Anxiety
There Is an Answer to the Mental Health Crisis
Address anxiety as the driving force, not a psychological diagnosis.
Posted May 9, 2023 Reviewed by Hara Estroff Marano
Key points
- Avoiding danger is what keeps us alive. Humans call the body's signal to do so "anxiety."
- Avoiding the sensation of anxiety drives much of dysfunctional human behaviour.
- Anxiety is a physiological reaction far stronger than the conscious brain. It cannot be controlled.
- We can redirect it. Addressing anxiety at the root physiological level will solve many mental health problems.
Anxiety is, simply, a warning signal. Every form of life has a withdrawal/avoidance response to real or perceived danger. All life forms, from one-celled organisms to humans, respond with complex changes to optimize the odds of survival. The reaction is powerful, unconscious, and automatic; it has evolved as an extremely unpleasant feeling in higher life forms. It compels action to lessen the unpleasantness of the sensations. Species that did not pay attention to such danger signals simply did not survive.
Staying alive
When you sense danger, how do you feel—anxious? Although this a core survival feeling, humans have the capacity to name it. The physical sensations of anxiety are the result of stress, threats, and life challenges—not the cause. Attempting to eliminate the unpleasant physical sensations is the driving force behind much of human behavior, and seeking safety is a necessary action to store up reserves to fight another day.
What happens in your body that creates the sense of dread? The term is “threat physiology.”
Threat physiology
Physiology refers to how your body functions. Your survival reactions are mostly unconscious, the responses hardwired and automatic. The human brain processes about 40 million bits of information per second. The conscious brain deals with only about 40 bits per second. Your unconscious brain is a million times stronger than your conscious brain—the reason it is not subject to being controlled. However, it can be regulated and reprogrammed.
Heart rate, blood pressure, blinking your eyes, acid-base balance, sweating, breathing, bowel and bladder function, hunger—these are all physiological activities affected by the perception of threat.
Drivers that activate threat physiology include:
- Stress hormones: adrenaline, noradrenaline, histamines, which ready the body to fight or flee
- Cortisol: mobilizes fuel (glucose) from tissues throughout your body (to enable fighting or fleeing)
- Glutamate: neurotransmission shifts from calming to excitatory, to increase alertness and sensitivity to danger signals
- Inflammatory cytokines (small molecules that transmit signals between cells): the immune system kicks into action, ready to protect against wounds.
Anxiety is a physiological state
Many other changes occur as the body shifts into fight-or-flight physiology. Consider how you feel when your body is in this state:
- Alert
- Nervous
- Afraid
- Angry
- Paranoid
- Terrorized
Being alert and nervous is somewhat the norm for day-to-day life. We have to be on the lookout for danger in order to navigate our day safely. Fear is appropriate in response to increasing stress, but it's intended to prompt a swift resolution. What if you cannot solve the inciting problem? You will have more of a threat response and perhaps become angry, also intended to definitively resolve the threat. But now your neocortex (thinking brain) becomes less active, and your amygdala-centered limbic system becomes activated. You physiologically cannot think clearly, and you may act out in destructive ways, including self-destruction.
If you remain trapped in this physiologic state, almost anything can happen—multiple kinds of addictions, abusive behavior, obsessive behaviors, depression, shortened attention span, eating disorders, cutting, allowing abuse, narcissism, lowered cognition, hoarding, social withdrawal; the list is endless. These are descriptions of behaviours people use to lessen or escape the impact of anxiety on their sense of well-being. Psychological diagnoses essentially are dysfunctional responses to chronic stress (threat).
A paradigm shift
The way we view mental health must change. Here are some suggestions.
- Eliminate the diagnosis of anxiety from the DSM coding system. It is a descriptive term for threat physiology and the driving force behind poor mental health.
- Most psychological diagnoses are descriptions of behaviors driven by the sensations created by threat physiology. Descriptions are less pejorative than labels (diagnoses).
- Substitute the phrase “activated threat physiology” for the word "anxiety."
- Anger is hyperactived threat physiology.
Dynamic healing
The root cause of our mental health crisis is sustained threat physiology. There are many ways of mitigating it and creating cues of safety, which calm the system. The model I've developed is called “Dynamic Healing,” and I believe it represents how medicine should be delivered. Its key targets:
- The input: You can process your stresses so as to have less impact on your nervous system.
- The nervous system: Resiliency/flexibilty can be increased so that it takes more stress to set off the flight-or-fight response.
- The output: Your nervous systems takes in sensory input, makes a summation, and sends out signals of threat or safety. There are ways to directly dampen the threat response.
None of the interventions are difficult and all require few resources. There are many clinicians in all medical fields currently applying these approaches. It is just not happening on a wide enough scale.
There is no question that symptoms and behaviors must also be addressed while people heal. But if the root cause is not dealt with, their suffering will continue. Hence, the nationwide burden and fallout of poor mental health continues to skyrocket.
Let’s do this!!
Our mental health crisis reflects a lot of needless suffering, as deep science has pointed the way to effective treatments for over 40 years. Most of clinical medicine is not connected to the data or is categorically ignoring it. It is certainly not being widely taught in medical school.
True change is going to have to emanate from the public demanding better care.
The answers tor our mental health crises are right in front of us if we just pay attention. Take your medical care and your life back. It is your right.