Sep 18, 2018

Why Am I So Anxious?

by Linda Egenes

Dr. Norman Rosenthal Talks About Anxiety in Women and How to Prevent It

Norman E. Rosenthal is the world-renowned psychiatrist, researcher, and best-selling author who first described seasonal affective disorder (SAD) and pioneered the use of light therapy as a treatment during his twenty years at the National Institute of Mental Health. He has written or co-authored over 200 scholarly articles and eight popular books, including two books on the Transcendental Meditation (TM) technique, Super Mind and the New York Times best-seller Transcendence. Rosenthal has conducted numerous clinical trials of medications and alternative treatments, such as TM, for psychiatric disorders. He and his work have been featured on Good Morning America, The Today Show, NPR and other national media.

In this interview, Dr. Rosenthal talks about his experience treating anxiety in his practice.

Linda Egenes: According to the Anxiety and Depression Association of America, women are twice as likely to suffer from an anxiety disorder than men. Do you find this in your practice?

Dr. Rosenthal: What happens in my practice is a function of who comes to see me. So I don’t think it’s a good representative sample. But certainly over the years I see that women are more vulnerable to depression and anxiety. So my experience in general corroborates that data.

L.E.: Do you feel this is a modern phenomenon?

Dr. Rosenthal: I don’t necessarily think it’s a modern phenomenon. Nobody knows why it should be, but there are both environmental and biological theories. The biological theories include the serotonin systems in the brain of women being different from men, as are many of the systems, particularly those pertaining to the sex hormones. Certainly before the menopause women have a more cyclical biology, and sometimes mood is tied to that.

I also think that women have their own special stresses. For example, we’re now seeing the #MeToo movement, and are hearing about all those assaults, insults, and difficulties that hadn’t previously been well understood and publicized. So if we were having this conversation five years ago, there would be all these undisclosed, undetected assaults going on and we wouldn’t really realize it was feeding into the depression/anxiety matrix of women. Not to say that it’s exclusively women, but it’s predominantly women who have been subjected to these kinds of attacks and insults.

And undisclosed trauma, shame, and keeping a secret—holding that in and having to live with it—has an impact on self-esteem and feelings of safety. If there were, say, harassment or discrimination going on in the workplace, you’d have to go back day after day with a smile on your face to not jeopardize your job. With all that happening to a woman, it’s anybody’s guess as to the impact. But it’s not hard to imagine that these would feed into increased depression and anxiety in women.

L.E.: I understand that you practice the Transcendental Meditation technique yourself and also recommend it to your patients. Can you describe how it has helped your women patients with anxiety?

Dr. Rosenthal: A woman patient comes to mind, an artist, who has a lot of anxiety. She specifically speaks to the benefit of Transcendental Meditation in regard to how she is able to proceed with more clear-headedness and not let things get her down so much.

There are many more women patients who say that things go easier, they don’t hassle as much, they don’t sweat the small stuff, and they’re not upset as easily or anxious as readily. Definitely, there are many women who have reported that.

L.E.: Do you feel that another reason for women’s anxiety is that more is expected of them?

Dr. Rosenthal: I do think that historically women have had to juggle more. It’s expected that they may take on the lion’s share of childcare and the household—even when they have a job that is just as demanding or more demanding than their husband’s.

I do see in the new generations the men stepping up more with the domestic and family stuff. They reckon that things should be fair. I think everybody’s happier when it feels that way. This is in contrast to the 1970s, when women started to work more and yet were still expected to hold more of their share of the domestic issues.

LE: That’s very encouraging to hear, that you’re seeing this in your practice. And do you feel this is having an effect on these women, reducing their anxiety?

Dr. Rosenthal: Yes, I think that gratitude goes both ways—each is appreciating what the other one does, and I think that’s good for a modern marriage, where there’s no head of the household. That’s becoming an antiquated term—it’s just two people working side-by-side. Of course, in single-care homes, there is a head of the household. And that’s a different story.

LE: How does TM work to relieve stress and anxiety?

Dr. Rosenthal: Metaphorically I’d say that it’s a surge protector. As we go about our days, stressful things are going to impinge upon us. You go into work and your boss says “I need that project by midday today.” And you think, “Oh my God, I already have a whole morning of work mapped out for me, and this is slammed on my desk and I have a deadline to meet and when am I going to do the other stuff?”

So that’s a stress that suddenly gets dumped on you. Or somebody rejects you, or someone says something nasty to you. And you worry, am I not respected? Am I losing status around here? Or is my job in danger? All these things—or whatever it is that you worry about—can cause anxiety.

If you meditate regularly, as I found personally and with my patients, these things all seem more manageable.

What is the mechanism? It looks like what TM does is condition the sympathetic nervous system. In a study by Goleman, people were subjected to violent images on a screen. In another by Orme-Johnson, they were exposed to obnoxiously loud noises. In each case, what they saw in the meditators was a surge of a function called the galvanic skin response (GSR), which is a measure of the conduction of electricity across the surface of the skin and is a physiological measure of anxiety.

If you get more anxious, GSR is going to go up. If you are less anxious it’s going to come down. GSR is one of the leads that comes off a polygraph and is used as a lie detector. The theory is that when we lie we get anxious because we’re worried we’ll be caught.

The research shows that when people practicing the Transcendental Meditation technique see a violent image or heard a loud, obnoxious noise, there is a quick rise and sharp fall. In people who are not TM meditators, there is a rise and a slow decline and then several blips following, even when there is no subsequent stimuli: so-called false alarms. The disruptive stimuli have passed, and yet you still get the blips in the sympathetic nervous system.

So what the TM is doing is slowing you down, buffering your response to stress. It helps to allow the stress response to operate while the stress is really there. The sympathetic nervous system settles down more quickly and doesn’t blip up again unless there’s a new alarm.

LE: What are the practical benefits?

Dr. Rosenthal: In practical terms, TM has been shown to have a benefit in lowering blood pressure. That can be hugely beneficial for the cardiovascular system.

Anxiety is a state in which these sympathetic nervous system responses are exaggerated. If somebody worries—am I going to finish it by lunchtime? Stress stress stress. Is my job in danger? Stress stress stress.

And the sympathetic nervous system kicks in and blood pressure goes up. Versus “You know, I’m going to just do the best I can, if I don’t get it done I’ll leave a note that says, ‘Hey, listen—I’ll need another hour or two but it’s coming along.’” If you’re behaving in a calmer way, others are going to follow suit and everyone’s anxiety is going to decrease.

LE: You just defined anxiety, but how does that differ from an anxiety disorder?

Dr. Rosenthal: There’s kind of a normal anxiety—like if you were in North Carolina right now, with a Category 4 hurricane barreling down, you would be appropriately anxious about boarding up your house properly, taking the furniture off the deck, and getting into your car and driving to a safe area in time. There would be a normal level of anxiety.

But if you had all those same feelings and there were no hurricane coming along, and you felt this level of anxiety day after day, that would be an anxiety disorder. You’d be having a lot of anxiety, it wouldn’t be serving what we call “signal function.” Anxiety helps us by signaling: there’s a hurricane. But if there’s no hurricane and you’re still anxious all the time it would not be serving a signal function, and it would be wearing you down for nothing.

LE: Can you offer any other simple, natural recommendations to help women prevent anxiety?

Dr. Rosenthal:

  1. Get a good night’s sleep.
  2. Make sure that you exercise regularly and stay fit.
  3. Eat healthy foods.
  4. Try to associate with people who are positive to the extent that you can. In other words, pick your environment whenever possible.
  5. Get a job where you are appreciated.
  6. 6. Whenever possible, take time to enjoy all that’s good in your life.
  7. Seek out whatever comforts you. For example, some people might find great comfort in a pet, a dog or a cat. I just met a young woman who was very afraid of flying. She was going to have to fly a long distance all by herself, and she wanted a letter to support the idea that her little pet dog was a therapy dog for her. She said he makes her much, much calmer.

I think we need to be creative. You need to ask yourself, “What is it that normally makes you feel better?” Because if you get enough sleep, enough exercise, eat healthy foods and choose to be with people who are supportive—these are good things that, along with your TM practice, will diminish anxiety.

About the Author

Linda Egenes writes about green and healthy living and is the author of six books, including The Ramayana: A New Retelling of Valmiki’s Ancient Epic—Complete and Comprehensive, co-authored with Kumuda Reddy, M.D.

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