We’re Never Stuck: A Guest Post by Ellen Vora
Anxiety is unpredictable, difficult to understand and, in many cases, mentally and physically crippling. Here at last is a comprehensive and nuanced look at how anxiety really works, as well as actionable takeaways to truly defeating it. Read on for an exclusive essay from Dr. Ellen Vora on writing The Anatomy of Anxiety.
Paperback $21.99
The Anatomy of Anxiety: Understanding and Overcoming the Body's Fear Response
The Anatomy of Anxiety: Understanding and Overcoming the Body's Fear Response
By Ellen Vora
In Stock Online
Paperback $21.99
From acclaimed psychiatrist Dr. Ellen Vora comes a
groundbreaking understanding of how anxiety manifests in the body and mind—and what we can do to overcome it.
From acclaimed psychiatrist Dr. Ellen Vora comes a
groundbreaking understanding of how anxiety manifests in the body and mind—and what we can do to overcome it.
The most critical idea I want readers to take from The Anatomy of Anxiety is that we’re never stuck. Over thirteen years in practice, I’ve witnessed countless people experiencing hopelessness and despair along their mental health journey. This suffering is needless, because we are not actually trapped in our conditions.
I believe my field has done us a disservice. Our limited menu of treatment options (medication, therapy) helps millions, but just as many people are left without adequate relief. We need to expand our approach.
I wrote The Anatomy of Anxiety because I realized we’ve been overlooking something crucial: mental health is often physical health. Much of what we consider to be intractable mental health conditions begins in the body and can improve as we support physical health. I call this “avoidable” or “false” anxiety. The suffering isn’t any less real, but its roots lie in physical imbalance that can be addressed.
Not all mental health is physical, of course—sometimes it’s unresolved trauma, socio-economic stressors, or our internal compass signaling misalignment. That last one is “purposeful” or “true” anxiety, which I explore in the second half of the book. True anxiety isn’t something to fix but something to listen to.
This insight about false anxiety crystallized while working with a patient I’ll call Maya, who came to me with generalized anxiety and panic disorder. Despite multiple medications and years of therapy, she remained highly symptomatic. When I asked about her understanding of her anxiety, she replied matter-of-factly: “I have a chemical imbalance. It’s just how I’m wired.”
This narrative—that mental health conditions result from genetic destiny and fixed wiring—is our least empowering story. Thankfully, it’s also inaccurate.
As a functional medicine practitioner, I approach mental health by resolving issues at their root rather than suppressing symptoms. While conventional medicine might prescribe an antacid for heartburn without addressing why stomach acid is leaking into the esophagus, functional medicine asks: “Why does this person have heartburn?” The diagnosis isn’t the final verdict but the beginning of an inquiry.
With Maya, we focused on healing her gut, improving sleep, reducing inflammatory foods, and adding healthy fats and proteins. Her panic attacks tracked precisely with blood sugar crashes, so we stabilized her blood sugar—and the panic stopped. Her decade-long irritable bowel syndrome resolved, coinciding with a remarkable improvement in her constant uneasiness. The remaining traces of anxiety faded when she transitioned off hormonal birth control, which many are sensitive to despite conventional medical opinion.
Maya’s anxiety improved even though her life circumstances hadn’t changed. Her symptoms weren’t inevitable “wiring” but “false anxiety” rooted in physical imbalance.
There are countless evidence-based environmental influences—sleep, inflammation, gut health, nutrition—that determine whether we’re anxious or thriving. Unlike our genes, we have control over these factors.
My hope is that this framework brings people empowerment, relief from unnecessary suffering, and most importantly, hope by revealing that so much of our anxiety is truly avoidable.
