Categorized | Stress

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The Neurobiology of Panic Attacks and Anxiety

In this article I am going to describe the basic neurobiology behind anxiety, and why anxiety can grow out of control, resulting in panic attacks. Using this basic understanding of the brain, I am going to show you how you can completely eliminate panic attacks and anxiety.

Anxiety, stress, and panic are all a consequence of the activation of the sympathetic nervous system, also known as the “fight or flight” response.

The sympathetic nervous system is activated when a human being experiences a sensation of threat and needs to fight or flee from a perceived danger. This involves the release of certain hormones, the most famous being adrenaline (epinephrine), and the stress hormone cortisol (the most important of a group of hormones called glucocorticoids). These chemicals set off a cascade of events throughout the body, such as increased heart rate, elevated blood pressure, increased respiration, muscle contraction, decreased digestion, and increased flow blood from the extremities into the vital organs. This response lowers the immune system in order to give a person more energy in the present moment.

This entire response is designed to increase a human being’s chances of survival in the face of threat. It is meant for acute, short term threats to survival.

Anxiety disorders develop when this response chronically fires off in the absence of threat. In modern society, we don’t face many physical threats to our survival. However, we tend to react to our everyday troubles in much the same way that our ancestors did to serious threats to their survival. The problem is that the stress response isn’t meant for traffic jams, C’s on our report card, or many of the other problems we face in modern life.

Corresponding to the physical response is the response in the brain. An area of the brain known as the amygdala (Greek for “almond”) is responsible for activating the fear response. It is often referred to as the “fear center” of the brain. When cortisol (a stress hormone) is released in the brain, the amygdala actually increases in responsiveness and grows new connections. This is known as the “arborization of the amygdala”. The amygdala literally gets bigger and more responsive to more subtle stimuli.

This is bad news for people with anxiety. Because at the same time the amygdala is getting bigger (and their anxiety increases), another part of the brain becomes less responsive, and can actually shrink when anxiety and stress gets out of control. This part of the brain is known as the hippocampus.

The hippocampus is the part of the brain that puts the brake on the amygdala. The amygdala can be conceptualized as the “accelerator” on your fear, panic, and anxiety, whereas the hippocampus is the rational voice that comes in, bringing logic, context, and relaxation into the picture. The hippocampus is the “brake” on your anxiety and panic.

When cortisol levels increase (during periods of intense stress, fear, anxiety etc.) this inhibits the functioning of the hippocampus. High levels of stress actually cause cell death in the hippocampus. In people who have experienced severe anxiety, the hippocampus actually atrophies and gets smaller.

But at the same time this is happening, the amygdala is having a party. It’s getting bigger and bigger, and more reactive. This is why panic can literally spin out of control and take over a person’s life.

So how does one counteract this negative process in the brain? Can an amygdala become less reactive if one gets treatment for anxiety and panic?

The answer is absolutely yes!

Remember, the hippocampus is the “brake” on your anxiety and fear. For example, suppose you’re going for a hike and you see a fallen tree branch on a trail that at first glance looks like a snake. You may feel a quick burst of fear, followed by a voice that says “oh, it’s just a tree branch”. That “oh, it’s just a tree branch” part of your brain is your hippocampus calming you down. If it weren’t for your hippocampus, your fear response wouldn’t stop.

Your hippocampus also stores explicit, verbal memories. When you remember your tenth birthday, or the fact that George Washington is the first president, those memories are stored in your hippocampus.

Your hippocampus works with your cortex (the thinking part of your brain) to calm your amygdala down. What this means is that correcting fearful thoughts actually promotes the functioning of your cortex and hippocampus.

In my program The Panic Plan, I go over how to correct these fearful thoughts. By doing this you actually change the structure and functioning of your physical brain. You are sending calming and soothing messages to your amygdala (from your cortex) telling it to calm down. Over time, after doing the exercises in my program, your amygdala naturally and habitually becomes less reactive. This is due to a process known as neuroplasticity, by which the brain grows new connections.

It is through this process that you become a more calm person. Panic can be completely eliminated.

Other techniques I show you in my program involve expressing suppressed emotions. When we hold our feelings in, this can also increase the activity of our amygdala, increasing the severity of anxiety and panic attacks in particular. By consciously processing our emotions, often times panic attacks instantly go away.

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