A lot is going on in the anxious brain. Many parts of the brain and various neurotransmitters, hormones and amino acids are busily contributing to your anxiety, but there are some main players of particular importance. It is important for you to get acquainted with these parts and their function so you can know and understand their role in anxiety and consciously learn to use CBT to intervene thereby using your brain to change the level, duration and frequency of your anxiety.
Note: Though I have studied neuropsychology extensively I am not a neurologist and this is a simplified version of what is going on in your brain. Enough, though, for us to use Cognitive Behavior Therapy (CBT) to work together on your anxiety issues.
Quick Overview. When a part of the brain called the Amygdala recognizes a stimulus that is similar to a previous emotionally negative experience, it assigns a negative significance to the present stimulus and alerts other parts of the brain to go into a stress response. Another of your brain called the Anterior Cingulate Gyrus (ACG) receives this emotional information, amplifies and filters it and passes to a part of the brain called the Prefrontal Cortex (PFC). The PFC examines and accesses the information, checking with memories stored in the hippocampus. Then sends back
modulating information to either confirm the current situation as negative and of concern or tell the Amygdala to turn off the alarm signal and let it go.
This is how it works if all the parts are working well. If not, the shut-off messages don’t get sent and anxiety if the result. Any time this process gets out of balance or the brain becomes too overactive or underactive, symptoms like anxiety can continue until you can make a change in your brain.
SPECT Scan of an Overact and Under Active Brain
Too active can lead to anxiety, tension, panic, physical symptoms of stress and poor decisions.
Underactive can lead to depression, apathy, lack of energy and decreased motivation.
So now let’s get acquainted with the workings of each of these parts.
(Cortex) Prefrontal Cortex. The Brain’s Boss with the Brake. This is the part of the brain that carries out the executive function. It can control and instruct all other parts of the brain. It keeps the more primitive emotional areas of the brain in check and instructs them in what is and is not a concern much like a parent does for a child. Children are less flexible in their responses to situations than parents, whose job is to instruct them and help them regulate. Like a parent, The PFC controls mood, behavior and impulses we’ll be glad we didn’t’ act on. It puts the BRAKE to undesirable behavior both internal and external.
The PFC is also known as the Optimistic Brian because it creates positive cognitive interpretations, sees options to handle negative situations and resolve problems satisfactorily.
The PFC is able to do this by obtaining information via neurotransmitters (messengers) from all part of the brain, evaluating incoming information and making decision about the significance of what’s coming in, deciding what needs to be done about it and instructing the other parts of the brain accordingly.
When the PFC is working well, it gets messages back to the other players to call a halt to needless worry and stop the physical sensations of anxiety. It provides our ability to concentrate, plan, control impulses, organize, follow through and much more. If it’s not working well, then your brain can run amok, so to speak, leaving you feeling helpless to control your thoughts and feelings and the uncomfortable physical symptoms of anxiety. With no executive control, you’re left to do things based on urges from the more primitive parts of your brain such as to fight, flee or freeze.
There are many possible reasons the PFC is not working well in the anxious brain, such as:
– There may not be enough energy (blood flow) to the PFC to override a bombardment of
excess anxious input pouring in from other parts of the brain. Anxiety itself actually diminishes blood flow to the PFC.
– The PFC may not be getting the right kinds or amounts of information from other parts of the
brain via neurotransmitters (messengers), i.e. too low serotonin, a calming influence, or too
high norepinephrine, a stimulating influences.
– The PFC may have inaccurate cognitive information from life experiences (or lack thereof) or
past traumas that are accepted as current, making good decisions impossible about
anxious input impossible,
– Trauma may disrupt PFC functions. Therapy can correct this.
– Insufficient parenting or cognitive issues like ADHD may prevent the PFC from being able to
understand or process information accurately.
– Hormonal imbalances such as an overactive thyroid gland or low estrogen.
– Low blood sugar (Hypoglycemia).
– Brain injuries, often unrecognized, may have impaired the PFC.
– It may be taxed by poor brain habits like drug use and CATS (Caffeine, Alcohol, Tobacco and
Sugar), too much stress, not enough sleep, eating nutrient-poor food, not drinking enough
water or a lack of exercise.
– A heightened arousal under stress has depleted the supply of energy and neurotransmitter.
The PFC will be your workhorse in changing your anxious brain by
using Cognitive Behavior Therapy (CBT).
|
|
We need to work together to address any issues hindering its proper functioning. They can’t all be addressed at once, of course. For example, eliminating or at least reducing things that make it harder on the brain like the CATS (Caffeine, Alcohol, Tobacco and Sugar) and adopting new habits that are good for your brain usually can’t be done all at once overnight. This is especially true when you already burdened with high anxiety, but you can do them gradually as your counseling progresses. There may well be a lot of work ahead, but the benefits will make it worthwhile and you’ll be able to enjoy some of them quite quickly.
The Anterior Cingulate Gyrus (ACG) The Brain’s Switch. This area of the brain is a bridge between the older emotional parts of the brain like the amygdala and the PFC. It is intended to make the connections for processing emotional, sensory, cognitive and motor information and enable you to switch smoothly between thoughts and feelings. It sets a positive emotional tone, enables us to see options, goes with the flow, cooperates, feels motivated, recognizes and corrects errors, negotiates, resolves conflicts and helps the PFC direct activity toward goals. When one way of thinking or acting isn’t working well, the ACG plays a role in finding solutions and new ways to pursue.
But when the ACG is not working well, it becomes a major culprit in creating anxiety and worry. When the energy to the AC is overactive thoughts get stuck there and the anxious brain emerges. Instead of shifting smoothly from thought and emotion, shifting from one idea to another and viewing problems as having many possible solutions, the ACG ruminatively holding on to hurts and mistakes. It creates a loop of worrying over and over about negative thoughts instead of shifting them. We become rigid and oppositional because the first connection it makes between emotion and thought gets stuck and does not shift smoothly to other options. When the ACG is stuck the PFC has a harder time communicating back soothing or correcting information to the fearful primitive parts of the brain.
On the other hand, when activity in the AC is too low it results in apathy and lack of motivation.
The Basil Ganglia (BG) – The Brain’s Idle. This part of the brain sets the general level of energy for all mental and physical tasks. It receives and sends information to
the Cortex. It communicates directly to the primitive parts of the brain and plays a significant role in the feeling of pleasure and awareness of when thoughts or actions are completed. It sets the general level of tension and drive. There are many GAGA neurons (cells) in the BG. GABA is a neurotransmitter (messenger) that tones down overactivity in the brain. The BG is also the site of many natural opioid receptors the body manufactures like endorphins, neuropeptides that block pain, slow breathing, and provide a general calming and anti-depressing effect.
When GABA fails to diminish activity in the BG, it becomes overactive and turns into another culprit in the experience of anxiety. We become tense, for example, on edge, and anxious but also:
– Emotional and Cognitive Negativity. We see something wrong with everything and predict the
worse for anything.
– Irritability, angry outbursts, and aggression with little or no provocation.
– High reactivity. When we’re tense we feel an overall level of arousal. We react strongly to small
stressors or changes. We startle easily, feel uptight and wired. It doesn’t take much to tip us into
feeling anxious, negative or angry.
– Shakiness and panic. The BG is important to motor control so it may be involved in the shaking
and agitation we experience with anxiety.
When hyper sensitive it can initiate panic attacks because it may just fire off alerts of danger without provocation.
The Limbic System (LS) – The Emotional Brain. The Limbic System is composed of four parts that make up the older, more primitive brain. They all play a part in anxiety.
The Thalamus is the relay station. It processes external stimuli so rapidly relays it to the
amygdala and the rest of the limbic system that it is considered to be the starting point of all
anxiety from the external environment. Instantaneous incoming stimuli from other parts of the brain may panic or anxiety.
The Hypothalamus processes internal stimuli and initiates the stress response (fight, fight,
freeze) when needed. Oversensitivity here causes of the overactive stress response and physical
symptoms of anxiety are heightened.
The Amygdala, which you met above, sets our emotional tone and gives out early warning
signals to threats in the environment. Some people have an oversensitive amygdala than
others. People with GAD often are born with a larger amygdala making them more sensitive
to possible threats. Oversensitivity leads to moodiness, negativity and excessive recognition of
threats where there are none. This especially true of overreaction to facial expressions
creating an anxious expectation of rejection or humiliation that occurs with social anxiety
The Hippocampus is the memory storage cabinet. It stores details of experiences for short term memory.
Memories create contact for emotional reaction, providing information for the cortex and the PFC and ACG to assess threat.
The combined information from the limbic system is transferred to and from the PFC via the ACG.
There is one more aspect of your anxious brain it’s important to understand to get a grip on your anxiety.
The Neurotransmitters
As mentioned before all parts of the brain must communicate to various other parts to effectively carry out their jobs. Communication takes place to neurons (cells) located in of the each part of the brain described above through neurotransmitters (messengers). The neurotransmitters also play particular roles in the experience of anxiety. They need to be properly balanced and in the right proportions to one another, neither too much or too little.
Here are the key neurotransmitters in the experience of anxiety along with their functions and a few examples of what happens if they aren’t able to do their jobs:
Glutamate – The Starter – is an excitatory neurotransmitter that initiates activity in the brain and is responsible for activating neuronal messengers. It’s distributed throughout the brain and functions in balance with GABA (see below). Without Glutamate communication doesn’t take place.
Norepinephrine (NE) – The Energizer Bunny –a rouses the brain the way adrenalin arouses the body. Keeps us mentallu and physically alert and energetic, enhances thinking, focus and dealing with stress. Too much makes us feel “hyper” and makes it difficult to calm down, relax or sleep. When constantly too high it is the hallmark of anxiety but when it is too low we may feel sluggish and have a hard time having the mental energy to fight off and correct negative thoughts, another hallmark fo depression.
GABA – (Camma aminobutyric acid) The Brake – is an inhibitory neurotransmitter necessary to stop the path of neuronal messengers. It too is found all over the brain and is very significant to anxiety because of its role is to slow down or relax overactive parts of the brain. We get anxious when it is low or out of balance with Glutamate which will keep charging us up. Without the break GABA provides cells continue firing constantly. This makes for a very overactive brain. Rumination, unremitting acute anxiety states and erratic panic can occur.
Serotonin (SE) – The Mood Regulator, is found in many areas of the brain and body. It has been called the feel-good hormone. It connects to the limbic system where it is vital in regulating mood, appetite, sleep, libido, impulse control, stress and pain response, perception of memory and a sense of reward that comes from accomplishment and good fortune. Any of these important functions can be compromised without SE. The PFC can’t do its job without adequate serotonin, so self-control and clear thinking is affected. Distorted thinking can arise from low serotonin as follows:
Part of the
The limbic system + AG + Orbital Cortex + PFC = Cognitive
Negative thoughts Less flexible Decrease impulse Poor concentration Distortion
and Mood Worry control, poor Inconsistent
Rumination integration of Attention
thinking & feeling
Adrenalin – The Gas Pedal, plays a major role in activating the stress response system. It activates the body to respond to a threat, challenge, and danger including the fight, flight or freeze reactions. It also gives us the “get up and go” we need to handle stress. If we are always under stress, though, it keeps our body on constant alert. Adrenal fatigue can result, making us tired and less able to handle even small stresses well.
Norepinephrine (NE) – is key to arousing the brain as adrenalin is to the body. Too much makes up feel “hyper” and makes it difficult to calm down, relax and sleep. When constantly too high it is the hallmark of general anxiety disorder. It overstimulates the ACG, PFC and Limbic system leading to hypervigilance, irritability and anger with little provocation. Also too much NE over stimulates the BG creating tension and the behavioral avoidance seen with anxiety.
Dopamine (DA) – Highly localized in the BG, DA is responsible for the sensation of pleasure and reward and for alertness, concentration, and attention in the PFC. It helps us learn and respond quickly to emotional situations as in seeing a car rolling toward you. The ACG needs it to provide drive and motivation. The pleasure producing aspect of DA is related to pain reduction. The greater the pain, the greater the DA release. The less DA the more pain and the less pleasure we feel, as is so common with anxiety. Too high DA along with high NE we leave us feeling “wired’ or frozen with anxiety. Low levels are associated with depression and apathy.
Beta-endorphins (BEs) – are actually peptides. They are responsible for diminishing the sensations of pain and triggering dopamine release and are vital to the sensations of satiety (the feeling of having enough) and completion, being finished. Without them the sense of completion is missing, causing us to do things over and over and on and on. When someone is in severe pain and BE is strongly active it triggers the release of DA.
By understanding the functions of these neurotransmitters you can see why various medications are selected for different symptoms of anxiety.
– SSRI’s, for example are aimed at boosting serotonin and are usually the first line of choice.
– NSSR’s are designed to balance norepinephrine and serotonin.
– Beta blockers decrease the release of norepinephrine.
– Benzodiazepines like Xanax and Ativan (for quick, short action) and Klonopin (for extended
anxiety relief) enhance GABA .
– Opioids aim to boost DA.
And so forth. Granted each of these medications presents its own problems and sadly they don’t always achieve their intended goals. MD’s do a lot of guessing to figure out which ones will best help a given GAD sufferer. But many people find that the right ones do help, at least to reduce anxiety enough to be a more active and successful in using counseling where you can learn to use your brain to actually change the anxious brain.
Certain supplements and foods that also can assist in balancing particular neurotransmitters, A list of best ones for given neurotransmitters is available to you as indicated.
Brief Summary
– Rumination – Overactive ACG
– Hypervigilance – Elevated NE or overactive BG
– Anxiety with despair – serotonin deficit effecting the Limbic System and the PFC
– Heightened worry and dread – Insufficient or ineffective GABA
– Over reactivity to stress – Overactive HPA (Hippocampus, Adrenal Pituitary) matrix due either
to biological predisposition and/or prolonged stress or trauma
Conclusion
The good news is that psychological treatment with CBT can change the anxious brain. CBT psychotherapy provide tools that help to your Prefrontal Cortex to improve its executive function so you can gain access to all parts of your brain. With these tools you can better control and instruct each part of the anxious brain. With CBT you can get all areas of the brain working together to modulate your thoughts, feelings and actions. When the tools are employed consistently with persistence, brain activity eventually changes to function automatically in healthy ways.
A lot is going on in the anxious brain. Many parts of the brain and various neurotransmitters, hormones and amino acids are busily contributing to your anxiety, but there are some main players of particular importance. It is important for you to get acquainted with these parts and their function so you can know and understand their role in anxiety and consciously learn to use CBT to intervene thereby using your brain to change the level, duration and frequency of your anxiety.
Note: Though I have studied neuropsychology extensively I am not a neurologist and this is a simplified version of what is going on in your brain. Enough, though, for us to use Cognitive Behavior Therapy (CBT) to work together on your anxiety issues.
Quick Overview. When a part of the brain called the Amygdala recognizes a stimulus that is similar to a previous emotionally negative experience, it assigns a negative significance to the present stimulus and alerts other parts of the brain to go into a stress response. Another of your brain called the Anterior Cingulate Gyrus (ACG) receives this emotional information, amplifies and filters it and passes to a part of the brain called the Prefrontal Cortex (PFC). The PFC examines and accesses the information, checking with memories stored in the hippocampus. Then sends back
modulating information to either confirm the current situation as negative and of concern or tell the Amygdala to turn off the alarm signal and let it go.
This is how it works if all the parts are working well. If not, the shut off messages don’t get sent and anxiety if the result. Any time this process gets out of balance or the brain becomes too overactive or underactive, symptoms like anxiety can continue until you can make a change in your brain.
SPECT Scan of an Overact and Under Active Brain
Too active can lead to anxiety, tension, panic, physical symptoms of stress and poor decisions.
Under active can lead to depression, apathy, lack of energy and decreased motivation.
So now let’s get acquainted with the workings of each of these parts.
(Cortex) Prefrontal Cortex. The Brain’s Boss with the Brake. This is the part of the brain that carries out the executive function. It can control and instruct all other parts of the brain. It keeps the more primitive emotional areas of the brain in check and instructs them in what is and is not a concern much like a parent does for a child. Children are less flexible in their responses to situations than parents, whose job is to instruct them and help them regulate. Like a parent The PFC controls mood, behavior and impulses we’ll be glad we didn’t’ act on. It puts the BRAKE to undesirable behavior both internal and external.
The PFC is also known as the Optimistic Brian because it creates positive cognitive interpretations, sees options to handle negative situations and resolve problems satisfactorily.
The PFC is able to do this by obtaining information via neurotransmitters (messengers) from all part of the brain, evaluating incoming information and making decision about the significance of what’s coming in, deciding what needs to be done about it and instructing the other parts of the brain accordingly.
When the PFC is working well, it gets messages back to the other players to call a halt to needless worry and stop the physical sensations of anxiety. It provides our ability to concentrate, plan, control impulses, organize, follow through and much more. If it’s not working well, then your brain can run amok, so to speak, leaving you feeling helpless to control your thoughts and feelings and the uncomfortable physical symptoms of anxiety. With no executive control, you’re left to do things based on urges from the more primitive parts of your brain such as to fight, flee or freeze.
There are many possible reasons the PFC is not working well in the anxious brain, such as:
– There may not be enough energy (blood flow) to the PFC to override a bombardment of
excess anxious input pouring in from other parts of the brain. Anxiety itself actually
diminishes blood flow to the PFC.
– The PFC may not be getting the right kinds or amounts of information from other parts of the
brain via neurotransmitters (messengers), i.e. too low serotonin, a calming influence, or too
high norepinephrine, a stimulating influences.
– The PFC may have inaccurate cognitive information from life experiences (or lack thereof) or
past traumas that are accepted as current, making good decisions impossible about
anxious input impossible,
– Trauma may disrupt PFC functions. Therapy can correct this.
– Insufficient parenting or cognitive issues like ADHD may prevent the PFC from being able to
understand or process information accurately.
– Hormonal imbalances such as an overactive thyroid gland or low estrogen.
– Low blood sugar (Hypoglycemia).
– Brain injuries, often unrecognized, may have impaired the PFC.
– It may be taxed by poor brain habits like drug use and CATS (Caffeine, Alcohol, Tobacco and
Sugar), too much stress, not enough sleep, eating nutrient-poor food, not drinking enough
water or a lack of exercise.
– A heightened arousal under stress has depleted the supply of energy and neurotransmitter.
The PFC will be your workhorse in changing your anxious brain by
using Cognitive Behavior Therapy (CBT).
|
|
We need to work together to address any issues hindering its proper functioning. They can’t all be addressed at once, of course. For example, eliminating or at least reducing things that make it harder on the brain like the CATS (Caffeine, Alcohol, Tobacco and Sugar) and adopting new habits that are good for you brain usually can’t be done all at once overnight. This is especially true when you already burdened with high anxiety, but you can do them gradually as your counseling progresses. There may well be a lot of work ahead, but the benefits will make it worthwhile and you’ll be able to enjoy some of them quite quickly.
The Anterior Cingulate Gyrus (ACG) The Brain’s Switch. This area of the brain is bridge between the older emotional parts of the brain like the amygdala and the PFC. It is intended to make the connections for processing emotional, sensory, cognitive and motor information and enable you to switch smoothly between thoughts and feelings. It sets a positive emotional tone, enables us to see options, go with the flow, cooperate, feel motivated, recognize and correct errors, negotiate, resolve conflicts and help the PFC direct activity toward goals. When one way of thinking or acting isn’t working well, the ACG plays a role in finding solutions and new ways to pursue.
But when the ACG is not working well, it becomes a major culprit in creating anxiety and worry. When energy to the AC is overactive thoughts get stuck there and the anxious brain emerges. Instead of shifting smoothly from thought and emotion, shifting from one idea to another and viewing problems as having many possible solutions, the ACG ruminatively holding on to hurts and mistakes. It creates a loop of worrying over and over about negative thoughts instead of shifting them. We become rigid and oppositional because the first connection it makes between emotion and thought gets stuck and does not shift smoothly to other options. When the ACG is stuck the PFC has a harder time communicating back soothing or correcting information to the fearful primitive parts of the brain.
On the other hand when activity in the AC is too low it results in apathy and lack of motivation.
The Basil Ganglia (BG) – The Brain’s Idle. This part of the brain sets the general level of energy for all mental and physical tasks. It receives and sends information to the Cortex. It communicates directly to the primitive parts of the brain and plays a significant role in the feeling of pleasure and awareness of when thoughts or actions are completed. It sets the general level of tension and drive. There are many GAGA neurons (cells) in the BG. GABA is a neurotransmitter (messenger) that tones down over activity in the brain. The BG is also the site of many natural opioid receptors the body manufactures like endorphins, neuropeptides that block pain, slow breathing, and provide a general calming and anti-depressing effect.
When GABA fails to diminish activity in the BG, it becomes overactive and turns into another culprit in the experience of anxiety. We become tense, for example, on edge, and anxious but also:
– Emotional and Cognitive Negativity. We see something wrong with everything and predict the
worse for anything.
– Irritability, angry outbursts and aggression with little or no provocation.
– High reactivity. When we’re tense we feel an overall level of arousal. We react strongly to small
stressors or changes. We startle easily, feel uptight and wired. It doesn’t take much to tip us into
feeling anxious, negative or an angry.
– Shakiness and panic. The BG is important to motor control so it may be involved in the shaking
and agitation we experience with anxiety.
When hyper sensitive it can initiate panic attacks because it may just fire off alerts of danger without provocation.
The Limbic System (LS) – The Emotional Brain. The Limbic System is composed of four parts that make up the older, more primitive brain. They all play a part in anxiety.
The Thalamus is the relay station. It processes external stimuli so rapidly relays it to the
amygdala and the rest of the limbic system that it is considered to be the starting point of all
anxiety from the external environment. Instantaneous incoming stimuli from other parts of the brain may panic or anxiety.
The Hypothalamus processes internal stimuli and initiates the stress response (fight, fight,
freeze) when needed. Oversensitivity here causes of overactive stress response and physical
symptoms of anxiety are heightened.
The Amygdala, which you met above, sets our emotional tone and give out early warning
signals to threats in the environment. Some people have an oversensitive amygdala than
others. People with GAD often are born with a larger amygdala making them more sensitive
to possible threat. Oversensitivity leads to moodiness, negativity and excessive recognition of
threats where there are none. This especially true of overreaction to facial expressions
creating anxious expectation of rejection or humiliation that occurs with social anxiety
The Hippocampus is the memory storage cabinet. It stores details of experiences for short
term memory. Memories create contact for emotional reaction, providing information for
the cortex and the PFC and ACG to assess threat.
The combined information from the limbic system is transferred to and from the PFC via the ACG.
There is one more aspect of your anxious brain it’s important to understand to get a grip on your anxiety.
The Neurotransmitters.
As mentioned before all parts of the brain must communicate to various other parts to effectively carry out their jobs. Communication takes place to neurons (cells) located in of the each part of the brain described above through neurotransmitters (messengers). The neurotransmitters also play particular roles in the experience of anxiety. They need to be properly balanced and in the right proportions to one another, neither too much or too little.
Here are the key neurotransmitters in the experience of anxiety along with their functions and a few examples of what happens if they aren’t able to do their jobs:
Glutamate – The Starter – is an excitatory neurotransmitter that initiates activity in the brain and is responsible for activating neuronal messengers. It’s distributed throughout the brain and functions in balance with GABA (see below). Without Glutamate communication doesn’t take place.
Norepinephrine (NE) – The Energizer Bunny –a rouses the brain the way adrenalin arouses the body. Keeps us mentallu and physically alert and energetic, enhances thinking, focus and dealing with stress. Too much makes us feel “hyper” and makes it difficult to calm down, relax or sleep. When constantly too high it is the hallmark of anxiety but when it is too low we may feel sluggish and have a hard time having the mental energy to fight off and correct negative thoughts, another hallmark fo depression.
GABA – (Camma aminobutyric acid) The Brake – is an inhibitory neurotransmitter necessary to stop the path of neuronal messengers. It too is found all over the brain and is very significant to anxiety because of its role is to slow down or relax overactive parts of the brain. We get anxious when it is low or out of balance with Glutamate which will keep charging us up. Without the break GABA provides cells continue firing constantly. This makes for a very overactive brain. Rumination, unremitting acute anxiety states and erratic panic can occur.
Serotonin (SE) – The Mood Regulator, is found in many areas of the brain and body. It has been called the feel-good hormone. It connects to the limbic system where it is vital in regulating mood, appetite, sleep, libido, impulse control, stress and pain response, perception of memory and a sense of reward that comes from accomplishment and good fortune. Any of these important functions can be compromised without SE. The PFC can’t do its job without adequate serotonin, so self-control and clear thinking is affected. Distorted thinking can arise from low serotonin as follows:
Part of the
The limbic system + AG + Orbital Cortex + PFC = Cognitive
Negative thoughts Less flexible Decrease impulse Poor concentration Distortion
and Mood Worry control, poor Inconsistent
Rumination integration of Attention
thinking & feeling
Adrenalin – The Gas Pedal, plays a major role in activating the stress response system. It activates the body to respond to threat, challenge and danger including the fight, flight or freeze reactions. It also gives us the “get up and go” we need to handle stress. If we are always under stress, though, it keeps our body on constant alert. Adrenal fatigue can result, making us tired and less able to handle even small stresses well.
Norepinephrine (NE) – is key to arousing the brain as adrenalin is to the body. Too much makes up feel “hyper” and makes it difficult to calm down, relax and sleep. When constantly too high it is the hallmark of general anxiety disorder. It overstimulates the ACG, PFC and Limbic system leading to hypervigilance, irritability and anger with little provocation. Also too much NE over stimulates the BG creating tension and the behavioral avoidance seen with anxiety.
Dopamine (DA) – Highly localized in the BG, DA is responsible for the sensation of pleasure and reward and for alertness, concentration and attention in the PFC. It helps us learn and respond quickly to emotional situations as in seeing a car rolling toward you. The ACG needs it to provide drive and motivation. The pleasure producing aspect of DA is related to pain reduction. The greater the pain, the greater the DA release. The less DA the more pain and the less pleasure we feel, as is so common with anxiety. Too high DA along with high NE we leave us feeling “wired’ or frozen with anxiety. Low levels are associated with depression and apathy.
Beta-endorphins (BEs) – are actually peptides. They are responsible for diminishing the sensations of pain and triggering dopamine release and are vital to the sensations of satiety (the feeling of having enough) and completion, being finished. Without them the sense of completion is missing, causing us to do things over and over and on and on. When someone is in severe pain and BE is strongly active it triggers the release of DA.
By understanding the functions of these neurotransmitters you can see why various medications are selected for different symptoms of anxiety.
– SSRI’s, for example are aimed at boosting serotonin and are usually the first line of choice.
– NSSR’s are designed to balance norepinephrine and serotonin.
– Beta blockers decrease the release of norepinephrine.
– Benzodiazepines like Xanax and Ativan (for quick, short action) and Klonopin (for extended
anxiety relief) enhance GABA .
– Opioids aim to boost DA.
And so forth. Granted each of these medications presents its own problems and sadly they don’t always achieve their intended goals. MD’s do a lot of guessing to figure out which ones will best help a given GAD sufferer. But many people find that the right ones do help, at least to reduce anxiety enough to be a more active and successful in using counseling where you can learn to use your brain to actually change the anxious brain.
Certain supplements and foods that also can assist in balancing particular neurotransmitters, A list of best ones for given neurotransmitters is available to you as indicated.
Brief Summary
– Rumination – Overactive ACG
– Hypervigilance – Elevated NE or overactive BG
– Anxiety with despair – serotonin deficit effecting the Limbic System and the PFC
– Heightened worry and dread – Insufficient or ineffective GABA
– Over reactivity to stress – Overactive HPA (Hippocampus, Adrenal Pituitary) matrix due either
to biological predisposition and/or prolonged stress or trauma
Conclusion
The good news is that psychological treatment with CBT can change the anxious brain. CBT psychotherapy provide tools that help to your Prefrontal Cortex to improve its executive function so you can gain access to all parts of your brain. With these tools you can better control and instruct each part of the anxious brain. With CBT you can get all areas of the brain working together to modulate your thoughts, feelings and actions. When the tools are employed consistently with persistence, brain activity eventually changes to function automatically in healthy ways.
If you are interested in any subject on this site, please contact me.
