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Neurobiology and the treatment of anxiety

Neurobiology is the study of the tissues and cells that make up the nervous system. It is a scientific discipline that studies brain function and nervous system functions. Researchers have studied the brain and how it works and looked at genetic and environmental contributors to anxiety disorders. 

Neurobiology is a sub-discipline of neuroscience and physiology. The complete vertebrate nervous system incorporates the peripheral and central nervous systems. The peripheral nervous system consists of nerves that branch off the spinal cord and connect with all body parts. The central nervous system comprises the retina, spinal cord, and brain.

Each part of the brain affects different behaviors, and neurobiology’s objective is to understand how they connect to various parts of the brain. Neuroscientific studies have established that the frontal lobe contributes to emotions, personality, problem-solving, judgment, attention, abstract thought, and planning. Neurotransmitters transmit three possible messages: exciting, inhibiting, or modulating. Fluctuations in these messages cause most neurobiological disorders. They can also be caused by problems in how these messages are received or sent. 

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TED Talk on panic disorder

Colin Bien is the founder of True Fabrics, a sustainable online shop offering fabrics from all over the world. He had a panic disorder for three years, and in his TED Talk, he explained what he experienced and how he recovered.

Bien developed a panic disorder four years ago, caused by malaria prophylaxes. He had his first panic attack while attending a workshop at an international conference. He felt like he could not breathe and was burning up inside. Bien believes that stress can come from many different sources, but jobs are often the cause. Bien talked to friends and realized it is common to feel purposeless and exhausted. He worked to improve his mental health by having behavior therapy and going on a personal journey of discovery to find what helped him. 

Panic attacks consist of three things: uncomfortable physical feelings, upsetting thoughts, and distressing emotions. The physical feelings intensify and trigger fearful thoughts, such as thinking you are going crazy or losing your mind. These feelings are perceived as a threat, which leads to anxiety, and that signals the beginning of an attack. The feeling of anxiety increases, and the vicious circle continues. People with panic disorders can change their behavior, for example, by not mixing with certain people and not going to particular places, but this only eases the situation in the short term.

Even though he did not use it, he carried medication prescribed by his doctor with him. This is called a security signal and can help lower your panic. He would call his mum during an attack; this is avoidance behavior. He would write down every thought he had during an attack; this is deflection. These actions can calm someone down for a few minutes, but as soon as they stop doing them, the stress happens again. They had a certain effect on him but did not help in the long term.

In therapy, he learned that the key to getting out of those routines was not to avoid or deflect but to acknowledge and accept. This realization had a huge impact on him. As soon as he accepted, he could start to change his reaction. By acknowledging the attacks, they became shorter and less intense. 

He got rid of some bad habits and introduced some good ones. He stopped smoking, drinking coffee, and drinking alcohol. He started running and changed his diet by eating more fruit, yogurt, and less bread, and stopping eating carbohydrates. He set goals every day and reflected on them every week so he could monitor his progress. 

The sum of all those changes made his life less stressful. It is the habit loop with trigger, routine, and reward. The trigger starts the habit, the routine is the action, the habit itself, and the reward is the benefit you gain from having the habit. To implement a new routine successfully requires the attributes of discipline, motivation, and continuity. The combination of what works and what does not is different for everyone. These new routines gave Bien back his inner balance, and combined with behavior therapy, he felt happier and less stressed and at the time of his TED Talk, had not had a panic attack for over a year.

Types of anxiety disorder

There are different types of anxiety disorders, such as general anxiety disorder, social anxiety, phobias, and panic disorders. Treatments for these disorders usually include behavioral therapy and medication, such as a kind of antidepressant called selective serotonin reuptake inhibitors. 

Generalized anxiety disorder (GAD)

This disorder is a long-term condition that involves having a constant feeling of dread or anxiety, which can hinder everyday life. People with GAD can feel anxious most days and will often not remember the last time they felt relaxed. They can have frequent anxiety for months or years. Anxiety becomes a disorder if symptoms continue for six months or more.

It is unclear what causes GAD, but it is thought that there are numerous factors. Research has indicated that these factors could be genes, experiencing trauma, long-term health conditions, and a history of drug or alcohol abuse. However, some people develop GAD for no discernible reason.

GAD symptoms include:

  • Feeling wound-up, on edge, or restless
  • Finding it difficult to concentrate
  • Getting tired easily 
  • Not being able to control feelings of worry
  • Having sleep problems
  • Being irritable
  • Having stomach aches, headaches, unexplained pains, or muscle aches

Social anxiety disorder

Social anxiety disorder is an intense, relentless fear of being observed and criticized by others. People with this disorder can be very fearful of social situations. This fear can be a barrier to attending school, working, or doing everyday things. It can lead to worry that the anxiety will lead to being judged by others. 

The symptoms include:

  • Pounding or racing heart
  • Blushing, sweating, or trembling
  • Stomach aches
  • Difficulty being with new people and making eye contact
  • Fearing being judged and being self-conscious 
  • Speaking with a soft voice and stiff body posture or way of speaking

Panic disorder

People with this disorder have regular and unpredictable panic attacks. The attacks are spells of discomfort, intense fear, or a feeling of losing control when there is no actual trigger or danger. 

Not all people who have a panic attack will develop a panic disorder. Panic attacks can happen several times a day or just a few times a year.

The symptoms of panic disorder are:

  • Chest pain
  • Pounding or racing heart
  • Trembling or tingling
  • Sweating
  • Feelings of being out of control
  • Feelings of impending doom

Phobia-related disorders

A phobia is a fear of situations or a particular object. With a phobia, the fear is extreme considering the actual danger caused by the object or situation. People with a phobia may be apprehensive about coming across the feared situation or object, like blood, heights, flying, injections, and animals. They will try to avoid it, but if it does happen, they will experience intense anxiety. 

There are many types of phobia and phobia-related disorders. Specific phobias often develop during childhood and may lessen with age. Complex phobias can be more debilitating than specific phobias. They typically develop in adulthood. One of the most common complex phobias is agoraphobia. This disorder can make someone feel anxious about being somewhere it might be difficult to leave if they have a panic attack. As a result, they may avoid being on their own, traveling on public transport, or being in crowded places. 

Neurobiology

Researchers study changes in neuron, neurotransmitter, and neuroendocrine activity in depression and anxiety. They examine the parts of the brain where most change happens. This research furthers our understanding of anxiety disorder treatment. Anxiety disorders cause neurological changes in bodily and mood functions. People with psychiatric disorders can be more likely to have anxiety disorders. Only a small proportion of people with anxiety disorders seek treatment. This is partly because it can be difficult to recognize the condition. 

Some emotional and personality responses come from the interaction of environmental influences and genetic coding. Genes can make someone more receptive to certain stimuli and contribute to resilience to others. Stress and fear are normal reactions to risk, whether the risk is present or not. Anxiety can be a normal reaction, but if it continues for some time, it can be detrimental to health and everyday life. 

Clinical studies have identified the hereditary nature of certain anxiety disorders. There are internal factors, like particular personality traits, that can make someone more likely to have this disorder. 

Environmental factors can also cause anxious feelings such as alcohol or drug use, parenting style, and stressful life events. People with close relatives who have anxiety disorders are more likely to develop the condition.

The higher cognitive centers are in the prefrontal cortex of the brain. They play a part in social behavior, thinking, and planning. The prefrontal cortex helps to keep emotional responses under control. Most emotional processing happens in the cortex. The brain structures are cumulatively called the limbic system. Neurogenesis and hippocampal growth are essential in building resiliency toward anxiety and stress. 

Within the limbic system, the most central role in regulating emotions is played by the amygdala. The amygdala plays a big part in forming anxiety and fear-related memory and can be hyperactive in anxiety disorders. It is connected to other brain structures, such as thalamus, hypothalamus, and hippocampus. Communication between brain centers and networks is through neurotransmitters. Dopamine, norepinephrine, and serotonin are well known for affecting emotional states. Studies on generalized anxiety disorder have found a high level of activity in the amygdala and ventrolateral prefrontal cortex. 

Many anxiety disorders develop in childhood, where long-term anxiety changes certain brain structures; these changes can be observed with neuroimaging. The advancement of neuroimaging technologies and the subsequent deeper understanding of the neurobiology of anxiety should influence treatment for anxiety disorders. In adolescence, there is faster physical growth, along with changes in emotional control, behavior, and cognition. The way the body develops at this time of life may cause changes in some brain areas that can be connected to the development of psychiatric disorders in later life. In young people, it may be easier to remodel certain brain structures using cognitive behavior therapy than in adults. When treating adults, medication can be used to alter the biochemical structure of the brain. 

When patients have anxiety disorders, selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are often the first treatment given. Despite advances in understanding neuroendocrinology, treating anxiety disorders is not always possible. Recent research has led to more drugs becoming available for this condition. For example, benzodiazepines have been effective in treating panic disorders.

Conclusion

Neurobiologists have an in-depth knowledge of the central nervous system, and this expertise has been applied to the study of anxiety disorders. More has been discovered about the workings of the brain, and advances such as neuroimaging have deepened this knowledge. Research has discovered why anxiety disorders develop and has increased understanding and influenced treatment. There are many types of anxiety disorders, and they can be treated with behavioral therapy and medication. As Colin Bien points out in his TED Talk about his panic disorder, people can change their behavior patterns, which can lessen symptoms. 

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