Understanding the Anxious Mind
Most, if not all, of us have experienced anxiety on some level throughout our lives. Anxiety can be a healthy response to stress when it motivates us to study for a test, for instance, or heightens our level of awareness when driving through a downpour. But, when feelings of anxiousness are experienced on a regular basis and out of proportion to their triggering event, anxiety can cause significant detriment to our quality of life.
The word “anxiety” comes from both the Latin root anxieta meaning “uneasy, troubled mind about a certain event” and the Greek root anxo, meaning “to squeeze, strangle, or press tight.” People who suffer from anxiety have intense feelings of apprehension, dread, worry, and tension in response to perceived stress that interferes with their lives and can affect relationships, sleep, health, work performance, and overall well-being.
It is estimated that over 40 million American adults (over 18 percent of the population), and 25 percent of teens between the ages of 13-18 suffer from an anxiety disorder. Anxiety disorders encompass a wide spectrum of disorders ranging from generalized and social anxiety to specific phobias. All have feelings of extreme anxiousness, tension, and discomfort. Often other symptoms such as sweating, nausea, abdominal pain, dizziness, palpitations, and pins and needle sensations can co-occur.
The causes of anxiety are many and can differ from person to person. A mix of genetic predisposition, brain chemistry, personality, trauma, and social factors, can play a role. For this reason, there is no “cure-all” solution that works for everyone. Effective treatment for someone suffering from an anxiety disorder requires customized care that is based on individual needs, lifestyle, and preferences. In this article, we’ll cover some of our favorite treatments but will in no way be able to report on all the options that are available and appropriate for each person, as there are a multitude.
A Brief Explanation of the Nervous System
The best way to picture the layout of the nervous system is to think of a tree with two main branches, one that is long and straight, and the other that keeps branching. These branches represent the two main components of the nervous system: the central nervous system which includes the brain and spinal cord (the long straight branch) and the peripheral nervous system which includes all the nerves that extend from the brain and spinal cord into other parts of the body (the branchy branch).
The peripheral nervous system branches further into the somatic and the autonomic systems. The somatic nervous system controls voluntary actions. You are using this system when you move your legs to walk, when turn your head to peek out the window, or when you lean your body forward so that you can smell a fragrant flower. The autonomic nervous system (ANS) is the opposite, involuntarily controlling (although as you’ll learn later, this is not always true) smooth muscle, cardiac muscle, and glands.
The ANS splits into three terminal branches: the enteric, sympathetic, and parasympathetic nervous systems. These are the branches that we will focus on.
The enteric nervous system (ENS) is housed in the gut. Who knew that your belly had its own brain? The enteric system helps control local blood flow, contraction of your intestines (to help move stuff along), secretion of mucus to protect the gut lining, and helps to modulate the immune system as well as various endocrine functions. The ENS also can play a key role in mental health. In fact, 90% of serotonin in the body is made in your bowels! When we experience anxiety, we are often mostly concerned with the other two remaining branches: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS).
The Sympathetic Nervous System (SNS)
The SNS is often described as the one controlling your “fight or flight” response, mainly your primal defense response. This is the system that we rely on to get us out of danger quickly. It does this by:
Dilating the bronchi in your lungs to optimize oxygen intake, increasing blood flow and thus oxygen delivery to vital organs by increasing heart rate and blood pressure, allowing your body to move quickly.
Releasing glucose into your blood, giving your body quick fuel, while also releasing adrenaline, boosting your energy.
Dilating your pupils so that you can better see items far away. When you are running from a predator, it is better to see the way out ahead of you than to focus on the tiny details up close.
To perform these functions, the SNS must decrease other activities in the body, most notably:
Fuel storage and insulin activity: focus is on burning through energy rather than storing it away
Digestion and salivation: when you are actively trying to get out of danger, digestion is not of prime importance and so energy and blood flow is shunted away from these systems to help deliver more blood and oxygen to your heart, lungs, brain, and muscles.
Relational ability: your brain is focused on staying alive, sacrificing your ability to relate and connect with others so that you have more energy and resources to run or fight.
Immune response: because immune system support is not necessary in immediate survival, this system is dampened.
For most of us, the SNS is the system that is overly engaged in times of heightened stress and especially anxiety. Unfortunately, it responds to many of our daily stressors in the same way it would responds to a life-threatening situation, so even though you might be taking a test instead of running away from a bear, your SNS is in charge and the effects become one and the same. It makes our palms sweat when we are nervous or makes our hearts pound and mouths go dry when we are about to give a speech. It can also make it nearly impossible to have a rational conversation during an argument.
The Parasympathetic Nervous System (PNS)
The other autonomic component is the parasympathetic nervous system, known as the “rest and digest” system. Often seen as the antithesis to the SNS, this system is engaged when you are in a relaxed state. If the SNS is the accelerator ramping up your defense response, the PNS acts as the brakes. It does this by:
Decreasing your heart rate back to normal levels after a stressor,
Increasing saliva, blood flow to your gut, and intestinal motility to help digest and eliminate foods,
Constricting your pupils to allow you to see up close (like reading this newsletter, for instance).
Enhancing your immune system response.
Increasing circulation to non-vital organs such as your skin and extremities.
Releasing oxytocin to strengthen social bonds,
Modifying your tone of voice so that you are better able to relate to others socially,
As you would expect, to perform the above functions properly, the PNS downregulates your body’s defensive responses.
For most of us, being in a parasympathetic state brings us that sense of ease and calm that helps us to relax and unwind. However, too much can be problematic resulting in a “freeze” or immobilization response to stress. People who react this way tend to freeze up, their minds go blank, and their heart rates can plummet sometimes to the point of passing out. Therefore, an optimally functioning autonomic nervous system holds the PNS and SNS in a healthy balance, not too much and not too little of either. Unfortunately, for those who experience anxiety, the balance is often tipped heavily toward the sympathetic system, keeping us in a constant state of danger surveillance.
Holistic Treatment Options
Biofeedback and Neurofeedback
So, what do you do if your nervous system is out of balance? The good news is that the autonomic nervous system is not as completely out of our voluntary control.
Through proper training the brain can “relearn” more helpful and efficient pathways that promote sympathetic and parasympathetic balance and allow you some control over physiological symptoms.
One way to retrain your brain is through a process called biofeedback. Biofeedback uses monitoring instruments to assess your neuromuscular and autonomic activity to gain a better understanding of your individual response to stress. Common monitoring parameters include temperature, heart rate variability, sweat conductance, and respiration rate. That feedback is then used to help create awareness of these responses so that you can recognize them as they come on, and training to allow you to gain some control over them. An example of this might be recognizing that your heart is beating faster and using breathing exercises to help prevent an oncoming panic attack.
In this way, biofeedback and neurofeedback can help[p treat many different conditions, including PTSD, anxiety/depression, ADHD, high blood pressure, migraines, and much more.
At Northwest Life Medicine Clinic we offer both neurofeedback and biofeedback to support to support our patients’ healing. How do you choose which is right for you? See below for more details. There is no right or wrong choice. Both work on the nervous system to establish more efficient neuronal pathways. Both help to enhance the ability of the vagus nerve to promote healthy SNS/PNS balance. They can even be combined for optimal outcome! Common results seen include increased focus and work stamina, reduced anxiety, reduced pain, improved mood, and improved sleep.
Neurofeedback
Effects are long lasting even well after completing all sessions.
Often takes at least 20 sessions to get full effect but improvement can be felt after just one session.
Passive process — you get to sit back and let your brain do all the work.
All work is done at the clinic.
Effects stand alone, requiring no additional “homework.”
Biofeedback
Effects are long lasting but require training, much like physical therapy.
Often takes at least 10 sessions to get full effect, but improvement can be felt after just one session.
Active process — requires simple daily home practice in addition to in-office sessions.
Learn skills that you can use outside the office to help you recognize and mitigate unwanted physiological stress responses as they occur.
Schedule a complimentary 15-minute Discovery Call to learn more about Neurofeedback or Biofeedback.