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The Hindu
5 days ago
- Health
- The Hindu
Consilient evidence links lack of vitamin D to neurodevelopmental issues
From bones to immune cells, vitamin D is everywhere, guiding growth and shaping defence. But could it also have an effect on the mind? A major new study suggests so. Published in The Lancet Psychiatry, the study drew from the extraordinary depth of Danish health data to establish whether neonatal vitamin D levels might contribute to psychological and neurodevelopmental conditions. What the study found Researchers at Aarhus University in collaboration with the Statens Serum Institut in Copenhagen used dried blood spot samples from 88,764 individuals born between 1981 and 2005 — part of a universal neonatal screening programme that stores nearly all newborns' blood in the Danish Neonatal Screening Biobank. From these samples, the team measured levels of 25-hydroxyvitamin D, or 25(OH)D, which is the standard marker of vitamin D status, and vitamin D-binding protein, which carries vitamin D in the blood and prolongs its activity. Using nationwide Danish health registries, the researchers tracked which individuals developed major depressive disorder, bipolar disorder, schizophrenia, attention deficit hyperactivity disorder (ADHD), autism spectrum disorder or anorexia nervosa — and asked whether their vitamin D levels at birth were linked to these outcomes. The results were striking. Babies with higher vitamin D levels were less likely to be diagnosed with schizophrenia, ADHD or autism. Newborns with levels about 12.6 nmol/l higher than average had an 18% lower risk of schizophrenia, 11% lower risk of ADHD, and 7% lower risk of autism. Vitamin D-binding protein levels were also linked to schizophrenia risk. To understand the broader public health impact, the researchers modelled a scenario in which every baby had vitamin D levels in the top 60% of the sample. In that case, they estimated that 15% of schizophrenia cases, 9% of ADHD cases, and 5% of autism cases might have been prevented. These effects appeared early, with children who had higher vitamin D levels showing lower risk from a young age. The lack of association with depression or bipolar disorder, the authors suggested, may reflect both the later onset of these conditions in life and the possibility that neonatal vitamin D plays a more central role in early neurodevelopmental pathways than in mood disorders. Testing plausible causality Observational studies, especially in nutrition, often face two big problems. One is reverse causation, where what looks like a cause is actually an early effect. For example, early brain changes might influence how the body handles vitamin D, making it look like vitamin D is the cause when it's actually an effect. The second is confounding, where a third factor like a mother's diet or immune health influences both vitamin D levels and the child's risk of mental illness. To check for these biases, the researchers turned to genetics. They started with the polygenic risk score (PRS), which looks at many small inherited differences that alter a person's vitamin D levels and generates a score. They found that individuals with higher PRS scores for vitamin D were less likely to be diagnosed with schizophrenia, ADHD or autism. PRS also helped rule out reverse causation since a child's later psychiatric diagnosis can't influence the vitamin D genes they were born with. However, PRS couldn't fully resolve confounding: where some variants might still influence other traits beyond vitamin D. Perhaps a gene variant perturbing vitamin D levels also alters neurodevelopment? As Upasana Bhattacharyya, a scientist at Northwell Health in New York, explained: 'While PRS can suggest a biological link, they mainly capture variants that are associated with a trait — not necessarily ones that cause it.' She added that PRS typically uses variations that are related to many other functions as well, thereby establishing associations without directionality. To test for a more direct effect, the researchers turned to Mendelian randomisation, a method that uses genetic variants that have a stronger effect on vitamin D levels. If people who inherit variants that raise (only) vitamin D levels consistently have a lower risk of schizophrenia, ADHD or autism, it will be stronger evidence of a causal relationship between vitamin D levels and the risk of developing these conditions. The researchers used two levels of Mendelian randomisation. First, they tested whether genetic predictors of vitamin D were associated with lower risk of psychiatric conditions. Then they examined two specific genetic variants in the GC gene, which regulates levels of vitamin D-binding protein in the blood. Together, they suggested that higher vitamin D levels may play a protective role, particularly in lowering the risk of ADHD and possibly schizophrenia and autism. What the findings don't mean While the study used powerful genetic tools to test for causality, the authors have cautioned that some important uncertainties remain. Some gene variants might influence both vitamin D and brain development independently, a phenomenon known as pleiotropy. And because vitamin D was measured only at birth, the study couldn't pinpoint which periods in pregnancy were more critical. Second, if deficiency begins in the womb, it makes sense for intervention to begin there, too. However, a 2024 randomised controlled trial in Denmark found that high-dose vitamin D supplementation (2800 IU/day) starting at pregnancy week 24 had no significant effect on the risk of autism or ADHD in children. But such results also depend on timing, dosage, and whether mothers were actually deficient to begin with. In short, while vitamin D may not be the sole or dominant factor shaping neurodevelopment, it remains a plausible piece of a larger, complex puzzle. Another key limitation was that nearly all participants were of European ancestry. In a smaller non-European group, the results were less consistent — possibly due to lower vitamin D levels, smaller sample size, and/or genetic diversity. For these reasons, the researchers concluded that while their findings support a causal link, they can't yet prove it outright. India's vitamin D problem Sunlight is abundant in India but vitamin-D deficiency is rampant, and the findings carry especial weight here. A study conducted at AIIMS Rishikesh between 2017 and 2018 found that 74% of infants and 85.5% of their mothers were deficient in vitamin D, with nearly half experiencing severe deficiency. Another study from Bengaluru observed that 92.1% of newborns were deficient. During pregnancy, the mother's body undergoes a complex set of hormonal and metabolic changes to supply calcium for the developing foetal skeleton. These changes intensify in the third trimester as the skeleton grows rapidly. To meet this need, the mother's intestines absorb more calcium, her kidneys excrete more, and her levels of active vitamin D rise to roughly twice their pre-pregnancy levels. Despite these adaptations, maternal vitamin D levels don't rise unless sunlight exposure or dietary intake improves. This is why even well-nourished pregnancies in India can result in deficiency. Sunlight alone isn't always enough. Evidence from Indian hospitals has also shown that a mother's vitamin D status directly shapes her baby's. A 2024 study conducted in the Bundelkhand region of India found a strong positive correlation between mothers' and their infants' vitamin D levels and interpreted it to mean babies born to vitamin D-deficient mothers were very likely to be deficient themselves. This reinforces the idea that vitamin D insufficiency is not just an individual issue: it is a biological legacy passed from one generation to the next, shaping not just bones but, as the Danish study suggests, brains too. These findings align with clinical experience in India. According to Anuradha Kapur, principal director of Obstetrics and Gynaecology at a Max Smart Super Speciality Hospital in New Delhi, timely supplementation in deficient mothers can remarkably improve both maternal and neonatal levels. In her practice, she said high-dose therapy — typically of 60,000 IU per week in the third trimester — has been effective and safe, with clear benefits in infant growth and immunity. A small Indian trial last year echoed these findings: babies born to supplemented mothers had significantly better vitamin D levels at birth. By six months, none had developed severe deficiency, compared to more than half in the control group. Caution rather than alarm The Danish study adds to growing evidence that early-life exposure, including nutrition, can shape long-term mental health. Vitamin D is no magic bullet, but through the right window, it might tilt the odds. Dr. Kapur noted that routine vitamin D screening during pregnancy remains uncommon across much of the country. While some obstetricians in urban areas do test high-risk pregnancies, cost and lack of awareness continue to limit uptake in rural and semi-urban settings. As a result, many deficiencies go undiagnosed, especially when symptoms are subtle or overlooked during pregnancy. She argued that India needs to shift from reactive treatment to preventive care. The growing evidence of vitamin D's role in neurodevelopment, she said, strengthens the case for routine antenatal supplementation, ideally beginning as early as the first or second trimester. 'This is not about alarm,' Dr. Kapur said, 'but about recognising that early brain development is shaped by access to nutrients — and vitamin D is one such modifiable element we can and must intervene on.' Anirban Mukhopadhyay is a geneticist by training and science communicator from Delhi.
BBC News
06-07-2025
- Health
- BBC News
Why so many young men dey struggle wit mental health, and no dey ask for help?
For recent years, di world don wake up to a growing youth mental health problem, and one group dey particularly vulnerable: boys and young men. Decades of research don establishe say men dey less likely dan women to seek support for dia mental health – 40% less likely, one 2023 US study find. But we still sabi little about how – or wen – teenage boys and young men ask for help. "Dis dey cause worry," a 2024 review for di European Child & Adolescent Psychiatry journal, "as adolescent boys and young men get high suicide rates but a low take-up of services." Wetin dey drive dis disconnect – and how schools, parents and policymakers fit step in to help? Suffer in silence Globally, one in seven adolescents between di ages of 10 and 19 experience a mental disorder, according to World Health (WHO) research last year. E find say depression, anxiety, and behavioural conditions na di most common disorders, and suicide remains di third leading cause of death among dose wey dey age 15–29. According to The Lancet Psychiatry Commission, up to 75% of all mental health conditions begin bifor di age of 25, wit di peak onset at just 15 years. While young pipo dey physically healthier dan eva, mentally dem dey struggle, and di numbers dey rise, making dis "a dangerous phase" for youth mental health. Yet despite di need, many boys and young men no dey use di mental health services available. "Ova di last 15 to 20 years, we don see an alarming rise for di prevalence of mental health conditions for both boys and girls, but help-seeking dey much less common among young men," sas Professor Patrick McGorry, psychiatrist and executive director of Orygen - Australia's National Centre of Excellence for Youth Mental Health tok Dat stronghead dey sometimes mean say young men dey only reach out wen dem dey for crisis. Social norms around emotional toughness and self-reliance dey often discourage boys to seek help, sabi pipo tell di BBC, adding dat studies consistently show say boys internalise di message wey say to dey show vulnerability na sign of weakness. Dr John Ogrodniczuk, a professor of psychiatry for di University of British Columbia in Canada and di director of HeadsUpGuys, a mental health resource for men, explain say many boys still dey equate seeking help wit failure. "If we tok about masculine socialisation, e get a lot of prescriptions about wetin men gatz do or not do: be stoic, strong, in kontrol, no show any weakness or vulnerability, figure stuff out on your own," e say. "You fit see how a lot of dis tins serve as barriers to form a connection to your own emotional life and asking for help if you need am." Dr Ogrodniczuk note say wen support dey tailored to men – for tone, language and approach – engagement dey increase. Informal approach Recent research don identify several oda themes beside di social norms and di stigma of showing weakness wey dey shape how boys view mental health support. Many boys no recognise dia symptoms or sabi how to seek help, and dem often no feel comfortable for formal clinical settings. Boys and young men dey often prefer informal help, like conversations wit friends, or anonymous, online support, and male-friendly messaging wey aligns help-seeking wit strength, responsibility and action get more impact. Dis don lead to some youth services ditching traditional clinical models. For Australia, for instance, di youth mental health organisation Orygen co-designed spaces wit young pipo wey dey offer "soft entry" – informal settings wia conversations fit happun. "Young men fit no dey as amenable to sitting in a consulting room for dia first contact. Dem fit no wan sit down for interview," Orygen executive director Patrick McGorry tok. "Maybe dem go rada get a more laid-back conversation, while dem dey do sometingelse - like going for a walk or maybe playing a game of pool or table tennis." Social media: na friend or enemy? Social media na double-edged sword: e fit connect isolated teens and provide valuable information, but also expose dem to harmful content and toxic ideals of masculinity. "Di majority of young men now dey connect wit men and masculinity influencer content," according to Dr Simon Rice, clinical psychologist and global director of di Movember Institute of Men Health. Movember research find say many young men wey dey engage wit "manosphere" content report worse mental health dan dia peers. But Rice stress say no be all content dey negative, and social media fit also be a useful tool to improve mental health. "We wan make sure say we fit harness di positive aspects of social media to bring communities togeda, to provide good health and mental health information, while minimising di possibilities for harm." Howeva, e say dat di working of social media algorithms dey present a serious challenge as dem dey designed to distribute content wey dey more likely to be viral for nature, and e dey hard for positive, health-oriented content to "win di algorithm". Professor Mina Fazel, Chair of Adolescent Psychiatry for Oxford University, agree say e dey crucial to teach teenagers and parents how social media algorithms work, pointing to soon-to-be-published research wey find say a third of young pipo don see content wey dey related to self-harm on social media for di past month. But Professor Fazel add say social media alone no dey to blame and broader changes for society fit dey considered as well. "Family and community structures dey change dramatically, and social media potentially fit play a supportive role for a lot of young pipo," she say. Loneliness factor One of di most serious challenges wey dem dey sometimes overlooked na loneliness. According to a Gallup survey wey dem publish for May, 25% of US men age 15 to 34 say dem don feel lonely for a significant potion of di previous day, higher dan di national average of 18% and di total for young women, also 18%. Dr Ogrodniczuk say dat di data for HeadsUpGuys show say loneliness and a lack of purpose na two of di most common stressors among young men. Sabi pipo underline di need to provide safe spaces wia boys fit build friendships and tok openly – no be just for designated therapy sessions, but for everyday interactions. Dat fit mean mentorship programmes, peer support groups or simply to retink how we tok about mental health for classrooms. Role of schools "E get quite a positive trend say wen young boys do seek help, dem dey usually find am helpful," Professor Mina Fazel tok. "E fit no actually matter wia dat help dey deliva: it fit be for school, e fit be for social services, e fit be for di community." E also get a growing evidence say school culture play a role for boys wellbeing. Academic pressure, particularly in contexts wia boys dey fall behind girls, fit fuel anxiety, frustration and disengagement. Professor Fazel believe schools need to dey redesigned to work better for boys. "Di majority of di world children get access to schools," she say, "so maybe dis na di place wia we really need to tink about not only di academic education of children, but a broader offer of wetin e mean to develop as adolescents - especially for boys."
Business Wire
30-06-2025
- Health
- Business Wire
Alto Neuroscience Highlights Peer-Reviewed Publication of PAX-D Study in The Lancet Psychiatry Demonstrating Robust Clinical Effects of Pramipexole for Patients with Treatment-Resistant Depression
MOUNTAIN VIEW, Calif.--(BUSINESS WIRE)--Alto Neuroscience, Inc. ('Alto') (NYSE: ANRO) a clinical-stage biopharmaceutical company focused on the development of novel precision medicines for neuropsychiatric disorders, today highlighted The Lancet Psychiatry publication of data from the PAX-D study evaluating pramipexole in patients with treatment-resistant depression (TRD). The study was conducted by the University of Oxford and was funded by the UK government's National Institute for Health and Care Research. Results showed pramipexole augmentation of antidepressant treatment, at a target dose of 2.5mg, demonstrated a large (Cohen's d =0.87) reduction in symptoms relative to placebo at 12 weeks, but was associated with a high rate of adverse effects. The link to the online publication can be found here. The PAX-D study results guided Alto's acquisition of ALTO-207, a fixed-dose combination of pramipexole and the antiemetic, ondansetron. 'Publication in an esteemed peer-reviewed journal like The Lancet Psychiatry underscores the significance of these findings and therapeutic potential of ALTO-207 to address a critical gap in TRD,' said Amit Etkin, M.D., Ph.D., founder and chief executive officer of Alto Neuroscience. 'ALTO-207 is designed to consistently achieve rapid antidepressant effect through faster titration, while mitigating the dose-limiting nausea and vomiting experienced with pramipexole alone. As we prepare to initiate our potentially pivotal, Phase 2b trial by mid-2026, we look forward to drawing on our proprietary insights on dopamine biomarkers in depression and partnering with the National Health Service network, including PAX-D sites to expand our clinical footprint and maximize the likelihood of success.' The PAX-D sites are supported by the National Institute for Health and Care Research (NIHR) Mental Health Translational Research Collaboration (MH-TRC) mission. Michael Browning, DPhil, MRCP, MRCPsych, Professor of Computational Psychiatry, University of Oxford, and lead study author added, 'As a physician, I am encouraged by the robust and durable clinical effects seen for pramipexole in patients with TRD. While pramipexole may offer greater antidepressant effects than other available TRD treatments, the slow titration aimed at mitigating dose-limiting AEs is likely to hinder adoption. These results make it clear that optimizing tolerability to overcome current barriers may lead to a paradigm shift in treatment.' Professor Browning presented results from The Lancet Psychiatry publication during Alto's recent investor conference call to discuss the acquisition of ALTO-207. A replay of the webcast is accessible on the Company's website here. About ALTO-207 ALTO-207 (formerly known as CTC-501) is a fixed-dose combination of pramipexole, a dopamine D3-preferring D3/D2 agonist, approved for the treatment of Parkinson's disease with demonstrated antidepressant effect, and ondansetron, an antiemetic, selective 5-HT3 receptor antagonist. As a fixed-dose combination, ALTO-207 is designed to enable rapid titration and higher dosing by mitigating the dose-limiting adverse events typically experienced with pramipexole. ALTO-207 is being developed to address the significant unmet need for patients with TRD. Chase Therapeutics Corporation, prior to asset acquisition by Alto, completed a randomized, placebo-controlled Phase 2a clinical trial evaluating CTC-501 in 32 patients with depression. CTC-501 met primary and secondary endpoints demonstrating significantly greater improvements on MADRS compared to placebo. Patients randomized to receive CTC-501 reached a mean dose of 4.1mg per day. CTC-501 was well tolerated in the maintenance period of the study with an adverse event rate similar to placebo. About Alto Neuroscience Alto Neuroscience is a clinical-stage biopharmaceutical company with a mission to redefine psychiatry by leveraging neurobiology to develop personalized and highly effective treatment options. Alto's Precision Psychiatry Platform™ measures brain biomarkers by analyzing EEG activity, neurocognitive assessments, wearable data, and other factors to better identify which patients are more likely to respond to Alto product candidates. Alto's clinical-stage pipeline includes novel drug candidates in bipolar depression, major depressive disorder, treatment resistant depression (TRD), and schizophrenia, and other mental health conditions. For more information, visit or follow Alto on X. Forward-Looking Statements This press release may contain forward-looking statements made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. These statements may be identified by words such as 'expects,' 'plans,' 'will' and variations of these words or similar expressions that are intended to identify forward-looking statements, although not all forward-looking statements contain these words. Forward-looking statements in this press release include, but are not limited to, statements regarding Alto's expectations for the timing, progress, and results of the planned ALTO-207 study, Alto's expectations about the potential benefits, activity, effectiveness and safety of its product candidates and Precision Psychiatry Platform ('Platform'); and Alto's expectations with regard to the design and results of its clinical trials. Actual results or events could differ materially from the plans, intentions and expectations disclosed in these forward-looking statements as a result of various factors, including uncertainties inherent in the initiation, progress and completion of the planned ALTO-207 study and clinical development of ALTO-207; the risk that Alto may not achieve targeted enrollment in the ALTO-207 study or that enrollment may take longer than expected; the availability and timing of results from the ALTO-207 study; and other important factors, any of which could cause Alto's actual results to differ from those contained in the forward-looking statements, which are described in greater detail in the section titled 'Risk Factors' in Alto's Annual Report on Form 10-K for the fiscal year ended December 31, 2024 filed with the Securities and Exchange Commission ('SEC') as well as in other filings Alto may make with the SEC in the future. Any forward-looking statements contained in this press release speak only as of the date hereof, and Alto expressly disclaims any obligation to update any forward-looking statements contained herein, whether because of any new information, future events, changed circumstances or otherwise, except as required by law. Availability of Information on Alto's Website Alto routinely uses its investor relations website to post presentations to investors and other important information, including information that may be material. Accordingly, Alto encourages investors and others interested in Alto to review the information it makes public on its investor relations website.
Miami Herald
20-05-2025
- Health
- Miami Herald
Vitamin D deficiency in infancy may increase risk of ADHD, autism, research finds
The development of a group of mental disorders, ranging from attention-deficit/hyperactivity disorder to schizophrenia, have been linked to vitamin D deficiencies in newborn babies, a new study found. The research, led by Australian professor John McGrath from the University of Queensland's Brain Institute, examined the vitamin D status of more than 70,000 people in a population study and was published in the June issue of the peer-reviewed journal The Lancet Psychiatry. 'Vitamin D is important for a baby's brain development, and low vitamin D levels are common in pregnant women across the globe,' McGrath said in a May 15 news release from the University of Queensland. 'This is why many countries recommended the use of vitamin D supplements during pregnancy.' The vitamin comes most often from sun exposure but is also present in some food and dietary supplements, researchers said. Previous research linked neonatal, or newborn, vitamin d deficiencies with increased risk of developing schizophrenia, according to the study, but there was a gap in examining other mental disorders commonly diagnosed in childhood. The Study Using national health registers in Denmark between 1981 and 2005, the research team looked for individuals diagnosed with at least one of six disorders: major depressive disorder, bipolar disorder, schizophrenia, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and anorexia nervosa, according to the study. The cohort was pulled from the entire population of Denmark born during that time frame, researchers said, all of whom underwent a routine screening test at birth that collected dried blood spots. These blood spots were then tested for 25(OH)D, or the primary form of vitamin D that circulates in the blood and helps regulate calcium and phosphate levels within the body, according to the study. When the researchers compared the vitamin D levels of those who had developed the mental disorders included in the study, they found a link. The Findings Those with lower levels of vitamin D immediately after birth had an increased risk of developing schizophrenia, supporting what had been suspected in previous research, according to the study. But the cohort also revealed links with other conditions. Higher concentrations of vitamin D were associated with decreased risk of autism spectrum disorder and ADHD, according to the study. On the other side of the spectrum, vitamin D deficiency seemed to act as a protective factor against anorexia nervosa, an eating disorder, researchers said. 'Risk factors traditionally linked to increased risks of schizophrenia, ADHD and ASD, such as lower intelligence and worse school performance, and childhood adversities, are paradoxically protective for anorexia nervosa,' according to the study. The research team noted one vitamin is likely not the only factor impacting the development of these mental disorders, as genetics and behavior of the mother also impact early childhood development, but something as simple as a prenatal vitamin may help decrease the risk. 'Similar to how folate supplements are recommended during pregnancy to prevent spina bifida, our research suggests that optimizing vitamin D levels in early life may reduce the risk of several neurodevelopmental disorders,' McGrath said in the release. The findings were part of a larger study founded in 2012, known as iPSYCH, designed to investigate mental disorders in Denmark, according to the release. The research team includes McGrath, Henriette Thisted Horsdal, Clara Albiñana, Zhihong Zhu, Sanne Grundvad Boelt, Nis Borbye-Lorenzen, Arieh S Cohen, Kristin Skogstrand, Lars Melgaard, Nadia Jensen MacSween, Marta Jadwiga Thorbek, Oleguer Plana-Ripoll, Liselotte Vogdrup Petersen, Cynthia M Bulik, Anders D Børglum, Ole Mors, Merete Nordentoft, Thomas Werge, Gunn-Helen Moen, Shannon D'Urso, Naomi R Wray, Bjarni J Vilhjálmsson, Esben Agerbo, Carsten Bøcker Pedersen and Preben Bo Mortensen.
The Hindu
23-04-2025
- Health
- The Hindu
All you need to know about: anxiety disorders
All of us have experienced butterflies in the stomach just ahead of an important exam, nervousness as we're headed for a job interview, or perhaps clammy palms just after we have risked our lives crossing a road in our country. Some amount of anxiety is normal, and even healthy -- it may help alert us to a dangerous situation and focus our attention. An anxiety disorder however, goes beyond this. Anxiety disorders are the world's most common mental disorders, says the World Health Organization (WHO), with an estimated 301 million people affected as of 2019. More women than men are affected by anxiety disorders. In India, as of 2017, a staggering 44.9 million people had anxiety disorders according to the research paper: 'The burden of mental disorders across the states of India: the Global Burden of Disease Study 1990–2017' in The Lancet Psychiatry. What are anxiety disorders? Anxiety is different from fear, though the two may often be confused. The American Psychiatric Association states that anxiety refers to anticipation of a future concern and is more associated with muscle tension and avoidance behavior, whereas fear is an emotional response to an immediate threat and is more associated with a fight or flight reaction – either staying to fight or leaving to escape danger. People with anxiety disorders experience fear worry that is beyond the occasional -- it can be intense, excessive and hard to control. These feelings, the WHO states, are typically accompanied by physical tension and other behavioural and cognitive symptoms. They are difficult to control, cause significant distress and can last a long time if untreated. In order for a person to be diagnosed with an anxiety disorder, in general, the anxiety must be out of proportion to the situation and must impact their ability to function normally. Children, adolescents and adults can all experience anxiety disorders. What are the types of anxiety disorders? There are several different types of anxiety disorders. These include: generalised anxiety disorder, panic disorder, specific phobias, agoraphobia, social anxiety disorder, separation anxiety disorder and selective mutism. People can have more than one anxiety disorder. Generalised anxiety disorder or GAD is the most common type of anxiety disorder. GAD is characterised by constant, excessive worrying, tension and fear, often about everyday responsibilities such as those at work or at home or even about minor, routine tasks and chores. This worrying often can't be controlled, it may be persistent and far more intense than the situation warrants. GAD can develop slowly, sometimes from childhood or adolescence, or from adulthood. What are the signs and symptoms of GAD? Symptoms can be psychological and physical. Some common symptoms include: trouble controlling worries and nervousness, feeling restless and being unable to relax, feeling irritable, having trouble falling asleep or staying asleep, sweating, trembling or shaking, heart palpitations, an inability to concentrate, difficulties in making decisions, dry mouth, sweating, shortness of breath or rapid breathing, nausea and stomach upsets, tingling in the hands or feet, cold, sweaty hands and the urge to avoid things that cause the anxiety. Anxiety disorders increase the risk for depression and substance use disorders as well as the risk of suicidal thoughts and behaviours, says the WHO. What causes anxiety disorders? The exact cause of anxiety disorders is unknown. They are believed to stem from a combination of factors including genetic, environmental and psychological. Researchers believe chemical imbalances of neuro-transmitters and hormones could play a role. Other factors that could increase the risk for an anxiety disorder include severe family or environmental stress, experiencing a traumatic event, living through abuse and long-term illnesses. Genetics also play a role as anxiety disorders can run in families. According to the WHO, anxiety disorders are closely related to and affected by physical health. Many of the impacts of anxiety (such as physical tension, nervous system hyperactivity or harmful use of alcohol) are also known risk factors for diseases such as cardiovascular disease. In turn, people with these diseases may also find themselves experiencing anxiety disorders due to the difficulties associated with managing their conditions. How are anxiety disorders treated? After ruling out physical problems that may be causing the symptoms, your healthcare provider may refer you to a mental health professional for a diagnosis. Treatment can include a combination of medication and psychotherapy. Medication can include anti-depressants and anti-anxiety medicines. Medicines may take time to work and some people may have to work with their doctors to find the right combinations, dosages and duration of medication. Cognitive behaviour therapy, which is a form of therapy, is also commonly used to treat anxiety disorders. This involves learning different ways to think, react and behave, after identifying thought patterns that cause anxious feelings. Self-care can also play an important role. This includes exercising regularly, cutting down on alcohol, quitting smoking, limiting caffeine, learning and practicing relaxation techniques, managing stress, meditation and participating in in-person or online support groups. Although highly effective treatments for anxiety disorders exist, only about 1 in 4 people in need (27.6%) receive any treatment, the WHO notes. Barriers to care include lack of awareness that this is a treatable health condition, lack of investment in mental health services, lack of trained health care providers, and social stigma. It is important to see your healthcare provider if you are experiencing symptoms of an anxiety disorder.
