ANXIETY AND ITS EFFECTS HEALTH UPON HEALING

Patrick Randolph, Ph.D.   Date updated: 4/18/2019

Anxiety is often a healthy emotion but when elevated, can cause or worsen health problems and slow recovery from medical care.

What are the symptoms of anxiety?

There are several types of anxiety, but the more common symptoms include (need link for DSMV Generalized Anxiety Disorder):

  • Restlessness and a feeling of being “on-edge”
  • Uncontrollable feelings of worry
  • Increased irritability
  • Concentration difficulties
  • Sleep difficulties such as problems in falling or staying asleep

What causes anxiety?

Anxiety is a healthy response to perceptions of threat or actual dangers. Potentially harmful worries or triggers such as being chased by an angry dog cause the body to ramp up certain functions like heart rate and cooling system, while increasing sensitivity to surroundings that prepare us to fight or run away.

The “Fight or Flight” system is very sensitive and reacts quickly to emergency situations that could threaten our safety or survival. After all, the body can’t wait long for the breath to send more oxygen to muscles when we are running for our very life!

The fight or flight response requires a great deal of energy and thus turns down bodily functions like digestion and immune functioning. After all, what’s the use of digesting food if we are about to be a cheetah’s lunch?

After the emergency is over, the “Rest and Digest” system kicks in to slowly relax our body and “reboot” the systems such as digestion that had been turned off, restoring balance. While we are quick to react as a species, we are also slow to relax as well.

While this survival system may have been very useful to avoid being a food source for other animals, it may get overstimulated by worry in the fast paced world of work, money, relationships, schedules, and getting ahead. The keen sensitivity to threat makes our bodies very reactive to thoughts and feelings about what might happen in the future, even when the immediate moment is quite safe. So anxiety may start to overwhelm, affecting health and day to day living when perceptions of threat are blown out of proportion. Anxiety disorders are commonplace in the U.S., affecting nearly 40 million adults.

In addition to what’s going on in our minds and environment, anxiety can also be caused by other factors including: genetics; medical factors; brain chemistry and drug use or withdrawal.

Just as anxiety is a normal expression of our survival instinct, stress management is a natural function of our everyday life that can be improved with instruction and practice. Luckily, we have some personal control over these systems by learning to interpret less and less as truly threatening and by training the “rest and relax” system to actively return our body and mind into a natural state of balance.

How does high anxiety affect the body?

Anxiety causes a flood of adrenaline, a hormone and chemical messenger in the brain, which can boost blood sugar levels and triglycerides (blood fats) that can be used by the body for fuel. When excessive fuel in the blood isn’t used for physical activities, the chronic anxiety and outpouring of stress hormones can have serious physical consequences including:

  • Suppression of the immune system
  • Digestive disorders
  • Muscle tension
  • Short-term memory loss
  • Premature coronary artery disease
  • Heart attack
  • Respiratory illness

The effects of anxiety on medical care and surgery.

Nigussie notes that there is an inverse relationship between preoperative anxiety and receiving preoperative information. This means that patients who know more about their surgery prior to admittance most often have less anxiety

ALTHOUGH INCONSISTENCY was found in the articles that were reviewed, most of the available evidence revealed a positive correlation between preoperative anxiety and postoperative pain among a wide range of surgical types.
https://aornjournal.onlinelibrary.wiley.com/doi/abs/10.1016/S0001-2092(07)60130-6

Among individuals having Lumbar surgery, failure to report improvement in pain and functional abilities was predicted by presurgical somatic anxiety.
https://journals.lww.com/spinejournal/Abstract/2000/10150/A_Prospective_Study_of_Psychological_Predictors_of.12.aspx

Elderly patients undergoing cardiac surgery with high anxiety had higher all-cause mortality and major morbidity to include stroke, renal failure, prolonged ventilation, deep sternal wound infection, or re-operation
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3677723/

How anxiety and depression may affect outcomes to surgery.

Anxiety and depression are the two most common mental health challenges and they tend to have strong overlap, with a recent national survey finding that more than half of patients with major depressive disorder have also had an anxiety disorder.
https://www.anxiety.org/anxiety-and-depression-always-co-occurence

Investigators studied 177,000 patients having hip replacement, knee replacement, hernia and varicose vein surgeries and found that patients with anxiety or depression were more likely to have wound complications, be readmitted to the hospital, and on average, had longer hospital stays. Those with more severe depression and anxiety tended to have worse complications and troubled recoveries.

The patients in this study were less likely to heal than those without depression and anxiety, adding support to the ancient axiom that conditions of the mind directly manifest in the body. It is important to not underestimate the importance of the psychological state before surgery.