Why Persistent Anxiety Leads to Other Health Problems

Why Persistent Anxiety Leads to Other Health Problems

The Medicine Cabinet: Ask the Harvard Experts

Q: My wife says that I worry too much and it’s bad for my health. Does worrying really cause health problems?

A: Feeling anxious now and then is perfectly normal. In fact, worrying can spur you to take positive actions in your life, including some that might actually benefit your health. For instance, you might worry that you don’t eat enough vegetables or you are too sedentary.

If your response to those worries is eating better and getting more exercise, then a bit of anxiety can be helpful. But excessive worrying can have the opposite effect when anxiety becomes so overwhelming that you stop functioning normally. That level of worry and stress may represent an anxiety disorder, a group of conditions that affect some 40 million adults in this country.

One common form, generalized anxiety disorder, is characterized by at least six months of excessive worrying or feeling anxious about several unrelated events or activities almost every day. About 5 percent of adults in the general population meet the criteria for generalized anxiety disorder. But the incidence is higher among people diagnosed with coronary artery disease (11 percent) or with heart failure (13 percent).

It’s not completely clear which comes first, persistent stress from anxiety or heart problems.

In the short term, our response to stress allows us to react quickly to an oncoming car or other danger. The heart beats faster and blood pressure rises, pushing blood to the muscles, heart and other vital organs. Our mind becomes more alert and focused. These are positive changes to help avoid injury.

Once the danger has passed, the body and mind quickly return to a steady state. However, people with chronic anxiety can experience a prolonged stress response, which leads to higher blood pressure and greater levels of inflammation. These changes increase the risk of heart disease, heart attack and stroke.

There are a number of ways to counter the stress response from persistent worry or anxiety. Some take just a few minutes, such as deep abdominal breathing, focusing on a soothing word like “peace,” and visualizing a tranquil scene.

Exercise is a terrific way to stifle the buildup of stress. Exercise, such as taking a brisk walk shortly after feeling stressed, not only deepens breathing but also helps relieve muscle tension. Movement therapies such as yoga, tai chi and qi gong combine fluid motion with deep breathing and mental focus, all of which can induce calm.

(Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.)