Help, I Have Anxiety In My Genes!

Do you know someone who you would describe as very emotional? Someone who seems to get thrown off-balance by seemingly trivial things, a spider in the bathtub, a fly in their soup, being five minutes late to an appointment. Now, can you think of someone you know who seems unflappable? That is, someone who gets stuck in traffic on their way to an appointment and just calmly calls ahead to alert the other party that they will be delayed, or, when someone backs into their car, they calmly get out to examine the damage, and then genially exchanges information with the at fault party.  

What’s the difference between them? Well, as I have addressed in my previous blogs, it could be due to genetics, environmental influences, or some combination of the two. Over the past century, in studies too numerous to mention, the preponderance of evidence points to the latter scenario, a combination of “nature” and “nurture,” to be the most likely scenario. 

 In 2020, a survey of 204 countries found that 374 million individuals suffered from some form of anxiety disorder. A study by the American Psychological Association revealed 34% of American’s will have an anxiety disorder during their lifetime.  Additionally, neither of these surveys include the millions of individuals who experience “subclinical” anxiety, that is, anxiety that either goes undiagnosed and/or doesn’t rise to the level of being labeled a disorder.  And while I have no formal statistics to back this up other than anecdotal evidence from my practice, and personally having lived more than six decades, I would suggest that few of us will escape this life without experiencing anxiety. After all, and as I have written in earlier blogs, it’s what our brains and bodies have evolved to do, and do well.

What is Epigenetics?

Epigenetics is the study of how our genetic make-up and environmental circumstances interact to influence our psychological and physical health. For the purpose of explanation, let’s move away from psychological health and look at a physical illness such as diabetes.  Diabetes is a disease the effects over a half billion people worldwide. Type 1 diabetes is a genetically linked autoimmune disease that causes the dying-off of the pancreatic cells that make insulin.  Individuals possessing this genetic defect always develop diabetes (usually before adulthood). That is, the genetic defect that is correlated with Type 1 diabetes “expresses” itself 100% of the time. However, 95% of people with diabetes have what is termed Type 2. This population is most likely born with a genetic propensity to develop diabetes, but it is not 100% certain that they will. Science has shown poor diet, limited exercise, obesity and even stress, increases the likelihood that an individual with this genetic tendency will develop diabetes.

This is where epigenetics comes into play. An individual with a genetic propensity for Type 2 diabetes may never develop the disease due to a healthy lifestyle. An individual with a genetic Type 2 propensity who eats high levels of simple carbohydrates, is overweight, and does little if any exercise, increases the likelihood that that their underlying genetic propensity will “express” itself; that is, they will develop diabetes.  Bottomline, epigenetics is behind whether a genetic predisposition is switched on or off based on the influences of environmental factors.

You and Your Anxiety

As scientists, doctors and psychologists continue to study the causes of psychological disorders, it is becoming increasingly clear that even the most highly genetically linked disorders have some environmental component.  And this not only accounts for whether an individual develops a specific psychological disorder, but also the degree to which the individual will experience the effects of that disorder.  That is, if a child is born into a family that has a familial history of a specific disorder, whether the child will develop the disorder and the degree to which that child’s life will be affected by this disorder is partly a function of their environment. If a child with a genetic predisposition to anxiety is born in a country that is in the middle of a conflict, filled with violence, displacement, food scarcity, etc., they will more likely develop an anxiety disorder than if they were born into a peaceful environment. If that child’s parents are also suffering with anxiety, again, there is a greater chance that the child will develop an anxiety disorder. (There is also a greater chance that the child will develop disorders that have been seen to share a link with anxiety, such as, depression, attention-deficit disorder, obsessive-compulsive disorder, even certain personality disorders).

Good News!

With all this said, and what may have been lost in the above conversation, is that we can
influence the effects our environment has on both our physical and mental health. We are not
doomed by our DNA nor for that matter the environment we are born into or find ourselves in
later in life. Through committed action, we can change not only our physical environment but
also our state of mind. Via the practice of mindfulness, we can become more aware of how we
are behaving, and then take action to create healthful changes. In this sense, behaving relates
not only to what we do physically (eating, drinking, exercising, participating in invigorating, life-
affirming activities), it also relates to how we react to our thoughts and emotions. For example, if
we find ourselves in a particularly stressful situation, (e.g., work, relationship, financial), rather
than getting caught up in rumination, worry and struggle, we can mindfully notice whatever is
“showing up” for us, put some space between our thoughts and emotions, and then choose a
“workable” course of action. This is an action that is congruent with our values, and that is
healthful, growth-oriented, and most likely to bring about positive change.
Again, when stressed, we often gravitate towards avoidance, trying to make ourselves feel more
good or less bad. We may binge on unhealthy food, drink, smoke, procrastinate, act-out in
anger, etc. Don’t get me wrong, sometimes walking away from our desk and indulging in a big
fat gooey donut works well to temporarily reduce our level of stress. However, if we repeatedly
engage in unworkable behaviors, we not only move further away from the person we wish to be,
we also increase likelihood that we will continue to engage in that unworkable behavioral
response (reinforcement). Most important, the more we engage in such unworkable responses,
the more likely we will trigger our epigenetic predispositions. So again, while our DNA and our
environment play major roles in our physiological and biological health, we are by no means
passive by-standers. On the contrary, our actions, how we relate to our thoughts and emotions
and how we react to them, impacts whether we switch on or switch off our genetic tendencies.
Even more exciting is that science has clearly shown that when we make changes in how we
behave, both physically and psychologically, we can create positive structural changes in our
brains. That is, how we think and behave can act back on our brains and bodies to create true
physiological change, This ability to create physiological change in our brain is termed
“neuroplasticity,” and has received, and continues to receive, a huge amount of attention in the
scientific, medical, and mental-health communities. This ability to use our mind and physical
body to act back on our brains and bodies is being utilized in such diverse fields as oncology,
pain management, and most of all the field of psychology. Interventions such as Cognitive
Behavioral Therapy (CBT), Mindfulness Based Stress Reduction (MBSR), Acceptance and
Commitment Therapy (ACT) and others, have been shown not only to produce cognitive change
but to change brain structure and functioning.   For Individuals who have been diagnosed with
an anxiety disorder such as Generalized Anxiety or Panic, as well as those who experience sub-
clinical levels of anxiety (the rest of us), these therapies have been proven not only to decrease
the experience of anxiety (frequency, intensity, duration), but in some instances, to result in a
complete cessation of symptoms.
In future blogs, I will go into greater detail on the workings of these therapies and how you may
avail yourselves of some of the most effective tools that they have to offer. Also, keep an eye out for a future blog on “neuroplasticity” as well as blogs that will address how you can actively
engage in promoting your own physical and psychological well-being.

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