How We Develop Anxiety

Our Brains Cannot Tell Psychosocial Stress from Fear

Psychosocial stress and fear have traditionally been looked at as different emotional experiences that are processed through different areas of the brain.  New study has found that this is not the case and the human brain reacts the same to both stimuli. The study used functional MRI which shows brain activation patterns.  Patterns were examined both during simulated fear and during psychosocial stress.  The reaction in the brain was the same during either situation.

Fear is a protective mechanism necessary for survival.  Stress, on the other hand, was always looked at as simply a reaction to an unknown such as, will I lose my job or catch the virus?  Stress was thought to create less “training” of brain activation patterns than fear, but this is not in fact the case.

If we have a close encounter with a 400 lb bear while hiking, we develop fear.  The encounter occurred because we were enjoying the view and didn’t notice the bear until we were too close to quietly turn around and retreat. The brain becomes completely focused on the bear and how to save yourself, fight or flight.  During this process, we don’t observe anything else and focus intently on the bear.  We have little observation of the blue sky or beautiful view from the trail.  This offers the maximum chance of surviving the situation.  This experience is also being recorded unusually strongly in the brain to protect us during another similar encounter.  We will watch the trail and look for signs of danger more intently on future hikes. In essence, this experience has been more intently wired into our memory so we react faster the next time.

 The stress of, will my job exist next month, will I be able to play a sport this fall?, or the many other stresses associated with this pandemic now looks as if it causes the brain to react in the same fashion.  The brain develops heightened awareness, intense imprinting of the stress in the brain and suppression of other memories during the stress.

Repeated stress is weighted heavier in the brain with subsequent exposures the same as repetitive fear is.  With time, the repeated activation of the stress/fear pattern in the brain begins to train the brain to stay in that activation even when no stress is occurring.  In essence, we begin to react to normal events as if they were very stressful, or as if there were significant fear present.  This increasingly heightened brain activation with repeated fear has been well known to cause future subsequent minor pieces of the fear that can trigger a very excessive brain reaction.  This is the hallmark of PTSD where a sound, image or other “piece” of a prior strong fear event now triggers an excessive reaction.

The disorder of anxiety in many ways is simply a brain that has been trained into a sustained stress/fear activation.  Normal events cause an abnormal reaction, anxiety.  The constant stress causes the brain to begin to weigh normal events as stress/fear events. 

Clinical anxiety disorders have been steadily increasing and affect 18%, or about 1 in 6 adults.  2020 is expected to create a sharp rise in this trend.  The traditional treatment until recently has centered on anti-anxiety medications.  These drugs, however, do not help everyone and are associated with adverse effects.  Telling of this is that only a third of patients suffering with anxiety end up treating it with medication. 

A promising alternative is neurofeedback, or EEG guided brain training.  The stress/fear activation pattern in the brain presents with specific alterations of brain activity seen on EEG.  Most typical of this altered activation pattern is too much beta wave activity in the front of the brain and excessive processing of information on the right side of the brain.  The front of the brain is where more intense focus is maintained such as in the presence of danger.  The right side of the brain processes more emotional information and that needs to be balanced against the more analytical left brain to prevent normal stimuli from generating too much emotion.

The image shows the 2 EEG patterns seen with anxiety, excessive right-sided processing and high beta activity in the front of the brain.  After repeated activation of this pattern, the brain has “rewired” now processing all information with too much emotion.  This process of “wiring” activation patterns in the brain called neuroplasticity is the basis of learning.  Things are repeated causing the brain over time to learn this pattern.  There is a dark side to neuroplasticity.  Frequently repeated negative activations in the brain use neuroplasticity to learn this pattern.  Repeated stress caused the excessive right-sided activation pattern to become “wired” into the brain.

Neurofeedback uses what imbalanced the brain, neuroplasticity, created by repetition of a balanced activation pattern to write a new activation “program” over the stress pattern.  The person watches a movie or show for 30 minutes while EEG electrodes are monitoring brain activation.  If the brain activates in a balanced pattern, the brain is rewarded by the screen and sound both being clear.  If the excessive right-sided or frontal high beta activation begins to occur, the “reward” (sight and sound) fades.  The brain will change its activation to try to get the reward back. 

This process will happen many times for several seconds during a training session.  Each time the brain is successful in recovering the reward, it is a learning cycle.  With many cycles over several sessions the brain begins to rewire back into the more balanced pattern. 

Unlike medication, neurofeedback restores a normal brain pattern to relieve symptoms rather than simply chemically making the symptoms temporarily not be noticed.  While medication effects tend to diminish over time, neurofeedback creates a progressively greater effect over time.

Neurofeedback will not change the circumstances of a stressful year.  It will, however, provide a non-drug way to undo these effects helping anxiety. For those who would like to see if neurofeedback can help, just call and schedule an appointment for a neurofeedback evaluation. 

Hur et al.  ANXIETY AND THE NEUROBIOLOGY OF TEMPORARILY UNCERTAIN THREAT ANTICIPATION.  Journal of Neuroscience 21 September 2020.