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Myth vs. Fact: Are Women Really More Prone to Anxiety?

Myth vs. Fact: Are Women Really More Prone to Anxiety?

Written by Jonathan Bailor, CEO SANESolution & Reviewed by Dr. Matthew Olesiak, MD Chief Medical Director, SANESolution

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If you often struggle with anxiety while your male acquaintances always seem calm and in control, you’re not alone. Research suggests that women do indeed experience anxiety more often than men.

In 2016, researchers reviewed 48 studies on the prevalence of anxiety disorders globally and discovered that women are nearly twice as likely as men to experience this condition.(1)

This is not a new finding. Studies have long shown that women are twice as likely to develop generalized anxiety disorder (GAD), panic disorder, and post traumatic stress disorder (PTSD) as men.(2)

Of the several types of anxiety disorders, only obsessive compulsive disorder and social anxiety disorder are equally prevalent among men and women.

Moreover, sex differences in general anxiety can be seen in early childhood, before the age of 4. By the time children reach 6, anxiety levels in girls are about twice as high as in boys,(3) which matches the ratio later seen in women vs men.

What is less known is the reason why women are more susceptible to these disorders.

Why Women Suffer Anxiety More Often than Men

Though the exact reasons for gender differences in anxiety are unclear, there are several factors believed to play a role.

Women’s Brain Chemistry is More Sensitive to Stress.

Research suggests that the female brain is more reactive than the male brain to a hormone that regulates the stress response. Female brains also have more difficulty adapting to high levels of stress.(4) Translation? Women’s fight-or-flight response may be more quickly triggered than men’s, and stay elevated for a longer period.(5)

Hormonal Changes Trigger Anxiety.

Numerous studies show an association between hormonal changes — such as those involved in pregnancy, menstruation, and menopause — and these mood disorders. In fact, a study conducted by Harvard and Emory University neuroscientists suggests that low levels of estrogen can lead to anxiety and other mood disorders,(7) while higher levels can soothe emotional disturbances.

Similarly, there is scientific evidence that testosterone may also calm certain types of anxiety. Low testosterone levels in men are not only associated with higher anxiety levels,(7) but patients with social anxiety disorder (SAD) are typically found to have lower levels of testosterone.

In fact, in a 2016 study, researchers discovered that a single dose of testosterone administered to women diagnosed with SAD lessened submissive reactions and reduced social anxiety.(8)

The fact that men naturally have higher levels of testosterone could explain why they are less prone to this condition than women.

Women Respond Differently to Stress

A study published in APA’s Journal of Abnormal Psychology suggests that the way women respond to stress increases their risk of anxiety disorders.

Women with anxiety disorders, researchers discovered, tend to internalize their emotions. This not only leads to withdrawal, loneliness, and depression, but it can also increase anxiety. Unlike women, men tend to externalize their emotions in physical activity, aggression, and similar behaviors, thus relieving anxious feelings.(9)

Women Are More Likely to Seek Help for Mental Health Issues

It’s important to note that most research on this subject involves those who have been diagnosed with anxiety disorders. As men are less likely to seek professional help for this condition, it is possible that the anxiety gender gap is not that wide after all.

Dangers of Untreated Anxiety

Anxiety — that familiar feeling of worry and nervousness — isn’t always a negative occurrence.

When faced with stressful situations, i.e. starting a new job, feeling anxious is common and normal. After a short time, the feeling fades. But for people plagued with anxiety, the fear and worry doesn’t go away but deepens and intensifies.

Anxiety disorders are the most common mental health illness in the United States, affecting an estimated 40 million adults.(10)

And it’s not a minor or harmless condition.

An anxiety disorder can interfere with day-to-day life, become disabling, and increase the risk of severe depression and suicide. It can also lead to alcohol and substance misuse, insomnia, digestive problems, headaches, trouble focusing, reduced quality of life, excessive absenteeism from work, and other issues.

In the United States, anxiety disorders cost the healthcare system and employers over $42 billion per year.(11)

Protect Your Mental Health: Solutions for Anxiety

Though anxiety is an extremely unpleasant sensation, it can be managed. If your anxiety is overwhelming or disabling, always seek the advice of a mental health professional. You can also try a few of these proven stress relievers alone or as an adjunct to therapy.

Meditation

Developed in India, meditation is a soothing mind/body practice that has been around for over 5,000 years.

During meditation, practitioners typically focus their attention on one thing, such as their breathing. Each time a thought intrudes, they gently bring their attention back to their breathing. Though seemingly simple, meditation promotes calmness in mind and body, reducing stress and anxiety.

There are many different forms of mediation. One of them, mindfulness meditation, has gotten a lot of attention for its health-promoting benefits. Mindfulness meditation involves being aware of what you are thinking, feeling, and sensing in the present moment…without interpreting or judging it. This intense, nonjudgmental focus relaxes the mind and body and may provide a host of amazing health benefits, including:(11)

  • Lowered blood pressure
  • Reduced anxiety and depression
  • Improved sleep
  • Reduced severity of irritable bowel syndrome (IBD) symptoms
  • Improved attention span

 

…and much more.

Yoga

Also developed in ancient India, yoga is a group of spiritual, mental, and physical practices that can relax and strengthen the mind and body and improve brain chemistry. People with anxiety particularly benefit from yoga, as it is especially effective at relieving stress.

Research suggests that yoga may provide many additional health benefits including:(13)

  • Improved balance
  • Enhanced stress management
  • Reduced body mass index (BMI)
  • Improved eating habits
  • Increased mental well being
  • Reduced pain

 

…and more.

Exercise

If you’re anxious, you might want to go for a jog or tackle DIY work in the old backyard pond – anything within reason to increase physical activity . Research shows that exercise, particularly aerobic exercise, can relieve stress.

Why?

Intense exercise changes brain chemistry, increasing levels of serotonin and other anxiety-busting neurotransmitters.(14) It also helps you “work off” those anxious thoughts and feelings.

Research shows that just 30 minutes of moderate-intensity aerobic exercise is enough to significantly improve mood.(15)

Breathe!

Breathing is one of the few functions of the autonomic nervous system that you can partially control. If used properly, it can be an effective tool for managing anxiety.

Respiration has been found to strongly influence the mental and physical state. Inhaling is controlled by the sympathetic nervous system, which briefly accelerates your heart rate and gives you energy. Exhaling, on the other hand, is controlled by the parasympathetic nervous system, which briefly decelerates the heart beat and calms you down.(16)

You can use this to your advantage. Research shows that one of the best ways to relieve anxious feelings is to practice a few rounds of slow deep breathing, making sure the exhalation is longer than the inhalation.(18)

Watch Your Diet

Nutrition is important for brain and body health, which in turn can prevent or relieve anxiety. Certain foods, such as caffeine, sugar, and refined carbs, are known to increase anxiety.

When it comes to managing anxiety, eating a well-balanced diet of high-quality protein, complex carbs, and healthy fats is the way to go. These foods can help stabilize your blood glucose levels, preventing spikes that contribute to anxious feelings.

In addition, there are a few specific foods and their vitamins that have been shown to help reduce anxiety symptoms.

Fatty Fish. Fatty fish contains essential omega-3 fatty acids that regulate neurotransmitters and reduce inflammation. This affects brain function. In fact, mood disorders are associated with reduced intake of omega-3s.(18)  Foods high in omega-3s include salmon, tuna, sardines, and mackerel.

Magnesium. This essential mineral is a cofactor in more than 300 biochemical reactions in the body. Magnesium has such a relaxing effect on the body that many people use it to help them sleep at night. There is research indicating that magnesium may also help reduce anxious feelings. One study on 126 adults given magnesium supplements showed significant improvement in generalized anxiety disorder.(19) Good sources of magnesium include dark green leafy vegetables, nuts, seeds, and whole grains.

Dark chocolate. Yes, the rumors are true…eating chocolate really does improve mood. Though the exact reason for this effect is unclear, dark chocolate is rich in anxiety-relieving magnesium. Plus, the polyphenols in dark chocolate have been shown to reduce stress. How much dark chocolate should you eat or drink? Well, one 2014 study suggests that consuming 40 grams daily for 2 weeks may reduce stress in females.(20)

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References

1- Remes, O., Brayne, C., van der Linde, R., Lafortune, L.. A systematic review of reviews on the prevalence of anxiety disorders in adult populations, Brain and Behavior, 2016; 6( 7), e00497, doi: 10.1002/brb3.497

2- Anxiety & Depression Association of America. Facts & Statistics. Updated Apr 21, 2021. Accessed Jul 9, 2021. https://adaa.org/understanding-anxiety/facts-statistics

3- Howell HB, Brawman-Mintzer O, Monnier J, Yonkers KA. Generalized anxiety disorder in women. Psychiatr Clin North Am. 2001 Mar;24(1):165-78. doi: 10.1016/s0193-953x(05)70212-4. PMID: 11225506.

4- Sex differences in corticotrophin-releasing factor receptor signaling and trafficking: potential role in female vulnerability to stress-related psychopathology,” Molecular Biology, published online June 15, 2010.

5- Hogan J. Why We Need to Start Taking Women’s Anxiety Seriously. Verily. Apr 28, 2016. Accessed Jul 11, 2021. https://verilymag.com/2016/04/men-women-anxiety-meds-prescriptions-sex-differences-mental-health

6- The Harvard Gazette. Estrogen and female anxiety. Harvard University. Accessed Jul 11, 2021. https://news.harvard.edu/gazette/story/2012/08/estrogen-and-female-anxiety/

7- Aydogan U, Aydogdu A, Akbulut H, Sonmez A, Yuksel S, Basaran Y, Uzun O, Bolu E, Saglam K. Increased frequency of anxiety, depression, quality of life and sexual life in young hypogonadotropic hypogonadal males and impacts of testosterone replacement therapy on these conditions. Endocr J. 2012;59(12):1099-105. doi: 10.1507/endocrj.ej12-0134. Epub 2012 Aug 31. PMID: 22972022.

8- Enter D, Terburg D, Harrewijn A, Spinhoven P, Roelofs K. Single dose testosterone administration alleviates gaze avoidance in women with Social Anxiety Disorder, Psychoneuroendocrinology, Volume 63, 2016, Pages 26-33, ISSN 0306-4530, https://doi.org/10.1016/j.psyneuen.2015.09.008.

9- Eaton NR, Krueger RF, Keyes KM, Hasin DS, Balsis S, Skodol, AE, Markon KE, Grant BF. An Invariant Dimensional Liability Model of Gender Differences in Mental Disorder Prevalence: Evidence from a National Sample. Journal of Abnormal Psychology, Vol. 121, No. 1. http://europepmc.org/article/PMC/3402021

10- Greenberg PE, Sisitsky T, Kessler RC, Finkelstein SN, Berndt ER, Davidson JR, Ballenger JC, Fyer AJ. The economic burden of anxiety disorders in the 1990s. J Clin Psychiatry. 1999 Jul;60(7):427-35. doi: 10.4088/jcp.v60n0702. PMID: 10453795.

11- Greenberg PE, Sisitsky T, Kessler RC, Finkelstein SN, Berndt ER, Davidson JR, Ballenger JC, Fyer AJ. The economic burden of anxiety disorders in the 1990s. J Clin Psychiatry. 1999 Jul;60(7):427-35. doi: 10.4088/jcp.v60n0702. PMID: 10453795.

12- National Center for Complementary and Integrative Health. Meditation: In Depth. Last Updated: Apr 2016. Accessed Jul 12, 2021.

13- National Center for Complementary and Integrative Health. Yoga for Health: What the Science Says. Feb 2020. Accessed Jul 12, 2021. https://www.nccih.nih.gov/health/providers/digest/yoga-for-health-science

14- Zimmer P, Stritt C, Bloch W, Schmidt FP, Hübner ST, Binnebößel S, Schenk A, Oberste M. The effects of different aerobic exercise intensities on serum serotonin concentrations and their association with Stroop task performance: a randomized controlled trial. Eur J Appl Physiol. 2016 Oct;116(10):2025-34. doi: 10.1007/s00421-016-3456-1. Epub 2016 Aug 25. PMID: 27562067.

15- Crombie KM, Brellenthin AG, Hillard CJ, Koltyn KF. Psychobiological Responses to Aerobic Exercise in Individuals With Posttraumatic Stress Disorder. J Trauma Stress. 2018 Feb;31(1):134-145. doi: 10.1002/jts.22253. Epub 2018 Feb 1. PMID: 29388710.

16- Bergland C. Longer Exhalations Are an Easy Way to Hack Your Vagus Nerve. Psychology Today. May 9, 2019. Accessed Jul 13, 2021. https://www.psychologytoday.com/us/blog/the-athletes-way/201905/longer-exhalations-are-easy-way-hack-your-vagus-nerve

17- Gerritsen Roderik J. S., Band Guido P. H. Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity. Frontiers in Human Neuroscience. Vol 12. Pages 397. 2018. DOI=10.3389/fnhum.2018.00397. https://www.frontiersin.org/articles/10.3389/fnhum.2018.00397/full

18- Ross BM, Seguin J, Sieswerda LE. Omega-3 fatty acids as treatments for mental illness: which disorder and which fatty acid? Lipids Health Dis. 2007 Sep 18;6:21. doi: 10.1186/1476-511X-6-21. PMID: 17877810; PMCID: PMC2071911.

19- Tarleton EK, Littenberg B, MacLean CD, Kennedy AG, Daley C (2017) Role of magnesium supplementation in the treatment of depression: A randomized clinical trial. PLoS ONE 12(6): e0180067. https://doi.org/10.1371/journal.pone.0180067

20- Al Sunni A, Latif R. Effects of chocolate intake on Perceived Stress; a Controlled Clinical Study. Int J Health Sci (Qassim). 2014;8(4):393-401.