Physiology Phriday: Anticipation and Anxiety

Anticipation and its relationship to anxiety.

This week we have been thinking about how we evaluate our world. Evaluations or judgements come from a variety of locations. Our expectations and desires prep us to look for certain kinds of “data.” Our histories and past perceptions prep us as well. Finally, what is actually happening is part of the data we use to evaluate ourselves and our world. Notice that we aren’t as logical and objective as we’d like to think. Instead, we ANTICIPATE life and then respond to data that fits into that anticipation.

The primary feature of chronic anxiety is that anticipation of negative, dangerous outcomes. The anxious person views ambiguous data (e.g., a boss who is grumpy, a funny feeling in the chest, etc.) and reads that data in the worst possible light (I’m going to get fired, I’m having a heart attack).

If the problem is bad habits in thought patterns, it would make sense that the treatment ought to be to challenge these logical fallacies with the truth. And while cognitive counseling does indeed work (clear data that one can challenge and reject anxious, ruminative thinking) most find that counseling stops anxiety from growing but doesn’t often stop it from starting in the first place. This struggle to fight anxiety leaves many Christians feeling quite guilty for not trusting God more. 

But what about the amygdala? There is significant research that anxious people have very activated flight/fight activity in the amygdala. In fact, brain scans of this area show greater activity in anxious people than non-anxious people even when they are responding to neutral events. Thus, the anxious person’s brain is in a chronic state of hypervigilance even when nothing is going on. Hypervigilance maintains higher levels of norepinephrine the body, which in turn keeps the adrenal system in high alert. Medications (of the SSRI and NSRI type) have the capacity to positively impact serotonin and Norepinephrine and thereby allow individuals to decrease the negative hormonal activity in the brain.

Which comes first?

So, does biological hyperactivity in the amygdala result from either bad experiences or bad thinking? Or does a predisposition towards overactivity of this part of the brain encourage negative and anxious thinking, forming a vicious cycle? 

Seems to me good treatment needn’t answer this question. Good treatment would include (a) medications that might make it easier to slow down the anxiety processes (biology and behavior), (b) recognition that vigilance can be directed via counseling work away from the feared object and to a better understanding of the brain, and finally (c) that one changes the goal from cessation from fear to a more godly and humble response to Jesus in their fear.

What I mean by (b) is that the anxious person see themselves as like unto a person with colorblindness or dyslexia. In each case, the brain functions in a way to send the wrong messages. The dyslexic person learns to recognize the problem and designs a means to compensate in order to truly see the right order of letters/words. The anxious person accepts that their brain sends certain messages but that their job is to stay remember that while something real is happening it is not necessarily the way their brain is putting the “facts” together. Thus, the work is not to remove the fear but to practice a better response to it.

Ironically, when the person reinterprets the stimulus differently, they do see a marked reduction in fear triggers.