What Type of Anxiety Do I Have? The 6 Types from Panic Proof, with Dr. Nicole Cain (Part 2)
- 2 hours ago
- 9 min read
This is Part 2. Part 1 covers cardiac, gut, and thought anxiety.
A new mom went to her doctor. She was losing weight without trying. Her heart raced. Waves of panic arrived without warning.
Her doctor congratulated her on the weight and offered her something for the anxiety.
Her name is Charlotte, and Dr. Nicole Cain writes about her in Panic Proof. Charlotte had hyperthyroidism and Graves' disease. A benzodiazepine does nothing for a thyroid.
Her anxiety had been doing its job the whole time. It was a message from an organ.
That is the premise underneath all nine types. Anxiety is a signal, and the signal has a return address.
In Part 1 we walked through the first three. Chest, gut, and thoughts. In this episode we go through the remaining six.
Six body systems can each produce anxiety. Your nervous system, your hormones, your immune system, your mood chemistry, your anger, and stored trauma. Each one leaves a different signature. Sorting which system is speaking tells you what to check next.
WHAT TYPE OF ANXIETY DO I HAVE?
Start with the symptoms that arrive alongside the anxiety, because those point at the system producing it.
Anxiety on its own tells you very little. The company it keeps tells you a great deal.
Numbness and tingling point one direction. Weight changes and heat intolerance point another. Flushing and itching point at a third.
Dr. Cain built the nine types around that principle. Each type is a body system. Each system has a recognizable set of companions.
The sorting is the work. Once you know which system is speaking, you know what to bring to your doctor.
WHAT ARE THE SIX TYPES OF ANXIETY IN PART 2?
They are nervous system, endocrine, immune system, depressive, anger, and trauma anxiety.
Type | What it points to | What tends to travel with it |
Nervous System Anxiety | Overall autonomic state | Numbness, tingling, muscle stiffness, headaches |
Endocrine Anxiety | Thyroid, sex hormones, adrenals | Weight changes, heat intolerance, palpitations |
Immune System Anxiety | Mast cells, histamine, inflammation | Flushing, itching, allergy symptoms, poor sleep |
Depressive Anxiety | Neurotransmitters and gut chemistry | Despair, low self-esteem, negative self-talk |
Anger Anxiety | High energy fight activation | Irritability, restlessness, craving heat and spice |
Trauma Anxiety | Stored survival responses | Nightmares, flashbacks, avoiding places or people |
Dr. Cain is clear that these are working categories rather than diagnoses. They give you somewhere specific to look.
WHAT IS NERVOUS SYSTEM ANXIETY?
It is anxiety produced by the overall state of your autonomic nervous system, and it speaks through physical sensation.
Dr. Cain's checklist starts with numbness and tingling. People notice they cannot feel their face, or their lips, or their fingers. Many wonder about a stroke.
Get examined first. Then consider that your nervous system may be reporting.
She has seen it present as pain. One patient lost her vision temporarily during panic. That produced fear of the fear, and the loop fed itself.
Other markers are simpler. Shoulders that ride higher and higher. Muscles too stiff to reach your toes. Headaches.
I describe something close to this as global high intensity activation. The whole physiological state sits on high. Very little is then needed to tip someone into shutdown.
CAN MY HORMONES BE CAUSING MY ANXIETY?
Yes, and a lab panel is how you find out.
Charlotte is the clearest version of this. Six months postpartum, losing weight, heat intolerant, panicking. Her only labs were from the hospital.
Dr. Cain's guidance is a full thyroid panel at minimum. Sex hormones when the symptoms are new. Estrogen, progesterone, testosterone. Cortisol and adrenal markers where relevant.
Then she asks the question I care about most. Why is the endocrine system out of balance in the first place.
Environmental toxins. Genetic variants like a COMT SNP. The endocrine disruptors we handle daily, including store receipts.
Ask whether it could be endocrine. Then ask why, and work on the why.
CAN INFLAMMATION CAUSE ANXIETY?
Yes. Inflammation reaches the brain, and the brain produces anxiety in response.
Your immune system is part of how your body answers danger. Mast cells degranulate as part of that response. That is a normal piece of staying safe.
You can see it in people who flush when anxious, or get itchy. Allergy season arrives and sleep falls apart alongside it.
Mast cells release histamine. Histamine is also a neurotransmitter, and it drives adrenaline upward.
I see mast cells as carrying the footprint of stored trauma. When someone arrives with histamine responses, it makes sense to me.
Dr. Cain adds what she is seeing now. Spike protein accumulation. Activated microglia, the immune cells of the brain. Neuroinflammation sits at the center of this conversation.
WHY DOES AN ANTIHISTAMINE SOMETIMES CALM MY ANXIETY?
Because if histamine is driving the anxiety, lowering histamine lowers the signal.
Some people notice they feel calmer after a Benadryl or hydroxyzine. Dr. Cain reads that as information.
It suggests the immune system is involved in producing the anxiety.
The useful question follows immediately. Why is my immune system talking this loudly.
She starts with exposures. Handling receipts all day. Microwaving plastic. Frequent hair dye, and whether henna would work instead. Then genetics, and how well someone clears estrogens.
The antihistamine is a clue about mechanism. The work sits upstream of it.
CAN MY GUMS BE AFFECTING MY ANXIETY?
They can, because the mouth is a major source of immune activity.
This one surprises people. Dr. Cain points to gingivitis and periodontitis. Gums that bleed when you floss them.
Immune cells respond to those microbes. Those cells can cross the blood brain barrier. So can the microbes, and so can what the microbes produce.
Her instruction to clinicians is direct. Send an anxious client to the dentist.
We are describing whole body health here. Mood, mental health, teeth, gums, and blood flow belong to one system.
WHAT IS DEPRESSIVE ANXIETY?
It is anxiety sitting alongside low energy states, despair, and negative self-talk.
Dr. Cain opens with a caution about treatment. SSRIs share an enzyme pathway with dopamine metabolism.
Pushing serotonin availability up can leave dopamine low. Someone becomes more alert and more motivated with no feel-good underneath. That is part of why the black box warning exists.
The signs to look for are despair, low self-esteem, and negative self-talk.
Then she goes down the timeline. What was this an adaptation to. Something that happened, or something that should have happened and did not.
In my framework, depression sits in low energy trauma biology. A line has already been crossed. The work is finding when, and why.
WHAT IS ANGER ANXIETY, AND HOW DO I COOL IT DOWN?
It is anxiety running on fight activation, and the body responds to cooling rather than heat.
Dr. Cain frames it plainly. Anger of this kind is autonomic arousal to something, and it belongs to the fight response.
Her practical guidance is the most immediately usable material in the episode. The body leans toward whatever holds its current state. A system in fight mode craves heat.
So people reach for hot drinks and spicy food. That tends to make it worse.
Cool it instead. Ice water. Popsicles. Something effervescent. Peppermint, fennel, or wintergreen.
Swap the hot vinyasa for a swim. Slow the body down, cool it down, calm it down.
WHY AM I ANGRIER AS I COME OUT OF FREEZE?
Because the survival anger that carried you into freeze is still waiting, and it surfaces as you come back up.
This is the piece I most want you to hold.
Coming out of chronic functional freeze brings anger with it. That is normal. It is healthy, and it is the way back home to parasympathetic.
You went into overwhelm carrying anger at whatever threatened you. Freeze did not remove that anger. Freeze held it.
How dare you scare me like that. That kind of anger is ordinary, and it waits for you.
So the sequence can look confusing from the inside. Sleep improves first. Then a phase arrives with less sleep, more energy, more irritability.
That phase is pockets of stored trauma opening. It is movement.
CAN TRAUMA WORK CHANGE A CONDITION LIKE PMOS?
Sometimes, and Dr. Cain has watched it show up on objective testing.
She writes about a woman she calls Esme. Esme came in for panic and anxiety. She also had polycystic ovarian syndrome, now known as PMOS.
Esme had done everything asked of her. Antidepressants. Birth control. Every dietary change.
The opening came from the timeline. Her symptoms began in childhood, after a frightening moment when her father came home and hurt her.
Her stomach held it. Menstrual irregularities followed, then polycystic ovarian symptoms.
EMDR on that memory is what moved her PMOS.
Dr. Cain's point is what that demonstrates. Trauma work can repattern the endocrine and the immune systems. The change can appear on a lab result.
HOW MUCH OF THIS IS STORED TRAUMA?
All six types sit on Dysregulation, one of the five patterns stored trauma produces.
Dysregulation is a body swinging between too much and too little without finding the middle.
Disease often travels alongside it here. Graves' disease, PCOS, and inflammatory conditions belong to that second pattern.
Dr. Cain says it directly. All of this is trauma. She separates trauma anxiety as its own type because sometimes it is the loudest thing in the room.
The mechanism underneath is one thing. Your body adapted. The adaptation held. The system repeats what it adapted to.
Sequence matters. Safety comes before support, and support comes before expansion.
That is what the Foundational Journey is built for. It is the six week entry point, and it builds capacity for the year long work.
NOTABLE QUOTES
"And the question is, why is my immune system talking?" — Dr. Nicole Cain
"You don't have an anger problem. This is an autonomic arousal to something." — Dr. Nicole Cain
"EMDR shows us that doing trauma work can actually help the body re-pattern its endocrine system, its immune system." — Dr. Nicole Cain
"As you come out of a chronic functional freeze, you will experience anger, and that is normal, natural and healthy. That is your way back home to parasympathetic." — Dr. Aimie Apigian
IN THIS EPISODE
01:00 Nervous system anxiety, and what it feels like
02:53 A herb for a nervous system worn down by stress
03:42 Hormone anxiety, and the blood work to ask for
04:37 Charlotte, and the diagnosis behind her panic
07:17 Immune system anxiety and mast cells
08:35 Why an antihistamine sometimes settles anxiety
09:07 Post-COVID inflammation and activated microglia
11:33 The mouth, the gums, and the blood brain barrier
13:01 Depressive anxiety and what an SSRI can set off
17:07 Anger anxiety, and how to cool the system
18:57 Why anger rises as you come out of freeze
20:36 Esme, her PCOS, and what finally moved it
Resources/Guides:
Take the free 2-Minute Assessment for Stored Trauma. Discover your primary pattern of responding when life becomes too much, then see how the other four show up.
Read Panic Proof by Dr. Nicole Cain. All nine types, with quizzes and checklists.
Get The Biology of Trauma book. The biology underneath these anxiety types, and what the body needs to come back to safety.
Part 1: Why Do I Feel Anxious for No Reason? The 9 Types of Anxiety from Panic Proof. Cardiac, gut, and thought anxiety.
Related Podcast Episodes:
ABOUT THE GUEST
Dr. Nicole Cain, ND, MA, is a licensed Naturopathic Physician in Arizona. She holds a master's degree in clinical psychology and trained in EMDR. She is the author of Panic Proof, published by Rodale Books. Her work focuses on integrative approaches to anxiety, panic, and trauma.
RESEARCH
Nautiyal KM, Ribeiro AC, Pfaff DW, Silver R. Brain mast cells link the immune system to anxiety-like behavior. Proceedings of the National Academy of Sciences. 2008;105(46):18053-18057. doi:10.1073/pnas.0809479105. PMID: 19004805. Animal research. Brain mast cells are directly involved in regulating anxiety behavior, which places immune cells inside the circuitry that produces anxiety.
Won E, Kim YK. Neuroinflammation-associated alterations of the brain as potential neural biomarkers in anxiety disorders. International Journal of Molecular Sciences. 2020;21(18):6546. doi:10.3390/ijms21186546. PMID: 32906843. A review of how chronic stress produces systemic inflammation, how that inflammation reaches the brain, and how it alters the prefrontal and limbic structures involved in anxiety.
A note on this episode: This conversation includes a description of a child being physically hurt by a parent. It also discusses SSRIs, benzodiazepines, and specific herbs. Please take care of yourself while listening.
Disclaimer: By listening to this podcast, you agree not to use this podcast as medical, psychological, or mental health advice to treat any medical or psychological condition in yourself or others. This podcast is for informational and educational purposes only and does not constitute professional advice, diagnosis, or treatment. Always consult your own physician, therapist, psychiatrist, or other qualified health provider regarding any physical or mental health issues you may be experiencing, and before changing any medication, supplement, or herb.
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