Learning how your brain and body work can give you a tangible understanding of your anxiety disorder and a sense of hope that you can gain mastery over it. In this chapter, you’ll discover how your brain works and how understanding its functions can help reduce your anxiety.
You’ll learn which parts of your brain are overactive and which are underactive when you’re anxious and how you can use your brain to experience less anxiety. Think of this chapter and the one that follows as a tune-up manual for your brain.
Although your brain weighs only three pounds, it contains 100 billion nerve cells, called neurons, and many more support cells. More powerful than any computer, your brain is not hardwired—it can create or reduce anxiety, according to what you do and how you think. Discovering how your brain works can help you use it to reduce your anxiety.
Let’s start with the big picture: your brain’s architecture.
Your brain has a right and a left hemisphere, each with unique talents and emotional tendencies. Your right hemisphere is talented at getting the “big picture,” or gist, of a situation. It is generally more creative and activates when you learn something new. Once you learn a skill, it often is encoded in your left hemisphere, where routines, linear sequencing, and language are processed. Your right hemisphere processes negative emotions, and your left hemisphere processes positive emotions.
The outer surface of your two hemispheres is called the cortex, which means “bark.” When you look at a picture of the brain, you’re seeing mostly cortex. The cortex is actually very thin, only 1.5 to 3 millimeters thick. It’s in this part, the “gray matter,” that most of your thinking takes place. Below the cortex is “white matter,” which consists of support cells covering the long nerve fibers that connect various parts of your brain.
Each of your two hemispheres has four major parts, called lobes. In each set of lobes are primary areas that are specialized for certain skills. For example, your occipital lobes specialize in vision; your temporal lobes in hearing, memory, and recognition; the parietal lobes in sensing physical sensation; and your frontal lobes in movement, problem-solving, and initiating behaviors.
Adjacent to the primary lobe areas are association areas, where input from other areas of the brain is processed. For example, the part of your left temporal lobe called Wernicke’s Area helps you make sense of what is being said to you. In your left frontal lobe, located in front of the primary area that controls movement, is an association area called Broca’s Area, which helps you speak.
Your peripheral nervous system, which controls your body, is divided into two parts: the voluntary (also called the somatic) and the involuntary (also called the autonomic). Your somatic nervous system is voluntary: it operates when you decide to move a limb or stand up. Your autonomic nervous system operates automatically. It maintains homeostasis; it makes sure that your body systems operate in balance. Your autonomic nervous system can get activated, or it can calm down. It can turn off the fight-or-flight mode when you don’t need it on.
Your autonomic nervous system also has two branches: the sympathetic nervous system, which regulates arousal, and the parasympathetic nervous system, which regulates relaxation. Your sympathetic branch activates your brain and body with neurotransmitters such as norepinephrine and epinephrine (adrenaline). The parasympathetic branch helps you calm down by releasing the brain neurotransmitter GABA, which acts to dampen the effects of adrenaline and to calm down your amygdala. You can learn how to turn on your parasympathetic system.
Deep within your temporal lobes are two structures that are involved in memory and play different roles in anxiety. They are the amygdala and the hippocampus. The amygdala, from amygdalon, the Latin word for “almond,” was named by early anatomists for its almond shape. It is the center of fear and tends to be hypersensitive in people with anxiety disorders. The hippocampus, named for its seahorse shape, helps you remember what is—and what is not—worthy of fear.
Your hippocampus and amygdala control two types of memory: explicit and implicit. You use your hippocampus in explicit memory when you try to remember what you had for dinner last night, when you have that appointment to go to the dentist, and what the name is of that familiar-looking woman standing in the checkout line at the grocery store. These are facts, dates, words, and events. It is this type of memory that people often complain they are losing.
Your amygdala controls a significant part of your implicit, or emotional, memory. It reacts unconsciously to events and situations that are potentially dangerous and activates the fear circuit in your body, known as the fight-or-flight response. Your amygdala triggers the fight-or-flight response via your hypothalamus-pituitary-adrenal axis (HPA).
Here’s how the process works: At the first sign of danger, the amygdala signals your hypothalamus to secrete a substance called cortical-releasing factor, or CRF. CRF in turn alerts your pituitary gland to release another substance called ACTH into your bloodstream. ACTH triggers your adrenal glands to release epinephrine and norepinephrine, two types of the brain chemicals called neurotransmitters. They charge up your sympathetic nervous system. About thirty minutes later, if stress persists, a stress hormone called cortisol is released to keep you activated. Cortisol further excites your amygdala.
This activation system makes evolutionary sense, because if our ancestors encountered danger in specific situations, they would want to remember that emotionally. In other words, feeling anxiety when in a particular situation, such as being too close to a lion’s den, reminds them that the den is dangerous. In the modern world, of course, most of us are not likely to regularly encounter a lion’s den. Yet, the memory system still exists. And once it gets turned on, it’s hard to turn it off. This alarm system is automatic; that is, it happens before your cortex (the part of your brain that does the thinking) has time to think about it. When your prehistoric ancestors encountered a lion, it was best to react immediately and not stand around admiring its mane, or wondering why it’s bothering you and not tracking down some tasty antelope. Your amygdala and the HPA axis kept your ancestors alive, so they could have children, which thousands of years later made you possible. You inherited the same rapid-response fight-or-flight system.
Your amygdala stirs enough fear in you to pull your car to the side of the road during a violent rainstorm or to react when you encounter a pit bull. This is normal and a good thing! However, if another car plows into you, or if the pit bull attacks, your amygdala can become oversensitive the next time you are in a rainstorm or encounter a pit bull. Having these experiences will not necessarily cause you to develop a panic disorder. But if you refuse to drive when it rains, or you stay away from all dogs, the fear of these encounters grows and can contribute to your developing an anxiety disorder. If you avoid rainstorms or dogs, your amygdala doesn’t have an opportunity to adjust to the fact that rainstorms and dogs aren’t necessarily dangerous. Consequently, you’ll feel fear when you don’t need to feel fear and anxiety.
Fortunately, you can tame your amygdala when it gets overactivated. You can do this by exposing yourself to rainstorms and dogs. By activating another part of your brain, such as your frontal lobes, while you are in rainstorms or petting a dog and telling yourself that there is nothing to fear, you can tame your amygdala and avoid developing a phobia of rainstorms or dogs. To rewire your brain to inhibit anxiety and strengthen the connections between your frontal lobes and amygdala, you’ll need to expose yourself to dogs or rainstorms often.
Of particular importance to anxiety are your frontal lobes. A sort of brain within the brain, your frontal lobes are sometimes called the “executive brain” because they orchestrate the resources of the rest of your brain. We have the largest frontal lobes of any species. For example, our frontal lobes comprise 20 percent of our brain; a cat’s frontal lobes, by contrast, comprise only 3 percent of its brain. That alone says a lot about the difference between our species. Cats don’t think about anxiety or read books about it. When they become anxious around someone, it’s extraordinarily hard for them to learn not to be anxious around that person. Humans can make such changes more quickly. That’s because our frontal lobes decide what to do, how to stay positive, and how to appreciate the larger picture of life.
Your frontal lobes are not the same. The left and right frontal lobes deal with emotions differently, just as your left and right hemispheres do. Your left frontal lobe is skillful at labeling emotion and putting a positive spin on your experiences. It promotes taking action. Your right frontal lobe is good at grasping the big picture. However, when your right frontal lobe becomes overactivated and is not balanced by the involvement of the left frontal lobe, you can feel overwhelmed and anxious. This is because your right frontal lobe promotes withdrawal and passive behaviors. To counterbalance the right frontal lobe, you need to take action. Taking action activates your left frontal lobe and its positive emotions; being passive activates your right frontal lobe and its negative (anxious) emotions.
Certain areas of your frontal lobes have different functions relevant to anxiety. The orbital frontal cortex (right behind the orbs of your eyes), for example, can be talented at controlling emotions, if it is “taught” to do this. It can shut down the fear network or, alternatively, hijack it—it exerts inhibitory control over your amygdala. The orbital frontal cortex learns how to control emotions, such as anxiety, from the way your parents taught you to control them, when you were growing up.
Along with the other parts of your brain that comprise what has been called the “social brain,” your orbital frontal cortex thrives on social interaction. In fact, from the first few minutes of life, your bonding experiences with your parents helped develop this social brain. Your later relationships modified those neural connections. Social support can help this part of your brain organize its inhibitory control over our amygdala and the fear associated with it.
The socially sensitive parts of your brain can help you lessen your anxiety and tame your amygdala. Brain cells referred to as mirror neurons are acutely sensitive to the intentions of others. They allow you to mirror another person’s emotions—to feel what they feel. They are essentially the brain-based explanation of empathy.
Positive relationships enhance your sense of well-being; negative relationships leave you feeling anxious and depressed. When you receive support from friends and family, your orbital frontal cortex and mirror neurons are activated, and you experience less anxiety and better mental health. This is why you don’t want to isolate yourself when you’re anxious. It helps you to spend time with family and friends.
Remember that your left frontal lobe is associated with positive feelings and action, and your right frontal lobe is associated with negative feelings and withdrawal. If you’re like many people who suffer from anxiety, you underactivate your left frontal lobe and overactivate your right frontal lobe. Withdrawal overactivates your right frontal lobe and your amygdala, which makes your anxiety worse.
When you isolate yourself, you don’t get the benefit of activating the orbital frontal areas and mirror neurons that help you control your emotions. Also, when you form intimate relationships, you activate the release of soothing neurochemicals, such as oxytocin. Higher oxytocin levels help blunt pain and help you feel comforted by other people.
To conquer anxiety, you need to activate your left frontal lobe. Because your left frontal lobe has language skills that your right frontal lobe does not, it makes labeling sensations with words (“this is nothing to be worried about”) an important part of overcoming anxiety. Its language ability allows you to label your experiences realistically, while activating your left frontal lobe and the positive emotions associated with it.
Your left frontal lobe and your orbital frontal cortex can shut down the HPA axis and the fight-or-flight response. This happens when you activate your left frontal lobe by labeling a situation from a realistic perspective, then take action by doing something positive. In other words, you label a false alarm for what it is—nothing to worry about—then you go ahead and expose yourself to the thing you feared, such as crossing a bridge or talking to strangers. Using this system, you can learn to tame your amygdala.
Patrick, a county clerk, experienced chronic free-floating anxiety and periodic panic attacks when he had to deal with the public. He did everything he could to try to keep his anxiety “under wraps.” For example, he never volunteered for extra assignments, especially if they involved interacting with others. He spoke only when spoken to, and, even when asked his opinion, he would often say, “Oh, I don’t really know.”
Patrick was overactivating his right frontal lobe with his passive and withdrawal behaviors. Consequently, his feelings of being overwhelmed and the negative emotions associated with his right frontal lobe were increasing. His passive behavior had allowed his amygdala to be hijacked, putting his frontal lobes into a hypervigilant state about any potential anxiety. Patrick needed to expose himself to fear-producing situations, so that his amygdala could become reconditioned to lessen its over-reactivity. This took repetition and consistency.
He started by visiting the break room at work to make small talk with the people he’d been working with for years but had always avoided. Day after day, despite not “feeling comfortable,” he kept showing up in the break room and even managed to strike up some conversations. Next, he started forcing himself to make small talk with the public. The more he practiced making conversation, the easier it became.
Eventually, despite his fear of taking action, Patrick began to volunteer for assignments, especially those that involved interacting with others. He learned to be more competent in dealing with the public and simultaneously felt less anxiety.
You, too, can tame your amygdala, by breaking old habits, such as anxiety, and establishing new habits. This is possible because your brain is capable of establishing new circuits and essentially rewiring itself. To understand how this happens, let’s take a closer look at what happens in your brain.
The 100 billion neurons contained in your brain’s lobes, hemispheres, hippocampus, and amygdala are not hardwired; they’re “softwired,” which means they can be rewired. Your neurons have the ability to make new connections with one another. Each neuron is capable of maintaining connections with about 10,000 other neurons. Those connections change as you learn things, such as how to become relaxed, instead of anxious.
Your neurons communicate by sending chemical messengers called neurotransmitters to one another across a gap called a synapse. This transmission is how one neuron gets another neuron to fire. You have more than 100 types of neurotransmitters in your brain.
Some, such as epinephrine, make you anxious, and some, including GABA and serotonin, calm you down. You want the neurotransmitters GABA and serotonin to work more efficiently in your brain, because they promote calmness and a better mood.
The synapses between your neurons also can change to make you less anxious. This ability to change is called neuroplasticity. Neuroplasticity makes learning new habits possible. Your brain changes its synapses when you learn something new, including how to be calmer.
The phrase “cells that fire together, wire together” describes how your brain reorganizes itself through neuroplasticity as you learn new things. The more frequently the new connections between your neurons fire together, the higher the chance they will fire together in the future and produce calmness instead of nervousness. They are “wired together,” because you are strengthening these new connections. This is the brain-based explanation for how habits get formed and how you can alternatively modify those habits.
The more you practice something, the more likely you are to do it in the future. In other words, the more you practice feeling relaxed, the more likely you are to feel relaxed in general. The same process applies to the anxiety techniques in this book. Neuroplasticity occurs when you do something over and over again. In other words, repetition rewires your brain and creates habits.
However, creating new habits requires effort. When water runs downhill, for example, it’s following the path of least resistance. Your brain does this, too—it does what it is used to doing. If you want to create a new habit, one your brain isn’t familiar with, you need to make a strong effort to do what you don’t feel like doing—and then keep doing it. Eventually, you’ll find yourself doing it without the effort. It will have become a habit. In other words, if you practice feeling relaxed, instead of feeling anxious, you’ll feel relaxed more often than anxious. Likewise, if you practice putting yourself in situations that once triggered anxiety, you will eventually respond to them without anxiety. This is possible because you can decide to override the overactivity of your amygdala. The more you practice the techniques in this book, the calmer you’ll be.
I’ve introduced a fair amount of information about your brain in this chapter. Here are a few critical points that are important to remember:
• Your brain is a complex organ that can change through neuroplasticity.
• If you continue to do what comes easily for you, your anxiety will continue.
• To conquer anxiety, you need to do what you don’t feel like doing.
• Because your implicit memory systems and your amygdala can’t change on a dime, you need to repeat the skills that you learn in the book over and over again to establish new habits.