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Nearly 30% of people suffer from anxiety at some time in their lives (Santana & Fontenelle, 2011); equally, almost 30% suffer from ongoing allergies (Sansone & Sansone, 2011). So, it seems likely many anxious people will also have allergies. This assumption is borne out by the research, which does indeed show a high rate of anxiety sufferers have allergies. In fact, the numbers are many more than expected, with a review of over 102,000 people showing 99.9% had both conditions, leading to the conclusion there is a strongly positive relationship between the two (Sansone & Sansone, 2011).

Since we know that the symptoms of anxiety and allergies mimic each other, this raises the question as to whether they are also strongly influencing each other. Could they, in actual fact, be creating a vicious cycle where one maintains the other? For example, with slow recovery from anxiety due to trauma, could it be that allergies are interfering with the healing process?
In their recent review of research looking at the relationship between allergies and anxiety, Sansone and Sansone (2011) found that the majority of the research supports the opinion that anxiety may heighten the risk of allergies by directly triggering the immune system. Several studies have pointed out that even small amounts of stress can not only increase the intensity of an allergy attack but also cause it to last longer (Kiecolt–Glaser, 2009). People suffering allergic skin reactions have especially been shown to have greater levels of anxiety (Annesi–Maesano et al., 2009). The theory is while allergies themselves are already caused by an inadequate immune system, the additional stress of anxiety can only makes things worse.

Conversely, allergies can interfere with anxiety by interfering with sleep through nasal obstruction. So, while many anxiety sufferers just crave a good night’s sleep to calm their frazzled nerves, they often don’t get it; and then they can quickly fall into a vicious cycle of allergies regularly hindering sleep accompanied by anxious fretting about not getting enough sleep.
Understandably, people tend to avoid activities that cause stress. Some anxiety sufferers may also avoid strenuous physical activity that produces bodily reactions they think might lead to anxiety. For example, for those suffering panic attacks, tightness in the chest and laboured breathing from physical exercise may heighten their alertness to another attack. Unfortunately, as these are the exact same symptoms produced by allergies, anxiety sufferers can become doubly over-sensitised to their body’s reactions and so avoid many activities they fear might cause anxiety.
At this stage it is clear that for people suffering from both anxiety and allergies, treating just one condition without considering the other is insufficient and new approaches to treatment are needed.

Treatment
When symptoms develop for sufferers of both anxiety and allergies, a sensible approach is to simultaneously ramp up the management strategies for each. Obviously, a natural approach is preferable, such as reducing stress and avoiding allergens (“Ten Commandments of the Allergy-Friendly Home,” 2014), but there will be times when anxiety or allergic reactions are just too overwhelming and need more.

Anxiolytics, such as Diazepam, can certainly knock a panic attack on the head and so reduce the significant strain on the nervous system. They can also help build confidence as part of an anxiety treatment program. However, research is now cautioning against the long-term use of these drugs. The findings of a recent study by researchers in France and Canada (Billioti de Gage et al., 2014) suggested that the regular consumption of benzodiazepines for six months or more can increase the likelihood of Alzheimer’s by 40%.

While many anxiety sufferers do not want to take prescription drugs, they will seek alternatives. Of the many that exist, Metagenics’ NeuroCalm is a popular natural remedy reportedly providing many anxiety sufferers with sustained relief. While some side effects such as tiredness have been reported, at least one of its components (passionflower) has been shown to be just as effective as Oxazepam but without some of the stronger side effects (Akhondzadeh et al., 2001).

A variety of remedies are also available for allergies (Davies & Katelaris, 2014). Specifically, for the common pollen allergies, the simple but effective age-old practice of regularly flushing allergens out of the nose with salt water can be helpful (Hermelingmeier, Weber, Hellmich, Heubach, & Mösges, 2012). Modern nasal sprays for allergies contain relaxing essential oils as well as sinus-clearing salt solutions. Alternatively, sprinkling eucalyptus into a daily bath or shower, or even the hand basin when you brush your teeth, can provide a natural steam clean for the sinuses at the same time as being relaxing (Kim, Seo, Min, Park, & Seol, 2014; Lee, Wu, Tsang, Leung, & Cheung, 2011). Some anxiety sufferers also find relief from chest tightness with cough drops containing menthol, while at the same time benefitting from them as a decongestant for their allergic reactions (Eccles, 2003).

Anxiety and allergies can place a serious strain on the body, and fighting back against free radical production and inflammation with high-dose antioxidants can help restore energy (Gautam et al., 2012; Salim, Chugh, & Asghar, 2012). The antioxidant, Nutralife’s Enzogenol (a New Zealand pine bark extract), has been reported to be effective in this regard; it is 20 times stronger than vitamin C and 50 times stronger than vitamin E (Frevel, 2006; see also the literature references to Enzogenol here: http://www.enzogenol.com/Default.aspx?page=1162). As zinc deficiency has been associated with the development of anxiety and allergies, supplementation may also be required (Ozdemir, 2014).

With regard to psychological treatment for anxiety, reestablishing a sense of control and confidence-building are important elements of any program––with hypnosis, meditation, mindfulness training, and systematic desensitisation often used for this. Adding heart rate biofeedback training (Tabachnick, 2015) can enhance these techniques by providing immediate feedback on the effectiveness of the practice.

At the same time, the American Psychological Society now advocates heart rate biofeedback training for allergy-induced asthma as well as anxiety (20).

References
Akhondzadeh, S., Naghavi, H. R., Vazirian, M., Shayeganpour, A., Rashidi, H., & Khani, M. (2001). Passionflower in the treatment of generalised anxiety disorder: A pilot double-blind randomised controlled trial with Oxazepam. Journal of Clinical Pharmacy and Therapeutics, 26, 363–367.
Annesi–Maesano, I., Beyer, A., Marmouz, F., Mathelier–Fusade, P., Vervloet, D., & Bauchau, V. (2006). Do patients with skin allergies have higher levels of anxiety than patients with allergic respiratory diseases? Results of a large-scale cross-sectional study in a French population. The British Journal of Dermatology, 154, 1128–1136. doi:10.1111/j.1365-2133.2006.07186.x
Billioti de Gage, S., Moride, Y., Ducruet, T., Kurth, T., Verdoux, H., Tournier, M., . . . Bégaux, B. (2014, September 9). Benzodiazepine use and risk of Alzheimer’s disease. BMJ, 349, g5205. Retrieved from http://www.bmj.com/content/349/bmj.g5205
Cohen, J. (2013, November). Breathing easier. Monitor on psychology, 44. Retrieved from http://www.apa.org/monitor/2013/11/breathing.aspx
Davies, J., & Katelaris, C. (2014, November 17). Hay fever survival guide: Why you have it and how to treat it. UQ News. Retrieved from https://www.uq.edu.au/news/article/2014/11/hay-fever-survival-guide-why-you-have-it-and-how-treat-it
Eccles, R. (2003). Menthol: effects on nasal sensation of airflow and the drive to breathe. Current Allergy and Asthma Reports, 3, 210–214.
ENZO Nutraceuticals Ltd. Enzogenol research papers. http://www.enzogenol.com/Default.aspx?page=1162
Frevel, M. (2006). Enzogenol: Three-part scientific review. Managing oxidative stress in disease—professionally. Part 1: Oxidative stress in inflammation. Retrieved from http://www.enzoprofessional.com/Editable/Assets/patient%20handout/oxidative%20stress%203%20part%20science%20review.pdf
Gautam, M., Agrawal, M., Gautam, M., Sharma, P., Gautam, A. S., & Gautam, S. (2012). Role of antioxidants in generalised anxiety disorder and depression. Indian Journal of Psychiatry, 54, 244–247. doi:10.4103/0019-5545
Hermelingmeier, K. E., Weber, R. K, Hellmich, M., Heubach, C. P., & Mösges, R. (2012, September–October). Nasal irrigation as an adjunctive treatment in allergic rhinitis: A systematic review and meta-analysis. American Journal of Rhinology and Allergy, 26, e119-125. doi:10.2500/ajra.2012.26.3787
Kiecolt–Glaser, J. K., Heffner, K. L., Glaser, R., Malarkey, W. B., Porter, K., Atkinson, C., . . . Marshall, G. D. (2009). How stress and anxiety can alter immediate and late phase skin test responses in allergic rhinitis. Psychoneuroendocrinology, 34, 670–280. doi:10.1016/j.psyneuen.2008.11.010
Kim, K. Y., Seo, H. J., Min, S. S., Park, M., & Seol, G. H. (2014). The effect of 1,8-Cineole Inhalation on Preoperative Anxiety: A randomised clinical trial. Evidence-Based Complementary and Alternative Medicine, 2014, 82016. Retrieved from https://www.hindawi.com/journals/ecam/2014/820126/
Lee, Y. L., Wu, Y., Tsang, H. W., Leung, A. Y., & Cheung, W. M. (2011). A systematic review on the anxiolytic effects of aromatherapy in people with anxiety symptoms. Journal of Alternative and Complementary Medicine, 17, 101–108. doi:10.1089/acm.2009.0277
Ozdemir, O. (2014). Zinc and allergy relation. MOJ Immunology, 1, 00005. Retrieved from http://medcraveonline.com/MOJI/MOJI-01-00005.php
Salim, S., Chugh, G., & Asghar, M. (2012). Inflammation in anxiety. Advances in Protein Chemistry and Structural Biology, 88, 1–25. doi:10.1016/B978-0-12-398314-5
Sansone, R. A., & Sansone, L. A. (2011, July). Allergic rhinitis: Relationships with anxiety and mood syndromes. Innovations in Clinical Neuroscience, 8, 12–17. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3159540/
Santana, L., & Fontenelle, L. F. (2011). A review of studies concerning treatment adherence of patients with anxiety disorders. Patient Preference and Adherence, 5, 427–439. doi:10.2147/PPA.S23439
Tabachnick, L. (2015). Biofeedback and anxiety disorders: A critical review of EMG, EEG, and HRV feedback. Retrieved from https://concept.journals.villanova.edu/article/view/1831/1735
Ten commandments of the allergy-friendly home. (2014, July 30). Retrieved from http://www.bosistos.com.au/blog/essential-oil/ten-commandments-allergy-friendly-home

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