On Anxiety

On Anxiety

What is the Normal Stress Response?

Humans, like all mammals, have a universal stress response. When a threat is detected, the emotional part of the brain signals the body to activate the fight-or-flight response. This is an adaptive mechanism designed for survival. Once the danger has passed, the emotion abates, and an animal, like a deer, goes back to foraging. For humans, this means the body returns to a state of calm.

When Stress Becomes Anxiety: The Tipping Point

However, for some people, this stress response breaks the bounds of normalcy, becoming excessive, dysfunctional, and near-constant. This is the definition of anxiety: the fear response overwhelms the entire system. The dam of normal emotional regulation—which allows for measured behaviors and responses—breaks. What is meant to be a self-preservative adaptation morphs into a chronic activation of the nervous system, which can become an anxiety disorder.

What Causes Anxiety? A Combination of Factors

A propensity for anxiety is rarely caused by a single thing; it is determined by multiple factors. The result is unique to each individual, with reactions running from alertness to excitation to panic. Key contributors often include:

• Early life experiences

• Specific emotional or physical trauma

• A genetically mediated sensitivity to nervous system excitation

  
  

This anxiety can also become attached to normal events, such as social situations, where there is no objective external threat. It can manifest as a feeling in the stomach; the gut contains many of the same neurotransmitters as the brain, which are activated through the vagus nerve in what is known as the gut-brain axis.

How Anxiety Generalizes: Understanding PTSD and Perceived Threats

Through processes of habituation and generalization, fear is no longer just a response to an objective, immediate, external source. It can be activated by any stimulus, actual or perceived, and become a generalized response.

This means anxiety can be triggered in the moment but is often caused by a distal event or experience, real or imagined. Post-Traumatic Stress Disorder (PTSD) is a clear example of this phenomenon. In cases like PTSD or generalized anxiety, the response can be triggered by a situation that isn’t inherently dangerous but is treated as if the danger were real. For example, it can manifest as:

• An internal feeling that one isn't good enough and will fail at a particular activity.

• An automatic feeling that everything one does will be met with negation and failure.

• 
  

How Psychotherapy Can Help Treat Anxiety

Psychotherapy works to reduce these automatic responses by using a two-pronged approach that addresses both the physical symptoms and the underlying thoughts.

1. Behavioral Tools for Immediate Relief

The first goal is to address the maladaptive anxiety responses directly. This approach is based on the principle that you cannot be both anxious and relaxed at the same time. It presupposes that the person is aware of the anxiety and is able to take corrective action using tools such as:

• Deep breathing exercises

• Meditation and mindfulness

• Other competing response techniques

  
  

2. Cognitive Approaches for Long-Term Change

The second approach is cognitive. This requires an understanding of the root cause of the anxiety and the ability to challenge dysfunctional ideas with counter-thoughts. For instance, one might tell themself, "This current situation is not the same as when I was younger and felt powerless."

This method replaces early, irrational thoughts with mature, rational ones. Achieving this cognitive shift takes time but can lead to lasting change in how you respond to anxiety triggers.

That’s the value of psychotherapy. Sometimes it is combined with psychotropic medication if the anxiety is severe and disabling. These medications work by various means affecting neurotransmitters, all designed to reduce nervous system excitation. A psychiatrist would recommend which medications at which dosage.