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The Interconnectedness Between Anxiety and Inflammation

Dr. David Hanscom, an orthopedic surgeon whom I’ve previously interviewed about strategies for chronic back pain, quit his practice to focus on educating others on becoming pain-free without surgery. Most recently, after surviving COVID-19, he turned his attention to prevention and surviving it, which is an important part of this discussion.

We've known for some time now that with diet, exercise and other interventions, you can radically reduce your risk of COVID-19. The focus of Hanscom’s COVID-19 prevention is on strengthening immune function through stress and anxiety reduction, and he has very specific and precise recommendations on how to do that.

As explained by Hanscom, pain is largely a symptom of stress and anxiety, which in turn are predicated on inflammation more so than psychological factors.

“You have to feel safe. When you feel safe, there's a profound shift in your body's chemistry. You're going from adrenalin, cortisol, histamines and inflammatory cytokines to growth hormone, dopamine, serotonin and GABA — all these incredible hormones and anti-inflammatory [compounds]. So, there's a profound shift in the body's chemistry, and people's pain disappears. They don't just manage the pain. The pain disappears.”

Cytokines, Anxiety, Pain and Poor Immune Function

Cytokines are small proteins that serve to regulate different tissues. There are both proinflammatory and anti-inflammatory cytokines. Cytokines have specific relevance to COVID-19, as they modulate your immune system and its function.

By reducing or resolving stress and anxiety, you lower levels of inflammatory cytokines, thereby allowing your immune system to function better. Hanscom has developed a working group that meets once a week to discuss and share information.

Other members of the group include Stephen Porges, Ph.D., a behavioral neuroscientist who developed Polyvagal 30, and Dr. David Clawson, a podiatrist who is very knowledgeable about cytokines.

“Cytokines are everywhere. Every cell in the body has cytokines. It's how they talk to each other. It turns out that the glial cells in your brain, that connect the tissue of the brain, put out cytokines. So do the endothelial cells, the linings of blood vessels.

When you have a threat — surgeons think in terms of muscle tension, sweating and heart rate — that to us is a threat response, versus safety where you relax and regenerate. What I didn't realize is that threat fires up the immune system, and ‘threat’ is all sorts of stuff. It's viruses, bacteria, cancer cells, a bully, a difficult boss, but also your thoughts, emotions and repressed emotions.

Neuroscience has shown us that those thoughts and emotions are processed in the brain the same way as a physical threat. It turns out that every degenerative disease is, what Clawson says, the same soup. In other words, we know that cardiac disease, critical vascular disease, adult onset diabetes, obesity, Parkinson's and Alzheimer's are just examples of inflammatory disorders. It's all inflammatory.”

Anxiety Is a Symptom of Inflammation

When your autonomic nervous system becomes dysregulated, you can — as Hanscom did — go from feeling fine one day to having a panic attack out of the blue the next. He explains:

“It turns out that anxiety, bipolar, depression and schizophrenia are all inflammatory processes. It's inflammatory. It is not psychological. Remember, anxiety is a result of a threat. [Threat] is the cause.

The threat creates a bodily response, which includes your immune system, and that sensation generated by the adrenalin and cortisol and these inflammatory cytokines, that's the sensation of anxiety. Since the unconscious brain processes about 20 million bits of information per second, and the conscious brain only processes 40, you can't do it with mind over matter.

I went to a psychiatrist for 13 years and talked and talked and talked … but I got worse. And, see, the solution for chronic pain is actually changing your brain to go a different direction. If you talk about the problem, you're actually reinforcing it.

The way you decrease anxiety is simply decrease that stress response. And you do it through direct means: Mindfulness, meditation, relaxation, anti-inflammatory diet. The anti-inflammatory diet turns out to be a huge deal … because what happens when you're in a constant threat, i.e., inflammation, which includes processed foods, these inflammatory cells start destroying your body …

The biggest message I want to get out there [is that] anxiety is a physiological response to a threat. Your whole body is on fire. You need to decrease anxiety, decrease cytokines, decrease that stress response. Again, if your body's inflamed, you're going to feel anxious.”

With regard to diet, there are several reasons for why processed foods cause inflammation. For starters, they tend to be very high in refined carbohydrates which, when consumed in excess, causes insulin resistance, thereby raising inflammatory cytokine production and massively increasing your risk of COVID-19. They’re also loaded with industrially processed omega-6 vegetable oils, which are proinflammatory.

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