Calming yourself down is easier than you think.
In last week’s column, I shared the four successive clinical stages of anxiety: a perceived threat, the feeling of fear and worry, the attempt at avoidance and the final long-term, ingrained anxiety disorder.
Today, I would like to describe what happens to our bodies and our brains when anxiety hits us. If last week’s column was the “why,” today’s column is the “how” of anxiety.
The human body has an excellent “fight or flight” response when confronted by a threat. I would add a third response: fight, flight or freeze, since anxiety can also make us become socially isolated and emotionally frozen.
The specific brain structure that determines that something is fearful and a threat is called the amygdala. It also interacts with the motor aspects of the periaqueductal area of the brain, telling us we should flee.
At the same time, parts of our endocrine hormone system (the hypothalamus, pituitary and adrenal glands) release cortisol, called the “stress hormone.” Continued activation of cortisol has negative short- and long-term effects. These include impaired cognitive functioning, increased blood pressure and a decreased life expectancy.
Anxiety disorders with a strong “worry” component, such as an obsessive-compulsive disorder, may have a slightly different brain circuit of action than other anxiety disorders.
It is interesting to note that the section for “obsessive-compulsive and related disorders” is separate from, and follows, the section on “anxiety disorders” in psychiatry’s latest edition of its diagnostic manual, the DSM-V. In everyday clinical practice, an anxiety disorder is often diagnosed with depression and/or a second anxiety disorder.
What are some of the brain’s neurotransmitters that are involved with anxiety?
GABA (gamma-aminobutyric acid) is an important neurotransmitter that inhibits and regulates the amygdala. GABA is also an important ingredient in medications, such as benzodiazepines, used to treat anxiety.
Benzodiazepines are used by 5 percent of the general population and by 10 percent of elderly…