Anxiety Insights: The psychological and evolutionary processes behind the most common mental health concern

Anxiety is the most common mental health concern that people seek psychological and psychiatric treatment for. There a numerous evidence-based treatment options to help individuals better manage their anxiety symptoms; however, I have found that educating my clients on the underlying physiological and evolutionary processes of anxiety has a profoundly positive impact on their experience and treatment outcomes. It’s almost as if having this education demystifies the experience of anxiety. It is no longer a scary, uncertain, and overwhelming experience, but rather a physiological response and evolutionary adaptation that actually makes sense once we understand it.

I tell my clients that the core emotion of anxiety is fear and the core cognitive, or thought, process of anxiety is worry.  At the root of anxiety is our brain’s attempt to help us survive at all cost. It’s most helpful to start at the beginning…like the actual beginning of humankind.

When humans first developed, our brains were much smaller in size and the majority of the brain was encompassed by what we now know as the limbic system. The limbic system involves numerous brain functions related to memory and emotion, but the most well-known is the “fight or flight” response. Early human beings had to contend with constant threats to their lives and it made sense that the vast majority of their brain function was dedicated to assessing for and responding to these threats. In other words, our early brains were primarily concerned with our survival and nothing else.

However, as the capabilities and knowledge of human beings began to grow, we developed families, civilizations, built buildings, used tools, explored higher order processes such as politics, religions, science, and technology. Because of this, the size of our brains also began to grow. But this growth was not just wasted space, rather we developed more sophisticated brain functions to help us with problem solving skills, logical thinking, rationalization, intellectualization, and metacognition. What we now call the prefrontal cortex developed later in human development and its primary concern is executive functioning and mental health.

The problem that modern humans often encounter is that these goals can be in conflict with one another. Our limbic system, well protected and buried deep in our brain, remains primarily concerned with our survival; while the prefrontal cortex, at the forefront of our brain structure, is concerned with sophisticated cognitive functioning and mental health. Individuals who experience anxiety and panic can experience these two systems as being in direct conflict and it can exacerbate distress.

I like to describe anxiety as a massive false alarm of the limbic system. Our brain and nervous system communicate that a threat or danger is present and the fight or flight system needs to be activated. The limbic system will trigger the release of adrenaline into the body, which is meant to prepare an individual to either fight or flee the threat. This is a highly effective system for survival. Unfortunately, in the case of anxiety, that “threat” may be something that does not require high amounts of adrenaline (i.e., test anxiety, public speaking, going on a date, having a hard conversation, setting boundaries, etc.). So what we see is that the adrenaline simply courses through the body without an outlet. This can result in the experience of common anxiety symptoms, such as rapid heart rate, shakiness/trembling, shortness of breath, chest pain, GI distress, and feelings of being on edge or restless. This is a well-designed and well-intentioned system that can assumably wreak havoc on our mental health.

The cognitive symptoms of anxiety, primarily excessively worry and racing thoughts, tend to operate on a similar process. Again, our brain will act in ways that it believes are most likely to ensure our survival. If we worry excessively, identify all possible outcomes, or assume the worst case scenario our brain believes that it can help us to effectively prepare and avoid any unfavorable or threatening outcomes. Again, this is a well-intentioned system, but one that if not effectively managed, can disrupt our functioning and cause us significant distress.  

Ultimately the experience of anxiety comes down to the battle between the brain’s processes of survival and that of mental health. And in 2024, because our survival is not often at immediate risk, we must find ways of prioritizing mental health. Even if that means overcoming ingrained survival instances.

Once my clients understand this underlying process of anxiety, we are able to view it more so as a process that is meant to protect, rather than a process that is meant to harm. It also gives us a road map for how to more effectively treat anxiety symptoms. We have to find ways of communicating to our nervous system that we are not in danger, do not need large amounts of adrenaline in our system, and ways to burn that adrenaline should it seep in.

Treat your anxiety in these steps:

1.     Realistically assess your environment and objectively assess any risks. This is where identifying and challenging cognitive distortions can come in handy.

2.     Be grounded in the present moment. Anxiety tends to live and thrive in the past, which we cannot change, and in the future, which we cannot control. Being in the present moment is typically very tolerable if we can stay here. Grounding skills can be incredibly helpful for this.

3.     Train your brain and nervous system to get used to the feeling of calm and safety. Meditation, mindfulness activities, and progressive muscle relaxation can be highly effective for this.

4.     Have a toolbox of skills that you can use to help ride the wave of anxiety and panic should it onset abruptly or become overwhelming quickly. DBT distress tolerance skills can be helpful for this.