How does anxiety work?

From Lifehacker.com.au

We all deal with anxiety in some form day to day. But anxiety can be a much stronger, more fearsome force for many people — one that never goes away. What is anxiety exactly, and what’s going on in your mind (and your body) when anxiety strikes?

Anxiety itself is a natural human response that serves a purpose. Our goal shouldn’t be to dismiss it entirely but to make it a healthy, manageable part of our lives. Even if you don’t suffer from an anxiety-related disorder, anxiety is part of our world, the same way stress, sadness and happiness are.

What Anxiety Is, and How It Differs from Stress

What Anxiety Does to Your Brain and What You Can Do About It

Anxiety is a sense of fear and apprehension that puts you on alert. Biologically, it’s designed to put us in a heightened sense of awareness so we’re prepared for potential threats. Unfortunately, when we start to feel excessive anxiety, or we live in a constant state of anxiety, we’re in trouble. Our bodies never turn off our fight or flight response, and we live with the physical and emotional effects of anxiety on a day-to-day basis, even when there’s no reason or cause for them.

On its face, anxiety can look like stress; but the reality isn’t so simple. Anxiety can arise as a result of stress, but stress can manifest in other ways. Stressors can make a person sad, angry, worried or anxious, while anxiety is specifically that feeling of fear, dread and apprehension we mentioned. You may never even know what’s causing your anxiety, or, in some cases, it can manifest on its own, without any real “trigger” or cause. Stress is often caused by external influences, while anxiety is an internal response. That’s part of what makes anxiety intrinsically different than stress, and also what makes it so difficult to manage.

What’s Actually Happening In Your Brain When You Feel Anxious

What Anxiety Does to Your Brain and What You Can Do About It

You know the feeling: That tense sensation in your stomach, the heightened sense of awareness you have about everything going on around you, the slight fear or sense of dread — that’s anxiety. Before your body feels the effects however, your brain is already at work. The National Institute of Mental Health guide to anxiety disorders also offers this description of the neurological processes at work:

Several parts of the brain are key actors in the production of fear and anxiety. Using brain imaging technology and neurochemical techniques, scientists have discovered that the amygdala and the hippocampus play significant roles in most anxiety disorders.

The amygdala is an almond-shaped structure deep in the brain that is believed to be a communications hub between the parts of the brain that process incoming sensory signals and the parts that interpret these signals. It can alert the rest of the brain that a threat is present and trigger a fear or anxiety response. The emotional memories stored in the central part of the amygdala may play a role in anxiety disorders involving very distinct fears, such as fears of dogs, spiders or flying.

The hippocampus is the part of the brain that encodes threatening events into memories. Studies have shown that the hippocampus appears to be smaller in some people who were victims of child abuse or who served in military combat. Research will determine what causes this reduction in size and what role it plays in the flashbacks, deficits in explicit memory and fragmented memories of the traumatic event that are common in PTSD.

The feeling of anxiety is part of your body’s stress response. Your fight or flight response is triggered, and your system is flooded with norepinephrine and cortisol. Both are designed to give you a boost to perception, reflexes and speed in dangerous situations. They increase your heart rate, get more blood to your muscles, get more air into your lungs and get you ready to deal with whatever threat is present. Your body turns its full attention to survival. Ideally, it all shuts down when the threat passes and your body goes back to normal.

Where Anxiety Comes from and Where It All Goes Wrong

What Anxiety Does to Your Brain and What You Can Do About It

The effects of stress are well understood, but where does anxiety come from? How do we know that it’s time to be “anxious”, and where is the line between “feeling anxious” and “suffering from anxiety”? We sat down with clinical psychologist Jeffrey DeGroat, PhD, and Roger S. Gil, MAMFT, to find that line.

Dr DeGroat explained that there are a number of psychological theories as to why anxiety exists. There’s the neurological (which we mentioned above), and the psychoanalytical, which describes anxiety as battle between the id, ego and superego. In this battle, he explains that “anxiety serves as a danger signal to an individual’s ego and/or superego that an individual is at an elevated risk to act upon an unacceptable id impulse. In the face of this anxiety, an individual’s ego and/or superego respond by attempting to manage an individual’s id impulses through elevated means.” Essentially, anxiety is a warning sign that you’re about to do something you may not want to. There’s also the cognitive theory, which suggests that anxiety arises when a person’s cognitive distortions, or irrational thought patterns, make them see everything as a physical threat, whether it’s an actual physical danger, an annoying coworker or a police officer on the side of the road. In behavioural theory, anxiety is a learned response due to exposure to frightening or stressful situations.

Regardless of which theory you subscribe to, it’s unhealthy when those instincts are turned on constantly. Your body’s stress response is something designed to be engaged when needed and disengaged; and constant anxiety keeps us alert and on edge all the time. Persistent anxiety, however, is a problem.

Gil explained that whether it’s caused by genetics or being brought up in an environment conducive to anxiety (as in, loud environments or parents and teachers who yell all the time), the problem emerges when your body and brain become “wired” to be on the lookout for potential threats that could come from any direction at any time, real or imagined. Anything that could cause an undesirable emotion, he explained, whether it’s fear, frustration, or doubt, could be a trigger for anxiety — and once you develop thinking patterns that reinforce every event in your life as a threat, it becomes a never-ending cycle.

Both gentlemen agreed that it’s an issue when you recognise that your anxiety doesn’t seem to go away, and you’re living with it on a daily basis. This is easier for some people than others though — if you’ve been suffering from anxiety for so long that it’s just part of your personal norm, you may not even recognise that it’s an issue, as Gil explains:

Many people have lived in an anxious state for so long that they don’t know any other feeling so they are unaware that they are suffering from persistent anxiety. Recognising anxiety isn’t easy in these types of situations however identifying its red flags is a good way to start. Are you pessimistic about the most innocuous situations to the point where it keeps you from taking risks? Do you find your mind racing to what possible negative outcomes there could be? Do you immediately attribute some external circumstance to a positive outcome that could be seen as the result of your efforts? If your answer is ‘yes’ to these questions, then you may suffer from persistent anxiety.

For some people, anxiety is situational. It’s normal to feel nervous at the prospect of having to speak in public. It’s not normal to feel anxiety about having a mundane conversation with your barista. Situational anxiety is one of those things that we can only overcome by confronting it. Generalised anxiety is something that can only be coped with by trying to rewrite the pattern of thinking that elicits it.

Regardless of whether you’re living with anxiety or suffering from an anxiety related condition, there are ways to deal with and lessen anxiety’s impact. It starts with recognising the effects of anxiety, and then learning the right ways to cope.

Dr Jeffrey DeGroat, PhD, is a clinical psychologist.

Photos by oliveromg (Shutterstock), sanguineseasFod TzellosQuinn DombrowskiM. DollyKarenAfrica Studio (Shutterstock), Supermac1961.

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