[HN Gopher] Researchers develop blood test for anxiety
       ___________________________________________________________________
        
       Researchers develop blood test for anxiety
        
       Author : FollowingTheDao
       Score  : 76 points
       Date   : 2023-03-08 12:27 UTC (10 hours ago)
        
 (HTM) web link (www.sciencedaily.com)
 (TXT) w3m dump (www.sciencedaily.com)
        
       | Footkerchief wrote:
       | Study link: https://www.nature.com/articles/s41380-023-01998-0
        
       | FollowingTheDao wrote:
       | Of the genes they note in the study (GAD1, NTRK3, ADRA2A, FZD10,
       | GRK4, and SLC6A4), I have significant polymorphisms in GAD1,
       | NTRK3, and SLC6A4, But I also carry NOS1AP and GRIN2B changes
       | which also are more highly correlated with anxiety.
       | 
       | The NTRK3 was a new one for me.
       | 
       | I have Aspergers, Schizoaffective Bipolar Disorder and a
       | panic/anxiety disorder.
        
       | drewbitt wrote:
       | I would have loved this. I had been fine my entire life until one
       | day I started feeling panic and subsequently had several panic
       | attacks that week and developed the related agoraphobia. It would
       | have been great to see what biomarkers had changed and ideas on
       | where this suddenly came from. The current treatment doesn't care
       | about the underline reasons as much as immediately giving you a
       | SSRI.
        
         | Llamamoe wrote:
         | Can you think of ANYTHING unusual around that time, physical or
         | mental?
        
           | drewbitt wrote:
           | I was taking a lot of supplements - basics like magnesium and
           | fish oil, all the way to choline, some mushrooms, amino
           | acids, EGCG etc. Nothing crazy or illegal but certainly more
           | than the average person takes. Unfortunately even after
           | stopping for months the panic disorder didn't go away.
           | Otherwise at that time work was easy and my life was not
           | stressful. It's a mystery.
        
       | macawfish wrote:
       | I wonder if this has to do with methylation status? From what I
       | remember there are different metabolic processes that enable
       | shifting between sympathetic and parasympathetic modes,
       | specifically the glutamate/glutamine cycle. People have different
       | ways of handling the nutrients that support this process (e.g.
       | various B vitamins). Switching back and forth between alert and
       | resting states isn't free, and people who have to do it a lot,
       | for whatever reason, can get exhausted in the process. For some
       | people taking vitamin B12 can be a relief, whereas for other
       | people it can worsen anxiety.
        
         | PragmaticPulp wrote:
         | FYI, most of the time when you read an article that reduces
         | complex functions to "methylation status", it's pseudoscience.
         | 
         | Methylation is a real biological function, but it has been co-
         | opted by alternative medicine peddlers as a convenient (though
         | incorrect) explanation for everything. It's part of a new wave
         | of alternative medicine that takes real scientific concepts
         | (methylation, glutamate/glutamine cycles) and tries to work
         | backwards from symptoms to assume the status of various cycles
         | in the body.
         | 
         | One key feature of this pseudoscience is that it often has dual
         | explanations for everything such that everyone will identify
         | with it. For example, when they say that Vitamin B12 can make
         | some people feel better but some people feel worse, they're
         | setting up an explanation that everyone will identify with: If
         | you give someone a supplement and ask them to see if they feel
         | better or worse over the coming hours, days, and weeks,
         | eventually they'll have a good or bad day and assign it to the
         | supplement. The methylation pseudoscience people capitalize on
         | this effect by claiming that all of their interventions will
         | either worsen or improve people's symptoms, which creates
         | confirmation bias everywhere.
         | 
         | One of the easiest ways to debunk the methylation alternative
         | medicine pushers is to examine how almost nobody claims to
         | actually recover from their treatments. It's always a back and
         | forth of thinking they're taking too much B12 or folate or
         | other supplements because they've been conditioned to believe
         | that all of their symptoms are traceable back to methylation.
         | 
         | To be clear, B12 and/or folate deficiencies are real and
         | measurable conditions that should be treated if present.
         | However, the idea that you can modulate all of the body's
         | processes up and down by taking varying levels of B12 and
         | folate supplements is pseudoscience.
        
           | arrosenberg wrote:
           | > Methylation is a real biological function, but it has been
           | co-opted by alternative medicine peddlers as a convenient
           | (though incorrect) explanation for everything. It's part of a
           | new wave of alternative medicine that takes real scientific
           | concepts (methylation, glutamate/glutamine cycles) and tries
           | to work backwards from symptoms to assume the status of
           | various cycles in the body.
           | 
           | I'm not gonna say you are wrong about this, but methylation
           | is also a super hot topic right now among legitimate
           | researchers and biotech companies. It's completely possible
           | that anxiety-response is modulated by methylation of specific
           | sites that produce cortisol and other biomarkers. Agree that
           | it's not _driven_ by methylation per se, but the biological
           | response could be tested and proven by analysis for specific
           | methylation patterns.
        
           | ipaddr wrote:
           | You argue to debunk requires no one to claim recovery then go
           | on to say B12 deficiencies are real and can be treated. B12
           | deficiencies often need to be continuously treated which
           | means you can debunk them. But they are real.. just not when
           | a group I dislike says so? Being anti pseudoscience puts you
           | in the same category as someone who is pro pseudoscience;
           | both groups misuse facts to present their side and justify
           | their position as the correct side in a holywar
        
             | PragmaticPulp wrote:
             | > You argue to debunk requires no one to claim recovery
             | then go on to say B12 deficiencies are real and can be
             | treated
             | 
             | B12 deficiencies are real and can be measured. Everyone who
             | has a B12 deficiency and supplements B12 back into normal
             | ranges will improve. This is an example of real science.
             | 
             | Using B12 and Folate to treat pseudoscientific
             | "methylation" issues that are presumed (rather than
             | measured) based on vague symptom reports that go in both
             | directions (e.g. some people feel better, some people feel
             | worse) is the pseudoscience.
             | 
             | > Being anti pseudoscience puts you in the same category as
             | someone who is pro pseudoscience;
             | 
             | What?
             | 
             | > both groups misuse facts to present their side and
             | justify their position as the correct side in a holywar
             | 
             | No, one side uses real science and the other side uses
             | _pseudo_ science. That's literally the definition of the
             | word.
             | 
             | Measurable B12 deficiencies are real and supported by the
             | science. Explaining everything, including anxiety, as
             | caused by "methylation status" is not.
        
               | ipaddr wrote:
               | You missed my point and took a side in a tribal war. Then
               | try to discredit the other side by putting in a qualifier
               | of 'real' to change the meaning of science to something
               | you can control by limiting who fits into this new group
               | to whoever you decide.
        
           | majkinetor wrote:
           | The same is true for ortdox medicine, I don't know why you
           | included only alternative medicine "peddlers".
        
       | sarojmoh1 wrote:
       | Anyone here actually find something that works for their anxiety?
        
         | a13o wrote:
         | I picked up a few useful tricks from Cognitive Behavioral
         | Therapy that I use to this day, but the best lessons came from
         | eastern philosophy.
         | 
         | Anxiety isn't a disease - you don't 'have' it. Everyone
         | experiences anxiety. It's a temporary signal, like stomach
         | butterflies or being starstruck. What happens next after
         | experiencing these signals is up to you. You can let your ego
         | take control, or acknowledge the experience and let it pass.
         | Sometimes it's a useful signal to act on. Many times it's not.
         | Think of your body like a tuning fork, the anxiety is you
         | vibrating in reaction to a new experience. There's nothing
         | inherently good or bad about new experiences, it depends
         | experience to experience. Therefore the anxiety reaction should
         | be taken under advisement but confers no knowledge about what's
         | to come, and shouldn't be treated like a warning indicator.
        
         | verteu wrote:
         | Which meds have you tried? Usually after trying 1-5 types,
         | people find one that helps significantly.
        
         | sethrin wrote:
         | So far: alcohol, sympathetic friends. Gonna give zoloft a shot
         | whenever they get around to filling the script.
        
           | vjk800 wrote:
           | Alcohol works so well for me that I'm sort of scared of it.
           | Often even after just one or two drinks I become the happiest
           | and most sociable person on the planet.
        
           | yamtaddle wrote:
           | > alcohol
           | 
           | Weed's healthier. Alcohol can help with a lot of the same
           | things, but the side-effects of terrible sleep and hangovers
           | can make the problem worse the next day. I understand weed is
           | also supposed to harm sleep quality, but IME it's not even
           | _close_ to as bad as even a light-buzz amount of alcohol, and
           | weed 's never given me a hangover. And it doesn't make you
           | gain weight (directly--munchies, LOL, but then again I get
           | those on alcohol, too, personally).
        
             | sethrin wrote:
             | Alcohol has maybe given me a hangover once. I also don't
             | typically have more than two drinks in a day, and if I am
             | having a bad enough day to want to use alcohol then that's
             | going to be closer to 2pm than bedtime. Cannabis use is
             | pretty continual these days, being locally legal, but I
             | don't find it very effective for anxiety. But actually one
             | of the main things I'm using for mood regulation these days
             | is programming. It's hard to think about code
             | simultaneously with anything else, and learning coding was
             | among other things a process of learning emotional
             | regulation with regards to coding, because it's not like
             | the computer cares if you find a bug challenging.
        
             | standardUser wrote:
             | I don't have any problems sleeping with low-to-moderate
             | amounts of alcohol and I certainly don't get hangovers
             | unless I'm really getting drunk. Then again, we all handle
             | different substances differently. For me, weed usually
             | causes anxiety, sometimes acute, severe anxiety. And
             | paranoia. Indica strains seem to do this much less, but
             | also make me incredibly sleepy. High CBD strains seem to be
             | best but are not easy to find.
        
             | jwmoz wrote:
             | Weed will probably exacerbate anxiety especially anything
             | that has a cerebral high.
        
               | eikenberry wrote:
               | It doesn't exacerbate it, though it doesn't cure it
               | either per-say. For example you still feel your skin
               | crawling while high, but it transforms the interpretation
               | of the sensation from super-annoying to mildly amusing
               | and completely ignore-able.
        
           | eddsh1994 wrote:
           | Alcohol is borrowing happiness today from tomorrow. If you
           | self-medicate with alcohol it _will_ be worse in the
           | longterm. Don 't fall down that rabbit hole.
        
           | jddil wrote:
           | Alcohol temporarily helps but you pay it back with interest
           | over time.
           | 
           | It sounds trite but exercise and sleeping/eating better is
           | really the only thing we have proof that works. (zoloft can
           | help kickstart the changes but it won't reduce anxiety long
           | term)
        
             | FollowingTheDao wrote:
             | It depends on the dose.
        
             | sethrin wrote:
             | I think I have more of an acute issue with anxiety, at the
             | moment mostly driven by financial insecurity combined with
             | unexpected medical expenses. Like what I really need right
             | now is a few thousand dollars in travel expenses and for
             | this precertification to go through, but failing that I
             | just need to make it from one day to the next.
        
         | notdarkyet wrote:
         | Cutting out alcohol was probably the biggest one. The effects
         | of alcohol on anxiety can last days for me. Low carbohydrate
         | diets seem to really help as well for me. Minimizes highs and
         | lows.
        
           | FollowingTheDao wrote:
           | Ethanol this will slow down NMDA receptor function by
           | lowering NMDA receptor population density.
           | 
           | https://pubmed.ncbi.nlm.nih.gov/2158789/
           | 
           | So the anxiety is your hangover and the NMDA receptor
           | population density returns to normal.
        
             | solarmist wrote:
             | This is interesting because I've only been able to get over
             | my anxiety after being prescribed memantine for
             | sensory/audio processing disorder (SPD/APD).
             | 
             | Looking back I was constantly in a state of hyper-awareness
             | that was so intense I couldn't understand speech in real-
             | time or move smoothly (keeping a beat took 100%
             | concentration so I couldn't learn an instrument) without
             | total concentration. I also had hyper-sensitivity to touch.
             | All this was from severe CPTSD growing up.
             | 
             | Memantine is an NMDA uptake inhibitor (probably). But I
             | don't really know anything about what role NMDA plays.
        
               | FollowingTheDao wrote:
               | NMDA is a receptor, not a molecule.
               | 
               | Memantine slows the amount of calcium that enters the
               | NMDA receptor in a way similar to magneisum. Zicn also
               | inhibits NMDA but by a different mechanism
               | 
               | https://ars.els-
               | cdn.com/content/image/1-s2.0-S00283908070022...
               | 
               | It is the calcium in the cell that triggers nerve
               | excitement and oxidative stress that triggers the
               | anxiety. I am over simplfying all of this.
               | 
               | I have the opposite problem. I have slow NMDA receptor
               | function but my Anxiety is caused by issues inside the
               | neuron (NOS1). Magnesium gives me anxiety.It may be that
               | my porr NMDA receptor function helps me a bit.
               | 
               | Really the root cause is low Cyclic Adenosine
               | Monophosphate (cAMP) signaling in the neuron stemming
               | from low Nitric Oxide or slow NMDA receptor function.
               | 
               | https://onlinelibrary.wiley.com/cms/asset/2bc96085-ac06-4
               | a3b...
               | 
               | Klonopin and ethanol increase the flow of GABA into the
               | cell and this
        
               | solarmist wrote:
               | Thank you for clarifying. I know a bit about the brain
               | and brain chemistry, but I was unfamiliar with NMDA
               | receptors.
               | 
               | Unfortunately the rest of your explanation was too
               | technical and I didn't follow any of it. Can you explain
               | what NMDA receptors are for and what the link to anxiety,
               | in either direction, is?
               | 
               | My anxiety wasn't caused by this, but I was able to treat
               | it because of the memantine. I just stopped memanitine a
               | month ago after about 5 years and all the symptoms seem
               | resolved now.
        
               | FollowingTheDao wrote:
               | You are saying that your anxiety was not casued my NMDA
               | receptor changes, but it was. Traumatic events change the
               | function and density of these receptors.
               | 
               | https://www.nature.com/articles/1301605
               | 
               | NMDA receptors allow calcium into the neurons. The more
               | calcium in a neuron the more excitable it is, like in
               | hyper-arousal.
               | 
               | By taking the memantine you allowed you possible grow
               | more healthy neural pathways, away from the
               | hypervigilance and towards calmness. I am assuning you
               | have been in therapy?
        
               | solarmist wrote:
               | Sure, on a technical level, but the cause of it,
               | globally, was several layers up the abstraction stack. It
               | feels like blaming the add and multiply instructions for
               | poorly written firmware/software, especially since it
               | resolved itself once I addressed the issues I listed
               | below.
               | 
               | Thank you for the paper. That's just the kind of thing I
               | was hoping to find.
               | 
               | The experience of going on memantine for the first time
               | was like becoming in sync with my body for the first time
               | that I could remember. My body, mind, and thoughts
               | stopped being out of sync, like a video that wasn't
               | streaming well. That allowed me to slow down (and not try
               | to anticipate the ten different ways a conversation could
               | go), stop rambling, and listen to what people were saying
               | to me instead of what I expected them to say.
               | 
               | I'm only seriously pursuing therapy now; hyper-
               | independence is another symptom of my CPTSD. I learned
               | all this by trial and error and reading ungodly amounts
               | of self-help books (moving to psychology books lately),
               | helping my wife through losing her parents at 21, and
               | teaching my wife to work through her PTSD.
               | 
               | What allowed me to be calm was learning to trust, at
               | least to some extent, people again (which I didn't even
               | realize was an issue) and learning to express my emotions
               | (I had nearly total blocks on sadness and fear). Then
               | slowly processing the traumatic events from my childhood.
               | After I forced myself to cry about one event (the last
               | time I cried as a child) and allowed myself to feel fear
               | about things I couldn't control, my chronic anxiety
               | faded, and now it is situational. I continue to work on
               | the underlying causes of these distinct reactions.
               | 
               | It is very difficult because fear of being like my dad or
               | being poor drove me so hard for 20+ years to become a
               | software engineer and make it into a top-tier company.
               | Without that desperation, I have to relearn (learn?) how
               | to live and do things.
        
               | FollowingTheDao wrote:
               | Yeah, I get it. My condition is more of a genetic
               | sensitivity to foods/environment. Yours was more caused
               | my the environment alone.
               | 
               | Different causes, different cures.
               | 
               | Glad you are doing therapy. While it had no impact on my
               | anxiety it helped me deal with the ramifications.
        
               | the-angry-dome wrote:
               | I'm definitely curious as to how you got to such a
               | nuanced diagnosis / underlying mechanism for your
               | anxiety. After an overnight sudden change, I'm told I've
               | been stuck in 'fight or flight', constantly, for about 20
               | years. I've gone from MRI to many medication trials to
               | genetic testing / perfunctory bloodwork, to therapy to
               | yoga to sriracha enemas (kidding), but never got anywhere
               | beyond feeling like the science overall is nascent at
               | best, and a total load of snake-oil quackery at worst.
               | 
               | Your miles seemed to have played out differently. How did
               | you go about arriving at the underlying pathology, so to
               | speak, and how confident are you that it is 'the right
               | answer'? Are you under the care of a doc / neuro / psych?
               | And if so, do they take your NOS1 explanation into
               | account when treating you?
        
               | FollowingTheDao wrote:
               | > After an over night and sudden change
               | 
               | This is important, you need to look at your total
               | environment to see what changed. It could be anything
               | from air pollution, diet, EMFs. Anxiety always has a
               | trigger and it is not always psychological.
               | 
               | > I'm definitely curious as to how you got to such a
               | nuanced diagnosis / underlying mechanism for your
               | anxiety.
               | 
               | I went through everything you did, but once I noticed so
               | many people were doing the woo woo route and nothing
               | helped, so I decided to learn about neurobiology,
               | genetics and nutrition. Almost everything you will read
               | about anxiety and mood is wrong. (For example, low
               | serotonin is the result of high GABA, and it is the high
               | GABA that causes depression, not the low serotonin or
               | dopmaine, that is just a result of the low GABA.
               | https://www.nature.com/articles/s41380-022-01730-4)
               | 
               | I was anxious as a child, and had OCD, so I knew it was
               | genetics. My mother had mental health issues as well all
               | up her side of the family. 20 years ago I ended up on
               | disability and doctors were of little help, just felt
               | drugged all the time, so I set off to research
               | neurobiology since I had the spare time and lived next to
               | a university research hospital.
               | 
               | Then when 23andMe appeared I jumped on it and it was all
               | right there. But it took years for more research to come
               | out which narrowed in on my problem. First it was genes
               | like CACNA1C and SLC6A4, but when I saw many immune genes
               | linking to my Ankylosing Spondylitis (ERAP1) it became a
               | bit more confusing. I kept seeing so many genes that
               | needed zinc flagging in my genome. High does zinc fixed
               | my autoimmune issues, as did long chain omega 3 (FADS1,
               | FADS2 also linked to mood). But the studies I began to
               | read about NOS1AP matched my genetics so I dove head
               | first into that pathway at it ll became clear how
               | glutamate was casueing my anxiety and paranoina and
               | psychosis.
               | 
               | I also have changes in GCH1 that controls the amount of
               | serotoin and dopmaine we make. I am in a study at
               | Stanford as they feel it is linked to ME/CFS. I was
               | diagnosed with CFS years ago but I only have infrequent
               | symptoms now.
               | 
               | I have one doctor who knows I know what I am talking
               | about and gets me some tests that might help me see what
               | is going on but this is all research level stuff, nothing
               | and doctor will see for years if ever. I am on Medicare,
               | fully disabled, so it is hard for her to get some weird
               | tests but she tries. She also helps me get meds I feel
               | might help that might not be her first thought. But meds
               | are no answer, they work until they do not.
               | 
               | Glutamate/GABA imbalance and nitric oxide will soon be
               | recognized as the drivers of mood disorders.
               | 
               | I am confidant I am right because all my friends have see
               | the change in me. Plus I no longer needs meds.
               | 
               | If I had you genetics I could probably see what is going
               | on with you. Let me know if you want me to take a look:
               | followingthedao@fastmail.com
        
               | biomcgary wrote:
               | I have a son diagnosed with autism, but I suspect that
               | SPD/APD would be more accurate. How were you diagnosed
               | and why was memantine prescribed?
        
         | buildsjets wrote:
         | As an OTC supplement, I occasionally use Sceletium Tortuosum
         | extract, which is marketed under the trademark Zembrin.
         | Sceletium Tortuosum is a South African succulent plant that has
         | been chewed by the San tribe people for thousands of years
         | under the name Kanna. (recall N!xau |=Toma in "The Gods Must Be
         | Crazy")
         | 
         | There have been recent peer reviewed studies showing it both
         | safe and effective, and placebo or not, I have noted relief of
         | my symptoms. It's also rather inexpensive compared to a lot of
         | other supplements, at around $0.30 for a daily dose.
         | 
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8124331/
         | 
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828542/
         | 
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8762184/
        
         | FollowingTheDao wrote:
         | Yes, I have. But yiou will really need your genetics to figure
         | it out. There are many pathwyas that when slw or fast that can
         | lead to anxiety.
         | 
         | I have my genome and found that I carry a change in a gene
         | called NOS1AP. This means I do not produce enough NOS1
         | (Neuronal Nitric Oxide Synthase, nNOS, CAPON) which leads to an
         | influx of calcium through the NMDA receptor.
         | 
         | https://pubmed.ncbi.nlm.nih.gov/25612209/
         | 
         | https://commons.wikimedia.org/wiki/File:CAPON_Binds_Nitric_O...
         | 
         | So basically I have low NOS1 and typically higher amounts of
         | glutamate and there for I am very excitable.
         | 
         | Klonopin as needed helps in emergencies but I rely on a few
         | dietary changes to limit bio-active compounds from inhibiting
         | NOS1. These include limiting a large range of phenol's that
         | inhibit NOS1 and avoiding air pollution (air purifier with
         | activated carbon).
         | 
         | P5P (B6) helps as well because I have issues truing glutmate to
         | GABA via the GAD1 enzyme. I also eat lower protein and zero MSG
         | like flavorings (Pea Protein Extract)
         | 
         | Doing these things has lead me off of all my meds, which is
         | huge.
         | 
         | I also have latent CMV which at times effects me since it
         | increases NMDA receptor function. CMV also gave me ankylosing
         | spondylitis and lung nodules.
         | 
         | https://bmcneurol.biomedcentral.com/articles/10.1186/1471-23...
        
         | zzzeek wrote:
         | lexapro, mindfulness meditation, and exercise (in that order)
         | 
         | someone else mentioned alcohol curbing too. definitely that as
         | well, as well as overall attention to sugar, caffeine, protein
         | intake, etc.
        
         | arrosenberg wrote:
         | If you talk to yourself a lot I'd recommend a pet to talk to
         | instead. Externalize your self-talk and try to make it nicer.
         | Use the pet to rubber duck solutions to life's problems.
        
         | StrangeATractor wrote:
         | These are mostly for managing your baseline anxiety levels:
         | 
         | Valerian capsules help, but get a good brand like Oregon's Wild
         | Havest, valerian tends to pick up lead in the ground. Valerian
         | helps a lot with panic attacks, too.
         | 
         | Make a habit of drinking rooibos tea. After it builds up in
         | your system it counters cortisol (in my experience, very
         | effectively). Mountain Rose Herbs sells quality rooibos.
         | 
         | Cut out caffeine, or try to limit it to green tea. Green tea
         | has L-theanine in it, which helps with anxiety. I'd like to
         | point out that caffeine doesn't leave your system completely
         | for quite a while and reduces your quality of sleep leading to
         | cognitive decline over time.
         | 
         | Eat well, sleep well and go outside more, preferably involving
         | vigorous exercise.
         | 
         | (I have no affiliation with the brands mentioned above but if
         | you're going the herbal route, quality is an important factor
         | and those brands have worked quite well for me)
        
         | SketchySeaBeast wrote:
         | Therapy has worked for me in the past as well as some
         | medications (very low doses of psychiatrist prescribed
         | benzodiazepines). Mostly I find that exposure to what makes me
         | anxious makes it lessen, but I've yet to find a way to deal
         | with my generalized anxiety as it'll often go hunting for
         | something else to be anxious about. I cope with the generalized
         | anxiety by trying to be as structured in my life to reduce the
         | chaos and noise.
        
         | j0hnyl wrote:
         | When I have anxiety spells, I force myself to do something
         | creative like draw or paint. It helps, but this is not exactly
         | available if you have a panic attack in the middle of a work
         | meeting or something.
        
         | corobo wrote:
         | Cognitive behavioural therapy, specifically for this: evidence
         | vs assumption.
         | 
         | Making assumptions is part of life, but it is important to
         | verify a lot of them. The system responsible for keeping you
         | out of danger fires in a "better safe than sorry" manner. If
         | you never train this response then it'll be inaccurate and
         | it'll fire off all the time and you get anxiety. Likewise if
         | the system has been trained by an entire school career of
         | bullying or negativity it'll need recalibrating (are you going
         | to get bullied as an adult for standing out? At least it's much
         | less likely)
         | 
         | For example I wasn't going to go to a meet-up because I thought
         | I wouldn't like it, or fit in, or whatever other reason - I was
         | feeling anxious.
         | 
         | Looking back at actual times I've gone beyond my comfort zone
         | in this way I realised that most times I end up a better
         | person, with a new friend, or at least enjoyed doing it. Worst
         | case I didn't get harmed in any way. Evidence overrules the
         | assumption.
         | 
         | You don't want zero assumption of course, feel free to assume
         | jumping off a cliff without anything to stop you hitting the
         | floor at high speed will be a bad time, but for things other
         | people are able to do without harming themselves or others at
         | least give it a quick pros and cons check before bottling it.
         | 
         | Unfortunately it needs it real world experience. Think of it
         | like working out; you won't get ripped just because you know
         | how to use the machines, you've gotta use them too. On the
         | positive side every time you push yourself successfully - and
         | these don't need to be massive, the snowball effect works here
         | - it's more evidence for next time. I now write down my
         | thoughts and feelings before and after so I can actually go
         | back and look at them in future if needed.
         | 
         | I'd highly recommend nerdy types try out CBT if it's a
         | possibility, especially if they don't feel like the "how does
         | that make you feel?" type of therapy is worth doing (I need
         | ideas and solutions, not a soap box!). It works really well for
         | me anyway, it's like debugging my brain.
         | 
         | Standard disclaimers: Don't use this comment as an alternative
         | to medical advice. What I know may not be what the therapist
         | taught me, this is my interpretation of that information. This
         | isn't the only thing I've learned in CBT but it is pretty
         | foundational for it to work well. As far as I know so far.
         | Works on my machine.
        
         | edmundsauto wrote:
         | Exercise, therapy concurrent with ketamine treatment.
        
         | jddil wrote:
         | Exercise. It's the silver bullet.
        
           | vjk800 wrote:
           | I don't have the source at hand, but I read somewhere that in
           | many hunter-gatherer societies, pretty much all people walk
           | 15-20 kilometers every day. Coincidentally, this is
           | approximately equivalent to the the amount of exercising I
           | need to do calm my anxiety down.
           | 
           | Maybe anxiety is just some kind of exercise-deficiency. After
           | all, we were made to move around, it's entirely plausible
           | that many biological processes in our bodies just don't work
           | well while sedentary and our anxiety is trying to tell us
           | that.
        
             | yamtaddle wrote:
             | > After all, we were made to move around, it's entirely
             | plausible that many biological processes in our bodies just
             | don't work well while sedentary and our anxiety is trying
             | to tell us that.
             | 
             | Muscle contractions function as the heart for our second
             | circulatory system.
             | 
             | https://en.wikipedia.org/wiki/Lymphatic_system
             | 
             | A few animals have an _actual_ second heart for that, but
             | we don 't--we have to move to make it work well.
        
           | ryanklee wrote:
           | I promote exercise as an excellent way to combat and prevent
           | anxiety/depression/etc., but calling it a silver bullet is
           | just wrong. Some people can do all the right things and still
           | feel like absolute shit at the end of the day. There are wars
           | that cannot be won.
        
           | FollowingTheDao wrote:
           | No, it's not, not for everyone. Exercise induced anxiety is
           | real for many people.
           | 
           | https://www.sciencedirect.com/science/article/pii/S003331828.
           | ..
        
             | janeerie wrote:
             | Thank you for this. There are multiple comments in this
             | thread saying exercise is the "silver bullet," but if you
             | have a severe anxiety disorder, it often isn't.
             | 
             | I am much less anxious on the days I don't exercise. I
             | still do it nearly every day because I want to stay
             | healthy.
             | 
             | What works for me? Good old SSRIs. They are my silver
             | bullet.
        
           | causi wrote:
           | Yeah, and it doesn't have to be "exercise" exercise either,
           | just exertion. Go work in the yard. Repair your house.
           | Reorganize your stuff. Build some shelves. Change your own
           | oil and rotate your own tires. Just do things that involve
           | moving your body.
        
         | BoxOfRain wrote:
         | I've found valerian root extract can be helpful sometimes but
         | it doesn't seem to work for particularly long, whatever the
         | underlying compound is it must have a short half-life.
        
           | FollowingTheDao wrote:
           | Valerian root contains valeric acid, which is how they found
           | the drug Depakote (Valproic acid).
           | 
           | It's effect has been attributed to the blockade of voltage-
           | gated sodium channels and increased brain levels of gamma-
           | aminobutyric acid (GABA).
        
         | standardUser wrote:
         | Therapy, Ativan, Running, Meditation in roughly that order.
         | 
         | Therapy helped defuse the worst of it quickly and gave me the
         | tools to manage it moving forward. Easily some of the best time
         | and money I've ever spent, though I consider myself incredibly
         | lucky to have found such a compatible therapist.
         | 
         | Ativan was always more of a placebo for me. I never took it
         | more than a few times per week and I haven't taken any in
         | years. But I still carry one in my wallet at all times, and
         | knowing I have that option puts me at ease.
         | 
         | Running for me is a very efficient way of generating that
         | after-workout high that tends to eclipse anxiety, at least
         | temporarily.
         | 
         | Mediation may be the best tool of the bunch, but I've never
         | been able to adhere to a regular schedule. But even on an
         | intermittent basis it can be helpful. I believe the form of
         | mediation I've practiced would be called mindfulness.
        
         | suby wrote:
         | Supposedly Lavender can help with anxiety.
         | 
         | https://astralcodexten.substack.com/p/lavenders-game-silexan...
         | 
         | Anecdotally, I bought a two weeks supply and didn't notice
         | anything different, but my own self-assessment may have been
         | flawed.
        
           | ksenzee wrote:
           | My psychiatrist says in her experience lavender takes 6-8
           | weeks to show any effect, and it only gets you a 10-20%
           | improvement. She prescribes it as an add-on when the existing
           | treatment regimen is mostly working.
        
         | jwmoz wrote:
         | I've only recently realised I think I have a problem. Last week
         | had horrendous migraines and anxiety which I couldn't shift. I
         | had to go to the doctors (UK) and beg them to help. I generally
         | live healthy, don't really know what else to do.
         | 
         | I'm now noticing my WFH job is starting to get to me so looking
         | to go into the office once a week or more.
        
         | vjk800 wrote:
         | Heavy exercising, especially aerobic exercising. Something
         | light like half an hour walk isn't enough, I have to properly
         | exhaust myself calm the fuck down. Some different workouts that
         | are usually enough are: one hour of heavy barbell training at
         | the gym, 45 minutes of running, two hours of brisk walking.
         | 
         | Also interacting people in a non-bullshit way works but is
         | often more difficult to do. Keeping up appearances and roles
         | works the opposite, but if I tell people what I actually think
         | and let myself be more emotional and less reserved around them,
         | I actually feel more connected, which alleviates anxiety.
         | 
         | I think that at the hear, anxiety is born out of insecurity.
         | Being connected (in a real, non-pretentious/bullshit way) with
         | people raises my security. However, this is often easier said
         | than done. I guess exercising works as a sort of a patch by
         | reducing my energy levels so much that I don't any left for my
         | anxiety.
        
           | jwmoz wrote:
           | Martial arts was always my natural medicine. Have not been
           | training much the last year or so, hoping to get it back on
           | track but it worries me as I can't do that forever as I get
           | old.
        
           | Terretta wrote:
           | > _Heavy exercising, especially aerobic exercising._
           | 
           | Possibly all this activity means hour(s) of not-stressor
           | focus is calming you down. All your "free" time is exercise
           | instead of stewing.
           | 
           | To rule out the time, swap these high time consumption
           | activities for 4 minutes of HIIT (high intensity interval
           | training) bookended by 2 mins warmup and 2 mins cooldown,
           | which is proven to have even better metabolic benefits due to
           | the 4 minutes of anaerobic intervals (sprints).
           | 
           | It's a shame more people don't know "this one trick". Few of
           | us have extra hours a day to gambol about. Most people can
           | find 8 minutes.
           | 
           | > _I think that at the heart, anxiety is born out of
           | insecurity_
           | 
           | Maybe exactly _at the heart_.
           | 
           | As noted in a discussion here last week, there's a heart-
           | brain link for anxiety, heart can cause the brain to feel
           | anxious. HIIT improves heart better than, say, beta blockers,
           | so it could be the mechanism is something like exercise is
           | improving heart which signals less anxiety to brain.
        
             | vjk800 wrote:
             | I've had enough lifestyle variation to say with quite good
             | confidence that it's the aerobic exercising that helps me.
             | Before I learned to manage my anxiety I tried to calm down
             | by just, you know, lying down and trying to relax, but it
             | never worked very well. My mind would just generate more
             | anxious thoughts and it would often get worse, not better
             | by just relaxing.
             | 
             | I've also don HIIT and I can confirm that 15-20 minutes of
             | HIIT (maybe 5-7 intervals with a bit of warmup) provides
             | the same results as one hour of more moderate form of
             | aerobic exercising. However, HIIT, when done properly, is
             | fucking horrible (several times I've been very close to
             | puking afterwards). I still do it maybe once every two
             | weeks, but I think I would die if I tried to do a proper
             | HIIT workout every day.
        
           | Melatonic wrote:
           | I am convinced that lack of exercise is exacerbating a lot of
           | peoples mental issues (not claiming it is the cause,
           | however).
           | 
           | Think about dogs. Anyone who has owned a larger, high energy
           | dog knows exactly what happens when they do not get regular
           | and intense exercise - they become an anxious mess and often
           | become destructive or even self destructive.
           | 
           | Are we really that different from dogs?
        
       | boh wrote:
       | I'm glad they figured it out since it was impossible to tell any
       | other way.
        
         | gregoriol wrote:
         | If there is a possibility for a simple test that gives a quick
         | and precise answer, it could be better than someone asking
         | someone and interpreting an answer.
        
         | Zealotux wrote:
         | >The test examines biomarkers that can help them objectively
         | determine someone's risk for developing anxiety, the severity
         | of their current anxiety and which therapies would likely treat
         | their anxiety the best.
         | 
         | It actually sounds more interesting than the headline suggests.
        
           | loldk wrote:
           | [dead]
        
           | derbOac wrote:
           | I do research in this area and I sort of bristle whenever an
           | article talks about "objective measures" of some
           | psychological phenomenon, as if the subjective experience
           | isn't really what it's about. So the framing of this article
           | really rubbed me the wrong way.
           | 
           | Having said that, I thought this was still interesting just
           | in terms of the biochemistry and molecular biology of systems
           | involved in anxiety.
           | 
           | I think the most practical utility of this might be in drug
           | treatment planning although that tends to not work out in the
           | real world as well as it does in theory and research.
           | 
           | Another angle on this kinda mentioned in various places is
           | that people come into the clinic claiming extreme anxiety
           | when they just want drugs to resell or abuse. But even that
           | could get tricky because lots of times people abusing drugs
           | also feel anxiety.
           | 
           | One elephant in the room with this paper is they didn't
           | really measure anything else. So it has some predictive
           | utility in "anxiety versus not" in a select group of people,
           | but what if other mood state issues are also moving around
           | with it? It's kind of like saying "hey our model predicts
           | cats in images" in some database where you've removed all the
           | dogs and foxes and otters and so forth and so on. Or maybe
           | it's like having a database where all the images with cats
           | also have a 80% chance of having a dog, fox, etc.?
        
         | abecedarius wrote:
         | It's common for a patient with a chronic mystery symptom to be
         | dismissed with "You seem very anxious. Anxiety can cause blah
         | blab blah." plus a useless-to-harmful prescription. A legible-
         | to-doctors test for 'anxiety', which doctors are expected to
         | use, might help reduce this kind of stupidity.
        
       | lapcat wrote:
       | The test is simple: if you fear getting a blood test, then you
       | have anxiety.
        
         | Temporary_31337 wrote:
         | IMO if you're getting a blood test for anxiety, that also
         | implies one is anxious.
        
           | efitz wrote:
           | I'm not trying to be flippant, but why do we need a blood
           | test for this when we have a test already, eg "Do you have
           | anxiety? Do you have any of these symptoms?"
        
             | Jiocus wrote:
             | Not everyone can identify anxiety symptoms in themselves,
             | especially if they have been experiencing them for so long
             | it's become 'normal'. There's also those that won't report
             | what they are actually feeling, even when asked explicitly,
             | for a range of reasons.
        
             | user8501 wrote:
             | Seriously. This could be replaced with a one question
             | questionnaire. Are you anxious?
        
       | user8501 wrote:
       | Researchers are becoming as useless as programmers
        
       | [deleted]
        
       | henriquez wrote:
       | This sounds useful for torturers and interrogators. In most
       | situations medical professionals can just _ask_ someone if
       | they're feeling anxious.
        
         | feoren wrote:
         | > In most situations medical professionals can just ask someone
         | if they're feeling anxious.
         | 
         | Except they literally refuse to believe your answer. You can
         | swear up and down "I was not anxious, I actually felt great"
         | and they fire back with "many people don't know when they're
         | anxious. You can be anxious without realizing it." It's
         | completely unfalsifiable, like the old asylums where everything
         | you could ever say is just more confirmation of whatever mental
         | illness they already decided you have.
         | 
         | If they don't know what's wrong with you and you don't have
         | symptoms that very specifically fit their pre-determined list
         | of the 100 things that might ever be wrong with anyone, then
         | some use "anxiety" as a catch-all, regardless of whether you
         | claim to have it or not. Everyone feels stressed occasionally,
         | so there's no objective way to self-report it. My "very
         | anxious" might be your "normal Tuesday night". They capitalize
         | on this to make it completely impossible to argue with their
         | "diagnosis" so they can get you out the door with a magic pill
         | to fix all your woes, while they move on to the next patient
         | they can give 3 minutes to out of their overbooked 12-hour
         | workday. I would do the same if I were completely overworked in
         | a trainwreck of a system run by incompetent hospital
         | administrators and faceless insurance companies.
        
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