Understanding Anxiety and Anxiety Disorders

Introduction

• Cultural Context: Mental health isn’t taken seriously; stigma exists
• Common Dismissals: People are often told to simply 'suck it up' or that 'it’s all in your head.'
• Seriousness: Anxiety disorders are as real as physical illnesses like diabetes.

Personal Observations by Dr. Jen Gunter

• Patient Symptoms: Constant worry, trouble sleeping, tense muscles, difficulty concentrating
• Lack of Treatment: Many aren’t receiving the necessary care
  • Reasons: Lack of insurance, past dismissal/minimization, stigma impacting future jobs/relationships
• Message: Severe anxiety is a health problem, not a moral or personal failing

Anxiety vs. Fear

• Anxiety: Response to uncertain threats, lasting longer compared to fear
• Fear: Response to an immediate threat, subsides quickly
• Function: Part of the threat detection to protect from predators

Biological Basis of Anxiety

• Amygdala: Initiates the alert to other brain areas for defensive action
• Hypothalamus and Stress Response: Triggers physical responses like increased heart rate and blood pressure
• Brain Stem: Puts the body on high alert
• Fight-or-Flight Response: Body’s automatic defensive mechanism

Regulation of Anxiety

• Ventromedial Prefrontal Cortex: Modulates the amygdala’s responses
  • Example: Seeing a tiger in a cage and rationalizing safety
• Hippocampus: Provides contextual memory, reinforcing the safety of known situations

Anxiety Disorders

• Definition: Malfunctioning threat-detection systems causing excessive worry about future safety
• Impact: Persistently disrupts work, school, and relationships; causes avoidance behaviors
• Prevalence: Approximately 16% of individuals have or have had an anxiety disorder
• Types of Disorders: Social anxiety disorder, panic disorder, agoraphobia, phobias

Biological Differences in Anxiety Disorders

• Brain Differences: Possible mix-ups in connections between the amygdala and brain areas
• Stronger Pathways: Increased anxiety strengthens these pathways, creating a vicious cycle

Treatment Options

• Mind and Body Connection: Practices to maintain overall health
  • Balanced diet, regular exercise, adequate sleep
• Meditation and Mindfulness: Slows down the fight-or-flight response
• Cognitive Behavioral Therapy (CBT): Identifies upsetting thoughts and challenges their realism, rebuilding neural pathways
• Medication: Short-term and long-term relief by down-regulating threat-detection mechanisms
• Outcome: Both medication and CBT can reduce amygdala overactivity seen in anxiety disorders

Conclusion

• Anxiety disorders can be treated and managed like physical health issues such as high blood pressure and diabetes.