Anxiety disorders, like most mental disorders, involve multiple causes including genetic, biological, social, and learning. And successful treatments sometimes target psychological or biological systems. Nevertheless, it is useful to consider that for most people with an anxiety disorder, there are false alarms sounding in the brain that set off a spiral of effects on the body that can lead to significant health concerns.
Let’s start at the beginning. Most people are frightened or startled by:
- loud noises
- sudden unexpected movements
- dark unfamiliar places
- large animals growling
- suddenly appearing snakes
- precarious heights
When scary things happen, the brain sends signals to the rest of our body to get ready to run like hell or take a stand and fight. Two areas in the brain appear to be the most crucial to fear responses: the hippocampus, which helps store verbal memories, especially those with emotional tones and the amygdala, which seems to govern and interpret fear. This circuit sends messages to the multiple brain systems that activate various stress hormones that in turn make the heart beat faster, increase blood pressure, and boost muscle power. This response evolved to keep us safe and works well when dangers are encountered.
The problem in anxiety disorders is that this system in the brain is turned on when there are no slimy snakes, roaring elephants, or dark and scary places. The fears and worries that people with anxiety have often involve anticipatory worries-or “what if?”
Being in this constant state of false alarm (imagine a fire signal blaring continuously in your brain) increases anxiety and can also damage your body. People with chronic Post Traumatic Stress Disorder have been found to have decreased volume in certain areas of the hippocampus (an area that is associated with memory). Physical costs of anxiety are far reaching, but surprisingly, so are the financial costs. One study in the Netherlands reported in the Journal of Abnormal Child Psychology found that anxious children cost society 21 times more than those children not judged anxious. Adults with anxiety disorders are more likely to have high blood pressures, diabetes, thyroid disease, gastrointestinal disorders, and cardiac disorders.
With all of the costs, including emotional, financial, and physical, treatment is critical. The great news is that anxiety can be successfully treated in most people through cognitive behavioral psychotherapy or medication. We usually recommend starting with cognitive behavioral treatments because they are quite effective and sometimes avoid the need for medications entirely. Consider medications as a backup resource.