How Anxiety Affects the Brain

Jennie Lannette, MSW, LCSW
October 6, 2020

Many areas of the brain are involved in dealing with anxiety, fear, and stress.

anxiety and the brain

Anxiety comes in many different forms. We might worry about an upcoming test, a health issue, a new relationship, or being criticized in public.

Feeling anxious about these things is normal, to an extent. In fact, many people believe that humans naturally evolved to have a cautious, if not negative, mind that looks and prepares for the worst. This may have helped the species survive and expand.

However, in those with more serious anxiety conditions, these worries become more extreme. They may begin to spiral into nearly constant anxious thoughts, present in general anxiety disorder (GAD). Or they could lead to panic attacks or be related to post-traumatic stress disorder (PTSD).

Scientists are still trying to understand how anxiety affects the brain. As it turns out, the way anxiety presents in the brain, and how the brain relates to it, is somewhat complex.

In the past, most believed that excessive anxiety was mainly tied to the amygdala, an almond-shaped part of the brain that relates to emotions. However, recent research has shown that many different parts of the brain are involved when it comes to anxiety. And how these areas of the brain communicate with each other are key.

A recent study showed that there are actually “fear circuits” that are activated when we feel fear or anxiety. Scientists found that when someone worries or prepares for a threat that’s not imminent, the cognitive-fear circuit kicks in. This circuit includes the hippocampus and areas of the prefrontal cortex, among others.

However, when there’s an immediate danger, a different part of the brain activates, involving the periaqueductal gray and the midcingulate cortex parts of the brain. So this suggests that the brain can typically understand the difference between worrying about the future and surviving in the moment.

In a recent study of stressed 10- and 11-year-olds, connections (or a lack of them) were found between the amygdala and parts of the prefrontal cortex. In healthy individuals, the scientists in the study note, there is open communication from the emotional areas of the brain (such as the amygdala) and logical areas of the brain (such as the prefrontal cortex). However, in highly anxious and stressed children, it was found that it was mainly the emotional parts of the brain talking, without much communication in the other direction.

Consistent results were found in a study with veterans with PTSD. A similar disruption between the amygdala and areas of the prefrontal cortex was found as compared to the control group without PTSD.

So what can we take from this growing field of brain science? There’s still a lot to learn and understand about how anxiety is perceived and processed in the brain. However, it seems that the way parts of the brain communicate with each other are a key to understanding anxiety, stress, and the fear response.

The recent results are not inconsistent with traditional views on treating anxiety. Cognitive therapists generally believe that ongoing anxiety and other emotions are influenced by our thoughts. While it is normal to have an initial emotional response, such as anxiety about a new job, it’s our thoughts that affect how we move through emotions going forward.

For example, many people may look for problems to occur in their jobs, noticing only the negative events that are happening. They hold onto these negative signs and may dismiss more positive signals. Over time, all of this worrying becomes a pattern that’s hard to break.

In cognitive behavioral therapy (CBT), people learn to notice and change their automatic thoughts, which may tend to be worrisome and negative. The effectiveness of CBT is proven across many areas of mental health, perhaps most prominently with anxiety disorders. Challenging thoughts and changing thinking patterns in the brain often results in decreased (or even the curing of) severe anxiety symptoms.

To get a sense of how thoughts can impact feelings, consider this example. Perhaps a new boss suggests that you work on one area of your job performance, while raving about several other things you are doing well.

An anxious mind may focus only the negative aspect, creating a spiral of worry and stress. This might be similar to what scientists were noticing when only the emotional parts of the stressed-out kids’ brains were working. The logical and emotional parts of the brain weren’t connecting.

Traditionally, talk therapies like CBT have helped people change their habits of thinking. Related exposure therapies, used to treat PTSD, panic disorder, and general anxiety disorder (among others), may work more with reprogramming the non-logical areas of the brain. This helps teach the emotional areas of the brain that a particular concern is not actually physically dangerous, even if we don’t like it. A combination of these methods is often used in evidence-based treatments.

In the example above of the boss, discussing the situation and the thoughts that arise may help improve connecting between the fearful and logical parts of the brain. CBT therapists often use a socratic method, helping clients to question and challenge their own thoughts. Ultimately, this reprograms how the brain works.

While we don’t understand everything about how anxiety is handled in the brain, we are learning more every day. As new science emerges, we may find more chemical and therapeutic treatments to help with various anxiety disorders.

Jennie Lannette, MSW, LCSW

Jennie Lannette is a licensed therapist who specializes in trauma, PTSD, and related issues. She has trained extensively in multiple evidence-based treatments. She has a decade of experience in inpatient, community, and private practice settings.

More For You