Panic Attacks & Anxiety; Where to Begin?

As discussed above, utilization of brain chemistry altering prescription benzodiazepines like Xanax or supplementing with things like l-theanine, valerian root, kava or even cannabis, although potentially helpful in the short term, do not necessarily address or rectify root cause. Very commonly, a large portion of the underlying issue with many types and degrees of mental illness is not a character flaw or “all in your head,” but due to various identifiable and modifiable factors that can alter our brain chemistry, and thus our mood, behavior, and how we perceive, interpret, and interact with the world.

When it comes to the brain chemicals known as neurotransmitters, and the link to panic attacks and anxiety, much of the focus is on serotonin and the above discussed GABA. Many times addressing GABA is good for the short term fix, and subsequent serotonin optimization for the sustained long term adjustment. Serotonin’s role in quelling anxiety is why things like St. John’s Wort or antidepressant SSRIs like prozac are often prescribed for anxiety.

It is also the reason why doing things to naturally enhance serotonin like consuming a diet rich in tryptophan (i.e. turkey, chicken, beef, brown rice, nuts, fish, eggs, fruit, vegetables, etc.), ensuring adequate levels of B vitamins, vitamin D, and magnesium necessary for serotonin production, and even being exposed to natural sunlight can help bolster serotonin levels and thus play a part of your holistic picture to addressing not only depression, but anxiety as well.

For the sake of this discussion, we focused on GABA; the inhibitory neurotransmitter which allows us to remain calm, cool and collected. There are a variety of reasons this can be altered, and digging to discover this is all part of the process. The idea is to ultimately go beyond simply up-regulating or stimulating GABA receptors with effective remedies like passion flower, valerian root, taurine, l-theanine, magnesium, or even Phenibut*, and create an optimal physiological melieu that eliminates the need for pharmacological or supplemental dependency altogether.

(*Phenibut is a GABA molecule with a phenyl (C6H5) group attached to it. Attaching the phenyl group to GABA enables it to cross the blood brain barrier and actually work in and on the brain. When the blood brain barrier (BBB) is intact, it actually keeps neurotransmitters like GABA and serotonin out.
This is why urine testing for neurotransmitters is suspect. It measures the amount of these chemicals in the periphery, more reflexive of levels in the blood or our organs, but not the brain. GABA and serotonin do not cross the intact blood brain barrier, which is why there is a question with the efficacy of neurotransmitter testing and whether or not measured levels in the periphery accurately reflect those in the central nervous system: the brain.
It is also why phenibut can be such a potent, short term solution to make life manageable while we sort things out. GABA, normally not able to cross the blood brain barrier, is carried across due to the phenyl group in phenibut.
Acknowledgement of the BBB factor is also why if you supplement with straight GABA and it does have a calming, sedative like effect, it can be indicative of a compromised or damaged BBB, which would not only be letting the normally unable GABA molecule into the brain, but other unwanted visitors as well. Taking GABA and noting the effects is actually called the GABA Challenge and can be used diagnostically to identify compromise or post treatment progress.)

We discussed the importance of B6 when it comes to neurotransmitters and beyond.  By including organic acids in your next round of advanced diagnostic blood work, you will be provided with the marker indicative of B6 deficiency (xanthurenate), along with a host of other organic acids that allow us to identify other potentially problematic, symptom causing deficiencies in not only the B vitamins, but various minerals and enzymes essential for optimal function.  Organic acids are the by-products of our normal metabolism and their levels can help us pinpoint and then address any kinks in the chain that could ultimately be the key to unlock issues like anxiety, panic attacks, depression and beyond.