REWIRE YOUR ANXIOUS BRAIN

Health News July 2021

By Ginny Graves

Worried about everything? Afraid of heights or crowds? Here’s the science of training your mind to get you back to a calm, happy place.

OUR MINDS are capable of magnificent feats of cognition—sending rocket ships into space, inventing drugs to kill deadly pathogens, remembering to buy everything at the grocery store without a list.

So why do these same minds also get fixated on fretful thoughts, like worrying that a temporary pay cut will lead to financial ruin or that a partner who is working late is probably having an affair?

Blame evolution. Deep inside your brain lies the limbic system, a cluster of structures that developed in the very first mammals to help them recognize and avoid danger.

When this system senses a threat, it triggers your body’s fight-or-flight response—releasing adrenaline, elevating your heart rate—within a fifth of a second, before your conscious brain is even aware there’s a problem. Every time you reflectively dodge an oncoming bus, a snarling dog, or a volatile colleague, this ancient risk-detection network is doing its job.

Trouble is, it doesn’t always analyze threats. And these days, since four-legged predators are rare, it often interprets mere discomfort or annoyances as danger. “The limbic system can be triggered by things like public speaking or crowded elevators or scowls from neighbors,” says Robert Leahy, PhD, a clinical professor of psychology in the department of psychiatry at Weill Cornell Medical College.

Those of us who are temperamentally or genetically vulnerable to anxiety (some 40 million people in the U.S.) are more likely to view those benign threats as real and obsessively worry about them.

Happily, our human brains are more sophisticated than early mammals’ brains. We have a cerebral cortex, a complex processing area that can do long division, remember to buy toilet paper—and talk our limbic system off the ledge.

Cognitive behavioral therapy (CBT), a skills-based anxiety treatment designed to change problematic patterns of thinking and behavior, offers a variety of techniques to help you reason your way out of a fear spiral, which happens because of how the brain is wired.

“Neuroscience has shown that brain networks that fire together wire together, so chronic worry trains your brain to be more anxious,” says Evian Gordon, MD, PhD, the chief medical officer at Total Brain, a mental health app.

We can tweak that wiring, though. A review of 41 CBT studies published in 2018 found that it was particularly helpful for generalized anxiety disorder, acute stress disorder, and obsessive-compulsive disorder. Combined with ingenious physical hacks that rein in your body’s amped-up anxiety response, it can provide short- and long-term relief for the chronically anxious.

“My therapist taught me to plunge my face in cold water when I feel a panic attack coming on,” says Emily Cahalan, 31, a long-time anxiety sufferer and occupational therapist in Mantua, New Jersey. “The shock of the cold water stops the panic in its tracks and helps me calm down enough to engage in CBT techniques, like questioning the validity of my worried, catastrophizing thoughts.”

The idea is to reset the way our brains function. But by learning to replace anxious thought patterns with ones that are less worrisome and more pragmatic, you can strengthen those thought patterns as well. Here are 12 ways to use your analytical primate mind to help your anxious mammal brain calm down.

Gain Insight Into Your Anxiety

Becoming familiar with your anxiety is the first step in taking conscious control of it, says Sarah Gray, PsyD, an instructor of psychology at Harvard Medical School. “You have to be aware of your thoughts before you can change them,” she says.

To do that, approach your worry like a scientist. “When you have anxious or worried thoughts, write them down, along with when they cropped up, what triggered them, and what other conditions were present. Were you hungry? Tired? Was it Sunday night and you were stressed out about the coming workweek?” suggests Gray.

“Gathering data can help you see patterns. Becoming aware of your anxiety triggers helps you understand why you’re anxious and respond more effectively. Maybe you just need a nap.” Bonus: Writing about your worries engages your cerebral cortex, which helps you see your fears from a more dispassionate point of view, and according to a study by researchers at Michigan State University, it also makes them less distracting.

Switch On Your Inner Calm

When the hallmark signs of anxiety and intense stress hit—rapid heart rate, sweating, inability to focus—use them as a cue to breathe. “Take six slow breaths a minute, counting to four on each inhale and to six on each exhale, because exhaling triggers the parasympathetic nervous system,” suggests Gordon. “It’s the single most effective way to put the brakes on the fight-or-flight response.”

Ideally, you should breathe like this for three minutes. But if you’re in the middle of a busy day, even a few 10-second breaths can help you regain your balance, says Gordon.

Get Grounded

Cahalan’s ice-water strategy is a grounding technique that interrupts the fight-or-flight response by triggering the calming parasympathetic branch of your nervous system. “When I can’t immerse my face, I just put cold water on the back of my neck,” says Cahalan. Another simple grounding technique: Sit quietly and notice five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste.

“When you’re anxious, your mind is catastrophizing about all the terrible things that are going to happen in the future,” says Emily Hu, PhD, a clinical psychologist in Los Angeles. The 5-4-3-2-1 technique brings you back to the present, she says, where, usually, nothing terrible is actually happening. It’s a spin on mindfulness, in which you sit quietly and notice your moment-to-moment thoughts, feelings, and sensations—and mindfulness has been shown to change your brain.

“It helps you become aware of your thoughts and sensations—and learn to observe them from a more neutral perspective, so you don’t get as caught up in them,” says David Carbonell, PhD, a Chicago-based psychotherapist and the author of Outsmart Your Anxious Brain.

Harvard researchers found that after eight weeks of daily practice, the brains of people new to mindfulness had increased gray matter in areas of the cortex associated with self-awareness and introspection, indicating enhanced function, and their amygdalas, the limbic-system structure that sets off the fight-or-flight response, had shrunk—a reduction that correlated with a drop in stress levels.

Visualize Your Anxiety Floating Away

Your imagination often embellishes and adds to your fears. But you can use this powerful cognitive skill to get rid of them too, says Leahy. “Imagine your scary thought as a balloon on a string that you’re struggling to hold on to because the wind is tugging it away,” he suggests. “Really picture the scenario. Then let go of the string and watch your worried thought float away in the breeze.”

Avoid Google-itis

Odd health symptoms trigger worry because they create uncertainty, which anxious brains dislike. “People Google symptoms because they’re seeking certainty, but no website can dispel your fears or provide a definitive diagnosis—so Internet searches only make anxiety worse,” says Leahy.

What’s more, if you combine two terms, like “headache” and “brain tumors,” you’ll validate that headaches can indeed be a sign of brain tumors, he adds. “If Googling symptoms eased anxiety, people who did it compulsively would be the least anxious—but they’re not.” Leahy suggests taking a walk, listening to music, or calling a friend when the urge to consult Dr. Google strikes.

Bore Yourself With Worry

If you’re caught in the spin cycle with a single worried thought and can’t break free, take away its power by repeating it over and over…and over. “Say it in your mind 200 or 300 times,” says Leahy. “When you face your fear, it eventually loses its power to scare you.”

The technique is especially helpful when you wake up in the middle of the night and start worrying about how tired you’ll be the next day. “Just repeat robotically, ‘I’ll never fall asleep,’ ” suggests Leahy. “And guess what happens? You doze off.”

Be Your Own (Pragmatic) Cheerleader

Whether you’re stressing about losing a big client or getting your kid into the best school, uncertainty is crazy-making. “I find it helpful to repeat the mantra ‘I don’t like this, I don’t want this, and I can handle it.’ It acknowledges that life is unpredictable—and that you’ll get through it no matter what happens,” says Carolyn Daitch, PhD, the author of The Road to Calm Workbook.

Then replace your fretful thoughts with ones that are rooted in facts: “I have plenty of savings to get through a financial setback, and I could always turn to my friends and family for additional help.” Or “My kid is smart and will thrive where he goes to school. And if he doesn’t, we can always try another school.”

Examine the Evidence

“Pretend you’re in court and need to provide proof for and against your worried thought,” suggests Gray. If you’re worried that everyone at your job is secretly judging you, say, identify colleagues who have consistently had your back. Then reframe the worry so it reflects the facts: A couple of coworkers seem judgy, but most are perfectly nice. “This isn’t about positive thinking,” says Gray. “It’s about realistic thinking. Your conscious brain recognizes the truth in rational, measured thoughts.”

Call Out Your Inner Critic

Anxiety happens when you buy into worrisome thoughts. “But just because you’re thinking something doesn’t make it true,” says Hu. “I’ve found it helpful to name my inner critic, who feeds me anxiety-provoking thoughts. I call her Yzma, after a movie villain.” Naming your critical inner voice may sound silly, but it is a reminder that thoughts are just thoughts—not necessarily the truth. “I tell myself, ‘Yzma is a crackpot. Why should I believe her?’ ” Hu says. “Externalizing her makes it easier to brush off things she says.”

Identify the Probable vs. the Possible

Let’s say your teenager is out past curfew. You could think (a) he’s probably been in a terrible car accident or (b) he’s probably lost track of time. “While the former is possible, the latter is far more probable,” says Leahy. “When you’re anxious, you’re often worrying about things that are unlikely and ignoring the far more likely scenarios. Stepping back and assessing whether your worry is possible or probable can calm you down.”

Embrace the Gray Area

“Lots of people with anxiety struggle with black-or-white thinking—‘I always get nervous and embarrass myself when I give presentations,’ for instance—which makes the anxiety worse and doesn’t reflect reality,” says Gray. “Words like ‘always’ and ‘never’ are red flags for black-and-white thinking.” When you hear yourself using them, challenge the thought. Then come up with a more realistic replacement thought, like “I’m sometimes nervous during presentations, but I usually find a way to power through.”

Remember That the Feeling Will Pass

When you’re caught in a worried thought or a panic attack, it often feels like the stress is never going to end. “But the truth is, even in extreme situations, anxiety always passes,” says Carbonell. “If there’s one truth to emotions, it’s that they’re ephemeral, and that’s true of anxiety too.” Think about the last time your anxiety was through the roof.

Did it feel awful? Probably. Did you worry you might not be able to handle it? Maybe. Did you get through it? You did. In fact, if anxiety is driven in large part by uncertainty, the one thing you can be sure of when you’re anxious is that the sensation will ease. So thank your unconscious brain for trying to protect you, and let it know that your conscious mind can take it from here.

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