There are numerous causes of anxiety and depression, including past trauma, chemical imbalances, substance abuse and genetics. These disorders are often a shitty pair that hang out with one another. Having one of these illnesses for too long usually means that its pal isn’t far behind. What I’d like to do in the next two posts is break down some of the biological, physiological and psychological elements of these disorders, so you can better understand what your body is going through when you experience them. For me, doing this helped take away some of the power that my disorders had over me. It also better prepared me for healthy lifestyle changes that would soon ease my anxiety and depression.
When I came to grips with the fact that my anxiety and depression weren’t going to magically disappear, I realized that I was going to have to put in a wholehearted effort to try and make sense of what was happening to my brain and body. I couldn’t process the thought of fighting something that I wasn’t able to understand. So, I decided to arm myself with the knowledge to combat the insatiable forces that were feeding on me from the inside out. Once I was able to give anxiety and depression a face, things seemed a bit easier to deal with. I finally understood why I was sweating, nauseous, shaky, and fearful when I was having an anxiety attack. Or why I was sedentary, hopeless, practicing poor diet choices, or extremely sad when I had bouts of depression. Breaking it down to a cellular and chemical point of view helped me normalize my disorders, which in a way made them seem less powerful and easier to treat. I hope you can use this information as a foundation for your own research in the future.
Explaining anxiety to somebody who has never experienced it can be an exhausting endeavor. Firstly, because a lot of the time anxiety sufferers can’t explain it to themselves. It’s such a mysterious affliction, often arising without any cause or tangible reason. Secondly, anxiety has a pretty wide spectrum of severity and symptoms. From an uneasy sense of worry that shows up every now and then, all the way up to full-blown chronic anxiety that leaves people hospitalized and heavily medicated, anxiety can come in many forms. Lastly, there are countless different triggers for anxiety. These mostly appear as phobias like spiders or heights, social situations, or worries of the future, such as deadlines at work or that nagging doctor’s appointment that you’ve been putting off.
In the opinion of many health professionals, anxiety is fear-based. We all have something that we’re afraid of, whether we’re willing to admit it or not. In human society, being afraid is often seen as a weakness, especially for men. We’re taught to hide our fears and bury them deep, so to not appear weak or of a lower order than the image of the alpha-male. This causes nothing but detriment to the developing male mind. Instead of learning how to deal with and conquer fears, we’re left to hide them but also carry them with us forever. Maybe the alpha-male is more fearless than its beta counterpart, not because he’s absent of fear, but more likely because he is able to confront his fear with confidence and a strong will. This concept isn’t just pertinent to men, either. Women deal with similar hierarchical structures in their daily lives as well. They constantly contend with the stereotypical image of beauty that’s been piled on top of them by media, significant others and authority figures, since childhood. They’re expected to look and act a certain way or risk judgement and degradation. This plays out poorly on a woman’s self-confidence and ability to stand up to fear and persecution.
Along with our fears, we also have some sort of baggage that we all carry with us; things that we keep putting off or don’t want to confront. Sometimes our brains, when confronted with difficulty, search for the path of least resistance. Usually because we lack the necessary skills to deal with certain challenges and hardships. The brain analyzes a growing personal problem and fails to understand it, so no solution is found. This computing error gets pushed to the side until it can be reassessed at a later date. Unfortunately, “out of sight, out of mind,” doesn’t work in this situation. It’s more like, “out of forefront of mind and into rear-mind.” The issues that we neglect to deal with become the past-due bills in the dank, dark corners of our psyche. Enough time passes, and the second and third notices pile up. Then, the letters marked “URGENT” come streaming in. Eventually, the phone calls and bill collectors show up and we’re left trapped in our houses, peering through the curtains at the messes we’ve created through pure ignorance and denial. Still, we try our best to shut off the lights and pretend we’re not home, but deep down we know that one day they’ll come back to greet us.
Our anxiety can be attributed to the Fight or Flight or Freeze Response. This is characterized by the body’s instinctual reaction to either fight, run away, or freeze when presented with impending danger. This all begins with your 5 senses.
Say you’re having a nice nature walk through the forest and you stumble upon a bear. This is the very beginning of your perfectly normal fear response, your body’s reaction towards its need for survival. Your eyes see this enormous threat lumbering towards you with hungry intent. This visual cue is sent to a part of your brain called the Thalamus which is responsible for relaying sensory and motor signals to the Cerebral Cortex. The Cerebral Cortex is where these visual signals are given meaning. Remember, your eyes have seen the bear, but your brain still must understand and acknowledge what a bear is. If a threat is detected, another part of your brain called the Amygdalae, which are responsible for emotions and survival instinct, immediately triggers the fear response. They do this by sending a signal to the Bed Nucleus of the Stria Terminalis (good luck remembering that one) or the BNST. The BNST perpetuates this fear response, aiding in keeping you in a heightened state of awareness and readiness.
Now, this is where the fear response begins to spread from your brain and into your body. While the Amygdalae are sending a signal to your BNST, they’ve also sent another signal to the Locus Coeruleus, a cluster of neurons located along the brainstem. This is where the neurotransmitter and hormone Norepinephrine is synthesized within the brain. Think of it as your body’s hidden stash of jet fuel. Norepinephrine floods your brain and body and kickstarts into action to deal with this not so cuddly bear and readying you for fight, flight, or freeze (or the more likely reaction of shitting your pants and crying in front of that snarling bear.) As the Norepinephrine courses through you, it invokes physical and mental changes in your body and brain. In the body, it starts to increase your heart rate and blood pressure to stimulate blood flow to your muscles, hopefully for running away and not for punching that bear while it eats you. It also starts to draw blood away from your digestion system, so it can be used in more important areas of the body. This is often where your nausea comes from when you’re having anxiety. In the brain, Norepinephrine is responsible for increased alertness, vigilance, and attention. Your pupils dilate to let in more light and your vision becomes acuter. Your fingers and toes tingle and you feel like you just drank a whole case of meth-laced energy drinks. These reactions are all completely normal, typical and healthy for the circumstances and probably sound familiar to you. But when you start having these same reactions while there is no bear or imminent threat to your life or safety, that’s when an anxiety disorder may be the culprit.
Anxiety disorders summon these fear and survival responses when there are no actual threats to our lives. The brain of an anxiety sufferer is unable to differentiate between a genuine threat, like the hungry bear, or a less rational threat like an ambiguous text from a loved one. Our brain’s rush into overdrive and we scramble to find a positive cause and solution. When only negative possibilities are found, this comes as the feeling of “impending doom,” as it is so eloquently described. To make matters worse, our brains become very adept at convincing us that there really is something that’s going to harm us. Left unchecked, the brain becomes a subconscious saboteur. Realistically, the brain is just doing its job. However, it becomes an unfortunate case of right intent, wrong time. This is where we need to train our brains to act properly, and only in truly threatening situations.
As I mentioned before, anxiety can have many leading causes. Some people are more susceptible to anxiety simply because of their genetics. It is now agreed upon by many medical professionals and experts that fears may be passed on through our genetic makeup by our ancestors. Studies have been performed on female mice, where they are taught to fear the scent of cherry blossoms by giving them an electric shock each time they come near one. As a part of the experiment, the mice become impregnated. Once the offspring are born, they are subjected to the same cherry blossom scent, minus the electric shock. Generation after of generation of these mice inherently fear that same scent. This is true, even if the female mice are artificially inseminated. This means that if hundreds of years ago, one of your ancestors was afraid of water because they almost drowned as a child, it could be a reason why you get anxiety when you step on a boat.
Fears can also be passed on through family members through more of a reactionary and behavioral point of view. Let say, instead of your ancient ancestor having a fear of water, it was your grandfather that had a close call with drowning. Maybe this became a serious fear for him, one that stuck with him throughout his life. As he got older, he might have been apprehensive and anxious when your father was playing with his friends at the pool. Your grandfather acted erratic and unpredictable, thereby passing on that fear of water to your father. And so on, down the line until it got to you. Finding our fears and the triggers of our anxiety are monumentally important in synthesizing our personal reparation and rebuilding. This is where counseling has a huge impact.
To have a trusted person that you feel safe and comfortable with is enormous when uncovering the root causes of anxiety and depression. Personally, I kept everything to myself for way too long. I’d stubbornly try to figure out my problems alone and unaided and in no time, I’d be frustrated, angry and hopeless. I’d see myself as stupid, useless and weak. Eventually, it began to perpetuate my self-loathing. I didn’t want anybody to see me as the failure that I saw myself. Over and over, I’d hit a wall, feel sorry for myself, and give up. Because it was easier to admit defeat than ask for help. It took me a long time to understand that the simple act of vocalizing thoughts can help clear away some of my everyday burden and pain, a little bit at a time.
Other external factors that lead to anxiety disorders can be less inherited and more environmental. Past trauma and abuse can have severe impacts on the development of a child’s brain as well as the reformation of an adult’s brain, post-trauma. Post Traumatic Stress Disorder (PTSD) is a very real and serious disorder that has gained light in recent years due to so many soldiers returning home with grave mental damage from the atrocities that they’ve witnessed while on duty. This disorder is characterized by depressive and anxious feelings, sleep disturbances, as well as changes in memory and concentration. However, PTSD isn’t just an affliction of the soldier who’s seen war. Physical, mental and sexual abuse, witnessing brutal violence and near-death experiences can all trigger PTSD in people from all walks of life, regardless of their occupation or social standing. Not unlike anxiety disorders, PTSD is often triggered by memories and is also attributed to increased Norepinephrine levels. Long-term stress and trauma can lead to a semi-permanent change in the neurochemistry of the brain. Just like in people with anxiety disorders, PTSD raises the levels of Norepinephrine and Cortisol to sometimes dangerous levels.
Cortisol is another hormone that aids us in times of danger. It too plays a key role in kickstarting our fight, flight or freeze response. Cortisol activity is controlled mainly by three areas of the body. The Hypothalamus, in the brain, secretes corticotrophin-releasing hormone, which signals the pituitary gland, located near the base of the brain, to release adrenocorticotropic hormone into the blood system. When this hormone arrives at the adrenal glands, on top of your kidneys, they notice the higher levels of the adrenocorticotropic hormone and produce cortisol that is then circulated throughout the body. Get ready for the withdrawal jitters, sweaty palms and underarms, the heart rate like a drum solo in a punk rock song, and the sudden urge to puke or shit in your pants.
Cortisol isn’t just an anxiety-inducing bodily terrorist. It plays many important roles in our bodies including anti-inflammatory responses and the formation of memory. It’s when we have over-elevated and sustained levels of cortisol that we run into problems. This can result in something called Hypercortisolemia or Cushing’s Syndrome. The brain becomes overrun by too much cortisol, resulting in cell death and changes in the function and ability in certain parts of the brain. The hippocampus, an area of the brain responsible for emotion, can literally shrink in size when overcome by too much cortisol. Ultimately, persistently induced stress along with the subsequent high cortisol levels can increase the chances of developing a major depressive disorder. Essentially, this resistance feeds on itself for sustenance and our brains become more sensitive to moderately stressful situations, thereby providing more food for the monster. It’s a good example that too much of a good thing can be a bad thing.
Anxiety disorders have the ability to drastically reduce a person’s quality of life. Left untreated or not treated effectively, these disorders can exacerbate themselves, leaving sometimes irreparable damage to the body.
Now, I understand this post might be a lot of information to take in. This was the result of weeks of sleepless nights reading PubMed studies, medical journals, and drawing diagrams while my anxiety was at its peak. I became obsessive about what was going on in my head and needed answers. I hope that, at the very least, you can find some relief in knowing that your brain isn't actually trying to sabotage you when you're having an anxiety attack. In fact, it's trying keep you alive by overreacting to threatening stimuli. As your confidence grows and your ability to be more balanced and present evolves, this stimuli becomes less threatening and you'll begin to overpower and gain control of your anxiety. It may not go away completely, but it'll feel more like a bug bite rather than a lion chewing your arm off.