 On episode 219 of the anxious truth, we're going to ask a question. Can prolonged anxiety hurt you physically? Hello, everybody, welcome back to the anxious truth. I am Drew Lincelotta, creator and host of this fine podcast. The anxious truth is the podcast that covers all things anxiety, anxiety disorders and recovery. If you are new to the podcast or the YouTube channel just stumbling in for the first time today. Welcome. I'm glad you're here and I hope you find the material useful. If you are a returning listener or viewer, welcome back. Thank you for your continued attention and support. I appreciate you guys. This is episode 219 of the podcast. We're recording early August of 2022. In case you're listening in the future, you know where I was at the time. Today, we are asking a question we're going to address a very common question that's on many people's minds in the community and that is can prolonged anxiety always being in this state of anxiety and fear for so long hurt me physically can damage my body and a little spoiler alert before I do my little preamble and we get into the actual episode. The spoiler alert is maybe I can't give you a definitive answer one way or the other because we just don't have one now. Alright, so keep that in mind. We're going to talk about the nature of the question the nature of the answer and why it's asked and and how to consume information to try and answer it and what you could do about this. But before I do, I had to remind you that the anxious truth is more than just this podcast episode. There are 200 and somewhat other totally free podcast episodes. There's the free newsletter that I write every morning four days every week. That's also a mini podcast. There is tons and tons of free social media content. There are three as of this date books on anxiety and anxiety disorders and recovery that I have written that are literally helping tens of thousands of people around the world. All of those things and more goodies that are coming soon can be found on my website at the anxious truth.com. That's the anxious truth.com. Go check it out. It's all there. So avail yourself with the resources and if you were enjoying my work and I'm helping you in some way and you would like to find a way to help me keep it free of advertising and promotion and sponsorships. All the ways to do that can be found on my website at the anxious truth.com slash support all the ways to support the worker there. It is never required but always appreciated. I appreciate all the support you guys give me in whatever form it happens to be. So thank you so much for all of that. So let's get into this. The question is can prolonged anxiety being anxious and afraid all the time for a long time hurt me physically. Will it damage my body? Now this is a question that most people in our community will ask at least sometimes for some of you, it becomes the primary driver of your anxiety. A lot of people become completely fixated and obsessed by this worry to the point where it is the primary source of fear. So regardless of which camp you're in, whether it's something you think about now and then or whether you are crippled by this fear today while you are listening. This episode is geared for you. A couple of things I want to talk about. I think we need to look at the context that the question exists in and the context that it exists in in 2022 is certainly different than the context that would have existed in 1970 or even 1990 like before the advent of the internet. So the internet has changed a lot of things for us. It has certainly changed how we consume information and it has changed the amount of information that it has available that is available to us at our fingertips at a moment's notice. So an anxious person that is really worried that anxiety is going to somehow damage their heart or give them cancer or cause an autoimmune disease can literally pick up any device any number of devices that they probably own at least in the West and immediately begin to ask that question at Google and just get buried in responses. But the responses are going to really vary very widely and it depends on where you go. So before I decided to do this episode I said well you know what let me spend some time and I put aside about six or seven hours and I did a bunch of research on this topic because I wanted to make sure I was pretty current with what's going on. I don't want to give you good information and I can tell you that there is a vast difference in the answer to this question. Will anxiety hurt me physically if it's prolonged depending on where you ask that question. So if I just go to Google and I type that in I get an avalanche of responses right again an avalanche of responses. Google knows me and it knows my habits but even knowing me and who I am in my search habits and the sites I tend to visit I am buried in sites that don't necessarily have the mission of giving me scholarly information or peer reviewed information or direct data. They are in the business of trying to get my attention. Now I'm not picking on the internet even though I am a little bit. The internet is a great thing and it has changed the world sometimes for good sometimes for bad. But in the end you have to realize that the internet is not designed by and large to give you the most accurate or applicable information. The internet in 2022 is essentially designed to keep your attention. So when you get sites like WebMD which are you know you know health line and those kind of sites wellness sites you know healthcare site alternative healing sites. Those sites are not necessarily designed. Yeah sure they want to help you they want to give you information. I'm not saying they don't but they're also really designed to keep your attention and get your attention. So my Google search results even mine even mine are really skewed heavily toward like oh my god this looks like I'm screwed. Like look at all these little blurbs for all these sites that are telling me that yeah there's a link oh my god there's a link there's a link there's a link. So if you look at the Google results for that question you can very quickly be overwhelmed especially it given your anxious state right now where you are seeing everything as doom like everything is interpreted through that fearful anxious distorted disaster lens. You can quickly look and say oh my god yes it's going to kill me no doubt about it is going to kill me. But when I say okay let me look at these results now let me use other resources. So now I'm going to go to Google Scholar. You will not find WebMD results you will not find health line results in Google Scholar. You will only find research papers and I'm going to ask the question in Google Scholar and then I'm going to take advantage of the fact that I have access to my university library in my grad program which is connected to scholarly databases all over the world and I'm going to ask the question there. I can tell you that I get very different results and draw very different conclusions when I go there. That is important that is important keep in mind that when you are trying to find definitive proof that your anxiety will not harm your body because you're terrified that it will you are going to generally be led in the opposite direction. Look at all these articles that you should click on to learn why it's hurting you. But really they should say well here's a bunch of articles that tell you that there's a link between being anxious depressed and some physical problems but we don't know if one causes the other. But that's not so exciting so you're not generally going to click on those. You're going to click on the one that sort of gives you the hint that like I have the answer come here I have the answer says WebMD. I have the answer says some healing or alternative medicine site. I have the answer click on me. Whereas Google Scholar nobody cares click on me don't click on me doesn't matter. You know the research that I can do through my university library doesn't matter doesn't matter like click on me don't click on me doesn't matter you're paying for the library anyway right. It really changes the results that you get. So here's what I know in this is not two years worth of exhaustive research. This is about seven I swear to say seven seven half hours that I spent going through some papers and I probably went through you know in one form or other about 20 papers or so you can't do hundreds of them in seven hours you just can't do it if you if you're reading like truthfully. So here is what I know. We can't answer the question definitively. What we can say is there does not seem to be any debate that there is certainly overlap comorbidity these things exist together right especially depression depression seems to be studied more than anxiety disorders but you know there's more study being done in anxiety disorders which is good but we can certainly say nobody seems to be debating this that there is a link of some kind right so if you are dealing with a depression or anxiety disorders you are more likely to also be dealing with health problems that's true but the other is also true from the flip side if you are dealing with health conditions you are more likely to also develop anxiety and depression. So you know at first glance and when the internet is allowed to sensationalize that for the purpose of getting your attention right and nobody watches the news for good news people watch the news because I want to hear what the dangers are in the world same thing applies with research on the internet the internet will sort of wash that in this like there is a link and we will imply that that one causes the other but in any of the research when you go through that you will see time and time again we don't have a cause a link here we have correlation we have comorbidity we have coexistence we can guess at what might be causing this but we don't have a clear path that says that being in an anxious state damages your heart we don't know that and interestingly let's look at as an example and we get too deep into it you guys can try and do the research yourself I'm not going to bore you with all the data but when you look at research into the comorbidity between anxiety depression and cardiovascular disease right cardiovascular disease biggest single cause of death in the US that's true but when you look at the link between depression anxiety and cardiovascular disease what a very large percentage of that study is based on people who are post MI myocardial infarction people who have already suffered a heart attack right so now you could kind of adjust and try and control for like well did you have panic attacks before the heart attack but sometimes that data just isn't there because nobody thought to look for it but a large portion of the study done on the link between say heart attack cardiovascular disease and anxiety and depression comes in populations of people who have already suffered a heart attack so you got to keep that in mind right that really changes the color of that data I'm not trying to dismiss it I'm not saying this is a thing that we should not be concerned about and look at not saying that at all that would be disingenuous of me so I'm not dismissing your fear saying it's ridiculous don't think about that I'm not saying that all we could be concerned about it we could think about that but consider that so when you are completely sure that the internet because web md and some healing site or some alternative health site or health line that wants to get your attention has convinced you that being anxious wears out your heart somehow I can tell you that when you look at the data that is underneath those articles that they sometimes site and sometimes don't you won't see that at all you will see like well people who suffer heart attacks often develop depression and along with that come elevated anxiety symptoms or even the development of anxiety disorders like that's a very different result isn't it you know but nonetheless we don't say that you won't find some of those sites say oh by the way this was in a population of people who have already suffered a heart attack or multiple heart attacks they don't tell you that part so I'm not saying that all of the research is just post-heart attack that's not true don't don't at me but I'm saying when you look at that nuance which you have to did really paints things in a very different picture right and the same thing holds true I've seen research I went through research that should that looked at the link between anxiety really depression and anxiety and IBS irritable bowel syndrome epidemiologically yes it looks like there's a link asthma looks like there's a link believe it or not looks like there is a an epidemiological link there's some comorbidity there some coexistence some overlap between people who have asthma and people who have depression or experience anxiety or have anxiety disorders like asthma I wasn't expecting to find that and interestingly one of the papers that I went through said oh look the more asthmatic relayed asthma related adverse events a person has the more likely they are to develop an anxiety disorder or start to experience depression see the difference there so you might look and say like oh my god there's a link between anxiety and asthma yeah but the link was the other way and so there are people that are trying to find some physiological basis is anxiety causing asthma or does the asthma cause anxiety there are people looking at that and I'm glad that they are they should but you see how that looks very different like oh if you have asthma the more you struggle with your asthma the more likely you are to be anxious and maybe develop depression and which wouldn't be news to anybody but in the mainstream if you I don't want to be mainstream media guy I'm not that guy my conspiracy guy but if you just did a Google search you would possibly be led to believe especially if you're already afraid and looking for confirmation of the disaster that anxiety causes asthma doesn't do that is nothing that says that the link between anxiety and cancer has been studied the link between anxiety and cardiovascular disease has been studied there's a lot of things like common issues here IBS same thing that's another thing that's been studied quite a bit yeah there's a link there's links we just don't know what the links are which direction they are in and every good study will point out the fact that there's like a bazillion variables there that you can't control for all of them especially if they're doing long term data review they're doing literature review like it's hard to do a specific study on that you can't really do experiments on that all you can do is review data and some of the data isn't necessarily clear wasn't organized properly didn't collect all the variables you need for the study so all the research that's reputable and reviewed will say like hey there's a ton of variables here we have to account for genetics we have to account for environment we have to account for diet we have to account for lifestyle we have to account for external stressors like socioeconomic stressors or relationships we have to account for things like drug use alcohol use there's so many variables that go into this so we can't say definitively that the anxiety causes this we just can't so the quick answer to the question isn't this hurting my body is I don't know you know I know you don't like it I know you're really worried about that but we do not see a specific link right now that says yeah there's a direct path I know people are going to come at me with things like heart rate variability yeah heart rate variability is turned out to be a thing it seems to be a measure of sympathetic nervous system activation that's a hundred percent true but that does not you cannot make the leap between that and see it's hurting my heart because we don't know that there's research out there that sites HRV right starts to understand that like oh yeah the variability in the way your heartbeat is so that seem to be an indicator of stress levels and say cardiac efficiency some people will want to say I'm no cardiologist I'm not claiming to be a doctor here but when you look at that research and you read it you say oh there's not really a link here HRV is descriptive not predictive at this point big difference okay so the other thing that I want to talk about when it comes to this question is number one there is no definitive answer but there's also no proof right now that you can point to that says oh here is the absolute the science says that this anxious state will destroy my heart it does not say that but I also want to talk about two other things first of all know address the adverse childhood event study the A study because a lot of people you will go to that and the A study you can look that up adverse childhood experiences it was Kaiser Permanente study that was done years ago it's it's really kind of groundbreaking research it really is and it did illustrate a lot of really important things that we need to look at more and especially in the trauma treatment and trauma resolution community that A study holds a lot of sway and it should right so the A study says that there is a correlation between people who stuck who suffer through a large number of adverse childhood experiences or events and people who develop specific health problems later on in life obesity diabetes heart disease addiction all those things so yeah that's out there hundred percent and like there seems to be a link here there's a link between you know living a difficult childhood and having these these legit heart not health conditions later on that's true and that's an important study it's a good study it opened the door to a lot of good conversation a lot of other research and a lot of different dialogue that needs to be had so I'm a fan of the study but sometimes people take that study and say see it says that trauma causes diabetes I've literally had people say that to me did you see the A study trauma causes diabetes but even the people who did the study who even to this day are talking about it will tell you flat out please don't read it that way that's not what it says it says there is a link there is an increased risk for these things so yes the you know those experiences create increase your risk for developing these things but we don't know why we can't say it causes it and please keep this in mind anxious person that that doesn't understand or really is having a hard time assessing risk right now everything is a is a risk to you greater than it is to me risk does not mean guarantee it does not mean that right so I know especially if you have health anxiety your ability to accurately assess risk and plug risk variables into like your life equations is off the rails it's totally out of whack right now you will take you know oh a 0.01 percent risk and turn that into 90 percent risk so when you hear that people who are dealing with these adverse childhood experiences people who live trauma are increased risk of people who are depressed for a long period of time are increased risk of you may read it causes it it is a guarantee it is not a guarantee it increases risk and we honestly do not understand why very clearly right now is it because of different changes in lifestyle people who study depression and these and these health conditions will tell you flat out like well we know that in depression there's a change in self-care and the way people manage their health and that sort of degrades and that seems to lead to this we don't know we don't know so please be very careful about going on the internet and deciding the internet said that my anxiety is ruining my heart it doesn't say that doesn't say that at all and risk does not mean guarantee and correlation is not causation now here's another really important thing that i want to kind of wrap this up with spend a few minutes on this consider a situation where maybe you are worried about this anxiety and we're talking about anxiety disorders here right we're not just worrying about life anxiety we're talking about anxiety disorders I'm worried that being in an anxious state all the time will impact my health down the road I'm ruining my body by doing this by being in this state consider the difference between somebody who is a prisoner of war or is incarcerated or is stuck in an abusive relationship or a child or anybody who's living with food insecurity shelter insecurity socioeconomic pressure like systemic problems those are external things those people in those situations didn't ask for those things you don't get to wave a magic wand sometimes you unfortunately have limited agency power and influence in changing those things you need help from the outside world sometimes from people outside of your own skin that's true but but an anxiety disorder is not that it's not that so consider the possibility that you were sitting on the sofa right now listening to this podcast worried sick about the fact that you're worrying will cause a health problem later on which makes you even more anxious which makes you worry more about this problem you see the cycle and that is internally generated and I want you to consider the possibility that when you ruminate on this and you worry and you overthink and you try to predict the future and you stay perfectly still because you are convinced that your heart your liver and every other part of your body is made of glass and you can't handle this you are almost choosing to create the situation that you fear see the issue here if I am stuck in a situation that is beyond my control and it is stressing me and I am in an anxious state all the time because I am fearful for my own safety my life my whatever my existence then yeah I'd be like how am I going to get out of this this is killing me maybe and how do I get even to get out of this but when you are in a situation where it is not out of your control you do have some agency you do have influence you have power in this process choosing to just worry about it and then take no action to address the thing that you think is going to cause a problem would seem crazy I am not calling anybody crazy here I am just trying to be brutally honest about this you know consider that worrying about getting cancer could be just as stressful as getting cancer so I am super worried that my anxiety will cause me to get cancer which makes me worry as if I have cancer I am super worried that my anxiety is stressing my heart and that worry makes me afraid which makes my heart beat faster except that that worry is a thing that you can address because it is internally generated right so really the answer to is this anxiety going to hurt me down the road is well what can I do to get out of this relationship with the anxiety so I don't have to ask this question again in six months or eight months or two years like it is super important to not just ask the question hope to get the answer that makes you feel better and then say okay I guess I will be okay and I can remain this way for the rest of my life or oh my god I feel like this is going to kill me in two years what can I do well you can do things like I would not talk into this silly microphone every week if I did not believe that you can do things to change your circumstances so I think it is just as important to understand that this is internally generated anxiety, fear and worry that we are addressing here on this podcast not invalidating anybody who is living in abusive situation who has legitimate life stress legit health problems that are causing emotional issues I am not invalidating that at all I am simply addressing the state of disorder and anxiety which is internally generated and over which we do get to exert some influence some agency some power I am not going to use the word control because it implies you just turn a switch off you can't do that but there are actions we can take to change our relationship with that anxiety so that it doesn't become a disaster for us and then we have to worry that it is a monster that will kill us by tearing our heart to bits down the road so consider that there is really an important second part of that question can this prolonged anxiety hurt me physically and beyond that what can I do to not prolong it anymore in this disordered state really important if you don't really continue and ask the second part of that question then the first part of the question can just play in a loop forever forever right so I do understand the self-perpetuating nature of that many people will say I am worried sick that I am damaging my heart so therefore I'm trying to do everything I can to not overwork my heart which means I won't do exposures I won't get off the sofa I won't bend down at the time I choose I won't climb the stairs because I've already decided that I'm hurting my heart so therefore I will be inactive and just let just worry which then makes my heart beat any fast makes my heart be faster and the cycle continues it's very typical we all know that if somebody went out right now if you saw somebody that was doing three hours of cardiovascular exercise everybody was like man that person is super healthy so you have to recognize the situation that you're in and your own personal context that this question will this prolonged anxiety hurt me physically existent it exists in your own personal context that doesn't have to remain what it is right I'm never saying it's easy you don't get to just change your mind and fix your anxiety there's no fast cure there's no magic wine I don't have magic words to make it go away but we do know that these disorders that we address are the most the most treatable mental health problems we have in the western world you can address this so there's no reason to just sit passively and worry for the next two years whether or not you're damaging your body you can control whether or not the state you fear is damaging or you can influence that state and change it over time with work and effort okay so I will wrap it up there I just think it's super important to understand the lens you're looking through which is a fearful lens understand that you have to be a little bit more critical consumer of information when you're trying to answer answer sort of loaded questions like this understand that there is no causal link right now because correlation does not equal causation understand that increase risk does not mean a guarantee that a thing will happen it only means increase risk which is based on huge number of variables that most of which we probably know right now and understand that you can actually do something about the situation you are afraid is going to harm you those are the those are the points there you go those will be the show notes anyway so that is episode 219 I'll wrap it up here I don't want to go much longer than this this is a little longer than I like to do even these days so that's it 219 in the books you know it's over because music if you want to check the show notes on this episode and I try my best to do details show notes you can always go to the anxioustruth.com slash 219 where you can kind of read an article based on this podcast if you are listening to the podcast on iTunes or Apple podcasts or Spotify and you can rate or review the podcast do me a favor leave a five star rating if you're digging it and if you have a minute or two write a review because it helps other people find the podcast and I kind of do this to help as many people as I can if you're watching on YouTube or listening as the case may be subscribe to the channel hit that notification bell right is that what I'm supposed to say as a YouTube influencer so you know when I upload leave a comment YouTube is great for comments I'm digging interacting with you guys these days I appreciate that that's one good way to support the work that I do is to just sort of help get noticed a little bit more the song you're listening to is called Afterglow is written by Ben Drake he wrote it a few years ago inspired in part by words he heard in this podcast and he's been gracious enough to let me use the song for the last couple of years it's what you hear at the beginning of the end of every show if you want to find Ben and his music you can do that at bendrake music.com go check him out tell him I said hello and that is it 219 in the books I will be back next week talking about something I don't know what it's going to be but I will be here so see you next week and remember as always this is the way