Helping alleviate anxiety
Anxiety can be defined as feelings of unease, worry, and fear that can be mild or severe. Anxiety refers to both the emotions and the physical sensations a person might experience when they are worried or nervous about something.
The first thing to understand is that anxiety is created in two different parts of the brain. There’s the amygdala type of anxiety, where you’re staying alert and jumping at any dark shadow. And there’s the prefrontal cortex type of anxiety, where you start to worry about whether you left the hob on, or you left the cat in/out, or whether you locked the back door before you left by the front door.
Distressing thoughts are more likely to come from the left hemisphere because logical reasoning occurs in the left hemisphere. Rumination or brooding is where a person repetitively mulls over an idea. Rather than coming up with an answer to the problem, this continued dwelling on a problem strengthens the circuitry leading to anxiety (neurons that fire together, wire together – Donald Hebb.) The right hemisphere creates anxiety based on imagination and visualization. The amygdala can become highly activated when the right hemisphere creates frightening images. Vigilance – a general state of alertness – is also based in the right hemisphere. Your cortex may see something – an event – like ambulances dashing down the road. It will then interpret that event, eg someone at my house has been taken ill – and this will lead to the emotion of anxiety in the amygdala. It’s the cortex’s ability to predict future events that gives us this ability to feel anxious.
The left prefrontal cortex is where a person plans and executes actions. We can anticipate events positively or negatively. The left prefrontal cortex is where anxious apprehension comes from. If a person finds themselves picturing frightening scenarios, those scenarios are being produced by the right prefrontal cortex.
Your amygdala is stimulated to be anxious when messages arrive from the thalamus indicating that there may be some danger. It will then kick off the HPA (hypothalamus, pituitary, adrenal) axis – taking the body into fight or flight mode. And if it can’t do that, it may use the vagus nerve to produce the more primitive freeze response. Usually, the same messages reach the cortex, which then decides that the threat is no more than a plastic bag (or some other non-threatening item). It then tells to amygdala to stand down.
The amygdala is also stimulated by the anxiety messages coming from the cortex. These anxiety messages have been created by the cortex. The amygdala will then also initiate the HPA axis and a person will find themselves feeling very anxious without there being a definite cause, and nothing to fight against or runaway from. A stress response looks like:
Wanting to run away
Chills or hot flushes.
There are ways to overcome feelings of panic. If it’s coming from the amygdala: try deep breathing, muscle relaxation, and exercise. If it’s coming from the cortex: remember it’s only a feeling, don’t focus on the panic attack, try to distract yourself, and don’t worry what other people think.
Being relaxed can reduce feelings of anxiety. Good ways to relax include:
Slow deep breathing – inhale slowly, deeply, and exhale fully.
Diaphragmatic breathing (abdominal breathing) – this is thought to massage the internal organs. Place one hand on your chest and the other on your stomach. Take a deep breath. Your stomach should expand.
Progressive muscle relaxation – this involves tensing and then relaxing one muscle group after another. Start with your hands then up your arms. Next tense and relax your feet, and work your way up your legs. Finally, start at the top of your head and work down your face, into your neck, your shoulders, and stomach.
Visualizations – we probably know quite a few of these.
Meditation – you simply concentrate on your breathing. Every time your thoughts move away from your breathing, you bring your focus back to your breath.
Exercise – this affects the levels of noradrenalin and serotonin levels of the amygdala, making the receptors less active. It also stimulates the left pre-frontal cortex more than the right. This has been associated with a more positive mood (and that helps to reduce anxiety).
Sleep – getting the right amount of sleep helps people to concentrate and helps them remember things. It also makes the amygdala less reactive.
Avoid catastrophizing (thinking that everything is currently awful or everything is going to be awful).
Cognitive defusion – this technique originated with Steven Hayes. Basically a person acknowledges a thought exists without accepting it, eg saying: “ah, once again I’m having a thought about failing my driving test”. It’s a dissociative technique and allows a person to observe their cortex working.
Cognitive restructuring – this technique gives you a way to change your cortex. The key is to be sceptical of anxious thoughts and challenge them with evidence, ignore them, or replace them with new coping thoughts.
Plan rather than worry – if you’re anticipating something bad happening, don’t worry about the event happening, plan some solutions. So, if the event does occur, you can execute your plan.
Engage the left hemisphere – events such as watching comedy programmes, reading articles, playing games, or exercise reduce the dominance of the right hemisphere.
Engage the right hemisphere – listening to music or singing engages the right hemisphere, so it can’t be negative.
Mindfulness – this results in the cortex responding to anxiety in a different way. It activates the ventral medial pre-frontal cortex and the anterior cingulate cortex, which are the parts that have a direct connection to the amygdala.
Other useful information about anxiety includes:
A trigger is any stimulus (sensation, object, or event) that becomes associated with an emotional memory of a negative event. Whenever something triggers a response, the amygdala produces a fear reaction and a learned behaviour is initiated. This gets stronger the more times the trigger occurs. The lateral amygdala doesn’t look for cause and effect, only association between two events.
Cognitive fusion is where we assume that what we think is real actually is real. A common example is believing that a situation is dangerous because of a feeling that it’s dangerous rather than there being any evidence that there’s a threat.
New learning in the amygdala occurs in the lateral nucleus. This is where you can train your amygdala to respond differently.
Optimism is more associated with left pre-frontal cortex activation and pessimism is associated with right pre-frontal cortex activation.
The right hemisphere has a tendency to focus on negative visual or auditory information.
The more activity there is in the nucleus accumbens (found in the frontal lobes) – an area associated with hope, optimism, and anticipation of rewards and where dopamine is released – the more dopamine that gets released and the more optimistic a person is. Optimistic people are less anxious.
Worry arises in the orbitofrontal cortex. This is an area of the brain that allows us to make plans and exhibit self-control. If we focus mainly on negative outcomes, this becomes worry.
The anterior cingulate cortex can get stuck on certain ideas or images, and this contributes to worry.
Reference: Catherine M Pittman and Elizabeth M Karle. Rewire your Anxious Brain: How to Use the Neuroscience of Fear to End Anxiety, Panic and Worry. New Harbinger, ISBN-13: 978-1626251137
based on an article in AfSFH by T Eddols