Managing Anxiety

Anxiety always results from a specific and consistent pattern of thinking. We become increasingly anxious when we anticipate some calamitous future event. Thoughts and fantasies of the future event trigger the amygdala, the part of the brain largely responsible for the "flight-fight" reaction. Adrenaline and cortisol and other preparatory substances are released into the blood; our blood pressure rises, our muscles tense, our breathing becomes more shallow and quick and our heartbeat becomes more rapid. Our bodies ready themselves for action.

Some sudden stimuli can trigger the amygdala directly without passing through the cognitive parts of the brain. Infants show a "startle response" to a loud noise, for instance. The majority of our anxiety, however, arises through conscious thought processes involving imagining a future event which we expect to be severely unpleasant. We see an object in a stranger's hand; we become anxious only when we identify the object as a "gun" and imagine the uses to which the person might put the gun. The same events taking place on a target practice range would generally produce much less anxiety, because we have assigned a different meaning to the gun and thus different outcomes. We could hardly become anxious at all if we had never seen a gun nor knew what it was. We can learn to recognize and to anticipate danger even in novel forms, which undoubtedly promotes survival.

Once we have imagined the future catastrophe our anxiety rapidly increases. The rate and degree of increase depend partially on the catastrophe we have imagined, and partially on biological and congenital factors that govern how strongly or quickly the amygdala responds. Some infants have more pronounced startle reactions than others, for instance. The same stimulus and fantasy may thus cause very different amounts of arousal in different people.

Our anxiety and arousal have now focused our brains on what may be a survival issue. One can imagine that early humans who did not focus on the future calamity and who went back to sleep or who froze like a deer in the headlights of a truck probably did not become our ancestors. Survival requires that we focus on the calamity and make a plan to deal with it. Once we have done this our anxiety drops at least somewhat and becomes manageable. Our plan lets us know what to do when and if the catastrophe happens.

However, in people who are biologically easily anxious, whose amygdala is perhaps over-responsive, the anxiety may rise to a degree that clear thinking becomes difficult or impossible. Such people may find it difficult to make a plan at all. They may find it difficult to tolerate imagining all the elements of the anticipated catastrophe because the very attempt to do so increases their anxiety beyond tolerance. Having been unable to make a plan, the brain seems to keep the calamity on a "to-do list" with a high priority, which means the catastrophe is re-imagined frequently. Each time it is re-imagined the process is cut short before the person can consider the elements in the catastrophe and develop a plan. The resultant anxiety and arousal thus can’t get resolved; the person attempts to limit the anxiety not by finding a solution or plan but by trying to avoid thinking about the problem altogether. However, lacking closure, the catastrophe is still on the "to-do list" and is brought to conscious attention again and again, resulting in chronic anxiety.

What I observe in chronically anxious people is a pattern of thinking about noxious future events that constitutes a kind of short-hand, a mental image or word that points to the catastrophe without directly invoking it. For example, when a car cut dangerously close to me on the highway at high speed, my reaction was sudden fear; I didn't imagine the potential catastrophe in any detail. The expletive that leapt to my lips in effect "stood for" the imagined disaster. As a result I decided to slow down and keep a little more distance. Even my limited plan was sufficient to reduce my anxiety somewhat.

Chronic anxiety is not a good thing. It's hard on us physically as well as mentally. It actually interferes with problem solving and may reduce our long-term survival raters. It certainly reduces our quality of life. Mark Twain said, "My life has been full of tragedies, most of which never happened". Chronic anxiety can be reduced by medication, but a more long-term solution is to recognize the importance of thinking through the elements of the catastrophe in spite of the discomfort and making a plan to deal with it. Anxiety itself is a normal function of the brain. Stopping anxiety through medication would not help us survive. There are dangerous problems and \dangerous people in our world, and we need to be wary of them. And it's best to have a plan.

Panic is another issue entirely and requires a different approach. Ask me if you want information.