Depending on which lens you use, the cause of anxiety and how to treat it will look different.

How Conventional Medicine Looks at Anxiety

According to the American Association of Anxiety, the exact cause of General Anxiety Disorder (GAD) is unknown. The symptoms tend to emerge gradually. Symptoms may begin at any age, typically emerging between childhood and middle age. Conventional doctors prescribe antidepressants to help you feel better, with the most popular being SSRIs (Selective Seratonin Re-uptake Inhibitors). These medicines boost the feel-good neurotransmitters in your brain like serotonin.

How Functional Medicine Looks at Anxiety

Functional medicine doctors and health coaches take a different approach. We look for root causes. What caused the neurotransmitters to get out of balance in the first place? How can we restore the balance? What will it take for the heal the body?  We begin with the gut and look for clues about its bacterial ecosystem (also known as its microbiome).A gut imbalance causes chemical messengers in our bodies to get confused and send out SOS signals to the brain. These SOS signals can make us feel worried, fearful, anxious, and depressed.

Why Would My Gut Be Out of Balance?

There are countless ways your gut’s ecosystem can get out of whack. Let’s explore some contributors, starting with when you were born.

Birth Journey

If you entered into the world through your mother’s birth canal, your microbiome got off to a good start. You automatically picked up a film of microbes as you made your way into the world. This journey helped colonize your gut in a good way. If you were delivered by c-section, your gut couldn’t begin to colonize until it was exposed to the environment, starting with the hospital. This meant it took longer to build diversity: two experiences, two very different microbiomes.

Baby Formula

Lots of good bacteria passes from mom to baby through breastmilk. Breastmilk helps babies develop a diverse gut bacteria population early in life. If you were formula-fed (like me), your microbiome needed time to build diversity. Again, through exposure to the environment.

Infrequent Exposure to Dirt

Dirt isn’t bad, it’s good! In his book, Eat Dirt, Dr. Josh Axe explains that soil-based organisms increase gut diversity and boost the immune system.  He offers 7 ways to get dirt into your diet. One example is to get rid of all those antibacterial soaps and hand sanitizers; they’re doing more harm than good!


How do antibiotics compromise our guts? From their inability to discriminate between “good” and “bad” bacteria. Antibiotics destroy ALL the bacteria they can find, including the good guys. One of my daughters had several ear infections when she was quite young. The doctor prescribed antibiotics. Back then, I didn’t understand that the antibiotics were also destroying my daughter’s gut flora. If I’d known, I would have supported her with probiotics and fermented foods at the same time.

Trauma and Grief

Chronic emotional stress inhibits stomach acid production, disrupts our digestive enzymes, and suppresses the function of the vagus nerve (the communication superhighway between our guts and our brains). Years ago—when my father was dying from brain cancer and I was getting divorced—I felt like I was carrying around a load of rocks in my belly. I couldn’t eat, and I lost 30 pounds in 3 months. It’s no wonder; emotional distress can cause major disturbances to our digestive systems.


Inflammation is sometimes obvious. For example, if you cut your finger, it gets red and swollen. Other times, you may not recognize inflammation. It may emerge as acne, allergies, autoimmune disease, fatigue, or itchy skin. Inflammation can also produce anxiety-provoking chemicals. These chemicals can create symptoms such as depression, lethargy, sleep disturbances, learning issues, and decreased social activity, mobility, and libido, and more. In the article From Gut to Brain: The Inflammation Connection, Dr. Kelly Brogan, MD states “Psychiatric researchers have observed that patients with higher levels of inflammatory markers are less likely to respond to antidepressants, and more likely to respond to anti-inflammatories.”

Brain Injuries

Brain injuries contribute to a broken communication network between the gut and brain. They can cause issues such as leaky gut, compromised intestinal mucosa, and brain immune dysfunction. It seems crazy, right? But don’t be surprised if you started experiencing anxiety after a head injury. A couple of years ago, I was riding my bicycle on a wooded gravel road along the Maine coast.  I heard a loud engine and instinctively squeezed both brakes, causing the bike to skid across the gravel. My head, shoulder, and hip slammed to the ground. Thankfully, I was wearing a helmet. Still, I’m pretty sure that hitting my head kicked off some chronic gut issues that I’m healing now, years later. Curious to learn more? Check out 7 Reasons a Brain Injury Can Destroy Your Gut.

Lyme Disease

Lyme disease is a bacterial infection spread by ticks, mosquitoes, spiders, and fleas. It’s spreading at epic rates around the globe, bringing with it a vast array of physical and mental symptoms such as fatigue, aches and pains, foggy thinking, disturbed sleep, heart palpitations, shortness of breath, and—you got it—anxiety and depression. Many of these symptoms present themselves in other diseases, which means that lyme disease is often mis-diagnosed. To make matters worse, conventional blood screenings for lyme disease are often wrong. The lyme bacteria hide in your gut and other parts of your body, and aren’t often picked up by the standard blood test. So what can you do? My family goes to an Eastern Medicine practitioner who uses an accurate diagnostic tool that tests energy fields in your body. He treats lyme disease through homeopathy. I am thankful that he treated one of my daughters, who is now free from the disease. The website “Lyme Less Live More” offers more holistic strategies as well.


In addition to compromising your lung function, cigarette smoking causes profound disruptions in the diversity and composition of gut bacteria. This lack of diversity can be a contributing factor to anxiety.  The good news is that if you can make your way through anxiety of quitting, you can restore the gut flora over time.

Improving Your Gut Flora 

While this gut-compromising list may seem lengthy and overwhelming at first glance, keep in mind that any disruption or imbalance that you may have in your gut can be reversed. “First we weed, seed, and feed, and then we heal and we seal,” says Caroline Barringer. Through attention to food, lifestyle, and nutritional supplements, your gut balance can be restored and your anxiety symptoms can be put to rest.