It’s there when I wake up. Something’s wrong. I haven’t opened my eyes yet. A minute ago I was sleeping. But now I’m awake and it’s there, lurking: Something’s wrong. My breathing tightens. I stretch my legs beneath the sheets. I feel my heart beating. The sense of creeping fear is diffuse, elusive, hard to pin down. It’s like catching sight of something from the corner of my eye. Something’s wrong.
Only nothing is wrong. I know that. I’ve experienced these bouts of dread for as long as I can remember. It’s familiar, which does not help me hate it any less.
Explaining chronic anxiety to someone who doesn’t experience it is like trying to describe a color they’ve never seen. I have friends who are surprised I suffer from anxiety. After a lifetime of learning to compensate, to push myself beyond my six-year-old fear of joining the Girl Scouts, I do not come across as a nervous Nellie. I am outgoing, talkative, adventurous. Last spring, I planned a Class IV whitewater rafting trip with my husband for three days in the summer. I started dreading it the minute after I booked it.
I go for long periods when anxiety leaves me alone, and I forget the tightness of its grip. But when it comes back, triggered by stress or worry about an upcoming challenge, it sticks around, greeting me every morning like some noxious troll who won’t shut up. Something’s wrong, it insists, or more accurately, something is about to go terribly wrong. I know this thought is irrational, but that doesn’t stop the spiral of anxiety that ensues. Nerves twitch under my skin. I scroll my list of things to do and feel uneasy, even about the tasks I’m (supposedly) looking forward to. When days begin like this, happiness is not on my agenda.
Too Much of a Good Thing
All animals react when confronted with danger, and that’s a good thing. The so-called fight-or-flight response, also known as the stress response, helps animals either move away from a threat or fend it off. Anxiety—the ability to anticipate danger—is even more of a good thing. Anxious humans who avoided areas rife with predators or saved food in anticipation of crop failure had a better chance of staying alive to pass on their genes. And make no mistake, that’s all evolution cares about. It doesn’t care that we exquisitely anxious humans might survive but be miserable a lot of the time, massaging our worry beads down to nubs. Let’s face it, in the modern world, with far fewer real threats in our environment, many of us are suffering from too much of a good thing.
Too much anxiety robs you of your capacity for joy. When everyday worry becomes chronic, it can flip over into one of several flavors of debilitating emotional disorders. Some sufferers develop specific phobias—agoraphobia, claustrophobia, social anxiety. Others, like me, suffer from generalized anxiety disorder, a free-floating emotional malady. The National Institute of Mental Health estimates that one in five Americans have had some kind of anxiety disorder in the past year. In turn, anxiety can lead to sleep disturbances, panic attacks, hypochondria, depression.
With so much misery at stake, it’s a relief to learn that lots of smart people have figured out how to ease anxiety. Whether you suffer from occasional worry or have a full-blown anxiety disorder, it’s possible to become fully engaged in life again. In the last three decades, scientists have decoded the spiral of reactions that, over time, build an anxious brain. Turns out, I’ve wired my own brain to be anxious. The good news is I’m learning to rewire it—and you can, too. The more we know about how anxiety actually works, the better we get at beating back the troll. Or at least making it behave.
Nothing to Fear But Fear Itself
To understand anxiety, you’ve got to start with fear, because anxiety is like fear run amok. Neuroscientists now know there are two distinct pathways in the brain that trigger the fight-or-flight response. Here’s the most direct one: You encounter something in your environment—a man running toward you with a knife, a car veering into your lane on the highway—and a part of your brain called the thalamus sends visual information directly to an almond-shaped structure called the amygdala. That’s the control center for the fight-or-flight response. When the amygdala detects a threat, it triggers a surge of adrenaline and an increase in blood pressure, heart rate, and muscle tension—to prepare you to act. A few weeks ago, as I rode my bike home, I suddenly braked, turned my handles sharply to the left, and barely avoided being hit by a car that had run a stop sign. I never saw it coming. But my amygdala did, and it may have saved my life.
To understand anxiety, you’ve got to start with fear, because anxiety is like fear run amok.
Here’s the modern glitch in that evolutionarily brilliant response: “We don’t go into fight or flight just when we’re being chased by a bear,” says Adrienne Taren, a neuroscientist and emergency-room physician at the University of Oklahoma. “We’re getting it every time our email pings or we’re sitting in traffic. Our amygdala is just going and going and going.” That constant barrage of low-level alarm is what we call stress.
So where does anxiety come in? Because we’re such imaginative creatures, we can get stressed out by simply thinking about something that may go wrong. The part of the brain that worries about a future event we’re anticipating is the prefrontal cortex, and that’s where the second pathway to anxiety starts—the one that creates that flurry of anxious thoughts you can’t seem to control. Worried thoughts in the cortex trigger a stress response in the amygdala, which explains why we can freak out about things that aren’t even happening. “I think of the amygdala as sitting there watching cortex television,” says Catherine Pittman, a clinical psychologist and coauthor of Rewire Your Anxious Brain. “You can be on your back porch, looking at the beautiful trees, but you’re thinking, ‘How am I going to pay my mortgage with these medical bills? They’re going to take my house away!’ Your anxiety spikes even though nothing around you is dangerous.”
It’s important to realize that the cortex can’t create anxiety on its own. It can only activate the stress response when it gets the amygdala involved. The amygdala, on the other hand, can bypass the cortex, detect threats in the environment, and react, quickly. When I swerved to avoid being hit by that car, my amygdala took over while my cortex was still figuring out what was happening. Similarly, when a veteran feels anxious at what sounds like gunfire, it’s because his amygdala has gone into overdrive. The amygdala is constantly sweeping the scene, comparing our current experiences with associations learned long ago and some that are probably hard-wired. When it finds a match, it compels us to react, even if the current situation really isn’t all that