Don't Believe the Hypothalamus: The Truth About Anxiety Disorder

We’ve all experienced feeling anxious at some point in our lives. And although we tend to think of anxiety as a negative condition, anxiety is actually a very normal and even protective physiological response that’s triggered in our bodies when our brain senses a threat.  For example, if we’re in a dangerous situation like being chased by a bear or escaping from a burning building, a part of our brain called the amygdala sends a distress signal to the hypothalamus, which in turn activates the release of stress hormones in our body such as cortisol and adrenaline.  These “stress hormones” prepare our bodies for the natural fight or flight response by opening our airways to take in more oxygen, converting glycogen to glucose for increased energy and increasing our heart rate and constricting our blood vessels to deliver blood to our organs and tissues more quickly.  

Normal Anxiety vs. an Anxiety Disorder

Again, while this response is helpful in dangerous situations, our body wasn’t designed to remain at this heightened level activity for extended periods of time.  But for people who suffer from anxiety disorders, this is exactly what happens. In cases of chronic anxiety, the distress signal that gets sent to the hypothalamus is due to an overstimulation of the fight or flight reflex in the amygdala.  Therefore the hypothalamus is sounding a “false alarm” of sorts. As a result, people with anxiety disorder remain in this state of heightened arousal, even when circumstances don’t require such a response.  If not controlled, this can put individuals at increased risk for health conditions such as heart disease or stroke, and can also diminish overall quality of life.

Treatments for Anxiety Disorder

So now that we know what causes anxiety disorder, what, if anything, can we do about it. Well, there are a few techniques that have been found to be effective in treating generalized anxiety disorder. One of the most effective therapeutic approaches is called Cognitive Behavior Therapy, or CBT.  The idea behind CBT is that our thoughts control our emotions and behaviors, therefore, if we can identify irrational thought patterns, we can change the way we feel and behave in response to the circumstances around us.  So remember, in the case of generalized anxiety disorder, our amygdala is sending false signals to our hypothalamus that is telling our body there’s a problem and we need to respond to.  For example, under normal circumstances, if a person hears that rain is in the forecast, we might just make a point to bring an umbrella but not think anything more about it.  However, a person with generalized anxiety disorder might assume the worst possible scenario, such as flooded streets that could lead to accidents and decide to stay home and not go to work or school, or attend to other responsibilities out of fear. A CBT approach would address the somewhat irrational fear that rain will necessarily lead to flood and accidents by reminding the person that while floods and accidents are possible outcome of rainy weather, this is not the case in most situations. In other words, CBT reminds us not to believe the hype created by the hypothalamus. Identifying and addressing these irrational thoughts about the weather or other triggers can create more positive emotions and in turn, decrease the symptoms of anxiety.

Medication vs. Therapy

However, in severe cases of anxiety disorder, anti-anxiety medications, such as Paxil or Zoloft may also be prescribed. These medications are a classification of drugs called SSRIs, which block the re-uptake of serotonin, a neurotransmitter which neutralizes the effect of the stress hormones and thereby have a calming effect on the body. Other medications, such as beta-blockers, work to address the physical symptoms of anxiety rather than the physiological causes. Since there are a number of anti-anxiety medications which work to relieve anxiety in different ways, it‘s best to consult with your physician about whether medication is necessary and which medicine might be right for you.

So let’s recap, remember that all anxiety isn’t bad, but chronic anxiety can be problematic. However there are effective therapeutic and pharmacological interventions that can help.