Unworried. Dr. Gregory Popcak

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Unworried - Dr. Gregory Popcak

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But the most important distinction to make is the one between anxiety and fear. Although people commonly use these two terms interchangeably, from a psychological perspective they are quite different. Fear is the natural, biological, and appropriate response to an imminent threat. Anxiety is when the brain’s natural fear circuits get hijacked by something that isn’t an immediate danger or could even be good for us (for instance, accepting a great new job or standing up for ourselves). In a sense, anxiety is fear’s evil twin.

      We develop the capacity for fear early. By eight months in utero, a baby’s fear and protection circuitry is fully developed and ready for action. Throughout life, in the face of a real threat, this circuitry injects chemicals into our brain and bloodstream to ramp up our senses and speed up our reaction time so that we can see all the ways we could respond and, if necessary, escape. When the fear-systems in our brain work properly, they serve a protective function, warning us away from danger and easing off once the threat has passed.

      Anxiety hijacks this God-given fear-threat system and causes us either to fear things that could be good for us (e.g., new opportunities, commitment in a healthy relationship), experience disproportionate responses (either in intensity or duration) to actual threats, or suffer feelings of panic when, in fact, no danger exists (e.g., panic attacks).

      In short, fear, as unpleasant as it may be, can be a great gift, a servant of our physical, emotional, and spiritual health and well-being. But anxiety represents a threat to our physical, emotional, and spiritual integrity that, left unchecked, can tear our lives apart.

      Feeling Burned Out?

      People often say they feel “burned out” by their struggles with anxiety, but most are unaware of the deeper truth behind this metaphor. Imagine soaking your hands in bleach for several hours, even days. You would get a chemical burn that left your skin severely raw and irritated. Even brushing up against something afterward might hurt tremendously. In a similar way, the chemicals (glucocorticoids) produced by the brain’s fear response are caustic. When persistently stressful or traumatic events trigger prolonged or too intense exposure to these chemicals, they create something like a chemical burn on your amygdala, the CEO of the fear/protection system. At the very least, this can cause us to feel every stressor more acutely, making it harder to respond in a calm, rational way. If anxiety persists, the amygdala blasts chemicals at another part of the brain called the hippocampus, which stores emotional memories.

      If the amygdala is the CEO of your fear/protection system, the hippocampus is the board secretary. While the amygdala is triggered in the presence of a threat, it’s the hippocampus’ job to “take notes” and remember that a particular event was anxiety-producing in the past. The next time you encounter that same event, or even something remotely similar, the hippocampus triggers the amygdala and reminds you that you “should” feel anxious — even if there is no practical immediate threat present. In the face of long-term stress, or an unusually traumatic stressor, the amygdala can blast so many stress chemicals at the hippocampus that it can cause it to shrink (like you might curl up in a ball if someone was yelling at you for a long time). When this happens, we tend to become less emotionally flexible and more easily stuck in unpleasant emotional states. In a sense, as the hippocampus shrinks, the secretary loses the notebooks filled with our happy memories and resourceful ideas and retains only the notebooks filled with frightening, scary, and traumatic experiences. Although this is not a pleasant experience, our brain responds this way to constant or overwhelming stress so that we can always be ready to respond to whatever new threats come our way.

      At its best, this partnership between the amygdala and hippocampus enables us to anticipate and head off potential problems. At worst, it causes us to develop an anxiety disorder in which an undercurrent of constant worry or even bursts of terror intrude upon every aspect of our lives.

      The takeaway from all this is that even though fear and anxiety feel very similar to one another — because they both are produced by the same fear-threat system in your brain — they are very different phenomena. The person experiencing fear reacts because they are having a genuinely protective, biologically pre-programmed reaction to an imminent threat to their safety or wellbeing. For instance, if you cross the street and notice a car bearing down on you, fear causes you to run across the street to get out of the car’s way. If someone was chasing you, intending to do you harm, fear would cause you to run faster to try to get away. If you were unable to escape, fear would enable you to fight back and defend yourself against your attacker. In the worst case, if you couldn’t get away, fear would cause you to try to hide and be as still as possible in the hopes of escaping your pursuer. As distressing as all these scenarios might be, they make sense. All these different responses to these various threats are adaptive. They are intended to preserve your life and safety. An immediate threat to your wellbeing provokes an immediate, defensive response.

      Anxiety, on the other hand, is akin to suffering a pinched nerve in the brain’s fear-threat system. The pain is real enough, but it’s the result of something happening inside of you, and not a response to an external, physical threat. For instance, if you had a pinched nerve in your leg, you wouldn’t call an ambulance. You would feel pain, and it might hurt terribly, but you would (1) recognize that the pain was coming from the inside of your body, not from an outside assault; (2) focus your attention on trying to breathe through the cramp and relax your leg; and (3) eventually engage in some limited exercise to work through any remaining soreness.

      Three Steps to Anxiety First-Aid

      One of the simplest ways to help your brain do a better job of dealing with anxiety is similar to that intuitive three-step approach I described that most people use for dealing with any other pinched nerve in their body: Relabel, Reattribute, and Respond. These steps are adapted from psychologist Jeffrey Schwartz’s groundbreaking work treating OCD as described in his book Brain Lock.

       Step One: Relabel the Threat

      You feel anxious. Don’t act out. Don’t start thinking obsessively about what you can or should do to try to get control of whatever is happening around you. Instead, check the feeling. Ask yourself, “Am I responding to an imminent (not a past or potential future) threat to my life or safety?”

      Remember, fear is an appropriate response to an imminent threat. It kicks you into high gear in the moment so that you can escape some clear and present danger — and then it goes away. That’s how fear is supposed to work.

      Anxiety, on the other hand, tends to be a fear response triggered by something that has either happened a long time ago, has not yet happened, or may not actually be happening at all. Likewise, instead of kicking you into high gear so you can escape an imminent threat to your life or safety, anxiety tends to hang around and haunt you. For instance, if you are afraid you might have said something embarrassing while out to dinner with your friends last week, you might keep replaying the scene over and over in your head and experience a low-grade sense of dread. Or if you have to give a presentation at work next week, you might imagine all the ways you might make a fool of yourself and struggle with a constant feeling of dread and terror. Or, alternatively, for no reason at all, you might just be suddenly struck with an overwhelming sense of panic that causes you to feel like something terrible is going to happen.

      The feelings associated with each of these experiences is not fear, but rather anxiety, because you are not responding to an imminent and obvious threat to your safety or wellbeing. In each of these instances, your fear-threat system — the part of your brain that is supposed to help you respond to imminent threats to your health and safety — is actually being hijacked by something that may be concerning but is certainly not an imminent threat.

      What difference does this make? It means that in each of these cases, you are not really experiencing fear. Rather, you feel fearful in these instances because the concerning event caused a misfiring of your fear-threat system. This is a small, but significant difference.

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