Anxiety can mean many things: it can be an emotion, feeling or it can be cognitive like anxious thoughts or as diagnosed illness. Anxiety can be thought of as the brain foreseeing problems and coming up solutions for them, a protective anticipation circuit. In other words anxiety is the future-focused mind. That’s why videogames and other distractions can feel so good for people suffering from anxiety, it essentially forces the mind to live in the moment for some time. That is also why meditation (Dr K’s Guide - Meditation) is so helpful with anxiety.
Sources of anxiety are mental and physical. Cognitive anxiety is centered around fears and insecurities about future, usually originating from early life. Physiologic anxiety is how the body and brain literally create anxiety, adrenaline surge, cortisol increase, sweaty palms, slightly cramping stomach, nauseous feeling. Adrenaline makes thoughts very black or white, all or nothing. Cortisol is a long term stress hormone that changes the reticular activating formation which prevents sleep and relaxation.
- Anxiety is our natural ability to foresee future consequences, so that we can make adjustments to protect ourselves
- Anxiety is also ego-centric, or relates to our sense of identity or insecurities (samaskaras) that we hold
- Anxiety flourishes due to our inability to face the uncertainty of the future
Our mind tends to deal with anxiety in four ways:
- Distraction
- Activities that bring us into the present: videos, videogames, movies, books
- Temporary relief
- Control uncertainty via avoidance
- Without doing anything there is no possibility of uncertain or unpleasant outcomes
- Kind of paralyzing
- Remove uncertainty via reassurance
- Asking others opinions
- Asking indirect questions to avoid directly tackling what we want
- Fighting the anxiety
- Trying to overcome anxiety by just doing what is causing the anxiety because that is what rationally feels correct
Actual solutions:
- Meditation
- Exploring, observing and being aware of where and how the anxiety comes from
- Surrendering to the outcomes that the anxiety is trying to prevent, kind of “so be it, bring it on” mindset
- Focus on action not the outcome as explained in Dr K’s Guide - Meditation
Clinical Anxiety Disorder
Everyone has capacity for anxiety and it is healthy to experience it in some extent. It becomes a disorder when the mind becomes overblown and every future becomes a catastrophe instead of a possibility of a catastrophe, impairing daily function by preventing action, interfering with sleep and so on.
There is a robust system of personality analysis called the Five Factors Model which describes human personalities in five dimensions. One of those dimensions is neuroticism, the tendency to worry.
Neuroscience of Anxiety
Fear is about present danger, danger that is already realized. Fear circuitry is about dealing, usually running away from, danger. Anxiety is about possible danger. Anxiety ciruitry then is about prevention and avoidance of possible danger.
Fear is generated in the central nucleus of our amygdala. When that region is destroyed, anxiety can still be experienced but fear response is diminished greatly. When the amygdala activates, the response is very short in duration, moments, minutes or couple of hours at most.
Anxiety comes from bed nucleus of the stria terminalis or BNST. BNST is future thinking, predicting danger, doing GABA projections. Alcohol activates the GABA system, the calming system in the brain. BNST has a more sustained duration for longer periods.
Medial prefrontal cortex or MPFC regulates attention, affective info processing and emotional info processing. MPFC allows us to restrain and direct our attention. In the case of thought loops, there is almost like a war between BNST and MPFC and MPFC is losing.
Hippocampus is where memories are formed and stored, it provides contextual info in environmental circumstances, so it is where learned experiences are.
Some SSRIs (More info in Dr K’s Guide - Depression) affect the BNST or inhibit it are anti-anxiety medications.
Treatment
Similar to depression (Dr K’s Guide - Depression) medications help to alleviate but not cure anxiety. They maybe permanently needed for people whose neurochemistry really is imbalanced, but for most the root causes for anxiety are more psychological.
Psychotherapy comes in different forms:
- Psychodynamic therapy - traditional talk therapy, exploratory and deep in nature, takes a long time to be useful, but in the end very likely to lead to changes. Highly variable depending on each person.
- Cognitive behavioral therapy - focused on thoughts, emotions, and behaviors and how they all influence each other. Emotions lead into thoughts and thoughts affect behaviors. Very organized and protocolized in nature. Is more standardized, not as individual in approach.
- Psychotherapy with spiritualism (like dialectical behavioral therapy) - like psychodynamic therapy but not only relying on science, focus on spiritual and meditative aspects.
Breathing and Mind
Studies show that breathing affects the mind and vice versa. Breathing slowly will calm you down, breathing fast will make you feel more anxious. Similar effect can be seen with facial expressions. Just reminding yourself to relax your facial muscles can help a little towards calming yourself down.
The Attachment Theory
According to attachment theory, the way in which caregivers respond to our needs leads to the how our brain wires to be more or less anxious. If caregivers are responsive, the world makes sense and is an orderly and safe place. If caregivers are intermittent or neglectful towards us, our brain wires to view the world as a dangerous place, leading to greater anxiety.
Attachment theory has an experiment for attachment types: Starts with an infant, one year old, mom is nearby. Mom then leaves the room and a stranger enters it, keeping distance from the kid. Then the mom comes back into the room and kids can have different reactions:
- Secure attachment - calms down quickly “nothing to worry about, I got freaked out, but now mom is back so all is well”
- Insecure attachment - continues to cry, gets clingy, tries their best to keep the mom around
- Anxious ambivalent attachment - wants to be comforted but gets angry or violent at mom for putting them in this situation
- Avoidant attachment - kind of don’t care, independence
It comes down to mirroring, since a child really does not know how to analyze themselves. So they turn to their caregivers to figure out how they should respond to something. When the mirroring is consistent (same situations have same responses from caregivers) that leads to secure attachment. Inconsistent mirroring leads to insecure attachment, there is no stability to responses and situations. Anxious ambivalent attachment usually comes from unstable mirroring from a different sense, it’s when the response is consistent but intermittent. Avoidant attachment is the result of unavailable or “toughen up” style of responses.
Thought Loops
Thought loops are when our mind goes down a chain of thinking and then loops back to the beginning. Thought loops can be very exhausting and unproductive when one is not able to control or stop them.
The mind is like any other organ or organism that wants to keep living and being active. Since it primary task is thinking, this is what it wants to preserve and keep doing. Thoughts are like food and bordom is like starvation to the mind. Thought loops are like the perfect food for the mind since they never end, it is very easy to go from boredom to some premade loops.
Tension in the Mind
Bizarrely, some of the ways in which we try to fight anxiety can add energy to the mind, making the anxiety worse. Often it seems like there is two conflicted parts in our mind the anxious part and the logical part trying to rationalize it away. It seems like the harder you try to hit the harder it swings back and the worse anxiety becomes. Kind of like those days where “I really need to sleep” and being unable to sleep because of those thoughts becomes a loop.
The way to combat it is to actually accept the tension and approach it with compassion towards yourself. Instead of “why can’t I sleep already, c’mon” maybe something like “damn that’s though, I really am having some trouble sleeping, but that’s okay, maybe the sleep will come, maybe not.” The other way is of course meditation (Dr K’s Guide - Meditation), but this can be quite hard as it may also feed this tension.