Anxiety and Insomnia Disorders

Anxiety and Insomnia Disorders have tripled in prevalence since 1980. What is going on? 

At Florida Detox & Wellness Institute, we treat many patients who self-medicate their underlying anxiety and insomnia disorders with drugs like Xanax, Klonopin, opiate pain medication like OxyContin or Alcohol.  

We also treat many non addicted patients who suffer from anxiety disorders or OCD, Obsessive Compulsive Disorder.These patients usually come to Florida detox for our Wellness Program – Treatment for Refractory Anxiety and Insomnia Disorders  

  

Anxiety

What Is It?

  

Anxiety is essentially excess electrical current flowing through the brain. The human brain is both a chemical and an electrical organ. It consists of billions of electrical cells called neurons. Because various types of anxiety are derived from different brain regions, the symptoms of anxiety will vary. Many patients experience anxiety as excessive worry and apprehension about the future.  

These patients worry about things that may never happen. They expect the worst from their future and constantly experience a feeling of impending doom. Other patients describe anxiety as edginess, the inability to relax and, in severe cases, pure panic. These patients often state, “I feel like my brain is plugged into an electrical outlet.” Anxiety disorders are the number-one mental health condition in American women. In American men, anxiety disorders are second only to alcohol and drug abuse.2 Clinical studies at Florida Detox and Wellness have shown that 90 percent of addicted females and 75 percent of addicted males use drugs and alcohol to self-medicate underlying anxiety disorders.  

Since 1980, anxiety and panic disorders have tripled in the U.S. At the same time, addiction has more than tripled. There is an obvious correlation. Patients are using drugs and alcohol to relax their anxious brains. The American Psychiatric Association has arbitrarily classified five main types of anxiety disorders based on patient symptoms, not causation.  In this chapter, the five classifications of anxiety from the psychiatric Diagnostic and Statistical Manual (DSM IV) will be discussed, and an attempt made to elucidate the true cause of each. There is much overlap among these various anxiety disorders.  

Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder (GAD) is essentially what the name implies, a generalized term. As described by the American Psychiatric Association, generalized anxiety is characterized by chronic anxiety, excessive worry, brain and body tension. Most often there is no emotional or social cause for it. Accordingly, patients with GAD become overwhelmed with everyday events and find relaxation almost impossible. Truthfully, the symptoms of GAD, as stated by the American Psychiatric Association, are derived from a combination of obsessive-compulsive anxiety along with the anxiety experienced by patients when they suffer excessive electrical activity in their brain.  

Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder is an anxiety disorder in which recurrent, unwanted thoughts and/or behaviors are prevalent. The obsessive-compulsive disorder (OCD) – type of worry is derived from a brain region called the anterior cingulate gyrus. PET brain scan studies have been performed on patients with obsessive-compulsive symptoms. They visualized OCD patients with overactivity in their anterior cingulate gyrus, and sometimes in the basal ganglia, the brain’s dopamine factories. Dopamine is a stimulating brain chemical. Excessive dopamine production from overactive basal ganglia causes too much electrical activity throughout the brain. Dopamine functions in many ways, but is very involved in the pleasure/reward pathway, and in memory and motor control.  

  

Dr. Daniel Amen, founder of the Amen Clinics, has performed extensive SPECT (single photon emission computed tomography) brain scan research studies in which he has also documented that OCD patients typically have an over-active anterior cingulate gyrus.8 Dr. Rick Sponaugle, founder of Florida Detox and Wellness, has used Dr. Amen’s SPECT scan imaging since 2005 to assist in the evaluation of addicted and non-addicted anxiety disorder patients. Additionally, Dr. Sponaugle’s clinical research confirms and further corroborates the specific brain chemical and hormonal imbalances that result in these brain regions becoming overactive.  

Normally, the anterior cingulate gyrus assists our brain with forgiving, forgetting and moving on. However, those patients who suffer over-activity in their anterior cingulate are unable to forgive or forget, and they have a tendency to hold grudges. They become hyper-focused on the negative aspects of their life. They develop stubborn personalities and become set in their ways. Frequently these people develop a serotonin deficiency stemming from the intestine. Serotonin deficiency is more common with age. Serotonin deficiency is the primary biochemical cause of an overactive anterior cingulate gyrus.  

 

Because these patients cannot register the positive events in their life, they begin to assume that nothing good can or will happen. Therefore, they worry excessively about their future. Patients with obsessive-compulsive anxiety worry themselves to sleep and wake up worried. When the obsessive-compulsive anxiety worsens, patients are many times officially diagnosed with obsessive compulsive disorder (OCD). Often these patients find relief when performing repetitive processes or behaviors.  

Tension in the brain and in the muscles, particularly in the shoulders and neck, as described by patients with anxiety, is normally derived from excessive electrical activity throughout nerves in the brain and body. This excessive electrical activity is also the underlying source of fibromyalgia.  

The cause of this excessive electrical voltage is an imbalance of neurotransmitters, the messenger chemicals that travel between nerves, along with an imbalance of the body’s hormones that modulate and control the activity of brain neurotransmitters.  

Panic Disorder

Panic disorder involves feelings of terror that can occur suddenly and often unexpectedly. These feelings can be accompanied by intense physical symptoms such as tachycardia (racing heart rate), nausea and sweating. These patients frequently develop a surge of panic when thinking about certain people or considering future events, such as work. Panic disorder is essentially a more severe level of excessive electrical current running throughout the brain.  

Dr. Sponaugle has diagnosed many patients suffering panic disorder with excessive accumulation of fatty toxins in their brain. This causes excessive production of the excitatory brain chemicals—PEA (phenyl-ethyl-amine) and glutamate. Glutamate is the most powerful electrifying chemical in the brain. Patients who suffer excessive glutamate levels have so much excessive electrical current in their brain that they literally “fry” brain cells. Brain scientists throughout the world are in agreement that excessive glutamate activity in the brain is the primary cause of premature dementia and early Alzheimer’s disease.10 Patients with excessive glutamate activity in their brains feel like “a walking panic attack.”  

Post Traumatic Stress Disorder (PTSD)

 

Post traumatic stress disorder (PTSD) is a type of anxiety that develops after a negative event or chronic negative scenarios in which serious physical harm has occurred or was threatened.11 Dramatic events such as violence, disasters, accidents or belligerent work  colleagues can trigger PTSD.  

Patients with PTSD demonstrate overactive basal ganglia (dopamine factories) on SPECT and PET brain scans. Excessive dopamine production from overactive dopamine factories causes excessive electrical current throughout the brain. Current theory is that the traumatic event or sequence of traumatic events thrusts the patient into a continuous state of what is known as “fight or flight.” This high-voltage state makes these patients appear edgy and jumpy.  

They frequently have a pronounced startle reflex. The human brain is essentially fully developed by age 13,  except for the frontal lobes, which don’t fully mature until the age of 25. For this reason, children are more vulnerable to developing excessive basal ganglia activity from traumatic experiences than adults.  

Social Anxiety

Social anxiety or social phobia describes patients who suffer excessive fear, heightened anxiety and self-consciousness in social situations. Patients with social phobia suffer a chronic fear of being watched or judged by others which results in avoidance of social situations. Social anxiety is derived from an overactive deep limbic system, the emotional center of the brain that becomes overactive from serotonin deficiency. Patients diagnosed with autism and Asperger’s syndrome demonstrate the most severe form of social anxiety—so severe in fact— that they cannot give others eye contact. They engage in conversation while looking down at their feet. Dr. Sponaugle has diagnosed severe serotonin deficiency in every autistic and Asperger’s syndrome patient he has treated.  

The deep limbic system is approximately the size of a walnut and resides within the midbrain. Interestingly, women structurally have a larger emotional center than men. This makes women more sensitive to emotional issues, thus, women are naturally better at nurturing children than men. When men develop a severely overactive limbic system from serotonin deficiency, they become more sensitive to emotional pain like females. The reason serotonin deficiency causes this specific brain region to become overactive is that the majority of the brain neurons in the deep limbic system are GABA nerves. GABA is a relaxing brain chemical that turns down the electrical voltage in brain neurons. Serotonin actually enhances GABA’s ability to activate brain receptors. When serotonin is deficient, GABA relaxation is compromised in the deep limbic system to a greater degree than other brain regions.  

Other symptoms of an overactive deep limbic system include moodiness, irritability, hopelessness, low self-esteem, decreased motivation, excessive guilt, negativity, the tendency to be easily offended, and depression.  

Depression that is derived from serotonin deficiency is also caused by an overactive deep limbic system. This type of depression has been arbitrarily labeled melancholic depression. One can understand why psychiatrists suggest that depression and anxiety frequently coexist in certain patients. Depression and anxiety derived from an overactive deep limbic system always coexist.  

What Causes It?

Serotonin Deficiency

  

Serotonin is a calming brain chemical. Serotonin deficiency is the most common cause of anxiety in Americans. Two chemical reactions are required for the production of serotonin.  First, the amino acid tryptophan found in food is converted into 5-hydroxy tryptophan (5-HTP) in the small intestine. The second step occurs in the brain where 5-HTP is converted to serotonin.  

Fully 99 percent of serotonin deficient patients treated at Florida Detox and Wellness suffer serotonin deficiency from their inability to perform the first step in the gut. When the gut is overgrown with excessive Candida yeast and toxic bacteria, like Klebsiella, their toxins disable factories in the lining of the small intestine and thus prevent the conversion of tryptophan to 5-HTP. Only one percent of Dr. Sponaugle’s patients suffer serotonin deficiency due to malfunction of brain serotonin factories. Those people have an issue with the second step, most often caused by excessive ecstasy abuse, exposure to toluene toxins (paint thinners, some nail polish/removers) and organic solvent toxins like benzene (common in gasoline).  

GABA Deficiency

GABA is the most powerful relaxing brain chemical. The body constantly converts the amino acid glutamine into glutamate, the brain’s most powerful stimulating brain chemical. Glutamate is then continuously converted into GABA. When patients suffer with gluten sensitivity, they develop severe intestinal permeability or leaky gut syndrome. They constantly leak undigested proteins from their gut into their bloodstream. Some of these proteins resemble glutamic acid decarboxylase, the enzyme responsible for conversion of glutamate into GABA. Subsequently, they develop a deficiency of glutamic acid decarboxylase resulting in excessive levels of the stimulating brain chemical glutamate and a deficiency of relaxing brain chemical GABA.  

Taurine Deficiency

Taurine is another calming brain chemical. It enhances GABA activity in the brain. When patients suffer excessive Candida overgrowth in their intestine, taurine is wasted in the kidneys and excreted in the urine. The toxic Candida yeast produces excessive levels of a substance called beta alanine. This protein competes for reabsorption with taurine in the kidneys. Beta alanine is reabsorbed and taurine is excreted into the urine. This can contribute to anxiety and insomnia.  

Estradiol Deficiency

Estradiol, the most powerful form of estrogen, enhances serotonin receptivity.  In the female brain, serotonin receptors remain closed when estradiol levels fall below 60-80 pg per deciliter. Thus, serotonin can’t quiet brain neurons. When females develop temporary estrogen drop out in the postpartum period or during menopause, they suffer symptoms of serotonin deficiency including depression and obsessive-compulsive worry.  

Women who suffer Candida overgrowth in their gut have an imbalanced gut microflora that produces both fungal and bacterial toxins (mycotoxins and endotoxins) enter the bloodstream and affect other systems of the body. Microbial toxins have been found to interfere with hormone function. At Florida Detox and Wellness, many women with prematurely low estradiol levels also have an underlying Candida overgrowth.  

Progesterone Deficiency

Progesterone is a calming hormone. Progesterone converts to another hormone, allopregnanolone, which also activates the GABA receptor.  Again, GABA is the most powerful relaxing brain chemical.  

Progesterone production in American females diminishes on average eight years before estrogen production. Healthy women begin to experience progesterone drop out around the age of 40. Women who suffer intestinal Candida overgrowth develop premature progesterone drop out. The Candida mycotoxins that suppress pituitary production of the hormone FSH, and that premature estradiol deficiency also decreases pituitary output of LH (luteinizing hormone), the hormone that stimulates ovarian production of progesterone. Dr Sponaugle has diagnosed menopausal progesterone production in many 25-year-old women who suffered toxic gut syndrome.  

Histamine Excess

Histamine is an inflammatory chemical as well as a brain chemical, not a well recognized fact within the medical community. Histamine’s chemical structure is nearly identical to dopamine, and it actually activates the dopamine receptors in the brain. Patients who develop leaky gut syndrome also develop excessive histamine levels in their brain. Histamine is released from mast cells every time an antibody attacks protein that leaks from the gut into the bloodstream.  

 

Patients with leaky gut syndrome typically develop multiple and often severe food allergies. They leak larger than normal undigested food particles from their gut into the bloodstream, then their immune system runs in overdrive attacking the foreign invaders. Patients with leaky gut always present with excessive histamine levels.  

The histamine flush, a red flush across the lower neck and upper chest, is so common in American women that their physicians think it is normal. They call it dermographia. Because traditional medical physicians have minimal knowledge of leaky gut syndrome, they fail to realize that the red flush is actually an indicator of excessive histamine production, a clear visual cue that the patient suffers excessive inflammation throughout the body and brain.  

Dr. Sponaugle has discovered that patients with the most excessive histamine production present not only with anxiety, but also bipolar-like symptoms. These patients have over-electrified brain scans that match bipolar patterns. It is interesting that the American Psychiatric Association has recently suggested the age of onset for bipolar disorder has decreased from the early 30’s into the early 20’s. Each new generation suffers more exposure to higher levels of antibiotics at an earlier age secondary to agricultural antibiotics in food and city water. This increased exposure is causing more toxic gut issues in younger children.  

Dopamine Excess

Dopamine is a powerful stimulating brain chemical. The brain’s pleasure center, the nucleus accumbens, runs on dopamine, thus, dopamine deficiency can cause depression. However, excessive production of dopamine causes too much electrical stimulation throughout the brain and, hence, subsequent anxiety. In even more severe cases, bipolar disorder and schizoid symptoms can occur.  

Dopamine is produced in the basal ganglia of the brain. Some patients inherit overactive basal ganglia and suffer an edgy type of anxiety as small children. They feel “like a deer in headlights” when asked to present their paper in front of the class—one of Dr. Sponaugle’s favorite diagnostic questions. A childhood filled with repeated emotional trauma can cause the basal ganglia to become overactive as well, producing too much dopamine and PTSD anxiety.  

Dopamine naturally converts to norepinephrine, which then converts to epinephrine (pure adrenaline). These three brain chemicals are known as catecholamines. The enzyme dopamine hydroxylase converts dopamine into norepinephrine in absence of copper deficiency and vitamin C deficiency. Copper deficiency can occur secondary to excessive zinc intake, or malabsorption of copper.  

Intense emotional or physical stress can stimulate excessive norepinephrine production from the A5 nucleus brain factory. This prevents downstream conversion of dopamine into norepinephrine with resultant excessive dopamine activity in the brain.  

Glutamate Excess

Glutamate is the most powerful of all the stimulating brain chemicals. Even a mild elevation in glutamate levels can cause tremendous anxiety. When the brain accumulates excessive fatty toxins, glutamate production increases to toxic levels. Excessive glutamate activity in the brain actually causes electrical destruction of brain neurons. This phenomenon is called ‘excitoneurotoxicity’. Common causes are indoor mold toxins, bacterial toxins, Lyme disease toxins, yeast toxins and industrial organic solvent toxins.  

Over 70,000 synthetic chemicals have been created since 1930 and the top 100 are known to be brain toxic. Glutamate production surges within the brain when it is saturated with these fatty toxins. Subsequently, the toxic brain feels a continuous power surge.  

 

The most common cause of excessive glutamate production in Dr. Sponaugle’s practice is toxicity from indoor molds. Tricothecene, the noxious black mold toxin known to flourish in man-made environments, is now recognized as seriously toxic to the human brain.  

Sadly, most psychiatrists in America are unaware of the fact that mold toxins can cause severe elevation of glutamate levels that result in bipolar and even schizoid symptoms. Dr. Sponaugle has correlated these neurotransmitter and mold toxin levels in hundreds of patients. Additionally, the most overactive SPECT brain scans seen by Dr. Sponaugle belong to mold toxic patients. Many have succumbed to addiction in their desperate attempt to turn down their excessive brain voltage.  

Norepinephrine and Epinephrine Excess

Norepinephrine is a powerful stimulating brain chemical that activates electrical energy in brain neurons. Intense emotional and physical stress results in excessive production of norepinephrine by the A5 nucleus, the brain factory that produces 90 percent of norepinephrine.  

Epinephrine is pure adrenaline and it stimulates electrical energy in nerves throughout the brain and body. Fully 90 percent of epinephrine is made in the adrenal glands which sit on top of the kidneys. Intense emotional or physical stress results in the brain’s pituitary gland over stimulating the adrenal glands, which then produce excessive levels of adrenaline, causing anxiety.  

Hyperthyroidism

Every cell in the human body depends on thyroid hormone to activate its mitochondria or energy factories. Thyroid hormone also enhances the ability of the catecholamines (dopamine, norepinephrine and epinephrine) to activate their respective receptors throughout the body and in the brain. When excessive levels of thyroid hormone are circulating through the brain, normal levels of dopamine, norepinephrine, and epinephrine produce excessive electrical activity and subsequent anxiety.  

Magnesium Deficiency

When calcium enters the calcium channel of brain neurons, electrical current is produced.  Magnesium competes with calcium at the calcium channel on the brain neurons. Magnesium reduces electrical activity in the brain by preventing calcium from entering the brain neuron, thereby decreasing electricity.  

Statistically 68 to 80 percent of Americans suffer magnesium deficiency, much of which is caused by excessive Candida overgrowth in their gut. Excessive Candida causes taurine wasting by the kidneys. Taurine combines with magnesium forming a salt, magnesium taurate, and then the two are excreted together in the urine.  

Potassium Deficiency

Potassium competes with sodium at the sodium channel on brain neurons thus preventing sodium molecules from entering the brain neurons. Sodium entry into the sodium channel produces electrical current. Potassium deficiency allows excessive sodium channel activity causing an overactive, over-electrified, anxious brain.  

Inflammation

  

Caffeine also induces anxiety. When one drinks too much coffee, anxiety-like symptoms appear. Doctors will usually ask if a patient consumes caffeine when evaluating anxiety disorders. Caffeine-induced anxiety has been shown to increase the amount of kynurenine in healthy patients. Kynurenine is an amino acid produced from tryptophan and, when present at high levels, means that the body is converting tryptophan into kynurenine instead of serotonin. Excessive caffeine consumption causes serotonin deficiency and an OCD-type of anxiety.  

High amounts of kynurenine are also seen in people who suffer excessive inflammation, which is present in people with anxiety.20 Interestingly, inflammation in the mouth, as with periodontal disease, has also been associated with anxiety.21 Periodontal disease occurs when there is an excess of pathogenic bacteria in the mouth, the toxins from these bacteria can cause excessive glutamate production and subsequent anxiety. This is just one more example of how digestive function is connected to brain function.  

Environmental Toxins

Pesticide and heavy metal exposure have been shown to induce anxiety behaviors. The neurotoxic effects of environmental toxins have been recognized for quite a while. With the exposure to thousands of toxins that people face daily, their cumulative effect is taking its toll.  

As these toxins build up and are stored in the body, health gradually declines. Anxiety is yet one more condition which may result from this toxic accumulation.  

What Are the Signs and Symptoms?

There are many symptoms of anxiety, and they vary for each anxiety disorder. However, many of the symptoms overlap. Some of these include:  

• Nervousness
• Panic
• Excessive worry
• Heart pounding
• Negative self-talk
• Mistaken beliefs
• Muscle tension
• Headaches
• Nausea
• Terror
• Insomnia
• Fear or phobia
• Avoidance behaviors
• Excessive shyness
• Nervous habits like nail biting
• Pessimism about the future  

How Is It Diagnosed?

To effectively diagnose anxiety disorders, physicians must have a thorough understanding of neuroscience, including brain chemistry and brain physiology. Physicians must understand that a majority of biochemical imbalances in the brain are caused by issues in other parts of the body.  

Physicians must be willing to spend adequate time with their patients in an effort to differentiate organic and biological causes of anxiety disorders versus emotional and social/environmental causes.  

Because of the historic lack of brain science, physicians and non-medical practitioners have automatically assumed that many anxiety disorders were caused by social and/or emotional issues. With the advent of brain imaging, brain science has exploded in the last 10 years. The exciting knowledge physicians can obtain from neuroscience publications gives them better ability to diagnose the true causation of anxiety disorders.  

It has become more apparent with recent advances in neuroscience that physicians should first rule out neurobiological disorders as a cause of anxiety before assuming the patient’s anxiety is “all in their head.” The presence of the patient’s family is particularly important in evaluation and chronological correlation of events that can subsequently cause anxiety. In difficult cases, brain imaging may assist the diagnosis, especially if head trauma is suspected. Head trauma to the temporal lobes frequently causes panic and anxiety that occurs spontaneously and, seemingly, for no reason.  

Proper diagnosis requires a thorough physical examination followed by an extensive evaluation of hormones and brain chemicals. The greatest advantage understanding brain function and physiology gives the diagnostician is the ability to ask the right questions of patients and their families. Patients will reveal the diagnosis if asked the right questions.  

What Are the Standard Medical Treatments?

 

The primary medications prescribed for anxiety disorders are antidepressants, anti-anxiety drugs and beta blockers. Antidepressants used include SSRIs (selective serotonin reuptake inhibitors), tricyclic antidepressants, and MAO inhibitors. Antidepressants are often used to treat panic attacks, social phobia and obsessive-compulsive disorder.  

SSRIs are the most prescribed of the antidepressants. These drugs come with unpleasant side effects, however, and have a paradoxical effect in some patients.25 People will respond well to SSRIs if their serotonin levels are deficient, but since other neurotransmitters may be involved, SSRIs will not be effective for everyone.  

Anti-anxiety drugs, or benzodiazepines, were traditionally used to treat anxiety, but due to their likelihood of becoming addictive, they are not usually the first option. These drugs work by activating the GABA receptor. When they are given, it is only for a short time period so as to avoid dependence and withdrawal symptoms.  

Beta blockers are used for the physical symptoms of anxiety, but do not treat the internal symptoms. These medications are most useful for predicted anxiety provoking situations like public speaking. Beta blockers can cause side effects that affect heart and lung function.  

Psychotherapy, specifically cognitive behavioral therapy, has been shown to be very effective in treating anxiety disorders.  In cognitive behavioral therapy, the individual learns how to recognize and change thought patterns and behaviors that manifest as anxiety.  

  

Additional Comments by Dr. Sponaugle

Obviously, the treatment for anxiety disorders should be chosen based on causation. In the past, psychiatrists, psychologists and mental health counselors automatically assumed that most anxiety disorders were derived from the patient’s inability to cope with life’s stressors, or were sequelae of negative emotional events.  

Those physicians who choose to become more empowered in the field of brain science have much more expertise in differentiating the actual cause of anxiety and, subsequently, the appropriate treatment regimen. We have determined that there are myriad neurobiological causes of anxiety that can be effectively treated in patients who have coexisting anxiety derived from emotional pain. In fact, when we optimize the patient’s brain function by correcting the neurobiological and biochemical causes of brain dysfunction, patients receive much more benefit from counseling and cognitive behavioral therapy.  

Physical exercise should be a first line treatment for all anxiety disorders. Exercise releases multiple anti-anxiety chemicals including endorphins. Exercise pumps more blood into our brain, which increases the delivery of oxygen and nutrients needed to heal damaged brain cells. The increased cerebral blood flow derived from exercise also helps flush out or remove the many man-made brain toxins.  

Our great grandmothers and grandfathers performed strenuous physical work outside in an abundance of sunshine and fresh air. They exercised 12 hours a day for survival. Today we sit behind a desk all day in a stuffy office, ridden with indoor toxins, unable to exercise until the end of the day when we are just too tired. On the way to that stuffy office, we play out the movie “Fast and Furious” while driving down an eight-lane highway, all the while developing stress-induced anxiety as we attempt not to get run over by the guy in the next lane. Why are we so astonished that the prevalence of anxiety and subsequently addiction in America has tripled since 1980?  

Treatment for situational anxiety derived from losing one’s home or going through a divorce, as well as other anxieties derived from emotional distress such as PTSD (post traumatic stress disorder) should be treated with quality counseling, cognitive behavioral therapy, eye movement desensitization, yoga and potentially, hypnosis. Remember, these same patients also have many biochemical issues that exacerbate or amplify their anxiety symptoms.  

Therefore these patients also must receive a comprehensive treatment regimen designed to optimize brain chemistry and correct neurobiological disorders; the same program we use to correct anxiety disorders caused by imbalance of hormones, brain chemicals and gut dysfunction.  

Gastrointestinal dysbiosis with intestinal permeability, or leaky gut syndrome, is the most common undiagnosed causes of anxiety disorders in Americans. Unfortunately, undisclosed antibiotic levels in our city water and food supply destroy the normal flora (good bacteria) in unsuspecting Americans. Therefore, accurate diagnosis and treatment of toxic gut syndrome will greatly ameliorate or completely eliminate anxiety in a majority of patients.  

Fixing a toxic gut will correct serotonin deficiency, taurine deficiency, magnesium deficiency, potassium deficiency, histamine excess and sometimes the more rare GABA deficiency coupled with glutamate excess.  

At Florida Detox and Wellness we begin fixing our patient’s toxic gut syndromes with cleansing herbals and colonics to rid the gut’s excessive accumulation of waste products. We have had great success with the Total Body Cleansing products. We follow gut cleansing with a Candida Cleanse—an herbal regimen that kills toxic Candida yeast and deleterious bacteria like Klebsiella.  

Because the gut uses the amino acid glutamine to heal the leaking intestinal lining, we prescribe a powdered supplement with L-glutamine, gamma oryzanol, marshmallow and ginger, all of which are natural ingredients that promote healing of intestinal cells. We place all patients on a daily regimen of quality probiotics—for life. America is now a country where the food, and even the city water, is laden with antibiotics. Therefore, ingesting daily probiotics is now a necessity in order to replace the healthy gut bacteria that are destroyed on a daily basis.  

Serotonergic medications, such as Lexapro and Cymbalta, simply to displace serotonin molecules from inside the brain cell storage units out to the nerve synapse where the serotonin becomes active. Four years ago, I was one of the top five Lexapro prescribing doctors in Tampa Bay. This was before I stepped back from “Big Pharma” driven medicine, and more thoroughly studied the physiology and biochemistry involved in the manufacturing process and distribution of serotonin in our body and brain.  

The problem with the serotonergic medications (SSRIs) is that they do not assist the patient   in making more serotonin. Their utility in the treatment of a serotonin deficient brain treats only the symptoms of serotonin deficiency. This is temporarily effective until the serotonin storage units are emptied.  

These medications never treat the true cause of serotonin deficiency which is usually the patient’s inability to convert tryptophan into 5-hydroxy tryptophan (5-HTP) in the small intestine. We utilize a pharmaceutical grade 5-HTP product that bypasses the gut step of serotonin production. In severe cases of serotonin deficiency, like Johnny, the NASCAR driver, (see his case study) we use intravenous 5-HTP.  

We use a pharmaceutical grade magnesium taurate to correct magnesium and taurine deficiencies. Severely elevated histamine levels respond well to vitamin C, vitamin B6 and SAMe supplementation. In severe cases, we utilize intravenous vitamin C and glutathione to accelerate reduction of excessive histamine activity, and more aggressively remove brain toxins.  

Lyme disease and mold toxicity are the two most common causes of excessive brain toxicity in my patients. We have diagnosed more than 60 cases of Lyme disease out of 600 addicted patients we treated last year. These patients had become addicted to OxyContin and Xanax attempting to treat the anxiety caused by the Lyme spirochete (bacterium).  

The Lyme spirochete toxin causes serotonin deficiency, histamine excess and elevation of glutamate. Obviously, treatment for this type of anxiety requires killing the offending pathogenic bug and any other co-infections, as well as aggressive removal of toxins from the infected patient’s brain. Western antibiotics do not adequately kill the Lyme bacterium if the patient has been infected longer than one year. We utilize high-dose intravenous vitamin C and other herbals such as Andrographis to successfully kill late-stage Lyme disease.  

Mold toxicity is endemic in the Southeastern United States and is under-diagnosed throughout America. Most American physicians are unaware that the toxins created by various indoor molds result in a tremendous elevation of the excitatory brain chemicals glutamate, phenylethylamine and histamine. Excessive activity of these stimulating brain chemicals causes severe anxiety, insomnia and even bipolar symptoms. Mold toxicity is a common cause of addiction as patients utilize Xanax-like drugs, OxyContin-like drugs or alcohol to quiet excessive electrical activity in their brains.  

Treatment of anxiety derived from mold toxins includes oral and intravenous medications to remove mold toxins from the patient’s brain and body. Until all toxins can be removed, the excessive glutamate, PEA and histamine levels must be counteracted to decrease the brain’s electrical current to more normal levels. We utilize intravenous theanine and oral theanine to block glutamate activity at the NMDA receptor and N-acetylcysteine to facilitate increased production of glutathione, which accelerates toxin remove and glutamate metabolism.  

PEA levels typically do not return to normal until the mold toxins are removed. Currently, we utilize Lyrica, temporarily, to block the excessive voltage derived from excessive PEA levels. Histamine reduction is achieved by reducing gut toxicity, healing leaky gut, and uncovering underlying food sensitivities.  

Biochemical Causes:  

Serotonin Deficiency  

Serotonin deficiency has become much more common in the American population secondary to lack of crop rotation, and the resultant vitamin and mineral deficient diet consumed by many Americans. Our serotonin factories cannot produce serotonin if we suffer from zinc, magnesium, or B6 deficiency. A recent study suggests that up to 70% of Americans suffer serotonin deficiency due to nutritional deficiencies and chemical toxins created by our industrial revolution.  

Serotonin deficiency causes two areas of our brain to become overactive, producing both anxiety and depression. Our emotional center (limbic system) lies in our midbrain and is about the size of a walnut. It becomes severely overactive with serotonin deficiency causing moodiness, irritability, negativity, hopelessness, excessive guilt and leads to anxiety and insomnia.  

The other region of our brain, which becomes severely overactive in patients with serotonin deficiency, is the brain’s ‘gear shifter’ and ‘worry center’. Called the anterior cingulate gyrus, when overactive, this region of the brain causes patients to become stubborn and stuck on negative thoughts, unable to forgive or forget, and seem to worry about everything.  

Patients who suffer undiagnosed serotonin deficiency frequently use alcohol, Xanax-like drugs, or pain pills like OxyContin to quiet or turn down the electricity in their overactive cingulate and their overactive emotional center. When these patients are properly diagnosed and treated, they no longer need to medicate with alcohol, Xanax or opiate pain pills (OxyContin, Vicodin etc.).  

Estradiol Deficiency
  

In females, serotonin receptivity, or the ability of serotonin to attach to and activate serotonin receptors is also dependent on sufficient estradiol levels, as mentioned above. The female with estradiol deficiency develops the same overactive regions of the brain as the serotonin deficient female.  

This biochemical relationship explains why some females have severe premenstrual depression, anxiety and insomnia symptoms three to four days per month when estradiol levels are at their lowest level. It also explains why approximately 30% of females suffer some level of post-partum depression. This is the biochemical phenomenon where, after delivery of a baby, a woman’s ovaries fail to produce adequate estradiol - usually for a three month to one year period. Brooke Shields is a brave celebrity who unselfishly increased awareness of postpartum depression by discussing it in public forum.  

Estradiol deficiency also causes myalgia (muscle pain), fibromyalgia and headaches. Many females who present to Florida Detox addicted to pain pills (OxyContin, Vicodin, etc.) are victims of failed American medical protocols. When intelligent hormonal evaluation and treatment is performed, these female patients no longer require pain medication.  

Progesterone Deficiency
  

Progesterone deficiency causes excessive bleeding, painful bleeding, and frequently anemia in young females. Many middle aged females who have not suffered anxiety or insomnia in their twenties or early thirties begin to notice these symptoms in mid-life due to progesterone drop-out.  

Unlike other addiction treatment centers, at Florida Detox we perform extensive evaluation of pituitary and ovarian hormones in all female patients. Our clinical research suggests that undiagnosed progesterone drop-out may be the #1 cause of alcoholism and Xanax addiction in middle aged females. When progesterone deficiencies are corrected with bioidentical progesterone, our female patients no longer need to medicate with alcohol, Xanax, Klonopin or opiate pain pills.  

Progesterone deficiency also results in increased electrical current (anxiety and pain) throughout the body: See GABA Deficiency below.  

GABA Deficiency  

GABA is our major inhibitory or relaxing chemical. GABA “turns down” electrical voltage and therefore deficiency causes anxiety and increased physical pain.  

GABA deficiency is often seen in patients with severe chronic stress and nutritional deficiencies. The most common cause of GABA deficiency seen in patients at Florida Detox is the female who suffers from underactive ovarian production of progesterone. Progesterone – through three chemical reactions- becomes a hormone with strong GABA/relaxing activity.  

Excess Histamine Production
  

Excess histamine production is commonly diagnosed at Florida Detox and Wellness Institute, especially in females who suffer from chronic fatigue and fibromyalgia, with candidiasis overgrowth being the most common instigator. Yeast overgrowth is found to be the leading cause of chronic fatigue, fibromyalgia and migraine headaches in American females.  

Histamine is elevated in response to our body’s reaction to chronic infection and consequently, the abnormally high levels of yeast found in Americans who have been exposed to excessive antibiotics. Through American poultry, doctors prescriptions, and city water contamination, Americans suffer overexposure to antibiotics, which kill the normal flora (good bacteria) in our intestines. Our good bacteria are our bodies’ defense against fungal and yeast overgrowth.  

Histamine is a mono-amine like dopamine and serotonin. Excess histamine levels can cause increased electricity throughout nerves in the brain (anxiety) and body (fibromyalgia). Treatment of underlying fungal overgrowth corrects the excess histamine levels, thereby ameliorating anxiety, insomnia, and total body nerve pain. These symptoms, when not addressed, many times lead to alcohol addiction, Xanax addiction, and/or opiate pain pill addiction (OxyContin, Vicodin etc.).  

Excess Glutamate Production  

Glutamate is the primary excitatory chemical in the human brain. Excess glutamate is frequently diagnosed in our anxious females who present to Florida Detox for Xanax or alcohol detoxification.  

Excess Dopamine Production  

Dopamine is a brain chemical that activates electricity in the brain. Too much dopamine “turns up the voltage” causing anxiety and sometimes paranoia (over thinking). Some patients inherit overactive basal ganglia (dopamine factories) or suffer PTSD induced overactivity of the basal ganglia. These patients, if properly diagnosed, can be treated with non-addicting dopamine blockers. This accurate diagnosis and treatment negates the need for patients to “turn down the voltage” with alcohol, Xanax or opiate pain pills (OxyContin, Vicodin, etc.).  

Many of our patients who suffer from excess production of dopamine, have been misdiagnosed at famous treatment centers. Simply diagnosed as ‘drug addict’ or ‘alcoholic’, these patients continue to relapse to alcohol or drugs. Stephanie, the first patient Dr. Phil referred to Florida Detox suffered from a serotonin deficiency and an overactive basal ganglia. She was self-medicating with Vicodin and Percocet to treat her undiagnosed brain chemistry imbalances. Stephanie is now 3 1/2 years post detox and remaines drug-free.  

Excess Norepinephrine/Epinephrine Production
  

Excess norepinephrine and epinephrine commonly result in anxiety, rapid heart rate and even panic attacks. The adrenal glands become overactive secondary to chronic stress, producing increased epinephrine. Chronic stress also creates an over-electrified brain, which produces increased norepinephrine. Once identified, these imbalances are easily treated with non-addicting medication.  

Is the anxiety always about low serotonin? When evaluating the anxiety disorder patient, many physicians assume that the anxiety is secondary to serotonin levels. Obsessive compulsive anxiety, which is the most common type of anxiety disorder in the United States, is a product of low serotonin. However, if physicians are focused only on serotonin deficiency, they will misdiagnose over half of the anxiety disorder patients.  

Another source of anxiety disorder can be excess production of excitatory brain neurotransmitters such as dopamine, norepinephrine, glutamate, and phenylethylamine. As well, patients can experience anxiety when they suffer from an under-active frontal cortex, otherwise knows as attention deficit disorder (ADD). Progesterone deficiency is a common etiology of new onset anxiety disorder in middle aged females. Progesterone naturally breaks down to GABA, a chemical which relaxes the brain. Many females present to SWI describing a chronological pattern of increased anxiety, increased menstrual bleeding and increased uterine cramping. This trio can often be treated with progesterone supplementation. When these biochemical causes of anxiety are diagnosed and treated appropriately, the patient no longer needs to ‘relax’ their brain with alcohol, opiate pain medicine or illicit drugs such as heroin.  

Obsessive compulsive anxiety (OCD)  These patients do suffer from serotonin deficiency. If the serotonoin deficiency is genetic, it is common to see a pattern in the family tree. These patients typically have mothers, grandmothers, aunts, or uncles who demonstrate excessive negativity. On PET scan or SPECT scan, these patients demonstrate an overactive deep limbic system (emotional brain) and an overactive anterior cingulate gyrus. The anterior cingulate gyrus is the brain’s gearshifter and it’s function is to promote forward thinking and rumination of the same repetitive and negative thoughts.  

Unfortunately, patients with low serotonin levels and an overactive cingulate, frequently ruminate only on the negative aspects of their life. They obsess on the negative, hold grudges, tend to be perfectionists, and frown upon ‘change’ in their daily routine. These patients, in extreme cases, exhibit social anxiety. The good news is that these patients respond well to serotonin enhancement from such medications as Lexapro, Paxil, or Zoloft. When treated appropriately, these patients actually demonstrate a more ‘relaxed’ brain on the brain scan. They become much happier and often more successful individuals.  

Interestingly, studies of cerebrospinal fluid have proven that patients with obsessive-compulsive disorder typically have 30% to 40% lower levels of tryptophan. Tryptophan is the amino acid from which your body manufactures serotonin. Patients who suffer magnesium or vitamin B6 deficiency are unable to convert tryptophan to serotonin. Addiction is common with low serotonin patients as these patients frequently self-medicate their anxiety with alcohol or OxyContin in their attempt to quiet the increased electrical activity in their brain. Patients will use and often abuse prescribed benzodiazepines (Xanax, Klonopin, Valium) for this problem. At Florida Detox and Wellness Institute, we have successfully diagnosed and treated hundreds of patients who no longer require self-medication with OxyContin, alcohol, or Xanax because they no longer need to ‘turn down the voltage’.  

Another person with a frequently misdiagnosed anxiety disorder is the patient who suffers from an overproduction of dopamine. Remember, dopamine is one of the major activating neurotransmitters in the brain. If there is excess dopamine activity in the brain cells, the patient will actually over-think and become somewhat nervous. This type of anxiety could be considered a few levels below extreme excess dopamine activity, which manifest as paranoia and/or schizophrenia. These anxiety disorder patients exhibit some over-thinking and mild levels of paranoia, but they often suffer from excessive worrying and fear. These patients on PET scan will demonstrate enlarged and overactive dopamine factories, located within the basal ganglia.  

For the sake of analogy, if we propose that a brain should idle at 1000 rpm (as example), we might suggest that these folks are idling at 2000 to 3000 rpm. They frequently give a history of nail biting or cuticle picking as children and sometimes as adults, and they often have what is called a ‘startle reflex’. With a startle reflex, these patients will often jump when approached from behind, even by a very familiar spouse or friend. These patients are usually conflict-avoiders and do not gravitate toward jobs in management. They have a fear of impending danger, which is usually unwarranted. Even if they are married and their career is going extremely well, they will continue to present with a worried look on their face and they will have great difficulty not believing that at any moment a big asteroid will fall from the sky. Some of these individuals on any given day may experience a full-blown panic attack.  

This excess dopamine activity type of anxiety does not respond to serotonin enhancement medications. These patients are frequently given medication such as Lexapro, Paxil, or Prozac. They do not respond positively. A more appropriate strategic approach in treating this type of anxiety disorder is to utilize the newer dopamine blocking medications such as Geodon or Zyprexa. These two medications can be given in very small (pediatric) dosing in adult patients. When these medications are utilized, the dopamine activity is decreased to normal and the patients no longer suffer from the anxiety disorder. When the anxiety disorder is effectively treated with these non-addicting medications, the patients no longer require alcohol, OxyContin, or Percocet drugs to “turn down the voltage”. Most recently, Dr. Daniel Crane (Chief of Anxiety Disorder Division at New York University Medical Center) wrote an article describing this exact treatment with the utility of Geodon.  

Most recently, we have diagnosed a small but pertinent subset of patients who present with all the appearance of the typical “excess dopamine producer” and their coinciding anxiety profile. These patients, however, did not respond well to medical treatment with a dopamine blocking medication like Geodon or Zyprexa. In our diligent search to ascertain the true etiology of their crippling anxiety disorder, we began to experiment with the medication Campral. Campral was just released from the FDA in February 2005 for its blocking affect of glutamate activity in post-detox alcoholics. Glutamate is an excitatory chemical, which increases the electrical voltage of the brain similarly to dopamine. When alcoholics ingest daily amounts of alcohol (which for them functions as a GABA drug ’turning down the voltage’), their brains will up-regulate the production of glutamate. After a patient is detoxed off alcohol, the brain requires three to six months to down-regulate glutamate activity to normal. Campral dampens the resultant anxiety disorder that these previous alcoholics experience through excess glutamate. We have postulated that potentially there are subsets of patients who, genetically speaking, have excess glutamate activity without having ever been  alcohol dependent. Our theory has panned out. The patients who present with an anxiety disorder, expressing similar symptomatology to that observed with excess dopamine production and don’t respond to dopamine blockers, will frequently respond to the glutamate blocking effects of Campral. In these patients, it appears they have a deficiency of glutamic acid dehydrogenase, which breaks down glutamate into an inactive state. When we block their excess glutamate activity with Campral, the anxiety subsides and they no longer feel the need to self-medicate with alcohol, Xanax, or OxyContin.  

As you can see, anxiety disorders are multifaceted in etiology, AND - we are in exciting times! The industrial revolution, while giving us much ‘progress’, has as well been somewhat stressful for our brains. I believe that God intended for our ‘fight or flight’ response to activate three or four times a year on the family farm. Prior to the industrial revolution, most of us would have experienced an excess surge of norepinephrine only three to four times per year. However, in the industrialized world replete with traffic jams, cell phones, and mothers wearing three hats, our norepinephrine levels are continuously surging throughout the days and weeks. This stress chemical, which is released from your locus coeruleus located in your brain stem, will cause an ongoing stress on both brain and body.  

The brain funtioning under continuous excess stress will churn norepinephrine, which has a negative effect on many other brain chemistry neurotransmitters. Our patients under continuous stress frequently have very depressed levels of  DHEA. DHEA, known as the mother of hormones, is the chemical which is required to make testosterone, estrogen and many other “sense of well being” chemicals. Certainly, lifestyle changes and counseling will serve to decrease stress levels. It is, however, dogmatic and not pragmatic (practical) to expect patients to undergo major lifestyle changes and career changes immediately following a detoxification process. It behooves those of us who pioneer in addiction medicine to attempt to intervene immediately after detoxification. In an effort to reduce the excess norepinephrine floating through patient’s bloodstream, at Florida Detox, we work diligently to control norepinephrine surges using medications (alpha and beta blockers), which counteract the effect of norepinephrine and its receptor as well. We also encourage outpatient counseling and sometimes cognitive behavioral therapy, which function in decreasing the patient’s stress response to certain everyday life situations.  

As you can see, anxiety is constantly working against our sense of well-being. Natural methodologies  to decrease the biochemical cause and effect of anxiety, including increasing physical exercise and a focus on spiritual growth are extremely important as well. We are reminded from Philippians, chapter 4, verses 6 and 7, to be anxious for nothing, but in all things to pray and give thanks to God, and then we can enjoy the peace and joy that God intended.