We have a special treat for you today on Anxiety Connection.  I have had the honor of interviewing Doctor Nitin Sethi who is a neurologist and the Assistant Professor of Neurology at New York-Presbyterian Hospital, Weill Cornell Medical Center. I was primarily interested in asking Doctor Sethi about the role of anxiety in exacerbating or even causing other medical conditions and illnesses related to the brain. We talk about a “mind-body” connection in that emotions can play a huge part in how our body physically reacts to stress and anxiety. But can anxiety affect the physical brain as well?

Doctor Sethi helps to answer some of these questions based upon his medical knowledge as a neurologist who treats brain diseases.

Thank you Doctor Sethi, for sharing your expertise with those of us on Health Central and Anxiety Connection.

My first question is: What are some of the overall general physical or neurological reactions to stress and anxiety?

I feel stress and anxiety are omnipresent in today’s life. We encounter stress and anxiety provoking situations all the time. When we get sick, this stress and anxiety only increases. This is especially true when someone is confronted with a chronic debilitating disease such as multiple sclerosis. Unfortunately many neurological diseases such as multiple sclerosis, cerebrovascular accidents (ischemic stroke and intracranial hemorrhage), brain tumors (primary and secondary tumors), migraines, chronic pain syndromes (such as fibromyalgia and chronic fatigue syndrome), lower back pain due to herniated disks and amyotrophic lateral sclerosis (also called Lou Gehrig’s disease) strike in the prime of life. Patients are frequently afflicted in their 40s and 50s and many are left behind with severe and permanent disability.

Let’s talk about specific neurological conditions which can be affected by stress.

How about Multiple Sclerosis?

The disease usually first strikes a healthy person in his or her early 20s. The course of disease then varies. Some patients experience a relatively benign course with few attacks and no major disability while others are not so lucky and experience multiple attacks separated by time and incur increasing neurological deficits such as weakness, problems with gait and balance, tremors and urinary incontinence. Psychopathology such as anxiety and depression is well known in MS. For a long time it was felt that it was the increasing disability which led to patients becoming depressed and anxious. Many in fact attempted suicide. When the incidence of depression and suicide in patients with MS was compared to that of patients with another equally disabling condition such as chronic inflammatory demyelinating polyneuropathy (CIDP) which is a demyelinating disease of the peripheral nervous system something very interesting came to light. In spite of equal disability, MS patients still had a higher incidence of depression and anxiety. What does this tell us? It seems diseases like MS and epilepsy which affect different parts of the brain such as the temporal lobes are themselves associated with psychopathology such as anxiety and depression.