The Truth About Anxiety

The Truth About Anxiety

What I am about to say may come as a shock to you. But the truth is there is absolutely no level of chronic anxiety you have to live with. I know this may be hard to believe, particularly if you have struggled with anxiety for years or even decades. If this is the case, I definitely don’t want to diminish in any way the suffering you have experienced.
 
Perhaps, you have attempted numerous treatments only to be disappointed yet again. And no, it is not all in your head. Actually, nothing is ‘in your head’; it is in your body. Psychology is biology. There is no psychology outside of biology. Through what is known as affective (emotional) neuroscience, neurobiology, and interpersonal neurobiology we now understand what is occurring in the nervous system of those who are experiencing symptoms of anxiety.
 
Psychology has moved beyond archaic theories into science thanks to technology such as fMRI’s. This stands for functional magnetic resonance imaging. Through fMRI’s we are able to observe real-time activity in the brain and see what brain regions are associated with specific mental activity.
 
In my opinion, anxiety is not a disorder but a symptom of things in the brain that are disordered. The first step towards understanding how to overcome symptoms of anxiety is to realize what actually creates the symptoms in the first place, which is activation of what is referred to as the Sympathetic Nervous System, or better known to most as the fight or flight response.
 
This system is responsible for orienting us to threat or something important that needs to be attended to, as well as increasing and mobilizing energy to do so. At lower levels, it elevates focus and attention and triggers action. At the higher end of the spectrum, it initiates a fight against a threat or rapid flight behavior. It is meant to be time-limited to the situation. Once the event has been responded to, the brain then activates a parasympathetic response bringing us back into homeostasis (a state of balance).
 
The problem arises when the brain and nervous system become chronically activated into a fight or flight response. The result is a continuous release of adrenaline and cortisol, a stress hormone, into the blood stream. Moreover, blood sugar is elevated to provide energy for the threat. Again when this is chronic, it promotes fat storage and high blood sugar. There are various negative consequences both psychologically and physiologically that result from a prolonged stress response.
 
As just mentioned, elevated blood sugar and fat storage can contribute to obesity and diabetes. This is one factor that can impede your health and weight loss goals. Increased cortisol levels also have a negative impact on the immune system. During times of stress you not only become fatigued but tend to acquire illness easier and more frequently. Cardiac issues can arise from the strain on your heart to pump blood and oxygen to the larger muscles to prepare to fight or flee.
 
Constant adrenaline and cortisol release to the brain have a detrimental effect cognitively: both become neurotoxic to the brain. The part of the brain known as the hippocampus is associated with memory and the production of new brain cells known as neurogenesis. When epinephrine (adrenaline) and cortisol become neurotoxic, they attack the hippocampus and begin killing cells. This results in difficulty with memory, focus, and concentration.
 
My experience is individuals then become more anxious about the decline in cognitive abilities. Another way anxiety affects memory is by making it more difficult to be present. Anxiety is always related to something in the future, whether that’s thirty seconds or thirty years from now. To encode things into memory requires being present and focused. If you are chronically worried about the future, it is hard to move things from short to long-term memory.
 
In addition, the brain is designed to orient to threat. This has survival value; paying attention could save your life at times. To achieve this goal, the brain narrows your field of awareness to allow you to hyper focus on the perceived danger. This greatly decreases what your brain selectively attends to and eliminates aspects of your environment. Think of a stressful time when others recalled an event and you don’t even remember half of what they are talking about.
 
Returning to the SNS, if the symptoms of anxiety result from a chronic activation of the SNS then the remedy should be identifying and resolving what is causing this constant stimulation of the SNS. In some sense, it really is that simple. However, the complexity comes in the actual implementation of this goal.
 
The problem with treatment as usual for anxiety is the majority of them neither identify the source of what is activating the SNS or resolve it. The most common treatments for anxiety are medication and cognitive behavioral approaches. I will explain shortly why neither of these approaches will resolve the core issue long-term.
 
I am not opposed to a pharmacological intervention when someone is in severe distress. A segment of my clients probably would not be able to begin therapy if they had not stabilized with the help of medication. However, I would say on a percentage basis this would be less than ten percent of people who would require this. However, what I experience day-in-and-out are individuals who are prescribed anti-anxiety medications and given no long-term plan for how to address the root of their anxiety.
 
Often, both clients and physicians are complicit in this. It’s easy for the physician, and quite lucrative to the pharmaceutical industry. The gross revenues for anti-anxiety medications are in the billions. For clients, it’s a quick fix, and you don’t to do the hard work it takes to really resolve the issue. The problem in this approach is two-fold: medications only suppress the symptoms and do not resolve the source of the SNS activation; and you develop tolerance over time, which necessitates taking higher dosages that can lead to physical dependence. Furthermore, given a long enough time period, these drugs will lose their effectiveness and are capable of causing permanent cognitive impairment. This is one of the dirty little secrets of benzodiazepine use with drugs, such as Xanax, Klonipine, and Ativan.
 
Although a healthier option, cognitive behavior approaches will not create an adequate level of neuroplasticity to address the issue neurologically. I want to emphasize I am not saying these approaches do not have value, but they are more based around containment strategies. And when I explain why in the next paragraph, you will understand why they are not enough. Think of a time you may have had anxiety related to a speech or presentation you had to give. You may have told yourself positive affirmations and coached yourself up internally. But when you stood up in front of others, your heart raced, your mouth went dry, and you began to forget everything you were going to talk about.
 
The problem is based in how the brain works. One view known as, The Triune Brain Model, divides the brain into three primary layers: the reptilian brain, the paleomammalian brain, and the neocortex. Each of these areas of the brain has different ways of coping with stress and threat. Every interaction we have with the environment triggers an emotional reaction of some sort. This provides us with rapid information related to what is occurring around us and gives us energy to react to it.
 
When we cannot regulate this energy and release it into an effective action, it triggers either a need for attachment or a fight, flight, or freeze response. The brain interprets emotional dysregulation as a threat to survival in the same way it would register a physical danger. I won’t go into the whole process here as to why this is so, but it will cause a decompensation of our sense of self.
 
At this point, we have the option of reaching for support, fighting, fleeing, or freezing, which includes dissociation in some form. Chronic activation of the SNS is the result of either being in an environment in which there are ongoing threats or a history of having to use the primitive defense of dissociation, which occurs in the reptilian brain. When we have to dissociate, the brain splits off whatever level of energy we cannot manage, similar to a circuit breaker, to prevent cell death and nerve damage from the dysregulated energy.
 
Herein lies the problem, this part of the brain, which is low and right, has no sense of time and cannot distinguish between people, time, and place. Anything that is even remotely associated with the original incidents or events will trigger activation of the frozen implicit memory. As human beings, we have two primary types of memory: explicit and implicit. The explicit memory is conscious memory – the images we can pull up in our mind’s eye or the facts we memorize, etc. Implicit memory is a felt sense in the body; it’s the feeling that goes with the event.
 
 
These two types of memory are stored in different areas of the brain. Explicit memory is located in the hippocampus, while implicit memory is in a part of the brain known as the amygdala. The amygdala is also associated with triggering the fight or flight response. Think of a time when you overreacted to a situation. This is due to implicit memory being activated. It is confusing because you can’t see it only feel it.
 
As mentioned earlier, implicit memory has no sense of time; it feels like it is occurring right now even if it took place thirty years ago. Moreover, even if it is not activated in the present, it is spinning around somewhere in your nervous system resulting in either chronic anxiety or emotional numbness. If the level of intensity reaches a certain degree, this is what we would refer to as Post Traumatic Stress.
 
The reality is this, every type of chronic anxiety is a form of traumatic stress, even if it doesn’t meet criteria for PTSD. The reason you, or someone you care about, has not achieved full recovery from this is because the mental health system either diagnoses you with depression or anxiety and does not identify the underlying neurological cause of what is generating a chronic activation of the SNS or overactivation of the parasympathetic nervous system, which results in habitual dissociation and numbness. Medication will not address or resolve the issue only suppress your symptoms.
 
Again, I am not against medication as a stepping stone to recovery. However, I regularly have clients who have been on anti-anxiety or opiate-based medication for years. It is a travesty and in some cases blatantly unethical.
 
I have never had one client who did not experience full remission of their anxiety who completed the treatment plan we created together. Full recovery requires processing the implicit memories from the nervous system and addressing any hormonal or nutritional imbalances. Once the source of the activation of the nervous system is eradicated, the recurrent triggering of the SNS will stop. I can assure you of this fact.
 
Please don’t allow yourself or a loved one to needlessly suffer any longer from chronic anxiety. You do not have to live with it. We know more than at any time in human history how the recurrent symptoms of anxiety develop and how to put an end to them. My purpose in writing articles or speaking at events is to get accurate information out to those who are in dire need of it. If you found this article useful please forward it to anyone you believe could benefit from it and be a part of helping someone heal and break free from their struggle with anxiety. I thank you in advance for your help and support.

Boynton Beach Counseling Center
Gateway Counseling Center
1034 Gateway Blvd. #104
Boynton Beach, FL 33426
Phone: (561) 332-1818

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