Good Anxiety

Harnessing the Power of the Most Misunderstood Emotion

Wendy Suzuki

• Editorial: Atria Books
• Año: 2021
• ISBN:
  9781982170752
• Categoría: Psychology
• Categoría: Personality in Psychology

World-renowned neuroscientist and author of Healthy Brain, Happy Life has developed an "absolute game-changer" ( Conscious Conversations podcast) for managing unwarranted anxiety and turning it into a powerful asset. We are living in the age of anxiety, a situation that often makes us feel as if we are locked into an endless cycle of stress, sleeplessness, and worry. But what if we had a way to leverage our anxiety to help us solve problems and fortify our well-being? What if, instead of seeing anxiety as a curse, we could recognize it for the unique gift that it is?As a neuroscientist, Dr. Wendy Suzuki has discovered a paradigm-shifting truth about anxiety: yes, it is uncomfortable, but it is also essential for our survival. In fact, anxiety is a key component of our ability to live optimally. Every emotion we experience has an evolutionary purpose, and anxiety is designed to draw our attention to a number of negative emotions. If we simply approach anxiety as something to avoid, get rid of, or dampen, we actually miss an opportunity to not only manage the symptoms of anxiety better but also discover ways to improve our lives. Listening to our worries from a place of curiosity, instead of fear, can actually guide us onto a path that leads to joy."Suzuki draws on decades of neuroscience, including her own research, and leavens her learning with a little personal storytelling to create a practical, science-backed guidebook for those seeking such a transformation" ( The Wall Street Journal ).

PART ONE The Science of Anxiety

1 What Is Anxiety?

The daily stress of living can often feel like it’s leaving us short of breath, literally and figuratively, as if getting through each day is like climbing a mountain. Our nights are often sleepless, and our days are marked by distraction and a difficulty shifting our focus away from bad things. We are filled to the brim with responsibility, worry, uncertainty, and doubt. We are overstimulated by everything from terror to FOMO (fear of missing out), regardless of whether this experience emanates from using Instagram, Twitter, or Facebook or reading news reports online. For a lot of us, anxiety seems like the only appropriate reaction to the state of the world.

People call it different things, but anxiety is the psychological and physical response to stress. The body does not know the difference between stress caused by real factors and stress generated from imagined or hypothetical situations. But by understanding the actual neurobiology of what triggers anxiety and what happens in our brains and bodies when it occurs, it’s possible to learn how to parse our feelings into smaller pieces that can be moved around and managed. It also becomes possible to leverage the energy of anxiety for good. Anxiety really does work like a form of energy. Think of it as a chemical reaction to an event or situation: Without trustworthy resources, training, and timing, that chemical reaction can get out of hand—but it can also be controlled and used for valuable good.

· ANXIETY AS DETECTION OF THREAT ·

Imagine you are a woman in the Pleistocene epoch and part of a hunter-gatherer tribe. It’s your job to forage near a shallow riverbed approximately five hundred yards from the nomadic tent encampment. Your twelve-month-old infant is strapped to your back as you reach down and search for edible shrubs alongside the river. Suddenly you hear a rustle nearby. You freeze immediately, stopping all of your movement. You crouch silently, so as to not disturb the baby and also to hide from a possible attacker. From this position, you listen for more rustling, trying to approximate the distance of the noise. Your heart begins to beat more quickly, adrenaline courses through your body, and you feel your breathing become jagged and shallow as you firm up your legs, ready to run… or defend yourself.

You are in the midst of a threat response: an automatic reaction to possible danger. If you stand up and catch sight of a large cat on the prowl, the anxiety response would no doubt be warranted and you’ll either freeze, flee, or fight, depending on an adrenaline-enhanced evaluation of your best chances for survival. If you stand up and see that the noise came from a low-flying bird, your heart rate will slow down and return to normal. The adrenaline and feeling of fear will subside quickly. Your brain-body will reset to normal.

This is the first level of anxiety: an automatic processing of threat. This ancient part of our brain works so fast and automatically that we are barely conscious of its functioning. It’s designed this way to ensure our survival. The brain sends signals to the body, which then reacts with increased heart rate, sweaty palms, a surge of adrenaline and cortisol, and a shutting down of the digestive and reproductive systems so that you can escape quickly or ramp up your strength to protect yourself and your offspring.

Now imagine another scenario, this time in 2020, where you live alone in a one-bedroom bungalow that backs onto an alley in a small suburban town. It’s evening, and you are preparing a cup of tea to enjoy while watching a new episode of your favorite show. As you plug in your electric kettle and look for some cookies in the back of the cabinet, you hear a loud crashing noise coming from the direction of the back door. Your heart quickens and you freeze for a moment as you stare toward the door in fear: Is it an intruder? Are you about to be harmed? At first, you feel afraid to move, but then decide to peek out the kitchen window. As you do, you catch a glimpse of the neighborhood raccoon. Now that you think about it, just last week you had to pick up trash strewn across your driveway. You return to your tea and TV show but can’t seem to settle down. You feel anxious and begin to wonder if your neighborhood is safe, if you should get a roommate, if you should move to another part of town or live in a high-rise so you don’t have to feel so close to the street. Then you recall a story about a recent surge in break-ins and wonder if you should get a gun to protect yourself. You may find yourself feeling suddenly afraid and confused by the very thought of handling a gun. You turn off the TV, unable to enjoy your show, and decide to take an over-the-counter sleep medication to knock yourself out. You just want to sleep away all the terrible feelings.

These scenarios may be hypothetical and set millions of years apart, but they both embody the trigger and experience of anxiety, with different results.

First, let’s take a look at what they have in common. Before you even become consciously aware of it, the brain detects the presence of a possible threat or danger and sends a signal to the body to ready itself to act. This response is in part physiological, as noted by the increased heart rate, the uptick of adrenaline, and the shallow breathing—these are all designed to prepare you to move quickly either to escape or defend yourself. The response is also emotional, triggered by the release of cortisol and noted by the immediate feeling of fear experienced in both versions. This threat response is often referred to as “fight, flight, or freeze,” which happens in microseconds as your brain tries to figure out if a stimulus is indeed threatening and whether to flee as fast as possible, fight the potential threat, or freeze and act as though you’re dead. This response is controlled by a specific part of our central nervous system called the sympathetic nervous system. With its main communication pathways located primarily just outside the spinal cord, this part of the nervous system works automatically and without our conscious control. It causes a cascade of reactions, including an acceleration of our heart rate, pupil dilation to better focus on the source of the threat, the queasy feeling in our stomach (an indication of blood rushing away from the digestive system to our muscles to enable fast action), and activation of our muscles to give us the power to either run or fight. The activation of all these systems is useful for dangerous situations. The physiological responses and the emotional experience of fear have to happen automatically in order to bring our attention to the threat of immediate danger.

In this way, anxiety is a hardwired threat response that our brain-body uses to protect us, as is the feeling of fear that reinforces the physiological changes.

In the first scenario, the woman’s brain-body reset as soon as she determined she was not in immediate danger. In the second case, the woman’s response continued even after she spotted the racoon. Her brain-body was caught up in the fearful feeling and she felt out of control. Professor Joseph LeDoux, a foremost neuroscientist and one of my NYU colleagues, explains that “fear states occur when a threat is present and imminent; states of anxiety result when a threat is possible but its occurrence is uncertain.”¹ LeDoux is differentiating between fear (experienced in the presence of a real threat) and perceived or imagined danger (experienced emotionally as anxiety). The Pleistocene woman experienced a very sharp instance of fear along with her body’s changes; the woman in the one-bedroom bungalow felt anxiety, a more prolonged, lingering emotional experience and one that she had trouble turning off.

Early research into anxiety focused on this preconscious, wired-in fear response as an evolutionary adaptive mechanism that is inherently natural and helpful. It’s our brain’s way of signaling us to pay attention to possible danger and is driven by our survival instincts. But as humans have advanced over time, and our world has become more complicated, structured, and socially driven, our brains have not completely caught up with the increasing social, intellectual, and emotional demands of our environment, which is why we feel anxiety as out of our control. This system, rooted in our more primal brain, is not adept at assessing the nuances of threats. Though the prefrontal cortex (i.e., the so-called top [executive] part of the brain critical for decision making) can help override these automatic fear-based responses through its intelligence, our primal brain, especially those areas related to these automatic threat responses, is still very much functioning as it was millions of years ago. This mechanism explains why the Pleistocene woman on the savannah and the contemporary woman in the town have, at first, very similar reactions to the noise. But it’s only the more evolved woman who feels the lingering anxiety and the ensuing what-if list of worries. The Pleistocene woman goes on with her day once she has assessed that there is no reason to feel fear of imminent danger. The suburban woman is stuck in bad anxiety.

Scientists such as neuroscientist and primatologist Robert Sapolsky² have uncovered a challenging truth: Our brains have not changed enough in response to the vastly different, more complex social landscape in which we live. The first-level, automatic emotional responses to perceived threats are still generated and triggered deep in the more primal brain (often called the limbic system, which includes at its core the amygdala, insula, and ventral striatum), but our modern-day brains do not automatically discern between a real and an imagined threat; as a result, we often get stuck in anxiety mode.

Sapolsky has shown that this lack of discernment is why we individually and as a culture often find ourselves in chronic stress mode. We are unable to filter possible threats in our environment, and we are unable to turn off the emotional, mental, and physiological response to these threats even if they are imagined. These unregulated responses undermine our health and create what can become a near-constant negative feedback loop—the very essence of everyday anxiety.

Sapolsky and other researchers have shown that our brain-body systems are in a chronic activation of threat response—but not due to real dangers like lions on the savannah. Instead, our stress is exacerbated by living in loud cities; the stress of illness or poverty; the stress of emotional abuse or history of trauma. Big or small, seemingly inconsequential or traumatic, our brain-bodies do not automatically distinguish between potential threats and excessive stimulation—this causes the body to initiate the risk assessment protocol even when we can see that it was simply triggered by a passing fire truck. In truly disheartening research, Jack Shonkoff³ and his researchers at Harvard’s Center on the Developing Child have shown that early and continued exposure to extreme stress creates near-permanent maladaptations in the brain, affecting IQ and executive functioning. Such stressors include food insecurity and either direct or indirect exposure to physical or emotional abuse.

Indeed, our response to imagined threats is often the cause of the bad anxiety I’m talking about—the chronic worry, distraction, physical and emotional discomfort; the sense of doom and gloom, the second-guessing of the intentions of others; the feeling that you have no control over your life. It’s all the “what-ifs” that come to us late at night when we can’t fall asleep or are triggered by a health scare or some unexpected traumatic event in our lives. When we get stuck in that loop, we get caught in a brain-body response that becomes essentially maladaptive.

· SIMPLIFIED FEAR/STRESS/ANXIETY CIRCUITS OF THE BRAIN ·

Although scientists are still working to fully reveal all the brain areas and interconnected circuits involved in this threat or, more accurately, stress response, they generally agree that the brain areas shown in the following diagram are intimately involved. Threatening stimuli are quickly detected by the amygdala, a small almond-shaped structure deep in the temporal lobe. Think of the amygdala as the director of the primal brain, and the prefrontal cortex (PFC) as the director of the top or executive brain. When the amygdala responds automatically to threatening stimuli (real or imagined), it activates a wide range of areas, including the hypothalamus, which controls the sympathetic nervous system, to respond to the threatening or anxiety-provoking stimuli. The sympathetic nervous system, working through the brain’s hypothalamus and pituitary gland, then activates the release of cortisol (a hormone produced in the adrenal glands), increases heart rate and respiration, releases glucose (energy), and prepares the body for action. (The sympathetic nervous system refers to the part of the autonomic nervous system that prepares the body for action in a fight-or-flight situation that is controlled by the hypothalamus.) In the modern-day stress response, this cycle happens, but the cortisol keeps being produced and released—this is the state of bad anxiety.

Figure 1: Definitions

Subcortical structures refer to any brain area below the cortex or outer covering of the brain.

“Bottom-up” brain processing refers to the automatic emotion-inducing signals from the lower brain to the cortex that assist in the processing of intense emotional reactions.

“Top-down” brain mechanisms typically arise from the prefrontal cortex and regulate the lower brain areas like the amygdala where intense emotional responses to stimuli are generated.

Sympathetic nervous system refers to the part of the autonomic nervous system that prepares the body for action in a “fight-or-flight” situation and is controlled by the hypothalamus.

HPA (hypothalamic-pituitary-adrenal) Axis refers to the complex interaction between the hypothalamus and the pituitary gland that, together, control the release of the stress hormone cortisol from the adrenal glands.

Another way to think about how the brain processes both emotion and thoughts is in terms of “lower-brain” or “bottom-up” functioning and “top-down” functioning. “Bottom-up” brain processing refers to the automatic emotion-inducing signals from the lower brain (i.e., the amygdala and other aspects of the limbic system) to the cortex to assist in the processing of intense emotional reactions. (The so-called lower brain also refers to any brain area below the cortex, i.e., “subcortical.”)

“Top-down” brain mechanisms typically arise from the prefrontal cortex and regulate the lower brain areas like the amygdala, where intense emotional responses to stimuli are generated. It’s the HPA (hypothalamic-pituitary-adrenal) axis that then manages the c...