I forgot something that immensely helped me: the probiotic Symprove.
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I know exactly what you mean. I tried all possible alternatives, but in the end the only thing which worked was a drug, specifically vortioxetin. But you neeed a good M.D. to lead you. Alternatively: HTC helps, but I cant get it where I live.
Question:
- How do you know you have an overactive amygdala? Was this through an fMRI?
- you mentioned your anxiety was genetic, but have you ever done a genetic panel to see if there are genes that correlate with neuropsychiatric disorders?
Suggestions:
Have you seen a psychiatrist or been recommended to one? They ultimately will be the most helpful (if you find a good one) in pharmalogical interventions.
Have you sought out or tried TMS(transcranial magneitc stimulation)?
What are your daily habits/lifestyle? Do you get outside a lot, do you sleep well, do you sleep on a normal light cycle(go to bed during the night and wake up during the day), do you exercise regularly, etc.
As someone mentioned, if the anxiety is diagnosed as severe, begin looking into severe depression treatments such as psychedelics.
In the literature, we know a good amount of the neurocircuitry involved in various neuropsychiatric disorders such as anxiety, but there is so much individual variation that it’s hard to narrow down specific treatment options. To add to this, there is significant variation on mechanisms invovled when you look in the literature and animal models, as it depends on the stress/anxiety paradigm used. Furthermore, in humans this is complicated by lifestyle factors and root causes( was it due to a traumatic event, environment factors, etc). FURTHERMORE, this is even more complicated by sex differences…
Honestly, the literature on neurochemical interventions as effective treatments remains mixed. Lithium, SSRIs, HDAC inhibitors, acetate supplementation have seen some results but unfortunately, there is still a lot of uncertainty within the field and lack of clarity on exact mechanisms contributing to anxiety.
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Many doctors will prescribe a beta blocker called propranolol which controls performance anxiety (such as public speaking) extremely well. You can look that up and discuss with your docs.
Otherwise, a routine habit/practice of a healthy diet, exercise, good sleep, breath work (like Wim Hof and Andrew Weil), meditation, yoga, positive thinking/cognitive therapy techniques, holy basil, ashwaghanda, passion flower, glycine, and magnesium.
But for those acute situations where the adrenaline is just out of control, propranolol.
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I have to give CR a lot of thought. I consume an extraordinarily healthy plant-based diet. To practice CR I would have to go less on healthy foods, which may have some other deleterious effects.
As for chamomile, I have taken it at night since it is a minor sedative. In fact, I also take glycine and theanine only at night. If they help with anxiety, I have not noticed anything during waking hours. I have to think about taking them in the morning.
There’s also a distinction between elevating mood and alleviating anxiety. They seem to be distinct. But improved mood enables me to better cope with anxiety. I used to use opiates for mood elevation. Now I only use the caffeine in black and green tea and some cocoa powder. Not sure that actually helps with mood.
I need to see a psychopharmacologist. But I am currently limited in my movement because of chronic pain (which obviously contributes to already-existing anxiety). Until I can see a psychopharmacologist, I have been looking for an intervention that I can try myself. So far, nothing “natural” has seemed to help. I will investigate TMS.
As for as my amygdala, I am just using that as a metaphor to assert that my anxiety is deeply rooted and longstanding.
Or no cure yet. The reality is the primitive state of modern medicine with regard to psychopharmacology.
Propranolol is a dirty drug that messes up with glycemic control and causes Parkinson’s disease.
Don’t take it.
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Do you have sources for this? I found this info commenting on this:
Another paper, also from one of APDA’s Centers for Advanced Research — this one at Washington University in St Louis, came to a different conclusion. This research group analyzed Medicare data in the US to discern the risk of PD in relation to use of beta blockers and beta agonists. Whereas propranolol was associated with an increased PD risk as was found in the Norwegian and Israeli studies, when this was adjusted for tremor prior to PD diagnosis, the association disappeared, suggesting that people with PD may be prescribed beta blockers early in their disease course as a way to control tremor.
Yet another paper analyzed a large data set, this one in Denmark, to determine the association between beta blockers and beta agonists. Its conclusions were aligned with the paper that analyzed Medicare data — that PD symptoms of tremor triggered the prescription of beta blockers and not the reverse.
These competing papers demonstrate the difficulties inherent in this type of research and more research is necessary to sort out the effects of beta blockers on PD risk. At this juncture, there is not enough information to instruct PD patients either to stop their beta blocker (or to add a beta agonist).
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I’ve been doing a deep dive on anxiety meds as well, that are not benzos or SSRI. Besides the obvious, starting with exercise, sleep, healthy diet and therapy, I’ve come to the following that have the most reviews and best safety profile… Each of them do have positive and negative experiences depending on your own body chemistry. Clonidine, Buspirone and for situational anxiety only, and if you have good self control, gabapentin. For me propranolol is also helpful for situational anxiety, so is clonidine (though based on reviews, the dose is important, 0.1mg is often too much, and you should half or quarter the tablet when you start - too high will cause drowsiness).
There are also good reviews on a Russian anxiolytic called Afobazole if you were open to something outside of the western medical system.
There are dozens of papers on the topic. Yes, people used to think that it was reverse causality. But we now have Mendelian randomization that shows causality: Nonselective beta-adrenoceptor blocker use and risk of Parkinson’s disease: from multiple real-world evidence 2024
Also, if the effect was due to reverse causality, we would only find the association for beta-blockers given off-label for tremors or anxiety. That’s mostly propranolol. And yet other beta-blockers, such as bisoprolol, are also associated with a higher risk of PD. So beta-blockers are the causal issue.
And in any case, they still mess up with glycemic control.
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Yes, certain “situations” are more anxiety-provoking. But my anxiety is not situational. It is longstanding and visceral. So I am looking for something for that. What do you think about THC, katamine, vagus nerve stimulation?
I’ll have a look over that when I have time thanks.
I’ve been aware of and researching CR since the 80’s. I have been on several CR lists, know personally many CRON practitioners and have been on CR myself for many years.
Of all the claims about the CR(ON) - Caloric Restriction Optimal Nutrition - diet, you managed to come up with a new one! The claim that transitioning to a CR(ON) diet will be less healthy than your current healthy ad libitum diet. That’s a new one!
I really cannot come up with how that can possibly be true.
I suspect you might have an inaccurate conception about what a CR diet is. In short, a CR diet is a diet that limits calories, as in a straight DR (Dietary Restriction) cut in quantity of whatever it is that you are consuming currently, or more commonly as practiced, of restructuring your diet to limit it to a given level of calories while maintaining an optimal level of macro and micronutrients amounts. This necessarily means consuming more nutritionally dense food, as you must fit all the nutrients into fewer calories. This generally means consuming the healthiest foods available. Note, CR does not imply a necessarily lower volume of food, only lower calories, which generally means more plants and fewer animal based foods, and almost complete elimination of processed foods. You may have to/wish to add select supplements.
On the other hand you are right to think carefully before embarking on CR. There is no sugarcoating this: CR is a very complicated and difficult lifestyle - yes, lifestyle… which is why I ultimately gave up on it after many years. I had no issues staying on the diet itself, but the social and practical aspects eventually proved too much. You cannot travel and vacation freely and explore. Your social life becomes restricted and difficult. It’s expensive. Unless your partner is on CR with you (as my wife was), it can be a source of stress and complications. It is time consuming and demands great discipline - the shopping, the prepping, the measuring, day after day. As my professional obligations increased, I simply could not spare the necessary time and I didn’t have the kind of wealth to hire a team a la Brian Johnson. In short, I decided that I spent too much of my life tending to the mundane practice of CR, with not enough time left to actually live my life. If I wanted to really be on CRON, not half ass it, that is. As if all that weren’t enough, it takes time to actually experience the full suite of benefits, like 2-3 years minimum - and those 2-3 years can be worse psychologically than your ad libitum life, before you reach the promised land of long term CR. That said, the benefits - as I experienced it - were spectacular, not merely physically, but psychologically; I was razor sharp, lightening fast and focused, resilient and felt bulletproof; all my senses seemed in hyper drive; food was delicious and hunger not an issue (disclaimer: 1. only true for long term CR 2. not true for everyone - for many, hunger remains an issue, even with good diet design).
I mentioned CR, because it is factually relevant to your question. This doesn’t mean it’s practical. In fact, to put it bluntly, being on real CRON (not the half-assed efforts that sometimes are claimed to be CR), demands a unique personality. At its height, the number of CRONies in the US, was about 1500, and most of them read the list/site. You do the math.
Could CR resolve your issue? Yep. Would you be able or willing to go that route - frankly, very doubtful.
Final tidbit. Historical/environmental evidence, hints. Highly counterintuitive - at times of starvation, the numbers of people with anxiety and related disorders like depression, drop drastically - you’d think the opposite… and yet. Even in times of extreme stress, like war, you don’t have the numbers of depressed/anxious people as in times of prosperity and peace. The brain, when stressed by very constrained resources cannot spare the cycles for unproductive rumination and free floating emotions and psychologically wasteful states like anxiety. The signals that trigger anxiety states demand energy the brain cannot spare as it must prioritize life preserving activities. In CR experiments with animals, a pretty universal finding is that the animals are more physically active than controls even though have fewer calories to operate on. Paradox. This is explained evolutionarily by greater need for food seeking abilities and sense sharpening. They must perform better to find food. This heightened state prioritizes productive behaviors, and eliminates wasteful behavioral patterns including unproductive anxiety. Like the CR studies in rats I cited in another post, where CR resulted in less anxious behavior patterns and brain activity. These effects are real.
But note one universal thing: however wonderful the benefits may be, however sharp the senses and capable the body, no animal or human would voluntarily choose to drastically limit calories, experience hunger, be on CR. Human beings are a bit different because of our intellect. We can and do choose to fast, often regularly. And, very, very rarely we choose to go on CR long term as a lifestyle. YMMV.
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Metformin is also considered a “dirty drug,” yet can still be beneficial.
Regarding glycemic control: Propranolol can mask symptoms of hypoglycemia (like tremors and palpitations) in diabetic patients, making it harder for them to recognize when their blood sugar is low. It can also slightly impair glucose metabolism, though this effect is usually modest in most patients.
Regarding Parkinson’s disease: Some studies have suggested a possible association between long-term beta-blocker use and increased risk of Parkinson’s disease, but the evidence is not conclusive and more research is needed to establish any causal relationship.
Propranolol is an effective and widely used medication for various conditions including hypertension, migraine prevention, and anxiety. The benefits often outweigh the risks for many patients when properly prescribed and monitored.
I am reminded of the late Jerome Kagan, a Harvard psychologist who has written about temperament. He began with 4 month old infants and exposed them to novel sights and sounds. Some 20% were highly excitable. Another 20% were unexcitable. He followed them into adulthood and found a high correlation between the high-reactive babies and introversion/anxiety later in life. The low-reactive babies were more likely to be extroverts (and criminals – a slow heart rate correlates with a lack of fear). This shows how temperament (high or low anxiety) can be intrinsic and as a result very difficult to diminish.
You do not sound like a person who has ever suffered from extreme anxiety.
But if it takes 2-3 years to optimize CR, I will search for more immediate solutions.
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Why do you talk like a brainless AI?
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I practice Zen meditation and highly recommend this for a variety of benefits but reduction of anxiety is one. I found this - Meditation-induced neuroplastic changes in amygdala activity during negative affective processing - PubMed, but have seen other studies showing the impact of meditation on the brain leading to physical changes in structures related to empathy and anxiety. Before taking any meds, I would also get checked for levels of neurotransmitters in blood serum but also get your gut tested as these are regulated by gut microbiome. I’ve had imbalances in my gut microbiome that affected my levels of dopamine and GABA. Resolving my gut issues brought these back into balance. Lastly, you should evaluate your SNPs for neurotransmitter related mutations that might be affecting your production/metabolism of these compounds.
This may sound like a copout, but not everyone has the capacity for meditation. Indeed, it seems anxiety is one such impediment to meditation. Again, I refer to Jerome Kagan. Anxiety manifests in four-month-old infants which suggests it runs deep in the psyche.
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Indeed, I can see how the attempt to meditate could contribute to anxiety – performance anxiety. That’s why there has been recent criticism of all the happiness books. The pressure to get happiness right or a non-anxious state right – but not achieving it – can lead to disappointment and more anxiety.
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