Signs of Teenage Anxiety
The six key signs to look out for are emotional changes such as frequent bursts of anger or tears, irritability and lack of focus; social isolation – for example not seeing friends, not joining in with peer group activities and spending more time alone; sleep disturbance eg not being able to get to sleep and staying up late, or waking in the night or having nightmares; physical problems such as headaches, gut problems and chronic tiredness; poor school grades and feeling overwhelmed by homework; panic attacks manifesting as sweating, dizziness, shortness of breath, chest pain and numbness and feeling unreal and like they’re not coping.
These are the classic signs of increased anxiety levels. In my 100% Health Survey we found that three in four people in Britain frequently feel stressed, with declining energy levels, and two in three experience frequent anxiety and tension, according to a UK survey of 51,000 people1. Chronic stress has dire long-term health consequences, increasing risk for heart disease by five times2 and doubling the risk for obesity, dementia and diabetes3. In fact, chronic stress is as bad for you as smoking, according a study in the Journal of the American Medical Association.4
Anxiety – an adrenal response to life
Behind all these symptoms is over-activation of the ‘fight or flight’ mechanism, originally designed to promote our ancestor’s survival – while they were hunting and being hunted by predators.
While modern stresses are rarely so extreme, they are far more frequent and relentless. Feeling overwhelmed at work, money or relationship worries, being stuck in traffic, for example – all these cause us to release the stress hormones adrenalin and cortisol, and to keep releasing them hour after hour.
Twenty-first-century living literally puts us on high alert. Smart phones are designed to do just that, grabbing our attention. They are WMDs – weapons of mass distraction. Consequently the average person check The average person checks their phones every ten minutes, swipes their smart phone 2,600 times a day and answers work-related emails on holiday so there’s no switch off. Two in three get ‘nomophobia’ – anxiety induced by not having a mobile phone signal. One in ten young adults even admits to checking their emails during sex! Being constantly on the go is draining, with one in five Brits now needing to take time off work due to the ill effects of stress.5 Add to this the Facebook induced one up manship to look cool and have smart things to post, exam pressures, growing debts at university, uncertainty about the future and careers and relationship problems and you have a recipe for anxiety, leading to poor sleeping, making you feel tired all the time. It also depletes dopamine, the precursor of adrenalin, which stops you feeling good. Dopamine is the central crux of the brain’s feel good ‘reward’ system.
The brain’s reward system is based on the release of dopamine, which gives us a short burst of wellbeing and satisfaction when we get what we want. It’s like slot-machine addiction: you continue to invest in the hope of hitting the jackpot. And clever marketing techniques keep us interested. Facebook, for example, uses prompts, swipe downs and red icons that we are encouraged to click in order to find out if we’ve ‘won’ and to get that lovely dopamine hit. Has a posting received a ‘like’? Do I have more ‘friends’? Has another person ‘linked’ to me on LinkedIn?
All of this means that your brain is being continually, insidiously and unwittingly lured into addiction, and not only by the social media giants. Gambling, gaming, food and pharmaceutical companies all entice us with similar techniques.
Most cope with tiredness with caffeine or sugar. But this makes our stress levels even worse. A sugary snack causes a rebound blood sugar and energy dip, which triggers adrenal hormone release. Sugar consumption has gone up from nearly zero for our ancestors to over 91 grams a week (that’s 22 teaspoons). Caffeine consumption, which causes the release of adrenalin, has increased to an average of around 300mg a day, which equates to six cups of tea or three cups of coffee. Many consume double this.
While sugar and caffeine give us energy in the short term, in the longer term they lead to constant adrenal overload. They give you energy like a bank loan gives you wealth. As a consequence, an increasing number of people are suffering from chronic anxiety, panic attacks, low mood, insomnia and stress-related weight gain.
It’s a vicious cycle because over-production of adrenal hormones leads to adrenalin resistance whereby a person craves more stress to get the same lift. That’s why so many people become hooked on adrenal stimulation, whether it is triggered by sweet foods, caffeine or constant mental activity. As a consequence we end up adrenally overloaded, literally addicted to stress and feeling wired and tired most of the time.
So, what’s the solution? You have to address both your body, which has become physiologically programmed to go into a stress setting, and you mindset, which has become psychologically used to reacting and anticipating stress.
Six Steps to Reduce Anxiety
1. Balance Your Blood Sugar, Quit Sugar and reduce or avoid Caffeine
Sugar triggers the reward system to release dopamine, but overuse leads to reward deficiency. In this sense, it is indistinguishable from heroin or cocaine.6 Dr Candace Pert, Research Professor in the Department of Physiology and Biophysics at Georgetown University Medical Center in Washington DC and the author of The Molecules of Emotion, was the first person to state this explicitly: ‘I consider sugar to be a drug,’ she wrote, ‘a highly purified plant product that can become addictive. Relying on an artificial form of glucose – sugar – to give us a quick pick-me-up is analogous to, if not as dangerous as, shooting heroin7.’ At the time, this comparison was greeted with cries of derision. Now, however, most people accept that sugar is indeed highly addictive.
Under normal circumstances, if you haven’t eaten for a while, your blood sugar dips and the adrenal glands release appetite and ‘hunter’ hormones. These induce a highly stimulated mood, which our ancestors needed before setting off on a potentially dangerous hunt. Your whole body is motivated to do whatever is necessary to find food … and when you finally find it, those first few mouthfuls taste really good! As the saying goes, ‘Hunger is the best sauce.’ When you’ve eaten your fill, the body’s appetite control mechanism kicks in. The adrenal hormones dissipate and you feel satisfied and relaxed. Time for a siesta, perhaps.
It is therefore essential to follow a low GL diet, never skip breakfast, snack appropriately when tired, and eat a combination of protein and slow-releasing carbs such as wholegrain toast with eggs, or nuts with fruit rather than sugary cereals or biscuits. My Get Up & Go shake for breakfast, made with berries and milk, is a great way to get good nutrition into teenagers.
Caffeine, in either coffee or strong tea, induces an adrenal state so it is really best avoided or limited to one cup a day. The ‘awake’ nutrients described below help reduce any withdrawal effects of quitting caffeine. If you need morer help read this report on how to quit caffeine.
2. Develop Emotional Intelligence
When stressed we lose intelligence, especially emotional intelligence, saying the wrong thing and over-reacting. There are many apps, books and classes that teach ‘mindfulness’ meditation and they do really help. One of my favourite apps is Headspace. What’s interesting is that new research is suggesting that mindfulness may work because it promotes more ‘emotional’ intelligence, which reduces anxiety.8 Emotional intelligence is all about learning how to react to challenging events. I especially like Heartmath as a daily practice, as opposed to just mindfulness, because the science clearly shows that it is heart-centred activity that most directly switches off a freaked out mind.
Heartmath, which we fully explain in the Stress Cure, giving the ‘Quick Coherence techniques’, has to parts to it. The first it monitor your Heart Rate Variability (HRV). This is done via a device that you plug into your smart phone, clipping the other end to your ear lobe, having downloaded the free app called Inner Balance. Now you’re effectively seeing your stress state which can be shown in colours (red to blue to green) or in sounds. Then there are some really simple techniques called Quick Coherence Techniques which we go through in the book. I’ve also made a film called ‘Coming from the Heart’ which you can see here
This is one of the fastest ways to switch of a stress or anxiety reaction. Practising HeartMath, with the goal of getting into and staying in the green just twice a say for 5 minutes will train you to not react so stressfully. It’s a brilliant thing to do before a potentially stressful event – an exam, a date, a difficult work or study meeting – to get you in the right headspace, or heartspace.
We all need to feel we belong – that we have people around us who love us for who we are. These sentimental needs also include the physical act of closeness, hugging and so on. Just think of young kids and their stuffy toys. A feeling of a lack of belonging, or pressure to be someone or perform well in some way, is a major source of anxiety. That is why it’s worrying is a teenager starts to withdraw from their peers and social contact. Some young people at university have little actual contact – walking around in parallel universes, living their social life through smart phones. We all need real friends and real friend time.
3. Supplement ‘awake’ and ‘chill’ nutrients to reload your reward system
One of the big problems with all this pressure is that it overstimulates the adrenal system and depletes us of dopamine, the brain’s building block for adrenalin and noradrenalin. Dopamine is part of the brain’s ‘reward’ network, making you feel good. As dopamine get depleted we feel less and less good, losing the meaning of anything, and losing confidence. It’s a major driver of depression and suicide.
Supplementing the right nutrients helps to reset the body’s reward system and speeds up recovery from addiction by taking the edge off the cravings that can develop when you switch to a new diet that is devoid of sugar and fast carbs, eating low GL instead. It also helps to reduce cravings for caffeine and allows you to reclaim your natural sense of connection and contentment, clarity of mind and purpose, and ability to sleep like a baby and wake up fully charged and refreshed.
The key amino acids are tyrosine and tryptophan – the main constituents of dopamine and serotonin, respectively. When our overwrought reward system becomes depressed, we become dopamine depleted and adrenally exhausted. Tyrosine is also a component of adrenalin (the fast-acting stress hormone), noradrenalin (which is associated with more positive states of stress) and the ‘energy’ hormone thyroxine. The level of another adrenal hormone – cortisol – increases in periods of prolonged stress, but in chronic stress, when we can no longer cope, it also becomes depressed. Meanwhile, the ‘good’ stress hormone – DHEA – and the ‘happy’ neurotransmitter – serotonin – are depleted. When this happens, you feel less natural joy and little sense of connection. As a result, serotonin depletion is viewed as a major cause of depression.
Of course, the pharmaceutical conglomerates are well aware this. Consequently, most of the antidepressants they produce are serotonin reuptake inhibitors, noradrenalin reuptake inhibitors, or a combination of the two. Cocaine and Ritalin (methylphenidate) are both dopamine reuptake inhibitors, which means they stop the body recycling this critical neurotransmitter. This gives a short-term boost but ultimately leaves the user more depleted, and hence more dependent on the drug. As a result, users can suffer serious side-effects when they attempt to come off it. It’s good for business, but often not so great for the person involved.
So, why not restore the brain’s natural balance by supplementing natural amino acids? For the pharmaceutical industry, the answer is simple: money! You can’t patent a naturally occurring chemical.
But does supplementing work? Consider an experiment conducted by Oxford University’s Department of Psychiatry9. Fifteen women were given a diet devoid of tryptophan, the main constituent of serotonin. Within eight hours, ten of them started to feel depressed. However, when tryptophan was reintroduced to their diet, without their knowledge, their mood improved. This is how quickly what you eat affects how you feel.
At the time of writing, twenty-eight studies had explored the use of 5-HTP (another precursor of serotonin that is produced from tryptophan) in the treatment of depression. Most of these trials concluded that it works as well as or better than the leading commercial antidepressants, with minimal side-effects.10 This is important research, because antidepressants have been linked to both suicidal and homicidal tendencies.11 For instance, a TV documentary in the well-respected Panorama series titled ‘A Prescription for Murder’ suggested that such medications may have induced pathological behaviour that culminated in dozens of mass shootings in the United States.12 Such adverse reactions may be rare, but doesn’t it make sense to explore the potential of a natural, safer, equally or more effective alternative?
Soldiers are already given the other key amino acid – tyrosine – to boost their dopamine and help them cope with combat stress. Meanwhile, many stimulant and alcohol addicts have extreme dopamine resistance, meaning their receptors are malfunctioning, which is why their cravings are so strong. Indeed, we all increase our dopamine resistance through too much stimulation. That’s why we ‘need’ ever more food, drink or social media likes and retweets to feel good … or at least normal.
However, this constant craving can be overcome in about a month with the right nutritional support, diet and lifestyle adjustments. You will find that you start to experience more control and less stress. You will restore a healthy balance between work and rest, waking and sleeping.
The best results I’ve seen involve taking ‘awake’ nutrients in the morning and chill nutrients in the evening – for a month. Awake nutrients include tyrosine and adaptogenic herbs such as the three Ginsengs (Korean, Russian and American) reishi and rhodiola. B and C vitamins also help. In studies those supplementing vitamin C and B vitamins have twice the energy and greater physical and mental stamina, concentration and alertness than those taking a placebo.13 According to a study at Alabama University, those with a vitamin C intake above 400mg have half the level of ‘fatigability.14 While research in the military has found that supplementing tyrosine, an amino acid needed for healthy adrenal function, improves performance under stressful conditions.15
Chill nutrients include GABA and GABA precursors and certain herbs, plus theanine, the relaxant found in tea. The amino acid tryptophan or 5-HTP is also important – it’s the precursor of melatonin, the sleep hormone (see section below on sleep). GABA not only inhibits the production of excess adrenalin, noradrenalin and dopamine, but works together with serotonin to keep your mood good. For these reasons, having adequate levels of GABA in your brain is associated with relaxation and happiness, while having too little is associated with anxiety, tension, depression and insomnia.16
In the US you can buy the natural amino acid GABA over the counter. However, the European Union has decreed that it must be classified as a medicine, which means it is no longer available over the counter in member countries. If you live in the UK or EU, you can buy GABA supplements on the internet from the United States and elsewhere, though. If you can find a reputable supplier, supplement 500–1000mg once or twice a day as a highly effective natural relaxant.
However, while GABA is not addictive, it should be noted that it can have side-effects when taken in large quantities. There is no reported downside to taking up to 2g a day, but 10g a day has been known to induce nausea or even vomiting, and to raise blood pressure. So use GABA wisely, especially if you already have high blood pressure. Start with no more than 1g a day, and do not exceed 3g a day.
GABA can also be made from the GABA precursors taurine and glutamine. Some supplements also contain the amino acid theanine, which can help you feel calm and alert at the same time. Research suggests that 50mg naturally stimulates alpha-wave
activity in the brain, which is associated with a relaxed but alert mental state.17 Therefore, supplements containing both theanine and GABA, or GABA precursors, can help you feel more relaxed and less ‘edgy18’.
The relaxing herbs that help are hops, passion flower and valerian, although valerian is classified as a medicinal herb so you won't find it combined with other nutrients. Lavender is also relaxing – having a bath with lavender oil at the end of a stressful day is a great way to unwind. Magnesium is also important, both in foods (greens, nuts and especially pumpkin seeds), supplements and in the bath as Epsom salts.
I often recommend people taking two Awake Food Formulas in the morning, before breakfast, and two Chill Food Formulas in the evening, an hour before bed, to help reset the brain’s chemistry towards normality.
5. Improve Your Sleep Quality
Getting enough good quality sleep is essential. Insomnia is actually a pretty good predictor of suicidal thoughts.19 I’ve written about what works for promoting sleep in my report [https://www.patrickholford.com/advice/the-complete-guide-to-a-good-night-s-sleep].
In a nutshell GABA, or GABA precursors, plus 5-HTP work. In a placebo-controlled trial, supplementing GABA and 5-HTP cut the time taken to fall asleep from 32 minutes to 19 minutes and extended sleep from five to almost seven hours.20 So does the CD Silence of Peace, available from www,holforddirect.com, which switches your brain into alpha-waves. A shot of CherryActive, providing a natural source of melatonin, works too. Melatonin definitely works but, once again, is available over the counter in the US but only on prescription in the UK. Take 3mg before bedtime if you suffer from insomnia. In my report I also talk about ‘sleep hygiene’ and how to set up the right environment for sleep.
6. Reset Your Mindset
Another key piece of the jigsaw is understanding what your stress triggers are and either changing them or reframing how you react. Many successful people have learnt how to face life positively, without letting stress take control. Famously, Winston Churchill said: “The pessimist sees difficulty in every opportunity. The optimist sees the opportunity in every difficulty.” But pessimism isn’t in your genes. Optimism is a mindset you can train yourself into, which this book shows you how to do.
In my book The Stress Cure I show you how to keep a stress log to unravel what causes you stress, your limiting underlying beliefs, and create effective new approaches. However, for long-term stress release you have to understand what your stress triggers and reset your mindset. In our book we go through how to do this, step by step. It involves five steps, which we call the A to D of stress, namely:
A – Activating Event: something happens in the environment around you.
B – Beliefs: you hold a belief about that event or situation.
C – Consequence: you have an emotional and/or psychological response to your belief.
D - disputation: dissecting those beliefs to see if they are rational
E - effective new approach: identifying a more supportive way to proceed.
(see section in book on ‘stress log’)
This also helps to build emotional intelligence.
Stop a Panic Attack by activating the Dive Reflex
Here’s a useful technique to know if someone experiences a panic attack or extreme anxiety, dipping your face into a basin of very cold water for 30 seconds (while holding your breath, of course) can instigate what’s called the Dive Reflex, which has a rapidly calming effect. This is because cold water stimulates your vagus nerve, which is a key part of your parasympathetic nervous system (PNS). The PNS works in partnership with your sympathetic nervous system (SNS), which is involved in the stress response. So after a stressful event has passed, it’s your PNS that takes over to calm you down and restore your body to business as usual. But triggering the Dive Reflex activates the PNS immediately, so you feel calmer and less stressed in a matter of seconds. Splashing your face with icy water, or pressing your face onto a plastic bag filled with ice, can also have the same effect for some people, and works better if you also lean forward and hold your breath for 30 seconds. The only word of caution is that this procedure should not be attempted by anyone with a slow heart rate or low blood pressure, as it slows your heart rate.
This is one of many simple techniques and practical advice to build stress and energy resilience to help you and your family thrive, rather than merely survive, in the 21st century.
Awake and Chill Food, Mood Food, Silence of Peace and CherryActive are all available from HOLFORdirect and are suitable in the same doses as an adult from the age of 14.
1. P.Holford et al., The 100% Health Survey, p.11-12, www.patrickholford.com
2. N. Vogelzangs et al., ‘Urinary cortisol and six-year risk of all-cause and cardiovascular mortality’, Journal of Clinical Endocrinology and Metabolism (2010), vol 95(11), pp. 4959–4964.
3. M. Kivmaki et al., ‘Common mental disorder and obesity: insight from four repeat measures over 19 years: prospective Whitehall II cohort study’, British Medical Journal (2009), vol 339:b3765 (available online at http://www. bmj.com/content/339/bmj.b3765.full). ; also see L. Johansson et al., ‘Midlife psychological stress and risk of dementia: a 35-year longitudinal population study’, Brain (2010), vol 133, pp. 2217–2224.; also see A.K. Eriksson et al., ‘Psychological distress and risk of pre-diabetes and type
2 diabetes in a prospective study of Swedish middle-aged men and women’, Diabetic Medicine (2008), vol 25, pp. 834–842.
4. C. Aboa-Eboule et al., ‘Job strain and risk of acute recurrent coronary heart disease events’, Journal of the American Medical Association (2007), vol 298(14), pp. 1652–1660.
5. Mind, ‘Mental Health at Work: Populus Survey of Workers in England and Wales’, 2013.
6. P. Holford, How to Quit without Feeling S**t, London: Piatkus, 2008.
7. P. Holford, How to Quit without Feeling S**t, London: Piatkus, 2008.
9. K.A. Smith et al., ‘Relapse of depression after rapid depletion of tryptophan’, Lancet (1997), vol 349(9056):915–919.
10. E. Turner et al., ‘Serotonin a la carte: supplementation with the serotonin precursor 5-hydroxytryptophan’, Pharmacology and Therapeutics (2006), vol 109(3):325–338; see also P. Jangid et al., ‘Comparative study of efficacy of l-5-hydroxytryptophan and fluoxetine in patients presenting with first depressive episode’, Asian Journal of Psychiatry (2013), vol 6(1):29–34.
11. P. Gøtzsche, ‘Antidepressants and murder: case not closed’, British Medical Journal (2017), vol 358:j3697, https://www.bmj.com/content/358/bmj.j3697/rr-4.
12. ‘A prescription for murder’, Panorama, BBC1, first broadcast 26 July 2017.
13. D. Kennedy et al., ‘Vitamins and psychological functioning: a mobile phone assessment of the effects of a B vitamin complex, vitamin C and minerals on cognitive performance and subjective mood and energy’, Human Psychopharmacology: Clinical and Experimental (2011), vol 26(4–5), pp. 338–347.
14. E. Cheraskin et al., ‘Daily vitamin consumption and fatigability’, Journal of the American Geriatrics Society (1976), vol 24(3), pp. 136–137.
15. J. B. Deijen et al., ‘Tyrosine improves cognitive performance and reduces blood pressure in cadets after one week of a combat training course’, Brain Research Bulletin (1999), vol 48(2), pp. 203–9.; also see C.R. Mahoney et al., ‘Tyrosine supplementation mitigates working memory decrements during cold exposure’, Physiology and Behaviour (2007), vol 92(4), pp. 575–82.
16. I.S. Shiah and N. Yatham, ‘GABA functions in mood disorders: an update and critical review’, Life Sciences (1998), vol 63(15), pp. 1289–1303.
17. L.R. Juneja et al., ‘L-Theanine, a unique amino acid of green tea and its relaxation effects in humans’, Trends in Food Science and Technology (1999), vol OR10, pp. 199–204; A.C. Nobre et al., Modulation of Brain Activity by Theanine, report for Unilever by the Department of Experimental
Psychology, University of Oxford, 2003.
18. K. Unno et al., ‘Anti-stress effect of theanine on students during pharmacy practice: positive correlation among salivary α-amylase activity, trait anxiety and subjective stress’, Pharmacology, Biochemistry and Behaviour (2013), vol. 111C, pp. 128–135.
20. F. Kripke, R.D. Langer and L.E. Kline, ‘Hypnotics’ association with mortality or cancer: a matched cohort study’, British Medical Journal (2012), vol 2(1):e000850 [epublished].