At Florida Detox and Wellness Institute, we have treated many patients who self-medicate their underlying anxiety and insomnia disorder with drugs such as Xanax, OxyContin, Percocet, Ambien and/or alcohol.

These patients usually present to Florida Detox burdened with tremendous shame and guilt. Incorrectly labeled ‘drug addict’ or ‘alcoholic’ at previous rehab centers, these patients in reality are self-medicating their severe anxiety disorder. The diagnosis (drug addict/alcoholic) is a misdiagnosis! Each time these patients relapse following a program, they experience even more guilt and shame, exacerbating their depression and anxiety. Soul pain increases and they feel more hopeless.

Anxiety and Insomnia Disorders

Commonly Cause:

alcoholism, Xanax addiction, Ambien addiction and
opiate (Vicodin, Oxycontin) addiction.

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 piece and joy that God intended.