Handbook of Religion and Health by Harold Koenig & Dana King & Verna B. Carson

Author:Harold Koenig & Dana King & Verna B. Carson [Koenig, Harold]
Language: eng
Format: azw3
Publisher: Oxford University Press
Published: 2012-02-05T16:00:00+00:00

Anxiety

Similar though less consistent findings are reported for anxiety. Robust cortisol responses to stress have been found in patients with anxiety disorder, particularly those with social anxiety (Condren et al. 2002; Roelofs et al. 2009). Experimental studies find that baseline cortisol is high in subjects with panic disorder. This is especially true when stressors are novel, threatening, or uncontrollable, which raises cortisol levels in both anxious and normal subjects, but especially in those with panic disorder (Abelson et al. 2007). In contrast, as indicated earlier, cortisol levels appear to be reduced in patients with PTSD due to negative feedback inhibition (Yehuda, Southwick, Krystal, et al. 1993).

Catecholamine levels are also increased in those with anxiety disorders (Mathew et al. 1980; Dajas, Nin, and Barbeito 1986). Furthermore, pheochromcytoma, a neuroendocrine tumor of the adrenal medulla that secretes excessive amounts of epinephrine and norepinephrine, often presents with anxiety symptoms (including panic attacks or exacerbation of preexisting anxiety disorders) (Gokce et al. 1991; Starkman et al. 1990). There is also evidence that anxious subjects produce more catecholamines (particularly norepinephrine) in response to psychological stress than do control patients (Gerra et al. 2000). Finally, catecholamine levels decrease in response to relaxation training in those with anxiety (Mathew et al. 1981).

As with cortisol, high levels of plasma catecholamines result in a down-regulation of catecholamine receptors as part of a negative feedback loop, resulting in reduced adrenegic receptor sensitivity. Furthermore, high levels of norepinephrine in the brain (associated with anxiety disorders such as panic attacks), do not always translate into high NE levels in the periphery (i.e., blood or urine) where it is typically measured.

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