Demystifying The Anxious Brain
Anxiety feels different for everyone. Some might experience predominantly physical effects on their body, whilst others might experience anxiety mainly in their thinking mind.
There are many factors that may lead to the development of anxiety including traumatic experiences, inherited vulnerability, chronic illnesses, health triggers and certain medications.
The brain and body are closely interrelated such that feelings of fear and anxiety trigger the hypothalamus in the brain to stimulate the release of hormones in our bodies which in turn produces the ‘fight-or-flight’ response, the physical symptoms.
MQ Mental Health Research highlight these common symptoms/experiences that anxiety sufferers may have:
- The presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs more often than not for at least 6 months and is clearly excessive.
- The worry is experienced as very challenging to control.
- The anxiety and worry may also affect cognitive functions such as edginess or restlessness, impaired concentration or feeling as though the mind goes blank.
There are some symptoms, patterns of thinking and biological mechanisms that are at the centre of many experiences of anxiety. Here are certain common threads including thinking patterns and biological mechanisms which researchers have identified:
Negativity bias
Those suffering from anxiety tend to interpret uncertain situations as having a negative meaning. According to Your Mental Health, researchers are interested in whether this is a general mechanism that applies to any ambiguous situation, or if it only applies to more specific situations that are relevant to the person.
Thinking verbally
Anxious people tend to think in words and sentences, rather than in images. Thinking verbally can involve intrusive thinking with jumping between thoughts.
Inability to direct or control attention
When anxious, the topic of uncertainty can become a spotlight of focus for the person, ignoring wider perceptions. This glued attention style is part of feeling threatened by a situation.
Uncertainty, avoidance and control
Uncertainty, avoidance and control are other common patterns in anxiety. Thoughts can be about the past (rumination) or the future (worry).
Researchers believe this is due to differences in connectivity in the amygdala (the emotional centre) and the prefrontal cortex (the centre for planning and problem-solving). There is something different about the mechanisms of control over thinking patterns in the anxious brain that means the prefrontal cortex cannot do its usual job of regulating emotional signals. This leads to a more sensitive flight or fight response.
“It really boils down to difficulties with appropriately regulating fear. Fear itself is normal. If we didn’t have fear we would not be able to survive, because we would have no system in place to tell us to avoid danger or threat. Anxiety is an example of adaptive processes gone awry, but when we treat anxiety we’re not focused on causes, but what keeps it going.” - Professor Bronwyn Graham
John Fendley - My Story
From Your Mental Health
John ‘Fenners’ Fendley is best known as a presenter on the Sky Sports television programme Soccer AM. As well as his love for football, having worked in football programming for nearly two decades, John is a keen ‘jacket enthusiast’ and is well known for the range of different coats he wears while presenting.
“I first remember experiencing anxiety after I’d finished sixth form and was working at a local shop. I had a meltdown when someone spoke to me aggressively, and I became anxious and tearful. It felt like I’d reverted to being a little boy. It was embarrassing, but I just wanted to go home. From then on, I started to have panic attacks. I cried a lot and had a breakdown of sorts. Looking back, it was probably linked to the death of my dad when I was young, although I didn’t feel like I was grieving.”
John talks about the role of uncertainty linked to anxious thinking. “The things that get me into an anxious or depressed state are the ‘what if?’ scenarios. I beat myself up about the way I feel, and I overthink. You wake up and that thought is there, and you can’t beat it with rational thinking. It’s like having a reception area in your head. When you’re feeling great and have balance in your life, the negative thoughts stay in the reception area. If you’re not feeling good, though, the thoughts get in and wreak havoc, gnawing away and debilitating you. You wonder if this is how you are feeling or only think you’re feeling. It becomes a constant battle between your subconscious and your conscious brain.”
Retraining The Anxious Brain
‘When you retrain the anxious brain, it’s just like learning a new skill that then becomes automatic. Negative thinking habits become replaced by more positive ones. It’s as though there is a T-junction or a fork in the road and, although you have always gone one way, you now see the other way. It’s not a conscious dwelling at the T-junction; you don’t even see the other path.’ - Professor Colette Hirsch, Professor in Cognitive Clinical Psychology at King’s College London.
According to MQ Mental Health Research, research has shown that psychological therapies, such as cognitive behaviour therapy, exposure therapy and psychotherapy are effective treatments for anxiety. Here are a few key treatments commonly used for anxiety:
Cognitive Behavioural Therapy (CBT)
Cognitive behavioural therapy (CBT) is a type of talking therapy. It is a common treatment for a range of mental health problems, including anxiety. CBT teaches you coping skills for dealing with different problems. It focuses on how your thoughts, beliefs and attitudes affect your feelings and actions.
Typically within the NHS, a GP can offer a type of antidepressant called selective serotonin reuptake inhibitor (SSRI). This type of medication works by increasing the level of a chemical called serotonin in the brain.
In research supported by the charity MQ Mental Health Research, Dr Andrea Reinecke from Oxford University is leading research on a single CBT session combined with medication.
There are two parts to this project, both of which build on previous clinical and lab research. The first involves refining the single-session CBT treatments, to understand more about why CBT can reduce anxiety and to ensure the rapid treatment is as effective as possible. The second is the first major study of whether a blood pressure drug could also be used safely and successfully to treat anxiety.
The potential of this treatment method is delivering a time-effective therapy supported by an existing drug used in a new way, enabling many more people to live a better life, more quickly.
Exposure therapy is a form of CBT particularly useful for people with anxiety in the form of phobias or obsessive compulsive disorder (OCD). Exposure therapy is defined as any treatment that encourages the systematic confrontation of feared stimuli, which can be external (eg, feared objects, activities, situations) or internal (eg, feared thoughts, physical sensations). The aim of exposure therapy is to reduce the person’s fearful reaction to the stimulus. Due to the nature of the therapy, medication can be applied in conjunction for a therapeutic effect.
Cognitive Bias Modification (CBM)
This therapy works towards a healthier thinking style for treating anxious thinking patterns.
Negative interpretation bias is associated with the repetitive negative thinking pattern in anxiety. CBM works to reduce this bias and so also reduces the occurrence of repetitive negative thoughts.
CBM involves training someone with anxiety to interpret ambiguous information as benign (rather than negative) or to generate positive interpretations.
By identifying the common threads of anxiety including thinking patterns and the role of uncertainty, researchers in the mental health field can help demystify anxiety and shed light on effective treatments to manage and ultimately retrain the anxious brain.
Support Resources
If you are concerned about anxiety, the first step is to talk to your GP. The mental health charity Mind has a number of resources to guide and support on talking to your GP here.
Mind provides advice and support to empower anyone experiencing a mental health problem. If you need non-urgent information about mental health support and services, call Mind’s Infoline on 0300 123 3393 or email: info@mind.org.uk
Or visit their website here.
Anxiety UK is a charity with an extensive range of support services designed to help control anxiety rather than letting it control you. Visit their website here.
Here are their support channel details:
Helpline: 03444 775 774
Text: 07537 416905
(open Mon-Fri 10:30-16:30)
References
To better understand Anxiety and to read John Fendley’s complete My Story, get your copy of Your Mental Health here.
Cognitive Bias Modification
Beard C. Cognitive bias modification for anxiety: current evidence and future directions. Expert Rev Neurother. 2011 Feb;11(2):299-311. doi: 10.1586/ern.10.194. PMID: 21306216; PMCID: PMC3092585.
MQ Mental Health Research
Researching better mental health for everyone.
View their website here: MQ Mental Health Research | Transforming The Future of Mental Illness
