How to Tame the Anxious Voice Within
Arthur Somers Roche once said, “Anxiety is a thin stream of fear trickling through the mind. If encouraged, it cuts a channel into which all other thoughts are drained.” If you’ve been affected by anxiety, you not only understand this quote, but you can viscerally feel it. If its owner doesn’t lead the mind, the mind will instead lead. If you’ve been diagnosed with anxiety disorder, your stream of thoughts, untamed as they are, often lead to an ocean of worry that defines your daily existence. Drowning in this ocean of worry, you no doubt crave a vacation on a mental island called peace, even if just for a few minutes.
According to the National Institute of Mental Health, anxiety is the most common mental health disorder in the U.S. affecting 40 million adults or 18% of the population. According to a study commissioned by the Anxiety and Depression Association of America, anxiety costs the U.S. 42 billion dollars a year, over one-third of the yearly U.S. psychiatric expenditure. The suffering that it causes each individual is immeasurable. Likely the result of the accompanying stigma, only one-third of those affected seek treatment. This stigma is unfortunate for two reasons. The first is that when balanced, anxiety can be a useful trait, otherwise it would not have survived evolutionary pressures. The second is that when the layers are peeled away, anxiety, as well as some other mental disorders, appear to be just as physical as other common diseases that are more “acceptable” to have.
Through evolution, we know that certain traits, if not beneficial to the human race, are typically weeded out. Those of us affected by anxiety have an ability, bordering on telepathy, to feel the emotions of others around us. Our mirror neurons appear to pick up subtleties in others that allow us to feel what the other person is feeling. By extension, this ability causes us to be better empathizers. This in turn makes us better friends and parents. In careers such as medicine, it allows us to become better healers since gaining the belief and trust of patients in a sickly state will, in itself, activate their healing system. Being able to conjure up worst-case scenarios can be useful in the realm of finance whether personal or professional, to minimize risk. The hyperawareness can help us keep loved ones safe such as kids around a pool. There are countless other examples of how having anxiety can be beneficial. As such, balance, not total suppression should be the goal of treatment.
The second reason why anxiety should not be stigmatized is due to the physical nature of its causes. Anyone with anxiety has heard the dreaded words “it’s all in your head.” If it were that easy, it wouldn’t cost the U.S. 42 billion dollars a year. Reactive airway disease, also known as asthma, in its simplest form is an over-reactive bronchial tree to environmental irritants. Because it can be explained materialistically, it’s considered a “real” disease. By contrast, anxiety is looked at solely as disorganized thinking that should be easily controlled by the mind affected by it. In her book, The Highly Sensitive Person, psychotherapist Elaine N. Aron shatters this non-materialist thinking about anxiety disorder. Our neurons work by releasing neurochemicals between each other under the direction of electrical signals known as action potentials. As we inherit our nervous systems from our parents, some of our nervous systems have a lower threshold to fire off these electrical impulses in response to outward stimuli. For the most part this firing off is not under conscious control. For this reason, those of us affected by anxiety are hyper-aware of our surroundings. We have trouble ignoring the feeling of the fly that repeatedly lands on our arm. We hear all of the conversations going on around us, being unable to focus on the person talking to us. We feel the mood of others in the room, intuitively picking out the person in the room who’s unhappy. We hear sounds louder than they are. All of this sensory overload results in anxiety.
One of the genes being looked at that may result in hyper-activity of the nervous system is known as GABRA-2. This gene codes for the activity of GABA, known as the calming neurochemical. Normally, GABA inhibits the firing of neurons. When not functioning properly, the emotional centers in the brain may not remain in a calm state, the end result of which is the feeling of anxiety. Benzodiazepines such as Valium and Xanax work by increasing the actions of GABA.
Another aspect of anxiety being looked at by psychiatrists and neuroscientists is the activity of certain brain regions. The most notable areas are the medial prefrontal cortex which sits just behind the forehead and the amygdala, an evolutionarily older structure that sits deeper in the emotional center of the brain known as the limbic system. The amygdala is in charge of the fear neurocircuitry and the fight or flight response. These two centers act as the yin and yang of a normal brain. The medial prefrontal cortex, being the more logical area responsible for impulse control, keeps the instinctual amygdala in check. It acts to counterbalance the activity of the amygdala. It’s thought that in those affected by anxiety, the inhibitory message sent by the prefrontal cortex to the amygdala to stop firing is never received. The resulting uninhibited firing away of the neurons of the amygdala (fear center) cause the fight-or-flight response and the subsequent signs and symptoms of anxiety.
Knowledge and awareness of the physical mechanisms of anxiety is the first step. The question then becomes can we control it? If so, then how? The good news is that we’ve been given the power to exercise control over our thought process, though this takes a great deal of time, consistency and practice. Our evolutionarily newer neocortex has given us the ability to subdue the mental afflictions of the more primitive, deeper structures of the brain. Our minds function like a garden. By creating a nurturing soil through our actions, we prevent the weeds, the worries, from taking over our minds. Instead our minds become more conducive to the growth of beneficial plants, positive thoughts, that nurture our spirits. The following actionable steps that can be taken immediately are as follows:
1) Set a daily reminder in your smart phone for a certain time every day where you can dedicate 5–10 minutes to meditation. This doesn’t need to be a fancy ritual. It does, however, need to be sustainable. Simply sit down in a quiet room with your eyes lightly closed focusing on the four aspects of breathing: slow down the rate, quieting the sound, increasing the depth and breathing in through the nose, out through the mouth. This will quiet down the sympathetic nervous system thereby blunting the response of the fight-or flight neurochemicals and hormones. Remember, consistency is the key.
2) Start exercising. Countless studies have shown that exercising three times a week for at least 30 minutes increases the feel good neurochemicals such as serotonin. The effects can take several weeks, however, with consistency the benefits will be felt.
3) Give your anxiety meaning. Think of a time where your anxiety has been an advantage rather than a disadvantage. Did your hypervigilance prevent yourself or a loved one from getting harmed in any way? Did you save that rainy day fund because of the fear of poverty?
By taking these steps, you create a nurturing soil in the brain, creating a garden that is less conducive to growing the weeds of worry. More importantly, these are natural, side effect free ways of balancing anxiety. Conventional medications may be necessary, but certain ones such as benzodiazepines are best minimized. Existentially, realize that your anxiety can be a gift. Make it your life’s task to find the reason why you were given it. Often in life we find that a perceived weakness can indeed be a source of great strength and wisdom. In the words of Edgar Allan Poe, “Never to suffer would never to have been blessed.”
M.J. Higby practices medicine in Phoenix, AZ. He is passionate about martial arts, most notably Brazilian Jiu Jitsu and Muay Thai. He enjoys writing about mental, spiritual and physical well being and questioning the methods by which we attain it. He is in the process of writing his first book about anxiety. Please follow him on Facebook and Twitter @MJHigby