If you’ve ever had a panic attack, you know that it can feel like a nonstop tsunami. Waves of anxiety, stomachache, racing heart, a sense of helplessness and hopelessness rush over you uncontrollably—often regardless of whether or not the initial threat was particularly dangerous or whether it’s even still present. Perhaps the worst part, though, is the nagging feeling that the sense of dread is all in your head.
But what if it was, in fact, all in your head—and not in a neurotic-basket-case kind of way? What if there was a scientific explanation for the way your brain responds to and controls the fear impulse?
Sonia Bishop, an assistant professor in U.C. Berkeley’s psychology department and the Helen Wills Neuroscience Institute, has found evidence that suggests exactly that. In a study published this year in the science journal Neuron, Bishop and researchers from Cal and elsewhere used magnetic resonance imaging (MRI) to scan the brains of 23 adults while they observed three virtual rooms. In the first, a person put his hands over his ears just before hearing a loud scream. In the second room, the person put his hands over his ears from time to time, but this did not predict the scream. In the third room, a scream never followed the gesture.
Depending on the situation, some observers responded with prolonged high anxiety, while others were quickly able to bring it under control.
“Fear conditioning has been looked at for a long time. But we were looking at mechanisms of vulnerability. Is there something in your brain that puts you more at risk of fear response? And why are some people able to dampen down fear and anxiety more quickly?” says Bishop, a slight young woman with a steely gaze, who began her academic career at the Institute of Psychiatry in London and studied cognitive neuroscience at the MRC Cognition and Brain Sciences Unit and University of Cambridge’s Department of Experimental Psychology before coming to Berkeley in 2008.
What Bishop discovered by studying the neural imaging of her scream-stressed subjects was that—contrary to what scientists previously believed—there are actually two independent physiological factors that make some folks more prone to anxiety.
The first is an increased responsiveness of the amygdala, the region of the brain that processes and regulates emotional responses—in particular that pesky Darwinian fight-or-flight instinct. The second is underactivity in the prefrontal cortex, the area of the brain that mitigates your fear response, telling you to calm down.
In essence, people who have both these characteristics get the double whammy—they’re more inclined to freak out when faced with a threat, and then once the floodgates are open, they can’t turn it off. “A lot of people have thought of this response as one circuit. The breakthrough was to pull apart that idea into two dimensions, which we think could help treat anxiety more effectively,” Bishop explains.
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The National Institute of Mental Health estimates that anxiety disorders—everything from panic attacks to post-traumatic stress syndrome and obsessive-compulsive disorder—affect some 40 million adults in the United States every year. It’s an astoundingly large number considering that Americans live in a relatively safe environment where they are not under continual threat of attack.
Most treatments for anxiety involve either antidepressants or cognitive behavioral therapy. “In each case, a significant minority of people don’t respond,” Bishop says. “But if we could narrow down the cause to either an over-reactive amygdala or the underactive frontal brain, then we might be able to choose treatment more effectively.”
Bishop believes that one of these therapies may involve teaching people with underactive frontal regions how to get in touch with their own inner workings. “For anxious individuals who can’t recruit frontal response, we’re hoping this research will lead to ways they can train their brains to trigger this mechanism deliberately, to make it a more automatic process,” she says.
She notes that in many other parts of the world, people have to face prolonged and unrelenting periods of life-threatening danger. “In the world today, it’s not very clear that the threat is ever gone. With terrorism, it’s not like all the things that made you anxious have gone away. You still have to get on a plane. Still have to wonder about that suspicious package,” she explains. “In Afghanistan or Iraq, there’s still bombs going off. We need to be able to deal with the fear response when the conflict is ongoing. We need to figure out how to down-regulate when the danger is still present.”
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San Francisco journalist Bonnie Wach’s writing has appeared in publications ranging from The New York Times Magazine to the San Francisco Chronicle and the Los Angeles Times. She last wrote for The East Bay Monthly on vegetarian food pioneer Mollie Katzen.
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