Anxiety can be overwhelming and all-consuming. One patient with severe anxiety told me, “Nothing feels safe, and I feel there are no grown-ups left in the world.” Another patient would feel terribly anxious whenever she thought anyone said something critical about her.
She compared it to someone “poisoning” her mind, as she would replay the words over and over, making it impossible to do or think about anything else. This led to her isolating and calling out from work until her mind would settle. During anxiety the “emotional brain” is overactivated, overriding the “thinking brain”.
Credit: Getty Images If certain cues set off a cascade of worry and stress, we may fixate on them and magnify their meaning, keeping our mind and body on overdrive. This can make it hard to think our way through situations. Our thoughts can be emotion-driven, negative, repetitive and hard to change (what has been termed “perseverative cognition”).
Neurobiologically, during anxiety, the “emotional brain” (including areas such as the amygdala, which determines the quality and strength of our emotional reactions) is over-activated, overriding the “thinking brain” (which includes areas within the prefrontal cortex or PFC, responsible for limiting amygdala activity). As anxiety increases, we have less access to the prefrontal cortical areas that would allow for flexible thinking. In such instances, the amygdala takes over, stimulating other areas to release stress hormones s.