By Dr. Dana Myatt

Anxiety and Panic Attacks: What You Need to Know

Anxiety is a normal human reaction to perceived danger – an example would be the anxious feeling that comes from hearing footsteps behind us when walking down a dark alley or having a tire blow out while driving in freeway traffic. Anxiety in such cases is a good thing – it sharpens our senses and prepares us to meet the challenge.

Panic is not a good thing as it causes us to revert to more primitive and less effective ways of coping. Instead of decisively getting out of the dark alley we might freeze and be in greater danger. Instead of steering our car swiftly to the side of the road we might over react and lose control of the car. Both freezing in fear and wildly over-reacting are common expressions of panic.

While it is normal to have occasional appropriate feelings of anxiety and even fleeting (but controlled) feelings of panic, it seems that for many people regular feelings anxiety and even frequent feelings of panic are the “new normal.” More and more people, from children to seniors, are reporting daily anxiety and frequent “panic attacks” – often over nothing at all – and teenage girls seem to be especially affected.

Anxiety and “panic attacks” are NOT normal in anyone unless they are in a highly stressful situation. People often try to explain it away as being circumstantial with excuses like  “my dog died” or “I got called in to my boss’ office” or “I had a really big exam” but really, ongoing anxiety and panic episodes should be considered abnormal in anyone who has an otherwise good life.

While everyone is different in how they deal with stress, we find many similarities in people who experience frequent anxiety and panic attacks. Dietary imbalances and deficiencies play a large role in panic attacks, and young women who are attempting to follow vegetarian or vegan diets can be especially hard-hit. Others who follow restrictive diets are at risk too.

Here’s the Doctor Myatt “short course,” on Anxiety and Panic Attacks. Full references can be found at the end of this article.

1.) Nutrient deficiencies are common in female adolescent vegetarians. This isn’t just my opinion; it is well-documented. (1-5)

2.) Nutrient deficiencies can cause mental health disorders including anxiety and panic attacks. (6-9)

3.) Nutrient deficiencies also cause immune dysfunction.(10)

Especially problematic are deficiencies of zinc (11-14), EFA’s (Omega-3 fatty acids) (15-19) B12, cholesterol, B vitamins and iron. (20-21)

Another major problem with many restrictive diets is insufficient protein. Protein breaks down to amino acids; amino acids are the precursors (building blocks) for ALL of the neurotransmitters (brain chemicals). Wow!

Precipitous drops in blood sugar, as often occur with high-carb, low protein diets, can trigger an adrenal release that causes a “panic attack.” It is a spontaneous “fight or flight” hormone rush in the absence of something fearful.

Reactive hypoglycemia may lead to a variety of different symptoms including:

· Blurry vision

· Panic attack

· Dizziness

· Fatigue

· Light headedness

· Headaches

· Heart Palpitations (22-23)

While it IS possible to get a full scope of nutrients while following a vegetarian and even a vegan diet, it requires a lot of careful planning. I personally find that most vegetarians and vegans are not careful enough with their diet to get adequate nutrients. A supplement is almost always in order, plus making sure that the diet does not induce hypoglycemia.

My Bottom Line: The first place to look for a cause of any mood disorder, including panic/anxiety attacks, is diet.

References

1.) Chiplonkar SA, Tupe R. Development of a diet quality index with special reference to micronutrient adequacy for adolescent girls consuming a lacto-vegetarian diet. J Am Diet Assoc. 2010 Jun;110(6):926-31.[“…micronutrient intakes were 50% to 70% lower than recommended dietary intakes (in lacto-vegetarian girls)”]

2.) Gibson RS.Content and bioavailability of trace elements in vegetarian diets. Am J Clin Nutr. 1994 May;59(5 Suppl):1223S-1232S.

3.) Hunt JR. Bioavailability of iron, zinc, and other trace minerals from vegetarian diets.Am J Clin Nutr. 2003 Sep;78(3 Suppl):633S-639S.

4.) Kirby M, Danner E. Nutritional deficiencies in children on restricted diets. Pediatr Clin North Am. 2009 Oct;56(5):1085-103.

5.) Tupe R, Chiplonkar SA.Diet patterns of lactovegetarian adolescent girls: need for devising recipes with high zinc bioavailability. Nutrition. 2010 Apr;26(4):390-8.

6.) Islam MR, Ahmed MU, Mitu SA, Islam MS, Rahman GK, Qusar MM, Hasnat A. Comparative analysis of serum zinc, copper, manganese, iron, calcium, and magnesium level and complexity of interelement relations in generalized anxiety disorder patients.Biol Trace Elem Res. 2013 Jul;154(1):21-7.

7.) Jacka FN, Maes M, Pasco JA, Williams LJ, Berk M. Nutrient intakes and the common mental disorders in women. J Affect Disord. 2012 Dec 1;141(1):79-85.

8.) Quick VM, McWilliams R, Byrd-Bredbenner C. Case-control study of disturbed eating behaviors and related psychographic characteristics in young adults with and without diet-related chronic health conditions. Eat Behav. 2012 Aug;13(3):207-13.

9.) Lakhan SE, Vieira KF. Nutritional therapies for mental disorders.Nutr J. 2008 Jan 21;7:2. [“…a lack of certain dietary nutrients contribute to the development of mental disorders. Notably, essential vitamins, minerals, and omega-3 fatty acids are often deficient in the general population in America and other developed countries; and are exceptionally deficient in patients suffering from mental disorders. Studies have shown that daily supplements of vital nutrients often effectively reduce patients’ symptoms. Supplements that contain amino acids also reduce symptoms, because they are converted to neurotransmitters that alleviate depression and other mental disorders. Based on emerging scientific evidence, this form of nutritional supplement treatment may be appropriate for controlling major depression, bipolar disorder, schizophrenia and anxiety disorders…”]

10.) Singh M. Role of micronutrients for physical growth and mental development. Indian J Pediatr. 2004 Jan;71(1):59-62.

11.) Cope EC, Levenson CW. Role of zinc in the development and treatment of mood disorders.Curr Opin Clin Nutr Metab Care. 2010 Nov;13(6):685-9.

12.) Foster M, Chu A, Petocz P, Samman S. Effect of vegetarian diets on zinc status: a systematic review and meta-analysis of studies in humans. J Sci Food Agric. 2013 Aug 15;93(10):2362-71.

13.) Kawade R. Zinc status and its association with the health of adolescents: a review of studies in India. Glob Health Action. 2012;5:7353. Epub 2012 Apr 12.

14.) Nahar Z, Azad MA, Rahman MA, Rahman MA, Bari W, Islam SN, Islam MS, Hasnat A. Comparative analysis of serum manganese, zinc, calcium, copper and magnesium level in panic disorder patients. Biol Trace Elem Res. 2010 Mar;133(3):284-90.

15.) Bondi CO, Taha AY, Tock JL, Totah NK, Cheon Y, Torres GE, Rapoport SI, Moghaddam B. Adolescent behavior and dopamine availability are uniquely sensitive to dietary omega-3 fatty acid deficiency.

16.) Biol Psychiatry. 2014 Jan 1;75(1):38-46.

17.) Liu JJ, Galfalvy HC, Cooper TB, Oquendo MA, Grunebaum MF, Mann JJ, Sublette ME. Omega-3 polyunsaturated fatty acid (PUFA) status in major depressive disorder with comorbid anxiety disorders. J Clin Psychiatry. 2013 Jul;74(7):732-8.

18.) McNamara RK, Strawn JR. Role of Long-Chain Omega-3 Fatty Acids in Psychiatric Practice. PharmaNutrition. 2013 Apr;1(2):41-49.

19.) Ross BM, Seguin J, Sieswerda LE. Omega-3 fatty acids as treatments for mental illness: which disorder and which fatty acid? Lipids Health Dis. 2007 Sep 18;6:21.

20.) Bourre JM.Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients.J Nutr Health Aging. 2006 Sep-Oct;10(5):377-85.

21.) Mikawa Y, Mizobuchi S, Egi M, Morita K. Low serum concentrations of vitamin B6 and iron are related to panic attack and hyperventilation attack. Acta Med Okayama. 2013;67(2):99-104.

22.) Gorman, Jack M., et al. Hypoglycemia and panic attacks. Am J Psychiatry 141 (1984): 101-102.

23.) Schweizer, Edward, Andrew Winokur, and Karl Rickels. Insulin-induced hypoglycemia and panic attacks. Am J Psychiatry 143.5 (1986): 654-655.

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