Beyond the Obvious: Surprising Causes of Anxiety You Need to Know

Several years ago, I thought I knew all I needed to about anxiety. I had been in a series of high powered jobs, probably needed to exercise more and could benefit with more therapy. Then I began attempting to remedy my anxiety and found a curious dilemma… it wasn’t getting better. I was trying everything — as one does when they’re an overachiever (and over worker). Therapy! Transcranial magnetic stimulation! Adaptogens! Nootropics! Meditation! Vacations! Nothing was really working.

It all came to a head in 2022 when my body broke down and I was forced to look my anxiety squarely in the face. I’m writing this now as someone with… very little anxiety now. I am not on a bunch of medication. I didn’t become a monk. This wasn’t just a case of burnout. Through trial and error, I discovered some underlying causes of anxiety and harsh truths that have led me to a better path. So, I’m sharing these with you with the hopes that it will help and avoid you the laborious path I took.

Photo by Stephen Leonardi on Unsplash

The Short Story

I learned two surprising things last year that I want to address here:

1. There are very real physiological causes of anxiety that are not spoken about and that therapists and most general practitioner doctors are not aware of or trained to address
2. Trying to apply surface-level therapeutic support to a deep psychological problem without making significant changes is like trying to stop a tree from growing by trimming branches. You have to cut at the root.

Photo by Nick Fewings on Unsplash

Physiological Causes of Anxiety

I’m not sure why it’s not written about more but there are many, many physiological causes of anxiety. For example, “mystery illnesses” like Lyme disease or mold (mycotoxin) poisoning can give you staggering anxiety and brain fog. However, most regular doctors will not test you for these and not all functional medicine doctors will either.

Last year, I started having regular panic attacks for the first time in my life. Some folks told me it was my age. Others said it was just my career. I knew deep down that it wasn’t the case and that it was something physiological — particularly because it seemed to correlate with what I ate.

However, getting people to believe you when you feel disregulated is difficult. I had therapists telling me I needed to go twice a week. Doctors telling me I simply had stress and a gut issue (that I didn’t actually have). Everybody’s answer seemed expensive, complicated and none of them felt right.

After five months of misdiagnosis and a fear I was losing my mind, I found Dr. Pearl Zimmerman, a master at solving medical mysteries. Within 2 weeks, she discovered my ferritin level was 6. Friends, that’s bad. I was in severe anemia. No medical professionals had tested my ferritin. Once she put me on iron capsules, all my anxiety went away and my insomnia stopped. I was grateful and yet angry. I had spent thousands upon thousands of dollars trying to get help. I was told I needed antidepressants and outpatient treatment. How long had I suffered and all I needed was… IRON?! I learned then the importance of not just testing iron, but also testing ferritin.

She also uncovered that I was dealing with some underlying poisoning that was interrupting my body’s ability to absorb nutrients. My detox pathways were closed and my body was basically going into non stop cytokine explosions anytime I tried to take an antibiotic or medication. When I ate inflammatory foods like gluten, dairy or sugar it would trigger inflammation that would trigger the severe anxiety. My gut was right — it was physiological. I wondered why nobody talks about this?

So… I’m telling you now.

Here are a list of physiological causes of anxiety: sleep disorders (apnea etc— I met someone once who fixed his jaw and no longer had anxiety), gut imbalance (the majority of our neurotransmitters are in our gut, if you heal your gut — you might just heal your mood), autoimmune disorders, inflammation, thyroid issues, blood sugar issues, hormonal imbalances, mold illness (all those mushrooms you’re eating and psychedelics you’re taking — might not be great for you if you have mycotoxin poisoning!), Lyme disease (a major driver of brain fog, anxiety, fatigue etc). There are more, but that’s a start.

If you intuitively feel like this might be the case for you, I recommend finding a well-qualified functional medicine doctor. But who to find? The advice I was given that has proven invaluable is: find someone who got into functional medicine because they had to, not because they wanted to. You’ll know what I mean when you start to look for a doctor and you’ll feel in your gut when the person is right.

Functional medicine is lucrative and many practitioners in this space get into it because it allows them more earning potential and freedom than traditional medicine. I personally prefer a FMD who is an MD versus a naturopath or chiropractor. That said, go with what resonates for you. My doctor is the most expensive medical doctor by the hour I’ve ever seen (and nearly all FMDs do not take insurance), that said… I have spent less on her than I cumulatively have spent trying to solve my problems on my own with a variety of other FMDs and practitioners.

Also, she got into this space because she’s a two-time cancer survivor with autoimmune issues who dealt with 7 years of medical mystery herself.

(Btw I have found that the best practitioners don’t do packages or the like… because they’re busy and don’t need to.)

If something deep down is telling you that your anxiety might not be just “all in your head,” listen. Your intuition won’t steer you wrong. Find someone who believes you.

Photo by Harry Cunningham on Unsplash

Cutting the Branches Instead of the Root

Now on to the psychology part of this.

Here are two harsh truths: many times we don’t want to face the truth and many people benefit off of sick people. In the end, the only person who can ultimately change you, is yourself. A doctor can’t help you if you don’t trust them and follow their suggestions. Neither can a therapist or a life coach or a rehab etc.

One of the benefits of my misdiagnosis last year was being forced to question whether my corporate career had been the source of my problems. I wasn’t sure. While I had a hunch my problem was physiological, I also knew that my work life was endlessly frustrating me. Chaos abounded and so did useless politics. I felt a lack of creativity and being a creative was what drove me to marketing in the first place.

So, I left to build my own advisory as a fractional CMO with my friend, Joel Lunenfeld. I’m not sure why I was so afraid of leaping for so long. Perhaps because the hell you know is better than the hell you don’t know.

When you have a resume chock full of impressive brands you begin to define yourself by where you’ve worked or what you’ve done instead of who you are. I see this with fellow friends in tech and entertainment all the time… the proximity to fame and status makes them feel validated… since deep down they haven’t addressed their own insecurities. When your validation is found outside of you… no new job or title or pay boost will fix it.

I get it.

Photo by pawel szvmanski on Unsplash

The Thing

I realize now that I had wasted thousands of dollars trying to throw a band aid on years of work-related frustration instead of facing the harsh truth that I was over it. My in-house career was The Thing I was unable to surrender because I was afraid to leave my comfort zone. I posit that we all have our Thing.

Maybe it’s a substance you know you need to give up. A toxic long-term relationship that you know you need to leave. A career that’s killing you slowly.

The Thing is a monster that will never go away until you kill it. If you keep trying to cut it’s tail or wound its side… it will just regenerate. You have to go full guns a-blazing GoT flame throwing and kill the dragon. You’ll feel scared and you may miss the dragon a bit after its gone… because it’s the hell you’re used to. But on the other side is the beginning of the life you’ve always wanted.

Photo by B K on Unsplash

Trust Your Intuition

I believe that our highest self, that inner voice that is supportive and wants the best for us, is easiest to hear when we’ve unplugged and can get quiet. It can be heard when we’re alone. It comes out in our journal. In the thoughts we have on a long drive. In prayer or meditation. In a nature walk. When we allow it space. You can’t force it to happen, you have to let it rise and listen.

As I’ve been on this journey this past year, I have made some wildly unconventional decisions that have truly served me. Decisions I would never had made before because I was driven by fear.

Quit my job. Quit people pleasing. Bailed on friends who were using me. Got back into cardio HIIT training. Gave up active yoga for restorative yoga. Got back into Al Anon.

…and I quit therapy. What?! Yeah, dude. Con. Tro. Ver. Sial. Take.

I shudder to write it down lest ye judge me, but it’s my truth.

I discovered pranayama breathwork late last year and the therapeutic experience I feel in every 60–90 minute session has given me a deeper release and clarity on my life than therapy has in years. I practice with a teacher because I believe in the power of facilitation and not trying to go it alone. I’m an isolationist and one of the things my intuition has taught me this past year is — I may not want people, but I need people.

To be clear, I’m not anti-therapy. I have been in and out of it since I was a teenager. I’ve done it all from EMDR to CBT to psychodynamic to Gestalt. It has helped me, for sure. I’ve just always found that I tend to find it useful in fits and starts. I always judged myself for that, but I don’t anymore. Now, I accept that it’s the most useful in phases when I truly feel I need it and with practitioners I truly trust/respect.

I’ll caveat by saying this, it took me months of learning how to trust myself again to get to this point. It took discussions with trusted mentors who listen and suggest vs. opine and demand that led to this. It took learning that I can trust my gut about my medical health and be rigorous until I find an answer that resonates to get here. It took seeing that my intuition was indeed right — to get here.

Today, I have a tool box that is very full and like I said, I have almost no anxiety.

Do I have fears? Oh yeah, the entrepreneurial life is not easy. That said, I no longer have terror… or politics… or narcissists… or people who are using me to get ahead… in my life. I have more joy and happiness than ever.

But it took…

1. trusting myself
2. finding a doctor I could trust and getting to the root of real physiological issues
3. and not being afraid to face The Thing to get there

Godspeed.