Approximately one in every five women has a mental health issue, such as depression or anxiety. Whether it stems from history of abuse, poor socio-economic conditions, or simultaneously juggling the roles of career and primary caregivers for children and/or aging parents, a woman’s resilience is tested on a daily basis. Add in the different life stages of puberty, perinatal and perimenopausal years, and it is no wonder that these sobering statistics are, in fact, very real.
Anxiety may be defined as excessive worry about normal daily life and inability to control fears. The National Institutes of Health define it as occurring more days than not and for a period of more than six months. Under the umbrella of anxiety disorder are panic disorders, panic attacks, social anxiety disorder, and different phobias. With time the effects of anxiety can begin to disturb a woman’s personal life, career, and health. Sadly, anxiety does not just affect adult women: 2.2% of American teenagers between the ages of 13-18 experience anxiety, with girls experiencing it at twice the rate of boys. It is suggested that women diagnosed with one anxiety disorder are also more likely than men to have an additional anxiety disorder diagnosis, major depressive disorder, and/or bulimia nervosa (McLean et al., 2011).
Being the most pervasive mental disorder in the United States, it is important women begin the process of self-care early on. As Hantsoo and Epperson suggest in their 2017 paper, anxiety symptoms can present during the lifespan of women, starting from a young age. The importance of when anxiety is diagnosed and during which stage of a female’s life helps us understand why disorders can become worse, such as during puberty or perimenopause.
(Image from Hantsoo & Epperson, 2017)
For example, a young girl experiencing anxiety during puberty may simply be because of higher sensitivity to the new fluctuating hormones. Of course, there is the social stress of being a teenager that can also create or exacerbate underlying anxiety. We also know that during the menstrual cycle, certain women experience what is known as premenstrual symptoms or premenstrual dysmorphic disorder, the latter manifesting in increased anxiety. The periods of pregnancy and postpartum and later the menopausal transition are all times in a woman’s life when hormones fluctuate wildly increasing susceptibility to any number of anxiety disorders.
FUN FACT: Did you know that the word “hysteria” is derived from the Greek word “womb”? Back in the day of Hippocrates, and well into the 19th century, “hysteria” was a catch-all phrase essentially used to diagnose women as crazy due to the female uterus.
The causes of anxiety can, of course, move beyond the confines of hormone fluctuations. From traumatic histories of various forms of abuse to social stressors (teenage years, anyone?), careers, and acting as primary caregivers, women, if not practicing self-care, are inundated with an enormous number of stressors that increase the risk of anxiety disorders.
So how can we protect our young girls and adult women from experiencing anxiety? From an integrative perspective and depending on the level of anxiety that already exists, there are several tools we can implement to help. The importance of self-care must be instilled at a very young age. As women, we tend to have a sense of guilt that comes with taking time to honor ourselves, to make ourselves a priority. It is time to break that pattern and home in on how important self-care is to our health. What might this look like? Whatever daily practice gives uninterrupted pleasure and calms the nervous system: a long hot bath, a sweaty yoga session, meditation or breathwork, reading a novel, the list is endless, and these simple pleasures can reap great rewards for the nervous system.
We also want to look at nutrition. We know that a diet comprised of highly inflammatory processed foods is associated with an increased risk of depression and anxiety (Li et al., 2022). Instead, we want to focus on the nourishing foods of a Mediterranean Diet: A diet comprised of healthy fats that fuel the brain, such as oily fish, olive oil, seeds, and nuts. We also want high quality protein that helps satiate the appetite, build lean body mass, and helps build important neurotransmitters. Many clinicians use a version of the ketogenic diet to help manage anxiety. This is particularly effective in the ability of ketones to increase GABA levels in the brain, a calming neurotransmitter that if low can lead to anxiety, stress, and fear.
Exercise, whether aerobic or strength training, is also an important factor in controlling anxiety levels. Research shows that even simply going for a short daily walk of 30 minutes can help ease anxiety and stress. For women, strength training is an extra important component as older age sets in and muscle and bone mass decrease with age. A common mistake is for women to begin increasing aerobic exercise to counterbalance mid-life weight gain, which overtime can have the opposite effect as intense cardio exercise increases cortisol and inflammation!
There are many supplements that, with proper knowledge, can help manage anxiety. The mineral magnesium is an excellent one that comes to mind as well as B vitamins, essential fatty acids, and Vitamin D. These along with some lesser-known supplements such as GABA, theanine, and 5-HTP are all options worth exploring with your primary care provider. Finally, I personally love the use of adaptogenic herbs, herbs that help the body regulate itself against stressors, such as Ashwagandha and Rhodiola. Anxiety is a real threat to women, and it should not be taken lightly or overlooked as unimportant emotions. Teaching our daughters at a young age to advocate and care for themselves without guilt is an important first step in battling the sobering statistics that plague the US population. The good news is that with the help of a trained healthcare provider, there are many nutritional and lifestyle factors that can help minimize anxiety!
Research:
Hantsoo, L., & Epperson, C. N. (2017). Anxiety disorders among women: a female lifespan approach. Focus, 15(2), 162-172.
Li, X., Chen, M., Yao, Z., Zhang, T., & Li, Z. (2022). Dietary inflammatory potential and the incidence of depression and anxiety: a meta-analysis. Journal of Health, Population and Nutrition, 41(1), 1-13.
McLean, C. P., Asnaani, A., Litz, B. T., & Hofmann, S. G. (2011). Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness. Journal of Psychiatric research, 45(8), 1027-1035.
