The sheer gravity of mental health issues worldwide has surfaced in recent years, and topping that list in many countries is anxiety.
1 in 5 U.S. adults experienced mental illness in 2018, which equates to approximately 47.6 million people.
1 in 5 is an astounding figure when you realize the number of people it includes.
I have been battling anxiety and bouts of depression for the majority of my adult life. I understand the struggle to get out of bed, the intensity of emotions, the stigma, and mental health ignorance so many display, and the toll it takes on your physical body.
Dealing with mental illness and anxiety can be a long and winding road of challenges and extremes.
Anxiety disorders are the most common mental illness in the United States today. They affect 40 million adults (18 and older) in the United States every single year. Although anxiety disorders are highly treatable, the majority of people suffering from them do not seek help. These disorders develop from different risk factors, including personality, brain chemistry, genetics, and various life events. From a personal standpoint, I can attest that childhood trauma can help increase anxiety as you grow older. That trauma can linger within your subconscious, causing you all sorts of irrational fears and worries.
But what is anxiety, and where does it originate?
THE BRAIN, NEUROSCIENCE, AND ANXIETY
According to the American Psychological Association, “Anxiety is an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.”
People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry. They may also have physical symptoms such as sweating, trembling, dizziness, or a rapid heartbeat.
Neuroscience and Psychology are two areas I have studied ever since I decided to get serious about my mental health. After years of struggling with anxiety, depression, and obsessive thoughts, I went back to therapy and began restructuring my life.
One of the knowledge gateways for me was reading book after book on both neuroscience and psychology. One of the books that caught my attention was ‘Rewire Your Anxious Brain’ by Catherine M. Pittman, Ph.D., and Elizabeth M. Karle, MLIS. This book gets into the differences between anxiety originating in the amygdala and anxiety originating in the cortex.
Until reading this book, I wasn’t even aware of any differences between where the anxiety stems from in the brain or why it’s essential to select the right treatment.
COMMON ANXIETY DISORDERS
Panic Disorder (PD)
People who experience spontaneous panic attacks and are too preoccupied with the fear of a recurring attack.
The Numbers: Affects 6 million adults (2.7% of the U.S. population), with women being twice as likely to be affected as men.
Social Anxiety Disorder (SAD)
An intense fear or anxiety of being judged, negatively evaluated, or rejected in a social or performance situation.
The Numbers: Affects 15 million adults (6.8% of the U.S. population) and is equally common among men and women.
Specific Phobias
Experiencing excessive and unreasonable fears in the presence of or anticipating a specific object, place, or situation.
The Numbers: Affects 19 million adults ( 8.7% of the U.S. population), with women being twice as likely to be affected than men.
Obsessive-Compulsive Disorder (OCD)
Experiencing obsessions and compulsions. Obsessions are intrusive and unwanted thoughts, images, or urges that cause distress or anxiety. Compulsions are behaviors that the person feels compelled to perform to ease their distress or anxiety or suppress the thoughts.
The Numbers: Affects 2.2 million adults (1.0% of the U.S. population), and is equally common among men and women.
Post-traumatic Stress Disorder (PTSD)
A serious and potentially debilitating condition that can occur in people who have experienced or witnessed a natural disaster, serious accident, terrorist incident, sudden death of a loved one, war, violent personal assault (such as rape), or other life-threatening events.
The Numbers: Affects 7.7 million adults (3.5% of the U.S. population), with women being more likely to be affected than men.
THE BRAIN, THE AMYGDALA, AND THE CORTEX
Before I get into the differences, let’s go over what the amygdala and cerebral cortex are and why they’re critical to the stress response we experience when facing anxiety.
The amygdala is the region of the brain primarily associated with emotional processes.
The cerebral-cortex is the furrowed outer layer of gray matter in the cerebrum of the brain, associated with the higher brain functions, as voluntary movement, coordination of sensory information, learning and memory, and the expression of individuality.
THE AMYGDALA PROTECTS
The amygdala is responsible for activating what is known as the fight, flight, or freeze response. During this response, there’s an activation of motor systems, an increase in neurotransmitters’ levels, energization of the sympathetic nervous system, and a release of chemicals such as cortisol and adrenaline into the bloodstream. Your body will undergo immediate changes such as increased heart rate, tensing of muscles, and dilated pupils. You may start to tremble and feel sweaty palms, heart-pounding, and bowel issues. Activating the fight, flight, or freeze response is a primary role of the amygdala.
The amygdala’s “language” is based on association.
But what does this mean, exactly?
Think of a little child. That child walks into a room and sees a teddy bear that frightens him or her. Now, the teddy bear itself is not threatening, but every time that child sees any teddy bear, he or she becomes filled with fright. That is the amygdala associating that particular teddy bear with a fearful emotion and activating the fight, flight, or freeze response in that child.
Emotional triggers begin to develop around these associations.
Whenever you come in contact with any stimuli associated with an emotional response in your amygdala, you will then become triggered. And after becoming triggered, you will want to avoid those specific stimuli to avoid feeling any negative emotions. Avoidance can cause problems because as you grow older, the number of stimuli will also grow, and if you haven’t managed them properly, you will be one overly-anxious person (trust me, I know!).
THE CORTEX OVERTHINKS
The cortex can initiate anxiety in a few different ways. The first way involves how the cortex processes sensory information. As the cortex processes this sensory information, it can interpret a perfectly safe situation as threatening. For example, a person fighting with their significant other sees a call coming in on their phone from that person and thinks, “Oh no, they are going to break up with me.” The cortex sees that call as a threat even though the call could be harmless. That is the cortex creating unneeded anxiety.
The second way the cortex can produce anxiety is by overthinking.
Overthinking is common for almost everyone, but some suffer from it much more than others.
Here are a few examples:
Parents leave their children with a babysitter and go out to a nice restaurant for dinner. The children are perfectly safe, yet the cortex creates all sorts of awful worst-case scenarios in the parents’ heads, which then triggers the amygdala and causes worry.
Another example would be prepping for a job interview. You start worrying that you’re going to look bad or come off like a fool in front of the interviewers. There is no sensory input to suggest such things, yet your cortex can create all sorts of unsavory scenarios that initiate an anxious response in your amygdala.
WHY THE DIFFERENCE BETWEEN AMYGDALA AND CORTEX BASED ANXIETY MATTERS
The difference between where your anxiety is originating is essential because there are different ways to manage each.
Not every technique for one will work for the other. So when someone says, “I’m struggling with anxiety,” the first thing I think of asking them is, “What type of anxiety?”
They’ll usually say either overthinking, obsessing, or that they really don’t know why, but they just have a nervous feeling inside of them. The first few are indications of cortex based anxiety, whereas the latter is usually an indication of amygdala based anxiety.
Think of the amygdala as the more “primal” state of anxiety; the physical sensations, increased heart rate, sweaty hands, trembling voice, and all the physical effects of anxiety pertain directly to anxiety originating in the amygdala. Whereas anxiety originating in the cortex is based more on “overthinking.” The cortex can create all sorts of crazy future scenarios and drum up memories from the past, both of which can cause anxiety. Often, we get caught up in these obsessive thoughts about the past or future and have difficulty shutting them off.
HOW TO REDUCE CORTEX BASED ANXIETY
I could write an entire article just based on this one question alone. There are numerous areas in which cortex based anxiety can wreak havoc on our lives, but there are also techniques you can use to reduce and even eliminate some of the anxiety.
Below are three key areas to focus on when managing cortex-based anxiety.
- Challenge your thoughts
- Use coping thoughts
- Replace worry with planning
CHALLENGING THOUGHTS
Challenging thoughts is one way you can manage cortex based anxiety. Cognitive fusion is when we attach a thought to an experience. We tend to get so caught up in the actual thoughts that we forget that they are merely thoughts, not actual events. Whenever you are overthinking a potential future worst-case scenario, you are practicing cognitive fusion. Getting caught up on these thoughts that haven’t happened, and might not ever happen, is what causes suffering and anxiety.
This is where it’s beneficial to challenge your negative thinking.
Ask yourself a few questions:
- What are the chances this will occur?
- If the worst-case does occur, what could I do to remedy the situation?
Most of the time, you will find that most of your worries about the future will never occur in the first place. And secondly, if they do happen, they probably won’t be as bad or horrific as your thoughts about them.
COPING THOUGHTS
Most of the time, when we are worrying, we are thinking negative and fear-based thoughts. These thoughts can range in severity, and they usually do not have substance backing their merits up. You might have a big presentation coming up at work, and your first thought is that you will fail and look bad in front of your entire company. Yet, every other presentation you’ve given previously has gone well. Using a coping thought or a more positive thought, such as, “I will do well on my presentation,” is a more suitable replacement than the original fear-based thought. Coping thoughts are more optimistic.
REPLACE WORRY WITH PLANNING
One of the most detrimental aspects of worrying is that it keeps us from acting on something. For example, you might have an idea for a business you’d like to start, yet you choose not to act on starting the business because of your worries about failure. Or maybe you want to ask that special someone out on a date, yet your thoughts keep telling you that you’re not good enough and that you’ll screw it up, so you never make that call. Worrying can derail us from living up to our full potential.
But replacing worry with a plan can be a solution. Once you have an idea about something you want to do, instead of getting caught up in the worries about it, make a plan of action. If you’re going to start a business, decide how you would go about it. If you want to ask that special someone out on a date, plan a time to call them and ask. You can also make plans for what could happen, so if the business starts failing, or the person declines your date offer, think about how you would respond. Planning is an effective and productive replacement for worrying.
IN REVIEW
Understanding where your anxiety stems from is critical because it allows you to manage it most effectively.
Cortex-based anxiety can be challenging because the thoughts triggered by anxiety can be deeply entrenched in our subconscious minds. Once those neural pathways are created in the brain, it can be challenging to change them. You will need to put in the daily effort and enhance your mindfulness about thoughts you’re continually thinking and how they affect your health.
Changing those anxiety-ridden thoughts takes time, but it can be done. Being consistently persistent with your efforts and observing those thoughts, and slowly replacing them with healthier ones will help you reduce anxiety to a more manageable level.
Although we strive to provide accurate general information, the information presented here is not a substitute for any kind of professional advice, and you should not rely solely on this information. Always consult a professional in the medical and health area for your particular needs and circumstances prior-to making any medical or health-related decisions. For your health-related questions, please seek the advice of a licensed physician or any other qualified health care provider immediately.
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