When the blood sugar level falls too low, the brain is rapidly deprived of energy. A correction must occur in order to bring the glucose levels back to normal, so the adrenal glands release the hormones cortisol and adrenaline which cause the liver to release stored sugar. Though the stored sugar from the liver does restore the blood sugar balance, the rise in adrenal hormonal output also increases emotional arousal and anxiety. Thus, the hypoglycemia cycle can perpetuate the physical and psychological symptoms of anxiety. Women who continue to eat a diet high in simple sugar often feel as though they are on an emotional roller coaster, tossed from highs to lows of anxiety and irritability on the one hand and fatigue and depression on the other, as their blood sugar levels fluctuate.

Most women can easily solve this problem by switching to a diet high in complex carbohydrate foods. These include whole grains, starches, whole fruits, and vegetables. When eaten by themselves or when combined with high-quality proteins such as nuts, seeds, and fish, the complex carbohydrates are broken down to glucose and slowly absorbed into the blood circulation, thus not triggering excessive insulin output. As a result, both the blood sugar level and the emotions stay healthy and balanced. In addi-tion, consuming proper vitamins and minerals supports glucose metabolism and pancreatic function, thereby preventing symp-toms in women prone to hypoglycemia-related anxiety attacks. Both the optimal diet and nutritional supplements for hypogly-cemia are discussed in the self help chapters of this book.

Anxiety Due to Immune System Imbalances
Immune system disorders can cause a variety of psychological as well as physical symptoms. These imbalances are discussed in detail in this section.

Allergies, Including Food Allergies
Many women are unaware that allergic reactions can cause mood changes such as anxiety. Allergies occur when the body's immune system overreacts to harmless substances. Normally, the immune system is on the alert for invaders such as viruses, bacteria, and other organisms that cause disease. The immune system's job is to identify these invaders and to produce antibodies which destroy them before they cause illness. In allergic people, this system begins to react to other substances-typically pollens, molds, or foods. Common food allergens include wheat, milk (and milk products), alcohol, chocolate, eggs, yeast, peanuts, citrus fruits, tomatoes, corn, and shellfish.

Sometimes allergic reactions are easily diagnosed, because the symptoms occur immediately after the encounter with the allergen.

Immediate allergic symptoms include wheezing, itching and tear-ing of the eyes, nasal congestion, and hives. Some allergic reactions are delayed; they may occur hours or days after exposure to the allergen. Delayed symptoms include anxiety, depression, fatigue, dizziness, spaciness, headaches, joint and muscle aches and pains, and eczema. Food allergies can also affect digestive function, caus-ing inflammation of the intestinal lining and pain in the abdominal area. Damage to the intestinal lining causes it to become more porous and permeable. When large particles of poorly digested food, to which the person is allergic, are absorbed into the body, the body's defense system is activated, precipitating damage to many organs and tissues by autoantibodies. (These are the immune complexes that attack your own tissues as if they were foreign sub-stances.) The person affected may be unaware that an allergy is causing her emotional and physical symptoms. This often occurs with food allergies, as well as with a variety of chemical triggers.

Food allergies commonly trigger anxiety episodes in suscep-tible women. Often, you crave the foods to which you are allergic. Thus, food addiction may actually be a sign of food allergy. Women commonly crave foods such as chocolate, chips, pasta, bread, and milk products. Often they find that once they start eat-ing these foods, they have a difficult time stopping. A woman who has the desire to have one chocolate can end up eating a whole box. The decision to eat one cookie can turn into a binge of ten or fifteen at one session, or a small dish of ice cream becomes a pint. Though hinging tendencies can be seen throughout the month in women with food allergies, they tend to be worse during the pre-menstrual period (which may commence as early as two weeks prior to the onset of menstruation). Alterations in mood as well as physical symptoms typical of anxiety, such as increased heart rate and respiration, often coexist with the food craving symptom.

Some holistic physicians test for food allergies by doing sublin-gual provocative tests. In this test, a food extract is placed under the tongue to see whether it elicits a reaction. Neutralizing anti-dotes are then administered to the patient to reduce or eliminate symptoms. This test is not used by traditional allergists, who con-sider it to be ineffective. Another way to test for food sensitivities is simply to eliminate suspected food allergens. First, the patient fasts, taking only distilled water for several days. Then she rein-troduces foods one at a time. If the patient is allergic to a specific food, a reaction will occur after she adds that food to her diet. Another method is to maintain a low-stress diet and to eliminate only the particular food to which you suspect you may be allergic, again reintroducing these foods sequentially to see how your body reacts. You may actually feel worse initially after eliminating high-stress foods, due to the withdrawal symptoms that occur after stopping anything to which you are addicted. (This can also hap-pen when stopping drugs and cigarettes.) During the period when you are determining your food allergies, keep a diary in which you record your emotional and physical symptoms, both on and off the offending foods. This will help you evaluate the severity of your reactions. Finally, there is a blood test now available called the RAST test; while quite expensive, it gives the physician a com-plete profile of allergens, including foods, pollens, flowers, grasses, and so forth.

Treatment for food and other allergies usually includes avoid-ing the offending substance, if possible, or using over-the-counter and prescription medication and desensitization shots. Managing stress and following a low-stress elimination diet may also help treat and prevent allergies. It is important to rotate foods and choose from a wide variety of high-nutrient foods. Certain nutri-tional supplements also help to support and strengthen the immune system. These topics are discussed in the self help section of this book.

Anxiety Due to Cardiovascular System Disorders
While cardiovascular problems primarily cause physical symptoms, mitral valve prolapse can cause psychological symptoms as well.

Mitral Valve Prolapse
Mitral valve prolapse is a heart condition that can cause anxiety--like episodes of palpitations, chest pain, shortness of breath, and fatigue. It does appear to be present more frequently in people with anxiety and panic episodes than in the general population. It is caused by a mild defect in the mitral valve, which is located between the upper and lower chamber on the left side of the heart. Normally, blood flows unimpeded between the two chambers. However, with mitral valve prolapse, the valve doesn't close completely. As a result, the heart is put under stress and can beat either too fast or erratically.

In more severe cases, the heartbeat can be slowed through the use of beta blockers, drugs that decrease heart rate and heart con-tractility by decreasing oxygen consumption. (This is discussed in detail in Chapter 11 of this book.) In addition, undue stress and stimulants such as caffeine-containing beverages like coffee, tea, and cola drinks should be eliminated in order to avoid triggering episodes of rapid heartbeat. Deficiencies of calcium, magnesium, and potassium should be avoided since these essential minerals help to regulate and reduce cardiac irritability. To ensure adequate daily intake, it is important to maintain a diet with sufficient amounts of these nutrients or to use supplements.

Common Causes of Anxiety