<%-- Page Title--%> Health <%-- End Page Title--%>

<%-- Volume Number --%> Vol 1 Num 151 <%-- End Volume Number --%>

April 23, 2004

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Understanding and Taming Anxiety

Worry gives a small thing a big shadow.
--Swedish Proverb.

One in four of us will suffer from an anxiety disorder in our lifetime. And the rest of us will worry, fuss, and fret far more than we need to. Now, in this excerpt from his book, "Worry," the psychiatrist who helped put attention deficit disorder on the map offers his treatment program for brooders.

Worry is like blood pressure: you need a certain level to live, but too much can kill you. At its worst, worry is insidious, invisible, a relentless scavenger, roaming the corners of your mind, feeding on anything it finds. It sets upon you unwanted and unbidden, feasting on the infinite array of negative possibilities in life, diminishing your enjoyment of friends, family, achievements, and physical being -- all because you live in fear of what might go wrong. People who worry too much suffer. For all their hard work, for all their humour and willingness to laugh at themselves, for all their self-awareness, worriers just cannot achieve peace of mind.

And yet, worry is a very treatable condition. Most people today are not aware of all that we have learned about worry in the last 50 years. Just as rainstorms may strike in different ways -- sudden thunderstorms, lingering drizzle, occasional showers -- so does worry attack its victims variously. We've come to understand the many distinctly different types of worry, and the underlying triggers. Worry may accompany simple shyness, depression, generalised anxiety disorder, or even post-traumatic stress disorder. Each kind of worry responds to specific and powerful techniques, from cognitive therapy to medication to regular exercise.

Worry is a special form of fear. It is what humans do with simple fear once it reaches the part of their brain called the cerebral cortex. We make fear complex, adding anticipation, memory, imagination, and emotion.

Worry takes many forms, but it almost always stems from an overwhelming sense of vulnerability and powerlessness. Many of us locate the source of worry outside ourselves, believing it is triggered purely by life experiences: "What is going on in the world to make me feel this way?" Such thoughts only increase our feeling of vulnerability.

And, as anyone who has worried knows all too well, even when the world is right, worry surfaces. Rational reassurances get no farther into the psyche of the worrier than words spoken in Martian. "Honey, everything will be fine. We are not about to go broke." "There really is no reason to obsess about your boss. He just told you that you were doing a great job!" "Truly, that mole on your back is not malignant melanoma!" The worrier may be momentarily calmed, but the fire soon flares again.

Why does the worrier go on worrying? His mind has, in effect, gone into a spasm, a grip that can't relax and accept good news. He is suffering a kind of "brain burn," because his system is continually pumping out a huge bolus of adrenaline under high pressure.

Today, we are finally beginning to understand the biology of worry, to pinpoint what is happening in the nerve cells of the worrier, rather than his soul. It turns out that some of us may be born worriers. Our autonomic nervous systems are cranked up higher, and our blood pressure, pulse, and respiratory rate may be higher.

And we may be less sensitive than others to the brain's natural stress modulators, which are activated by the neurotransmitter GABA (gamma-amino butyric acid). People who have a good supply of GABA, or brains that are especially responsive to it, may be innately cool and calm. By contrast, a fascinating 1996 study actually linked a gene (called SLC6A4) to individuals who are highly susceptible to anxiety, pessimism, and negative thinking. Other pioneering research, has revealed that children who are high-strung and highly aroused early on often become tense, shy worrying adults. And brain scans have shown that people who ruminate have excess activity in a part of their brains called the cingulate cortex.

Our new knowledge has enabled us to stop blaming worriers for their woes, and begin helping them to get better. One of our newest and most powerful findings is that brains are adaptable and flexible. You cannot give yourself a new brain but you can be redirected, retrained, reassured, and reset. You can change.

This article was first published
in Yahoohealth




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