The neuroscience of: anxiety

Olena Pfirsch delves into the science behind anxiety- and its reception throughout history.

One in every five people in the UK will experience anxiety as a mental disorder during their life. But what exactly is it?

Anxiety is defined by a feeling of unease, worry, or fear: and when this becomes prolonged and overwhelming, it characterises a mental disorder. Symptoms of anxiety include nausea, fast breathing, tenseness and feelings of dread, as well as insomnia, sweating, raised blood pressure, restlessness and rumination (focusing on negative thoughts). In extreme cases, chronic anxiety can cause panic attacks or be a symptom of PTSD (post-traumatic stress disorder).

Moments of fear come in many different forms – what may scare me won’t necessarily be scary to someone else. Any terrifying situation is registered by the region of the brain called the amygdala, which then sends stress signals to the hypothalamus and the sympathetic nervous system (SNS) to release specific neurotransmitters and hormones. The SNS coordinates the release of noradrenaline (excitement), adrenaline (fear), and in some situations cortisol (terror). The adrenaline rush makes the body more alert – as heart rate increases, blood glucose levels go up, and more energy is sent to muscles thanks to a shut-down on non-essential systems.  Included in this is the digestive system, giving the well-known sensation of ‘butterflies’ in the stomach.

These hormone and neurotransmitter releases prepare an individual to react with either a ‘fight’ or ‘flight’ response; they can either face the fear or actively run away. When the threat is over, the hypothalamus acts to calm the body down through the para-sympathetic nervous system (PSNS). However, when the PSNS doesn’t kick in, the adrenaline and cortisol hormones in the bloodstream can keep building up. This heightened state of awareness makes people more prone to panic attacks, and to being perceived as ‘overly anxious or worried’ about situations. During a panic attack, a person can experience shaky limbs, pins and needles, chest pains, sweating, nausea, faintness, and a disconnection to one’s own body. An attack can last for 20 minutes or even an hour if a second attack immediately follows the first.

Causes of (and responses to) anxiety range from person to person, two people in exactly the same situation can experience fear of the same thing but react very differently. Evolutionarily speaking, fear in certain situations has been passed down as a way of ensuring survival. The caveman who chose flight over fight probably had a greater chance of survival against a sabre-toothed tiger – after all, he didn’t have to outrun the tiger, just the other cavemen.

Commonly, if a person experiences what they perceive to be a distressing situation, anxiety is likely to be triggered. Being placed in similar situations, being reminded of the event, or worrying about encountering something similar can then re-trigger that anxiety. This can cause a person to suffer a panic attack or even to avoid being placed in that situation again, a response that can be disruptive to the person’s life.

There are many ways to help a person treat and cope with their anxiety; today, talking therapy and cognitive behavioural therapy (CBT) are the most popular. CBT combines talking to a professional and setting goals to achieve that can then be evaluated in a positive way instead of ruminating on the negatives. In the past, however, anxiety hasn’t been understood as well as it is today.

In ancient Greece, anxiety was known as ‘hysteria’ and was only believed to affect women: today we know that 1 in 8 men are affected by anxiety. Hysteria was, apparently, caused by the uterus wandering around the body blocking passages and obstructing breathing (according to Plato). It was also believed that hysteria caused ‘female semen’ –  poisonous, of course – to be stored up in the body, with sex being the only way to relieve it.

The Renaissance period also had the view that anxiety only affected women; but this time they burned them at the stake. Women who showed symptoms of anxiety may have even been accused of witchcraft.

Victorians, with all their advancements in technology and medicine, continued the theme that only women suffered from anxiety. They took up the practices of lobotomy and electroshock therapy on anxiety patients. Patients were often sent to an asylum, before an ‘at-home cure’ was discovered that would later be known as the vibrator. Apparently, some doctors had similar thought processes to the Greeks.

It was not until the US Civil War, Russia’s war with Japan in 1904, and World Wars One and Two happened in (relatively) quick succession that it was realised that men can also suffer from anxiety. Changing names from ‘irritable heart syndrome’ and ‘nerve weakness’ through to ‘shell shock’ and a variety of phobias, it wasn’t until the 1980s that the term anxiety disorder was created.

Recognising anxiety disorder is the first step to coping with it. Advancements have led to new treatments being discovered, from meditation to medication with anti-depressants and beta-blockers. Anxiety has been around for a long time, and one thing’s for certain: no-one who deals with it is alone.

More information: https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/#.WAY_6fkrLIU

Talk to someone at UCL: https://www.ucl.ac.uk/student-psychological-services/index_home