMR are chosen based on your specific symptom profile.
To be most effective, the mindbody techniques should be tailored to each patient, especially because some people in the beginning can experience what is called paradoxical anxiety when they attempt to do some of these techniques on their own. These issues can be overcome with guidance.
Supplements including nutraceuticals, botanical extracts, medicinal fungi, adaptogens and and minerals can all be helpful for different aspects of anxiety. Each person will likely have a slightly different ‘stack’ of supplements based on their specific case and will likely not need all of these:
A variety of medications are available to help alleviate anxiety symptoms. The choice of medication often depends on the severity, duration, and specific type of anxiety disorder.
Selective Serotonin Reuptake Inhibitors (SSRIs), such as fluoxetine and sertraline, are commonly prescribed as first-line treatments.
Alternatively, Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) like venlafaxine and duloxetine may be prescribed to modulate both serotonin and norepinephrine neurotransmitters, which may work better for some people for contributing to mood regulation.
For short-term relief or situational anxiety, Benzodiazepines, such as diazepam or lorazepam, can provide rapid relaxation; however, their potential for dependency and side effects warrants cautious use.
Beta-blockers, typically used for heart conditions, have also been found to be effective in some people in managing the physical symptoms of anxiety, such as palpitations and tremors.
Some patients with anxiety have tried many of these medication options and found them either unhelpful or having intolerable side effects. In these cases, novel therapeutics such as medical cannabis can help as part of a holistic approach, alongside other integrative therapies when first line drugs have failed.
Environmental factors also impact our resilience from noise and light pollution to actual air pollution and chemicals in the foods we eat. Our environment also interacts with our genes to influence how we respond to our external environment. For example, if you have the genotype for certain enzymes not working as strongly as they could, you may be more sensitive to the effects of pollutants in the environment, which can influence a wide variety of health symptoms.
Having Indoor plants has been shown in several studies to lower anxiety levels. Having plants which clean the indoor air and also have been shown to have positive mood benefits is a good way to start, including plants such as snake plants, spider plants and ferns.
Creating a calming indoor space in a corner of the home can also help if you suffer from anxiety as a place you go to when you are feeling stressed to take even 5 minutes of meditation or relaxation breathing. Reducing clutter especially in the bedroom and at workstations may also help reduce anxiety levels.
For individuals grappling with anxiety disorders, fostering meaningful social connections and engaging in activities that evoke passion can be invaluable for improving mental well-being. Research has consistently demonstrated that establishing warm, close relationships contributes to enhanced physical health, strengthened immune system functioning, and overall cognitive vitality.
One particularly effective means of alleviating stress and anxiety is through interactions with animals. Numerous studies have shown that spending time with pets or therapy animals can significantly lower anxiety levels, promote relaxation, and even improve cardiovascular health. This phenomenon, known as the human-animal bond, exemplifies the power of connection in combating anxiety and enhancing emotional well-being.
Furthermore, nurturing social connections with friends, family, and support groups can play a pivotal role in reducing anxiety. By fostering a sense of belonging and understanding, these relationships can provide comfort, reassurance, and encouragement during times of distress. Actively engaging in social activities or pursuing shared passions can create opportunities for connection, bolster self-esteem, and cultivate resilience in coping with anxiety.
Incorporating social bonding and passion-driven pursuits into one’s self-care routine can be instrumental in the journey towards healing from anxiety. By embracing connection and seeking support from others, individuals living with anxiety disorders can experience the transformative effects of companionship and shared experiences on their path to improved mental health.
There is no standard blood test to diagnose anxiety, it is a clinical diagnosis.
From stress tolerance and resilience testing to looking at the gut microbiome for biomarkers, circadian rhythm dysfunction, and factors like COMT gene mutations which affect neurotransmitter levels in anxiety, functional medicine testing can also play a role in the holistic treatment of anxiety. These tests are optional. In some cases, they can help further personalize treatment based on genes and biomarkers.
Gemma, 38 years old, suffered on and off from anxiety since her early 20s but became worse after the birth of her first child
Goal: Conquer anxiety to feel more confident and at ease with socialising and parenting
History: After trying medication as well as group CBT, she was looking for a different approach
The plan: after a thorough integrative assessment, Julie was started on a specific medical cannabis plan to reduce anxiety during the day and get to sleep at night. She was also started on a personalised diet and nutraceutical protocol and started a simple breath-based nervous system relaxation practice done alongside her medical cannabis dose.
Outcome: 3 months later, she was no longer having panic attacks, much happier, and calmer at home and no longer had issues getting to sleep.