By Carissa Weber
Talking to people over the years, anxiety has presented itself and so many ways. For some, it is the ice cold sweats and the inability to move. For others, it is as perfectionistic drive and thoughts that race a million miles a second. No matter the case, anxiety is something that all of us have struggled with at least once in our life. The official stats at the Anxiety and Depression Association of America indicate at least 40 million people worldwide have anxiety (that is a lot of people!). Personally, I think this number is highly underestimated.
In this post, we are going to talk about what anxiety really is, and why it exists in our brain. We’ll take the time to look over there at the mechanics all of it and why it just makes sense in certain cases.
When you first hear the word anxiety, what comes to your mind? Merriam-Webster Dictionary defines Anxiety as: a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome (1828). If you read the last two posts, Neurotransmitters: The Language of the Brain and Fight-Flight-Freeze: The Ultimate Coping Skill, they did a great job in outlining the chemicals in our brain responsible for increasing distress (big shout out to adrenaline and noradrenaline). It also outlined the role of the amygdala in distress and the triple F response. Let’s take it one step further, and explore the role of that darn amygdala (and the rest of the limbic system) in anxiety.
Let me start off first by saying an anxiety response is very similar to the triple F response. It is not however, as intense as the fight – flight – freeze response (We will get to the differences between the two in a bit). The anxiety response starts in the same way: by our senses provide our limbic system with information and that darn amygdala interpreting that information is potentially stressful. In turn, the amygdala sends an S.O.S. through the thalamus to the hypothalamus. Once the hypothalamus receives the S. O. S. message, it informs the adrenal glands to release adrenaline and noradrenaline. At the very same time, the hippocampus reacts to the message of stress being received and activates itself. As you may remember, the hippocampus helps with emotional regulation (and assists in the release of the neurotransmitter glutamate, which also helps with memory). This is where the triple F response starts to break away from an anxiety response.
In anxiety, it is been noted in several studies (including a study by neuroscientist Joseph LaDeoux) that the prefrontal cortex is much quieter and less active in someone who has anxiety. LaDeoux found in mice with anxiety the amygdala is hyperactive and overly sensitive to any sort of stimulus coming from our senses. With that darn amygdala being so loud, so impulsive (and so annoying might I add) it decreases the reuptake of serotonin to the prefrontal cortex. What does that do? It essentially puts duct tape over the prefrontal cortex’s mouth and allows the amygdala to run rampant, kind of like a three-year-old on a sugar high. Now if we compare this with the triple F response, there is still some prefrontal cortex activity happening. Although the prefrontal cortex is quiet, it is still able to identify and agree with the amygdala that you are in danger and the fight – flight – freeze response is needed for survival.
What is really interesting, is with the triple F response, we can almost always blame that darn amygdala. When it comes to anxiety and nervousness (which is different than fear might I add) it starts in a new part of our brain called the bed nucleus of the stria terminalis (or BNST for short).
What is this BNST? This gland of the limbic system is located on top and either side of the amygdala. It plays a hand in emotional regulation, attachment (oxytocin likes to hang out here), and bodily functions. When it comes to feeling anxious or nervous, the BNST intercepts information before the amygdala can (I know, that is super fast) and detects if it is something that needs that extra spark of anxiety. This gives that darn amygdala all the incentive it needs to keep sending out the message that something isn’t right (the BNST and amygdala are best friends in that department). Despite the fact that science knows about the BNST and its basic role, how it works is still fairly unknown. Really all that is known is when we are anxious and/or nervous (like waiting for test results to back, or the repair bill on your car) it is way more active than that darn amygdala.
One thing that is known is the BNST is that it seems to help the thalamus completely bypass the prefrontal cortex, which allows our worries and anxiety to ruminate. This is because the BNST can identify more activation cues for anxiety (better known as emotional triggers) than controls for the anxiety. Can’t stop thinking about how crappy the news is lately? Worried about how bad that utility bill will be? Preoccupied with what you have to make for dinner? That is because the hypothalamus has told the adrenal gland to trickle cortisol versus dumping in like in the triple F response. That slow trickle is enough to keep the prefrontal cortex guessing what it should really be doing and that darn amygdala large and in charge of running the show.
When anxiety, nervousness, or worry are present, the hippocampus tries really hard to regulate them by recalling positive memories. Since the prefrontal cortex is out of loop of regulating these emotions, the hippocampus is taking a big leap in trying to fill in. By doing so, the hippocampus releases GABA and glutamate (the neurotransmitters responsible for calming us down and recalling those memories) to decrease those emotions. Does it work? Not always. That stream of cortisol kind of allows the adrenaline and noradrenaline to keep flowing and blocking the brain’s ability to take in those feel-good neurotransmitters, along with serotonin and oxytocin. As that continues to happen, the hippocampus’ ability to recall memories decrease (that is why your memory sucks when you are anxious!). Science also thinks this is why the hippocampus is smaller in the brains of people with chronic anxiety and PTSD (Avery, S. N., Clauss, J. A., & Blackford, J. U., 2016).
What does this mean for your body’s physical response? Like I mentioned in last week’s post, Fight-Flight-Freeze: the ultimate coping skill, the release of cortisol, adrenaline, and noradrenaline impacts our body in the following ways:
- Rapid heart beat
- muscle tension
- increased respirations
- stomach and digestive upset (yes, it is common to feel nauseous and perhaps even experience increased gas and diarrhea)
- struggling with memory and recalling events
- feeling “on edge” (you know, like you just downed a whole pot of coffee and are now angry at everything for no identified reason)
- A decrease sensation of pain
There is another way people react to anxiety. For some, their triple F response kicks in and they like to avoid what is causing the anxiety. Ever procrastinate? Avoid returning texts or emails? Some people are more prone to shut down and flee from their anxiety as a protective mechanism. For others, they may feel “amped up.” If you are like me, I find myself making more lists, taking on more projects, getting stuff done. Some people dare to call me a perfectionist, a go-getter, and even ambitious. These traits come from my darn amygdala (and maybe your amygdala as well) as it tries to fight the situation and gain control.
Now that we have an understanding of how anxiety happens in the brain, lets take some time to honor what starts the anxiety outside the brain. Known as triggers, these events are what kickstarts the whole anxiety process.
Sometimes, we are able to identify those triggers right off the bat. For example, if you are someone who gets really nervous before a test or getting an email from your boss. These, along with triggers that happen outside of your control, are known as external triggers. These external triggers are things we have no control over, despite our senses telling us we should have control over them. Here is a list of some other common external triggers you may face (this list isn’t all inclusive):
- A large social gathering
- Deadlines at work/school
- medical concerns (hormone imbalances, thyroid conditions, blood sugar changes, blood pressure changes, digestive issues, the list can continue)
- Poor diet/not eating when you body asks for food
- Employment changes (for better or worse)
- Changes in relationship status
- Seeing/smelling something/one that reminds you of a traumatic event
- Financial changes
- Poor sleep
- Car troubles
- Being stuck in traffic
Some external triggers can be in our control as well. Maybe you decided to get a late cup of coffee to help you finish a project. That increase in caffeine can mimic and increase feelings of anxiety. Perhaps you procrastinated until Sunday night to do the laundry and now are frantically trying to get clean clothes for the week. Could it be you chose to use substances (legal or not) to try to relax (recreationally or self-medicating)? Withdrawal symptoms, cravings, and even overusing them can lead to a spike in anxiety.
There is a such thing as internal triggers for anxiety. Internal triggers are things that are happening INSIDE our brain. You got that right: the emotions and thoughts rolling around in our head can trigger anxiety. Feeling anger and keep replaying an argument with a friend? Internal anxiety trigger. Feeling less than confident about that job interview? Internal trigger! Feeling ashamed about eating that whole box of Oreos? You got it, internal trigger. The emotions and thoughts we hold on to can shape our anxiety experience. Even if we cannot pinpoint or identify our own brain is creating the anxiety, it still plays a big role in it. Here is a list of some of the internal triggers we face on a daily basis:
- Unhealthy self-esteem
- Comparing ourselves to others
- Constantly talking negatively about ourselves
- Ruminating about what we wished we could have said/done
- Feelings of inadequacy/not being good enough
Half the battle of challenging our anxiety is knowing how to recognize when it is happening. In my experience as a therapist, many people identify when the anxiety is in a full-fledge amygdala-taking-hostages situation, but not when it is starting.
Coping Skill Alert!
Taking time during your day to do an emotional check-in with yourself to identify both the physical and emotional feelings you are having is a great start to learning about your anxiety. By keeping track of those feelings on the daily for a few weeks (yes, 2-3 weeks), you can learn about your external and internal triggers. Once you know your triggers, you can start to implement changes that actually work! Now, journaling doesn’t have to be all fancy and long-winded. it can be as simple as listing the feelings/thoughts you are having. If you would like, here are some prompts to use to help get your journaling adventure going:
- What thoughts keep popping up in my brain?
- What is my body feeling right now?
- What events are going on around me right now?
- These things trigger my anxiety today…
- When was the last time I felt like this?
- Is there anything I’m holding on to that isn’t helping me?
- What changes (good or bad) happened today?
Journaling helps with anxiety in several ways. First, It allows your prefrontal cortex to take inventory and rip off that duct tape that darn amygdala put over it’s mouth. This translates to your prefrontal cortex increasing its problem-solving abilities and a decrease in impulsivity in that darn amygdala. Journaling can increase the communication between these two parts of the brain, hence reducing anxiety. Second, journaling is an outlet that releases serotonin (true story, check out Simon Young’s Article How to increase serotonin in the human brain without drugs). I want to challenge you to give journaling your feelings/thoughts a try and see what things pop up as anxiety triggers. You may surprise yourself.
Wow! So much information for such a little post! I want to thank you for investing in yourself and reading this post. Hopefully you have a better understanding why you’re brain does the many things (rational or not) it does. In my next post, I will be going over more of how healthy coping skills impact Mental Health. I know that this is the post that many of you are looking for! I want to thank you all for your patience as I build up the information, and the case, for why coping skills are working in our brain! Next week, you can look forward to learning about “amped up” anxiety and “shut down” anxiety, as well as a few coping skills to help challenge that darn amygdala into calming itself down.
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- Author Unknown. www.supportadaa.org. Date viewed April 13, 2021
- Avery, S. N., Clauss, J. A., & Blackford, J. U. (2016). The Human BNST: Functional Role in Anxiety and Addiction. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 41(1), 126–141. https://doi.org/10.1038/npp.2015.185. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677124/
- Greenberg, Melanie (2019). Understanding Brain Circuits of Fear, Stress, and Anxiety. Retrieved from https://www.psychologytoday.com/us/blog/the-mindful-self-express/201909/understanding-brain-circuits-fear-stress-and-anxiety
- Grinwis, Summer (2019). 30 Journal Prompts for Anxiety and Depression. Retrieved from 30 Amazing Journaling Prompts Anxiety and Depression – (thesunshinesuitcase.com)
- Merriam-Webster Dictionary (1828). Retrieved from https://www.merriam-webster.com/dictionary/anxiety
- Owens, Becca (date unknown). How to Recognize and Overcome Triggers for Anxiety. Retrieved from How to Recognize and Overcome Triggers for Anxiety | Talbott Recovery (talbottcampus.com)
- Tams, Lisa (2020). Journaling to Reduce Covid-19 Stress. Retrieved from Journaling to reduce COVID-19 stress – MSU Extension
- Young, S.N. (2007). How to increase serotonin in the human brain without drugs. Journal of Psychiatry & Neuroscience: JPN, 32(6), 394-399. Retrieved from How to increase serotonin in the human brain without drugs (nih.gov)