Fear On / Off Switch?

This would be very good news for those of us who have issues with having fear, panic, and anxiety responses that don’t work as well as they should.

Researchers at Harvard Medical School’s affiliate McLean Hospital have identified a protein in the brain that serves as a trigger for how we respond to fear, real or imagined. This finding increases the chances that scientists may be able to develop medications that could help regulate this faulty fear switch in people suffering from certain types of anxiety disorders.

In the study, the researchers looked at the neurons in the amygdala of mice lacking the TRPC5 gene and discovered that they did not fire as well as those in the brains of normal mice. At the same time, neurons in the same region of the brain of the mice missing the TRPC5 gene were not as sensitive to the neuropeptide cholecystokinine, commonly released in the brain during situations of innate fear or anxiety…

Let’s hope that this research continues and that we see some pharmaceutical trials of new medications as a result.

Researchers identify a fear on-off switch , via Anxiety Insights

Does Serotonin Help Moods?

In the treatment of depression, SSRIs (selective serotonin reuptake inhibitors) or SNRIs (selective norepinephine reuptake inhibitors) have become mainstrays in pharmaceutical treatment for many patients. Scientists are now asking two questions – do they work, and do they work the way everyone assumes they work?

Anxiety Insights has an interesting look at some research being performed at universities in Oxford and Belfast that questions the common belief that low serotonin levels are behind depression, and instead posit that serotonin therapies affect emotional processing.

In a recent randomized double-blind study, 42 healthy men and women who did not is have depression were given antidepressants (SSRIs or SNRIs), or a placebo for seven days. After a few days of treatment with SSRIs, they became more positive in their emotional outlook based on performance on tasks of emotional processing. These positive biases in emotional processing were independent of their reported mood.

“The drugs work quickly to change how people experience the world emotionally. We believe this is due to the effect of the drugs on emotional processing, rather than directly altering mood. Remembering and experiencing events in a more positive light helps to lift a person out of their depression,” he said. This mechanism of the action of antidepressants is compatible with cognitive behavior therapy suggesting that this dual approach will be helpful for people with depression.

Add to this research into genetic indicators that may shed some light into which patients might benefit from treatment and which might be prone to certain side effects, like weight gain, and it’s clear that while much is known about serotonin, there are many mysteries yet to be solved.

Rethinking Serotonin , via Anxiety Insights

Using Weather to Teach a Child About Fear

My eight year old son – we’ll call him Sam – has inherited his Dad’s fascination with weather.

From his earliest days, when he could barely hold his head aloft, he would swivel in the direction of the magical TV box whenever the weather radar would come on the screen, or if he heard the computer-generated voice that gave the NOAA forecast superimposed over the map on our local weather channel.

Living in central Ohio, severe weather in the form of terrible thunderstorms and tornado watches is common. The combination of flat, open spaces and cold fronts often churns up the atmosphere, which means the local weathermeisters frequently interrupt regularly scheduled programming to jam their Super Nexrad Doppleganger Accu-Panic 4000 in our faces as they chart the speed and direction of the forthcoming swath of probable doom.

For Sam, there’s really only two things he knows about a tornado. First, they destroy homes and kill people, as evidenced by the video played and replayed ad nauseum on said TV box. Secondly, they are talking about tornado watches or warnings where he lives. Fear and panic set in, and Sam believes a tornado is heading through our subdivision, as the sky is dark and the wind is blowing where he is.

It’s senseless to explain to a pre-teen that the odds of dying in a tornado are roughly 1-60,000, or that he stands a much better chance of death by falling down (1-246) or via an air travel accident (1-20,000). That’s the thinking brain approach, and he’s not responding intellectually. His reaction is an emotional one, generated by the feeling brain. And he’s not alone. The vast majority of adults have exactly the same reaction. Even though the odds of dying of heart disease are 1-5, we still eat butter, cheeseburgers, and chips. There’s little trepidation about hopping in the car even though statistics tell us there’s a 1-100 chance of dying in a crash.

We watch news reports of horrific storms and stare at video of the carnage, and listen to sobbing testimonials from families surveying their destroyed homes, or townsfolk eulogizing the lost.  That personalizes the event in our minds and keeps it in the forefront of our memory. It’s difficult for us to recall the hundreds of tornado events each year that don’t cause death or serious injury, but our mind can quickly flash on examples of video and still photos taken from news reports and print media that document the worst scenarios. So when “tornado” hits our conscious mind, viola! Terrible event, death and destruction, risk alarm clangs loudly, fight or flight kicks in.

Between 1976 and 2000, the mean number of yearly tornado fatalities was 54. From 1912 to 1936, the mean number was 260, almost 5 times as many. So the risk has decreased substantially. But you wouldn’t know that because modern communications keeps the 54 foremost in our minds.

So how do you teach a child to not be afraid of a tornado?

I do it by telling him that in my 48 years on this planet, I have never seen a tornado, smelled a tornado, or lived anywhere that a tornado hit. He can connect with that – and there’s trust and credibility built in that no amount of statistical information can approximate. We also talk about what to do if one does happen to head our way. We know exactly where in the house we’re going to go and what we’re going to do, so he feels empowered in his situation. It’s no longer abstract – more than 17,000 days have passed without Dad experiencing a tornado, so it must be pretty darned unusual.

Then we eat healthy foods (mostly), always wear our seat belts, and change the batteries in our smoke detectors. Because I don’t want Sam to be fearful like me. I want him to live his life by paying attention to the important things while being somewhat resistant to the fear culture that’s developed.

Who knows. He might even grow up to be a storm chaser.

Fear: So Easy, Cavemen Did It

Unless you’re a former member of the Kansas Dept. of Education, the concept of natural selection seems entirely logical.

Throughout our evolution, the weaker of the herd didn’t survive to procreate and spread their genetic flaws. If you couldn’t outrun a tiger, you were dinner. If you could outrun a tiger, then your offspring would probably have those marvelously strong legs and a runner’s endurance.

Over time, we learned what to fear. If we were too stupid, or headstrong, or suffered a deficit of common sense, we became some other creature’s appetizer. I mean, look at humans compared to wild animals around the world. We didn’t have a lot going for us outside of our brains, which we used to compensate for our physical limitations. Again, the pea-brained among us, the less intelligent, would walk into quicksand, or bend down by the river to get a drink and get bitten by a croc, or stop paying attention to where we were going and fall into a ravine where we would lay until our bones were picked clean.

So we developed this hard-wiring over time – little schematics engraved on our gray matter – that didn’t require us to think about things quite so much. Some call it instinct, or intuition, and you see examples of it today. There are certain things that just don’t feel right, and we react without needing a lot of coaxing or intellectualizing.

Have you ever been face-to-face with a grizzly bear? I haven’t – but I’m pretty sure if one popped his head into my office, my reaction would be a combination of fear and panic. I’ve never had a bad experience with a grizzly. I’ve never met anybody who had had a run-in with one. WikiAnswers tells me there are less than 30 bear attacks a year – and as of November 2008, there were 6,734,923,433 people in the world. It’s completely irrational for me to be afraid of a bear attack, given those stats, but I guarantee you I am afraid of bears. Thanks for that, Stephen Colbert.

There’s something in my DNA that makes me afraid of bears, because my ancestors probably had bears visit them in their caves on occasion in search of warmth, food, and hibernation. Again, if the caveman ignored the bear threat, there’s a chance they would be a last supper before the big winter nap.

So we have all of these strands of information etched into our very being, which came in handy 100,000 years ago, but most of that stuff isn’t applicable today. It’s still there, though, sending us warning signals, raising red flags, popping off flares, all out of self-preservation.

Perhaps that’s the reason why we seem to be so afraid these days. We’re living longer than ever, fewer of us are dying of cancer and similar conditions, and we generally have things much better than our ancestors of even a few hundred years ago. There’s really no reason for us to be so skittish.

Over the next couple of weeks, I’ll share some of my ideas on why we’re so afraid. Feel free to chip in with your own thoughts.

The Thing I Fear Most Is Fear

In 1580, French essayist Michel de Montaigne penned this sentence in “Of Fear,” The Essays (Les Essais). Others have used variations of this theme since (FDR is his inaugural address, for one) and there’s a lightning bolt of truth in this phrase for those with panic and anxiety disorders.

Once I started having panic attacks in my late 20s, fear and trepidation concerning the next episode began to intrude on everyday life. Knowing how unpleasant panic attacks were for me, I began to fret about attacks before they happened as I postulated and predicted the next one.

Would I be on an airplane? That would be terrible, for there is no escape from the pressurized metal tube in the sky. How about stuck in traffic on a tall bridge? Feeling the sway of the span would cause my heart to race in anticipation, completely ignoring the fact that engineers build flexibility and elasticity into the structure to ensure fault tolerance and to prevent catastrophic failure.

A crowded meeting room? A party filled with my friends? A job interview?

Once I began to anticipate the (inevitable) next attack, I was all but ensuring its occurrence. I became a walking, talking self-ensuring prophecy of anxiety.

Fear is scary, and physical / emotional response to perceived risks is part of our survival instinct. But it seems like we’re a lot more afraid than we used to be. I’m not sure if it’s because we see and hear hyped-up threats constantly in our 24 hour news cycle, or if we’ve lost our sense of ratio and proportion.

Driving is one of the more dangerous modes of transportation. If you ask around, people would generally acknowledge this statement as true. But in the aftermath of the 9/11 attacks, when everyone was afraid to fly, more people took to driving to get to their destinations, even though the risk of driving far outweighs the risk of being in a plane that’s commandeered and flown into a skyscraper.

It’s projected that an additional 1,595 people died in traffic fatalities in the year after the World Trade Center attacks, the deaths directly attributable to the increase in people driving. Statistically, we stand a 1-6,000 chance of dying in a car crash. Since only 3000 people have died due to planes crashing in tall buildings at the hands of terrorists in the history of the world, and of those, only a couple of hundred were inside the planes themselves, it stands to reason that we tossed aside rational thought and elementary school arithmetic out of fear. And rather than making us safer, fear increased the number of deaths and injuries we faced, directly opposite the result we were seeking.

It’s important for us to be able to step back, take a deep breath, and evaluate whether the measures we take out of fear are helping or hurting our cause. It’s not an easy exercise, but it is a necessary one. Otherwise, we’re constantly reacting.

More people die of malaria in a month than have died from swine flu in recorded history, but people wore ineffective surgical masks in public and began to stock up on Tamiflu rather than sending mosquito nets to Africa.

Fear makes us do idiotic things.

Meditation Helping Troubled Veterans

The Seattle Times details a new “mindfulness-based stress reduction” therapy for veterans experiencing Post Traumatic Stress Disorder (PTSD). Once thought to be applicable only to hippie freaks and David Carradine fans, meditation and mindfulness are rapidly becoming the go-to tool for therapists as they search for ways to assist soldiers and sailors who have been witness to unspeakable havoc and human destruction.

Mindfulness treatment asks participants to be aware of their thoughts and physical pain without judgment. It’s easy to stew over negative thoughts, which can cause more stress and frustration.

By simply pausing to pay attention, people can notice patterns in their thinking and put thoughts into perspective to improve their lives. Deep breathing, meditation and yoga help with this process.

Scientific studies have shown the technique can help patients with a range of issues, including anxiety, depression, chronic pain and rheumatoid arthritis. Kearney hopes to add PTSD to that list.

“I quickly found that people with PTSD sought out the class to find additional ways of dealing with this problem,” he said. “We’ve had many patients report to us the ability to be present in the actual moment helped their PTSD.”

Learning about the Buddhist concept of mindfulness and how meditation can be used to facilitate the mindful state was enormously beneficial to me when I began to grapple with my anxiety disorder. The easiest way to explain it is that the combination of mindfulness and meditation gives my fears a “time-out” where, for that period of time, I’m in charge of my thoughts and emotions. By forcing myself to use my mind in a reasoned, practical, intellectual manner, I’m effectively disabling the runaway thought processes that often lead to the anxiety reactions and behaviors.

I’ve never had much use for the formalized exercises or chanting that often accompany meditation, but repeating key phrases and/or vocalizing my emotional state while clearing my brain of extraneous thoughts has evolved through practice and is now an essential part of my coping mechanism toolbox.

Kudos to the VA Puget Sound Health Care System for their innovative approach to helping our vets.

Seattle hospital teaches meditation to troubled vets

Suffering Sucks

I hurt my back the other day by sneezing. I wasn’t pushing an elderly lady out of the way of a speeding, out-of-control truck, or wrassling a bear. I was walking across the parking lot at work, my laptop bag slung over my left shoulder with my umbrella held up with my right hand, ineffectively deflecting the nearly-horizontal raindrops, when I felt that familiar itchy-tickle of a ker-choooo that would seconds later erupt.

Ker-choooo. Ouch.

So I’ve spent the last couple of days enjoying my new regimen of Tylenol and Advil, alternating between shiny red tablets and adobe-hued caplets, and it still hurts. Muscle spasms are a bitch.

It’s not the first time I’ve experienced lower back trouble – more like the 73rd. Fully supportive of the Buddhist concept of impermanence, I know the pain and tremors won’t last forever. Unless they do. And it’s only truly excrutiating when I walk or stand a certain way, so I’m trying to avoid the curse of being upright. Sitting is bearable, and luckily, my sitting position creates a nice shelf for my laptop so I can wallow in my discomfort and tell you all about it.

Didn’t this just turn out to be your lucky day?

Anyway, as I was walking the (seemingly) three miles from the parking lot to my son’s flag football game this morning, each step a reminder of my sneezy ways, I decided to follow my own advice and let the pain and discomfort in. No more fighting it, embracing it, calling it by name. Pain. I feel you. You hurt me with each stride. Come in and make yourself at home. I know you won’t stay long, and there’s no use denying you or wishing you were elsewhere.

It still hurt. A lot. Embracing pain and suffering sucks, man.

What a great reminder of mindfulness and a gentle rebuke of elevated expectations. Why was a part of me anticipating the pain to lessen simply because I acknowledged its presence? That’s not how this works, Boddhavista.

It’s reminded me that I’ve been a bit impatient and easily frustrated of late. Petty annoyances and meaningless inconveniences have bothered me, a cause-and-effect mentality developing where I was feeling put-upon. This has led to me spending way too much time thinking about me, with little regard to the troubles and suffering going on around me. Certainly not right-thought or right-action.

A lesson exists in my back pain, as I’ve struggled with simple tasks like putting on my pants and getting in and out of the car. It’s a lesson that entails understanding suffering in all of its forms and realizing that when I’m having a bad day, feeling all whiny and cranky, I need to look around and observe the pain and tribulations of others.

Rather than feeling sorry for myself, I should continue on my path to compassion and work to ease the suffering of others, because it is only by continuing my growth and healing during difficult times that I demonstrate my knowledge of the role of suffering in our lives.

The Buddha’s teaching on suffering is that we need to accept the things we can’t control, such as loss, sickness, aging, and death. This has been my reminder.

What Makes Us Happy?

Joshua Wolf Shenk, writing in the Atlantic, takes a very deep look into 72 years of Harvard research to see if there’s some obvious formula to happiness.

The Harvard study followed 268 men who entered college in the 1930s throughout their education, careers, marriages, family-rearing, and into old age. The collected data gives some keen insight into our perception of happiness and how we tend to form our own particular flavor of happy.

There are several powerful nuggets to be gleaned from Shenk’s essay, and it’s highly entertaining and educational to navigate your way through the mind of psychiatrist George Vaillant, who acted as a sort of curator of these stories for 42 years.

Happiness can be as difficult to define as it is elusive to locate. Some see it as a state of contentment or joy. Others equate being happy with pleasure or satisfaction with the quality and direction of their life. In his book The Art of Happiness, the Dalai Lama noted, “I believe that the very purpose of our life is to seek happiness. That is clear. Whether one believes in religion or not, whether one believes in this religion or that religion, we all are seeking something better in life. So, I think, the very motion of our life is towards happiness.”

Interestingly, the co-author of the Dalai Lama’s book, psychiatrist Howard C. Cutler, MD, noted that in his many years of treating patients for a variety of mental health issues, not once did he or his patients articulate “being happy” as a goal of their therapy or treatment. Cutler’s colleagues similarly had never used happiness as an outcome, focusing rather on correcting troubling behaviors or helping patients develop coping mechanisms to allow them to function better in society. But achieve happiness? Never!

I’ve struggled with allowing myself to feel happiness and joy, my anxiety and fear always sitting on my shoulder, ready to whisper that nothing ever lasts, so if I give in and glee it up, there will be an inevitable hard landing when happiness ends.

But does it end? Ten years ago, my answer would have been yes, of course. My journey has shown me differently, however, especially as I took measure of the role anxiety was playing in both how I defined happiness and what a happiness lifecycle was supposed to be. As usual, anxiety distorted my view significantly because to be happy really is to take things as they are and to cede control, two major obstacles for me, because of the inherent vulnerability that accompanies such emotions and actions.

As Shenk describes in his essay: …positive emotions make us more vulnerable than negative ones. One reason is that they’re future-oriented. Fear and sadness have immediate payoffs—protecting us from attack or attracting resources at times of distress. Gratitude and joy, over time, will yield better health and deeper connections—but in the short term actually put us at risk. That’s because, while negative emotions tend to be insulating, positive emotions expose us to the common elements of rejection and heartbreak.

Who knew that the marketing departments of various state lottery commissions had the answer with their “You’ve gotta play to win!” campaigns?

What Makes Us Happy?

Anxiety? Toss the Safety Behaviors

During the height of my fear-and-anxiety driven existence, I would often seek to employ “safety behaviors” in my daily life as a kind of buffer against all the bad things I imagined were out there, just waiting to happen.

What are some examples of safety behaviors? Have you ever selected an aisle seat close to an exit, or better yet, the window seat in the exit row, when you purchase an airplane ticket, just in case you needed to get off that aircraft in a hurry?

How about pre-medicating yourself when there was the possibility you might find yourself in an anxiety-causing situation, like giving a presentation before a large group or going to an event where you didn’t know anyone.

Do you ever follow superstitious routines that seem pretty ridiculous, but decided there’s always the possibility that something could go wrong if you did something differently, so why chance it?

The point is, relying on these safety behaviors does nothing to improve your situation or help you cope with functioning with anxiety. Quite the opposite – you develop this invalid crutch that you lean on to help you through, which means you never regain the strength or muscle memory you once had before fear and panic got in the way.

If you say the same words over and over, and nothing bad happens when you do, it’s easy to believe that repeating that mantra is what helped you survive the anxious situation, but nothing could be further from the truth. People who sit by exit doors die in plane crashes. Sorry to be the one who breaks that to you, but it’s true.

What, then, are we anxious folks to do? One idea is to expose yourself to the very things that make you nervous or anxious, and consciously toss away the safety behaviors, reminding yourself that they are a sham. Feel the dread and discomfort that this causes, and deal with it using whatever tools you’ve happened to pick up along the way.

Let the worry and fear pass through you and out the other side. Accept it for what it is, embrace it, understand it, and then let it evaporate away, like a cool morning mist.

It won’t be easy at first, and you probably won’t be successful, but that’s okay. It’s alright to fail.

What you will be able to say is that you made it through on your own, with no crutches, and you’re prepared for the next practice. Soon, you’ll be saying “Hi!” to Mr. Anxiety Monster, giving him a wink, and waving him past. Well…mostly.

For more of my blathering on these kinds of things, check out my posts Anxiety Can Lead to Gift Giving , Compassion for Self-Healing and What To Fear?

Two Faces of Anxiety Disorder

Anxiety Guru has a short posting about the two faces of anxiety. From the blog:

As anxiety sufferers we all understand by now what constitutes an anxiety symptom.  It could be palpitations, chest pain, dizziness, or more thought based symptoms like racing or disturbing thoughts.  In my case I have experienced both, but interestingly rarely have I experienced both at the same time.

That’s an interesting perspective, but not one that I share. My experiences have generally been more linear in nature, where there’s a correlation between the physical issues and the busy brain.

For example, I’ve had problem with feeling pain or discomfort in my chest or side, which often would kick off the panic escalation process.

“What does a sharp pain mean versus a dull ache?”

“What’s this bump? And if I have the same bump on the other side of my body, does it mean the bump is normal?”

“What vital organ is located close to the source of the pain?”

“Is the pain due to a cramp, or do I have fatal pancreatic cancer!?”

One holiday, friends bought me a book for hypochondriacs, which they thought was funny, but all it did was lend credence to justify my anxiety. “See, a certain number of people have strokes from holding their head at an odd angle while holding their phone between their ear and shoulder so they can free up their hands. It restricts the blood flow to the brain, dammit!”

My own situation is entirely holistic, where high stress manifests itself in lower back pain, while conversely physical maladies have a knack for kicking off my panic response.

What do you think? Is your panic and anxiety more physical or mental, and can you keep them separated?

The Two Faces of Anxiety Disorder