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Repairing the Toll of Uncertainty

A time of high anxiety demands measures to fortify the nervous system.


If anxiety thrives on uncertainty, then 2020 has already captured the title of the Year of Anxiety. Almost everyone on earth is in uncharted territory. Not only is the coronavirus novel, but so is the experience of global quarantine of unknown duration to prevent the spread of a bug that infects and kills with a greater degree of caprice than science has so far been able to keep up with.

A certain amount of anxiety is adaptive—in this case, a prudent prod to taking and maintaining self-protective measures indoors and out. But the scale of the pandemic wrought so many changes so suddenly that health worries about oneself and loved ones have an excess of company. There’s angst about jobs and the economy, the availability and deployment of needed resources at every level of functioning, the education and advancement of our children, what life after will look like, and the governance of the country in an election year.

Uninterrupted, anxiety has a way of feeding on itself. Rumination about the unknown not only consumes inordinate amounts of time, it also breeds expectations of catastrophe.

People manage the uncertainty that feeds anxiety in various ways. According to communication researcher Sean M. Horan of the University of Fairfield, some seek to reduce it by consuming the latest information about the pandemic from many sources; others limit exposure to the news. One way is not inherently better than the other, but conflict may compound the stress when two people in a household manage their uncertainty in opposite ways.

For all its ability to challenge our attempts to control it, anxiety nevertheless sustains life, explains David Hanscom, author of Back in Control. A spine surgeon, Hanscom finds that most chronic back pain is caused by anxiety and focuses on educating patients about how to break its grip.

Anxiety, he contends, is a bodyguard, a neurochemical signal of danger, and it’s meant to be unpleasant in order to compel you to take action to lower the neural hormones doing the signaling. When you can’t escape the threat—whether it’s a physical one or simply the product of your own thoughts—your body secretes even more stress hormones in an effort to increase your chance of survival. If sustained, that wreaks havoc on physical and mental health. Then anxiety becomes more like a prison guard.

There are ways to escape the prison of anxiety. Relaxation strategies are effective. Stimulating the brain so that it becomes less reactive to stress—expressive writing is one approach—has been shown to help as well.

But it’s also important to fortify the nervous system against the ravages of stress and anxiety. Evidence has long shown that the B vitamins play a key role in maintaining mood and mental health. The value of the Mediterranean diet in preserving cognitive function is attributed in great measure to the abundance of B vitamins it supplies.

The eight vitamins that make up the group share roles as cofactors in metabolic processes, many of them essential to brain operations, from energy production and DNA maintenance to the synthesis of neurosignaling compounds. Since their roles are interrelated and they work in concert, adequate levels of all eight are needed for optimal neurological functioning.

A deficiency of any one limits the absorption and effectiveness of them all. Studies show that much of the population is deficient in one or more B vitamins and could benefit from supplementation. In fact, researchers say, with the possible exception of folic acid, levels of vitamin B “well above dietary recommendations” are warranted for every facet of brain function.

Another approach to protection mobilizes the gut microbiome. A lack of beneficial bacteria in the gut has been linked to many aspects of mental health, notably resistance to depression and anxiety. Stress triggers an inflammatory response in the gut, and agents released by the gut travel to the brain, where the resulting neuroinflammation exacerbates anxiety.

Mounting evidence suggests that the gut can be deployed as a pathway to protection through the use of specific probiotics. Studies so far pinpoint Lactobacillus rhamnosus as having the greatest ability to reduce anxiety.

The capacity to enjoy life, says Hanscom, depends on multiple approaches to minimizing levels of stress hormones.

ABCs of the Bs

  • B1, thiaminE, helps the brain utilize glucose, synthesize neurotransmitters, and stabilize the cell membranes of neurons. Lack of thiamine diminishes the energy available for all mental activities and predisposes neurons to death by overexcitation.
  • B2, riboflavin, not only contributes to energy production but converts the serotonin precursor tryptophan into niacin.
  • B3, niacin, is involved in a vast array of brain processes through its contribution to energy metabolism, the synthesis and repair of DNA, signaling between nerve cells, and the conversion of B9, folate.
  • B5, pantothenic acid, is involved in maintaining the structure and function of brain cells and the synthesis of multiple neurotransmitters.
  • B6, pyridoxine, is essential for brain development; plays a critical role in the synthesis of dopamine, serotonin, GABA, and noradrenaline transmitters as well as of the hormone melatonin; influences inflammatory processes; and especially works in concert with vitamins B9 (folate) and B12.
  • B7, biotin, is essential for metabolization of glucose, the brain’s primary fuel, and for cell signaling.
  • B9, folate, or its synthetic sister folic acid, is crucial for brain development and for gene expression and DNA stability. Most of its functions are conducted collaboratively with B12, notably the conversion of precursor amino acids into numerous neurotransmitters.
  • B12, cobalamin, is essential for cognitive function and maintenance of memory.

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