29 ms·

Anxiety is in your body, not your mind

391 points by rainhacker 5y ago

baron_harkonnen 5y ago
This might come as a surprise to some, but it turns out your mind is also in your body
jfb 5y ago
Descartes and his duality strike again.
- ozim 5y ago
  I also think it is silly that people don't think that "your body == your mind". It is simple to discard neurons that are scattered through the body, but those are also neurons.
  - jfb 5y ago
    I think it's more complex than one equals the other; the two phenomena are inexplicably interconnected. The duality is a very non-helpful frame to use to analyze, well, basically anything.
bananaboi 5y ago
Non-authwalled link: https://outline.com/ycjSSm https://outline.com/ycjSSm
- Igelau 5y ago
  Seriously, I've seen nothing on Medium that would be worth paying or registering for. It's LiveJournal dressed like a newspaper.
22c 5y ago
I wish there were a little more examples of how this methodology deals with the stress/anxiety response. The article seems to spend more time talking about why it thinks "thinking brain" CBT/talk therapy doesn't work rather than "surival brain" techniques which do work. It also brings up "mindfulness" as one solution, which I consider almost analogous to CBT, or at least a close relative. It also seems counter-productive (to me) that the solution for one subject was to "strike out and defend himself within the safety of a therapy session". What is that person supposed to do in the moment? Ball up their anxiety and wait for therapy?
- Igelau 5y ago
  CBT seems very poorly suited to anxiety. 1. Most of the CBT literature is aimed at treating depression. 2. Anxiety is going to strike when you don't have the time or resources to sit down with pen and paper and analyze what's going on, and there is a lot of that in CBT.
  - 22c 5y ago
    I think it depends on what techniques are applied. There seems to be specialist branches of CBT such as MCBH and ACT which might be better suited to these scenarios. However, my point is that the article seems to spend more time telling us that CBT doesn't work (without providing much evidence) than why "survival brain" techniques are better. I haven't learned much from this article other than some people think CBT is not suitable for dealing with anxiety.
  - firecall 5y ago
    I'm having therapy and CBT, and I wouldnt say thats my experience. I think it is useful for dealing with anxiety. Learning to recognise triggers and having strategies in place to deal with the issues causing anxiety. Anxiety, when it's a problem, is generally at an irrational level! Anyway, everyone is different and has a differnt experience!
Igelau 5y ago
Sometimes. Sometimes not. I've seen both sides. My anecdata: My road rage was definitely my body and responded to therapy that targeted the sensations in the body. My anxiety was not. It was a way of thinking. Ruminating thoughts. Cascades of potential disastrous outcomes. I needed medication and I needed to talk to a therapist. She seems unqualified to be giving out misguided medical advice in such certain terms. Minds get in the way of comprehending other minds, and broad statements are difficult to make truthfully.
burlesona 5y ago
I noticed as young adult that I didn’t really worry or consciously stress, but my body had somewhat predictable reactions to situations that I would realize, in hindsight, were highly stressful. Those physical reactions sucked, and as they got worse over time, it really concerned me. At some point I was encouraged to go to CBT, which I did, but honestly it made things worse. I became hyper aware of how anxious I was at any moment, and the more I noticed the more it worried me. Years later I tried mindfulness meditation and found that it helped. But also, I finally hit a kind of turning point where I just realized that there was nothing I could really do about anxiety or the physical symptoms that came along with it. I decided to mostly try to quit noticing and thinking about it. And that really helped. I still feel stress and anxiety symptoms sometimes. They still suck. My conscious mind is still the last to recognize what’s going on. But, overall, I feel I can handle a lot more stress now than I could ten years ago without it ruining my quality of life, and more importantly I can recognize the stress, not worry too much about it so I can get through it, and then rest and recuperate (as soon as possible) and recover much quicker than when I was younger. I’ve concluded that the best advice is to learn not to worry about things. Unfortunately that’s easier said than done, and I’m not sure I have any advice on how to learn to do that :/
- danlugo92 5y ago
  Interesting. I've been reaching a similar conclusion recently.
- bamboozled 5y ago
  > I just realized that there was nothing I could really do about anxiety or the physical symptoms that came along with it. I decided to mostly try to quit noticing and thinking about it. And that really helped. I think this is mission accomplished from your mindfulness practice, you realized that you're not really doing anything and that anxiety just appears, you accepted it and it felt better.
  - osacial 5y ago
    There are some problems with that type of approach - there are some things that won't vanish, if you stop thinking about them.
sammalloy 5y ago
One other thing to consider, that I rarely hear anyone talk about, is that anxiety can sometimes be a symptom of an underlying physiological condition or disease. For example, hypoglycemia-related anxiety is a common complaint.
- Sunspark 5y ago
  This is true. Vestibular disorders in the inner ear can cause anxiety.
- Jtsummers 5y ago
  If you discuss it with your doctor (and you should) they will run tests to try and rule out physiological causes. I know they did for me with both depression and anxiety, as I had other signs/symptoms of a thyroid disorder (turned out my thyroid was fine, I was just very stressed out and long term severe stress-induced anxiety, for me, leads to severe depression).
- hanniabu 5y ago
  Also I thought I was developing anxiety attacks at one point but turns out it was just heart burn. Didn't find out until it got worse. The symptom was that it messes up your breathing to the point where you have to consciously start breathing and can't take deep breaths with your diaphragm. As soon as the heartburn goes away you're able to breath normally again.
  - j8014 5y ago
    LOL I'm 99% anxiety free after I learned to manage my allergies and diet! I make light of the situation now but at one point in my life I was confused and freaked out because of the symptoms you mentioned and everyone including the doctors thought it was stress. After thousands of dollars in medical all I really needed was Benedryl, a better diet and a new primary care physician.
- PragmaticPulp 5y ago
  This is true, but it’s more rare than it sounds. It’s a challenge for doctors because mental health still carries a stigma of weakness, whereas physical ailments don’t. Many patients are resistant to mental health diagnoses, instead insisting that they are suffering from undiagnosed physical ailments. Doctors do consider physical causes for issues like anxiety, but they’ll avoid proposing it directly to the patient in order to avoid giving them the wrong idea. There have been several studies performed on this topic, although they tend to focus on depression. The number of cases with identifiable physical causes are in the low single digit percentages. In other words, keep an eye out for additional symptoms that may suggest a physical ailment, but start with the most likely explanation: That the disorder is best approached as a mental health issue
wombatmobile 5y ago
> Anxiety Is in Your Body, Not Your Mind Yes, and, your mind is in your body, not just your brain. That's why human consciousness is different to any common conception of computer consciousness. The difference between computers and humans is that human thoughts are driven by the needs of the body - to respirate, to eat, to defecate, to reproduce, to sleep, and to avoid being predated.
- taneq 5y ago
  Exactly, and this is why all those "YOU don't do X, your brain does it" type things are so silly. "You" are your body. Your mind is something your body does to figure out where to get food and sex and how not to get eaten by tigers. Everything else is a crazy side-effect of this process.
- achillesheels 5y ago
  How do you define mind? I would agree that the mind is regulated by brain inputs but not sufficiently. It is self-determining.
Barrin92 5y ago
I think the advice of focusing on how to turn anxiety symptoms down and moderate physical responses are fine, but it's kind of missing the point, at least for serious cases of anxiety. I suffered pretty badly from it in my early 20s (apparently typical age for this kind of stuff), and you go very quickly from particular anxiety attacks being the issue, to fear of anxiety itself being the bigger issue. An anxiety/panic attack is physically scary the very first time, but by the tenth time what you're really afraid of is the loss of control and the anticipation of anxiety. Chronic sleeplessness is often the same way. Dealing with literally sleeping better is one thing, but at some point the real issue becomes the mental concern with sleep itself. Dealing with physical anxiety symptoms is good, but if you're mentally anxious your first thought after dealing with an anxiety attack by breathing deeply is "okay, but what if it doesn't work the next time?". It's that mental attitude that I think many people have trouble dealing with.
- neitherboosh 5y ago
  What you described sounds a lot like what I’ve been going thru, especially the part about “fear of anxiety itself being the bigger issue”. Have things gotten better for you?
  - Barrin92 5y ago
    Thanks got a lot better for me, thanks for asking. When I was out of uni and started to work much of it resolved itself, I really wasn't happy with academia and it didn't help. If you've got serious problems getting professional help is always a good thing but don't think it's not going to get better. Anxiety, even quite severe, is not uncommon.
- dQw4w9WgXcQ 5y ago
  > your first thought after dealing with an anxiety attack by breathing deeply is "okay, but what if it doesn't work the next time?" It always will. Practice choosing various thoughts in your focus (thankful, calm, happy, etc) and watch how the feelings seem to follow ~15-30 minutes after. It will always work (in time) because it's literally a neurochemical reaction with physical laws equivalent to the guarantees of gravity. You're basically asking "what if the laws of physics and biology stop working for my body?" Admittedly you can get yourself stressed enough over months or a single impactful event to really require some dedicated relaxation time, but the body will always over time respond to relaxation. And recovery is not linear, but moreso analog with ups and downs. In my experience people struggling with anxiety (and everyone gets anxious) can be impatient and want their feelings to resolve in seconds to minutes. And typically that comes bundled with some perfectionist desire to avoid a past fear ("if I do X I'll never experience Y terrifying thing again") which winds themselves up further in the moment as they monitor for a calming outcome that takes longer than they wanted ("Oh God, I'm trying to relax but I'm not calming down!"). Literally start a stopwatch and give yourself 20-30 minutes to sit with the pain, focus on breathing/calm thoughts, and watch as it dissipates like the steam off a car after you turn it off.
sampl 5y ago
For anyone interested in this, I highly recommend the book The Body Keeps the Score by Bessel van der Kolk, a psychiatrist who studies PTSD. He writes about this clearly and elegantly—must read for those dealing with anxiety, and certainly with any traumatic stress.
- lovelyviking 5y ago
  What essential this book tells? Can you explain more about what you have learned from it?
- voisin 5y ago
  Another is “Widen the Window”
aYsY4dDQ2NrcNzA 5y ago
A long time ago I read about a study which examined people’s physiological reactions to riding a rollercoaster. They compared coaster lovers to mildly-phobics. Their conclusion was the two groups experienced the same physiological reactions. What differed was their mental state, how they contextualized the event. If that study was accurate (and god knows whether it was), then I would conclude that anxiety isn’t strictly “in the body.” It’s more like a feedback loop with the mental state.
creamynebula 5y ago
The idea that anxiety and stress are phyisical things in your body is widely known by yogis for thousands of years!
hourislate 5y ago
Here is a tip that works wonders. Delete FB and twitter, both are incredibly destructive to the mental well being of millions (and don't go to Reddit). The less time you spend on the Internet the better you will feel.
ed-209 5y ago
Anxiety is so general a diagnosis as to be useless in discussing treatment with exercise and breathing.
dkarras 5y ago
Eh, a gross oversimplification. Feeling troubled by being anxious in the modern world is a "cerebral" issue. The guy who mistook an innocent animal as a tiger and freaked out because of it didn't feel bad for feeling anxious for no reason. We do. Because it interferes with our daily functioning / responsibilities in the modern world. Anxiety is also very frequently comorbid with other mental disorders. Especially OCD or OCD like tendencies, depression etc. I am medicated now and feel a lot better but when my anxiety was worse, the chatter of my "conscious" brain murmuring about "what if" scenarios was the worst. My point is, yes, anxiety manifests itself in a physical way, big time, but that is only half the problem. The discomfort with being anxious, constantly thinking about the possibility of having an anxiety attack even if you are not physically anxious "at that time", evaluating the "what if" scenarios, the constant planning to work around possible issues, all that torture are very cognitive pursuits and they were a lot of a bigger burden on my quality of life than experiencing an anxiety attack now and then.
- h0l0cube 5y ago
  The argument makes more sense when you realise that Valium/Diazepam is basically a muscle relaxant. Edit: Source here, happy to hear from another domain expert refuting this https://www.youtube.com/watch?v=CAOnSbDSaOw&list=PL848F2368C90DDC3D&index=16&t=4715s https://www.youtube.com/watch?v=CAOnSbDSaOw&list=PL848F2368C...
  - dimal 5y ago
    That's not really true. They act on GABA, which is the main inhibitory neurotransmitter throughout the central nervous system. So one of the effects is muscle relaxation, but that's only part of their effect.
    - h0l0cube 5y ago
      Maybe it's not strictly true, but got this from Robert Sapolsky (Stanford neurobiology professor): https://www.youtube.com/watch?v=CAOnSbDSaOw&list=PL848F2368C90DDC3D&index=16&t=4715s https://www.youtube.com/watch?v=CAOnSbDSaOw&list=PL848F2368C... His opinion, or the best understandings on this, might have changed though. From the YT transcript: > Here's somebody taking Valium for anxiety, and here's somebody taking Valium to relax their muscles. What's up with that? It's the exact same thing. And it is a very James-Lange moment. What's part of anxiety about? It's monitoring the level of tension in your body. It's getting feedback from muscle tone. He seems to be suggesting that the mode of action for Valium to reduce anxiety is that of reducing muscle tone. Not an expert, so I can't argue about it.
johnsmith4739 5y ago
Who in their right mind would take their psychological advice from a fiction writer?!? First, no, anxiety is not in your body. Fear, just like any other emotion is in your brain. You might get physiological responses in the form of chemicals in your body. That is an effect, not a cause. Second, neocortex is not "thinking brain," its role is to manage social interactions. Cognition is a small part of that. Third, mindfulness is the opposite of any therapy I can think of. It is an ego-depletion technique proven to be detrimental to people suffering from anxiety and depression. Finally, I don't know who performed therapy on the author but some steps seem to be missing: //> when you have an anxiety attack, the only thing you can do is to perform the grounding exercises. Yes, that is the moment you start counting and do square breathing exercises. If people in the military can do it while in stressful situations, you can do it from behind a macbook. Nothing is treated mid-episode. //> once the episode is over, you can explore the trigger. Chances are that your response is healthy, you are in a situation you should be anxious, but your behavioural response is over the top. A trigger contains the stimulus, the circumstance and your personal patterns (e.g. personal experiences). //> part of the role of the therapist is to help you figure out the patterns. The other is to see if your behavioural responses are productive for you or not. If loud sounds make you run like hell, that is a good thing in an active shooter situation or a war theatre. Not so much at a birthday party where a balloon popped. /rant
- sabellito 5y ago
  > It is an ego-depletion technique proven to be detrimental to people suffering from anxiety and depression. Got any recommended reading on this bit?
  - johnsmith4739 5y ago
    On the reduction of self control: https://www.sciencedirect.com/science/article/abs/pii/S1053810012000104 https://www.sciencedirect.com/science/article/abs/pii/S10538...
- staticman2 5y ago
  Some of us have not found the psychological "advise" of experts to be helpful, and taking advise from a writer seems as potentially helpful as anything else. The slate star codex blog has a post about the gulf between therapist book and reality https://slatestarcodex.com/2019/11/20/book-review-all-therapy-books/ https://slatestarcodex.com/2019/11/20/book-review-all-therap...
AlexTWithBeard 5y ago
It's both. Approximately half of depression cases respond well to psychotherapy. Approximately half of depression cases respond well to antidepressants. The halves are (seemingly) independent: for about a quarter of all patients both work and for another quarter neither works.
The_rationalist 5y ago
Here is an overview of the state of the art in GAD: TL;DR Tofisopam appears to be the ideal long term anxiety medication except it's understudied despite being old, which is a real shame. Pregabalin is likely the second best candidate however some people reports horrible anecdotes with it (brain breaker) As always the best blog about the topic is from Scott Alexander: https://slatestarcodex.com/2015/07/13/things-that-sometimes-work-if-you-have-anxiety/ https://slatestarcodex.com/2015/07/13/things-that-sometimes-... Best recent meta analyse of the SOTA https://pubmed.ncbi.nlm.nih.gov/30712879/ https://pubmed.ncbi.nlm.nih.gov/30712879/ Anxiety is more prevalant than depression yet is extremely under reported. While ADHD and depression have relatively safe and effective medications for long term treatment, chronic anxiety doesn't. Some antidepressants are safe long term treatment for anxiety however they are not very potent (compared to benzodiazepines) Benzos are not a long term solution because of tolerance, of their sedative effect and of their persistent impairment of cognitive performance. The ideal medication has the following properties: Required: 1) no persistent loss of cognitive performance Studies shows that popular benzos negatively affect cognitive performance even months (years?) after their use. 2) no hypnotic effect at normal dose Desired: 3) no loss of cognitive performance while in use. 4) No or low tolerance 5) no sedative effect It happens that there are at least 2 benzos derivatives that share those properties: Tofisopam (Emandaxin and Grandaxin) and Hydazepam (Gidazepam IC) are drugs that are benzodiazepine derivatives. Like other benzodiazepines, they possesses anxiolytic properties, but, unlike other benzodiazepines, they do not have anticonvulsant, sedative, skeletal muscle relaxant, motor skill-impairing, or amnestic properties. Moreover Tofisopam (apparently) induce NO COGNITIVE PERFORMANCE LOSS! See e.g this DOI on scihub https://doi.org/10.1007/978-3-642-74031-2_13 https://doi.org/10.1007/978-3-642-74031-2_13 The most interesting NON-benzos: Pregabalin's anxiolytic effect appears after one week of use and is similar in effectiveness to lorazepam, alprazolam, and venlafaxine, but has demonstrated more consistent therapeutic effects for psychic and somatic anxiety symptoms. Long-term trials have shown continued effectiveness without the development of tolerance, and unlike benzodiazepines, it does not disrupt sleep architecture and produces less severe cognitive and psychomotor impairment. Pregabalin also exhibits a lower potential for abuse and dependence than benzodiazepines.[43][44] Hydroxyzine has been shown to be as effective as benzodiazepines in the treatment of generalized anxiety disorder, while producing fewer side-effects.[13] Moclobemide potentially more potent than SSRIs, however much slower to act than benzos. CONCLUSION: * Tofisopam appears to be the clear winner. Hydazepam might be as well but can't find information on cognitive performance. Pregabalin appears to be the best non-benzo * reversible Maois might be the safest/potent well studied medication for long term use and do not destroy libido contrary to SSRIs. This is a major issue because anxiety is a major commorbidity of ADHD and given that MAOIs increase norepinephrine/dopamine quantities it might interact badly with concurrent use of stimulants. However some anecdotal studies shows that it can be safe, however the use of beta blockers might be needed (for e.g 50mg of Vyvanse) A plausible and surprisingly understudied solution for the SSRIs effects on libido might be TRT.
orsenthil 5y ago
Personal anecdote. Just a few days ago, when I was feeling anxious, I just stayed firm at my desk, and firmly approaching the situation without the thought of giving up, even if I couldn't solve the problem, I felt, I could control my anxiety a little better.
- Zelphyr 5y ago
  There is a term I heard once for what you did: "Disobey the fear." You want to run from the anxiety, but at the same time, you logically know you're not really in any danger. Disobeying that urge to run re-trains your body such that after a little practice, the fear comes and goes, often barely registering in your conscious mind.
tern 5y ago
What a pleasant surprise to find this article at the top of HN! Minutes ago I finished a workshop on a somatic therapy technique. It's a relief to see these ideas gaining mainstream attention after so many years of making little progress on my own anxiety, depression, and procrastination. For other relevant scientific perspectives, I recommend looking into the theory around "memory reconsolidation." - Kaj Sotala does a good job of summarizing an important book in the field here: https://www.lesswrong.com/posts/i9xyZBS3qzA8nFXNQ/book-summary-unlocking-the-emotional-brain https://www.lesswrong.com/posts/i9xyZBS3qzA8nFXNQ/book-summa... - How Emotions are Made also provides a perspective from neuropsychology on what's going on: https://www.amazon.com/How-Emotions-Made-Lisa-Barrett/dp/1328915433/ https://www.amazon.com/How-Emotions-Made-Lisa-Barrett/dp/132.... - The Polyvagal Theory stuff mentioned in the article is also great, and some classic accessible books on the overall topic include The Body Keeps the Score and Waking the Tiger. I'm personally a fan of a technique called Emotional Resolution (EmRes), which is notably simple and effective, and that you can learn to apply to yourself after a 90 minute course, but there are many other approaches: Organic Intelligence, somatic experiencing, cranio-sacral therapy, bioenergetics and core energetics, and many more. Effective self-therapy methods include Core Transformation, Focusing, and "self-therapy". Keywords to search for are: "somatic therapy," "body work," "energy work" or "energy medicine."
- fblp 5y ago
  Great summary, thank you for sharing!
scorxn 5y ago
I was almost 30 when I had my first ever panic attack. I was alone and convinced it was a heart attack, called 911, and felt fine by the time the ambulance reached the hospital. Embarrassed, I was ready to brush it off, but instead saw a therapist for the first time. She took out a stopwatch and had me breathe through a narrow straw. Within seconds, my face and limbs went completely numb; I couldn't move, and was amazed that I could form words. I sat with my head in my hands for what felt like forever. Eventually it passed, I felt utterly exhausted, and she asked what I thought the stopwatch said. "I dunno, 10-15 minutes?" Nope, 90 seconds. That experience made me start taking my mental health seriously.
- QuercusMax 5y ago
  Why did breathing through the straw cause that reaction?
  - sooheon 5y ago
    Try breathing through a straw (or two put together) just after your heart rate's been raised (i.e. via exercise). It's very anxiety inducing.
  - Zelphyr 5y ago
    Simply breathing through a straw may not do it. My therapist had me run up and down a flight of stairs for about 30 seconds and then breathe through a straw cut down to about 3 inches while holding my nostrils closed. Your body thinks you're not getting enough oxygen. You're getting plenty, it's just that it all coming through that tiny hole tricks your body and that triggers panic sensations. Doing that several times exposes you to those sensations and you eventually get used to it and allows you to manage more intense sensations.
    - moldavi 5y ago
      I'm not sure that's correct. I've heard that high CO2 levels trigger the parasympathetic nervous system which calms us down. One could get the same effect from breathing into a paper bag, I think.
WWGaussDo 5y ago
So good to see a story about the physical aspects of anxiety at the top of hacker news! I’ve struggled with anxiety my whole software career and finally found something that really worked for me —- identifying the triggers of my anxiety, and focusing on my physiological sensations after I recall them, much as described by Pat Ogden in the article. Another software engineer friend and I are starting a company to help software engineers reduce stress and anxiety! We’d love to hear from any of you. Tinyurl.com/happyhackers
madrox 5y ago
I'm nearly 40, and didn't relate to anxiety at all until I was 35. Until then, I would use lots of different words to describe how I simply wasn't good at being in a number of situations. I now believe that was a better way of thinking, because once I identified what was happening to me as anxiety, it actually got worse. "Anxiety" is something that should be treated and actively managed, which puts fuel on the fire. The less I frame my mental health in terms of anxiety, the better off I am. I'm sure there are any number of reasons why this way of thinking won't help others, but I totally get why lots of ADHD sufferers have started calling it "bees in my head" instead of ADHD. What we call things affects how we think about it.
WWGaussDo 5y ago
So good to see a story about the physical aspects of anxiety at the top of hacker news! I’ve struggled with anxiety my whole software career. I finally identified the big triggers for me - morning standup when I was late on a ticket, when a test would inexplicably fail, when a coworker wound comment in a PR asking me to redo a chunk of work that I knew would take more time. And I identified them based on how my BODY felt. And once I could identify the actually environmental triggers, I could start to resolve them. A lot like this article talks about! My conscious mind wasn’t in control of my anxiety, and the looping thoughts in my head didn’t even have much to do with the trigger. They were the symptom, not the cause. Another software engineer friend and I are starting a company to help software engineers reduce stress and anxiety! We’ve seen some pretty miraculous results so far. We’d love to hear from all of you anxious software engineers :) Tinyurl.com/happyhackers
- peach 5y ago
  Thanks for sharing. Interesting to hear someone is trying to take care of this aspect. Especially since it's very much underplayed in our industry.
deleted 5y ago
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11thEarlOfMar 5y ago
I believe that an inappropriate anxiety response is typically one element of a syndrome, and generally not a stand alone response. Most likely, if you are focusing on anxiety to the exclusion of other aspects of your life, and I mean past, present and future life, you are likely missing opportunities to effectively address it. That said, one therapy that has worked for at least one person I know was Dielectical Behavior Therapy[0]. As they went through the program, they learned that their hyper-arousal to any unexpected event led to an anger response that led to saying terrible things to the person who had not behaved as expected. This led to a general mistrust of others and a dwindling supply of friends who transitioned to acquaintances who then stopped calling entirely. DBT get them to recognize that their response was not typical and offered a path to practice alternate responses. They learned to defer their response and seek clarification or confirm intentions before reacting. They've become a much less unpleasant person to be around. [0] https://www.verywellmind.com/dialectical-behavior-therapy-1067402 https://www.verywellmind.com/dialectical-behavior-therapy-10...
CyanLite4 5y ago
As a person who is currently in CBT (and seeing positive results), the biggest thing that helped me is to understand trauma, and cognitive distortions. Just as this article says, your thinking brain is trying to piece together and digest what has happened. The problem is often that we repress it during the peaceful down time that our thinking brain is trying to make sense of it. We drown it out with drugs and alcohol, or we try to make ourselves so busy that we don’t think about it (hence creating more anxiety through work issues, family drama, or overstimulation). Best thing that works for me is to learn to accept it. Process it. Digest it. Learn and talk through examples of how it’s safe to experience the world again. This is part of the de-escalation process. Note, this goes against advice of “oh just don’t worry about it”. This approach is essentially “okay self, bad shit happened, let’s finally talk about it”. Your thinking brain is designed to keep bringing this up until it gets resolution. This is resolution. And cognitive distortions helps me because I understand now how my mind plays tricks on me. When I say things like “this bad thing happened, I’ll never be able to get over it”, it’s giving too much power to that bad event. I don’t have to feel or think that way. I’m allowed to change my thought process and think “yeah that bad event happened, but I can’t let it be the end of the world for me.”
hivacruz 5y ago
Just seeing the picture of the article made by throat getting bigger from the inside. Anxiety sucks.
singingfish 5y ago
I have a close friend with an autism diagnosis who has a very unusual relationship between their brain and the rest of their body. One of the consequences of this is that they become very anxious and get trapped in a nasty anxiety vicious cycle that can last several days.
franklyt 5y ago
Your body and mind are one. It is scientifically inaccurate to believe otherwise. This isn’t a pedantic point: the mind/body distinction is pseudoscience that used to be believed widely in scientific circles. This readjustment hasn’t really reached common practice yet.
Zelphyr 5y ago
A form of CBT that has been shown to be particularly effective at anxiety and panic is Acceptance and Commitment Therapy (ACT). If you've been struggling with anxiety, I highly recommend seeking out a therapist who has been trained in ACT. You can also read and watch anything produced by Dr. Stephen C. Hayes, one of the therapists who developed ACT. He did so himself due to panic and anxiety and this was after becoming a psychologist. The whole field is quite fascinating.
monkeydreams 5y ago
It was only when I was heavily medicated for depression and anxiety that I realised the physical symptoms of anxiety. Whenever I was expecting a negative outcome, or when I was surprised, my body would give me a jolt of pain along my vagus nerve. Literally any negative event would cause me pain, and it was this pain that my brain was seeking to avoid. My current medication does not remove this pain altogether, though it diminishes the sensation significantly.
- defterGoose 5y ago
  Out of curiosity, do you mind sharing what medication you're on? I feel like i have a strange vagus nerve dysfunction as well.
  - monkeydreams 5y ago
    I'm on Valdoxan (ago melantine).
  - darkerside 5y ago
    I've had a similar issue, and PPIs and H2 blockers have helped
comeonseriously 5y ago
"Wait to worry" I tell my self. Can I do anything about the situation at this very moment? No? Wait to worry. Yes? The DO IT. It's not perfect, but man, it helps me get through some stuff.
cletus 5y ago
This is a weird article. The headline doesn't really match it. Like it says the thinking brain is the last to know and the author suggests this is a physiological response. But all that's really saying is that anxiety isn't a conscious response. But that just means it's a subconscious response and not a physiological response somehow removed from the brain. Also, what does "in your body, not in your mind" even mean? Let's face it, the distinction between your mind (or brain) and your body is a useful abstraction, nothing more. Nerve cells extend from your brain throughout your entire body. Where does your brain end and your "body" begin? Life isn't software that lends itself to neat abstraction layers.
lampington 5y ago
Interesting article. I have occasional (every few years) periods of anxiety. Last time around I went through a course of CBT, some of which I found moderately helpful - don't try to suppress feelings of fear, just acknowledge it and move on - but I was certainly not cured. Then my doctor suggested I try out the Alexander Technique. I wasn't convinced, but gave it a go. Something about it helped, and quite significantly. The logical part of me rebels against this, as AT is full of woo, but the effects were undeniable. The practitioner I went to focused a lot on feeling the floor beneath you, the seat supporting you, and so on -- I don't know how typical that is for AT, but perhaps that was the part of it that was effective for me. It would certainly fit with what the article says.
babarganesh 5y ago
i think no, it's not "not in my mind but in my body". my take is that anxiety occurs first by warping a person's attention, and the mental and physical symptoms of that follow.
johndoe42377 5y ago
Bullshit. Brain runs the body. Anxiety is a bodily state driven by processes in the brain. Autistic people know it best.
aantix 5y ago
Nutritional deficiencies should be part of this conversation. A majority of Americans are magnesium deficient. Magnesium calms the nervous system. “In healthy adults, magnesium sits inside the NMDA receptors, preventing them from being triggered by weak signals that may stimulate your nerve cells unnecessarily. When your magnesium levels are low, fewer NMDA receptors are blocked. This means they are prone to being stimulated more often than necessary.“ https://www.healthline.com/nutrition/what-does-magnesium-do#brain-benefits https://www.healthline.com/nutrition/what-does-magnesium-do#... Mg L-threonate has helped my anxiety 2x more than years of talk therapy.
- ddlutz 5y ago
  What dose do you take? I might give this a shot.
  - aantix 5y ago
    One dose of magnesium l-threonate with l-theanine before bed. One dose in the morning. Each dose is usually 3 capsules, containing 144mg of elemental magnesium.
- Asooka 5y ago
  Not sure who downvoted you, you're absolutely correct. The usual culprits are magnesium, vitamin D and calcium. Those can result in moderate depression and anxiety in otherwise healthy individuals. Getting tested is pretty cheap, pretty much everyone with anxiety, depression or chronic fatigue should get some simple bloodwork done first to rule out the easily correctable causes.
deleted 5y ago
[deleted]
peteretep 5y ago
> Not only did all that talking not do much to alleviate anxiety, but it could also even have made it more acute. If you’re going to go counter to a large body of scientific evidence (re efficacy of CBT), ya need something stronger than the thoughts of some people trying to hawk products, ya know?
dghughes 5y ago
I had anxiety for the first time in my life recently in the form of pain in my upper left chest. From a new job I hate (but pays well) and added to that my dad is very sick. Worse still is I'm the age my grandfather and his son (my uncle) died. I've read how people who have major stress in their lives develop a reduced ability to cope with stress. That seems like a terrible spiral downward.
ineedasername 5y ago
It's difficult to take advice from an article that has a statement like this mixed in: "We are a cerebral culture, which makes us very equipped to deal with problems that require reason and logic"
gerash 5y ago
For those interested in the subject I suggest listening to this https://youtu.be/ntfcfJ28eiU https://youtu.be/ntfcfJ28eiU
didibus 5y ago
Something seems contractictory to me with this. It's trying to say your thoughts don't affect it, yet it describes a scenario where only rational cognitive concepts cause the fight or flight response. How does the "survival brain" know that Covid-19 is scary, dangerous and to be feared? How does it know how dangerous it is to gauge the response? Similarly, how does it know the meeting at work is dangerous if you're late too it? That it's important for you to be there on time? Etc.
- runarberg 5y ago
  I feel like statements like these do a disservice to the science behind them. The “fight of flight” is meant as a simplification of automatic behavior changes (which might involve different chemistry in the brain which increases alertness; and in evolutionary terms are beneficial to your survival and procreation). But it is a gross oversimplification. There is little evidence that the systems involved are a direct fight or flight response system. They are certainly involved in fight or flight but that is not by any means the only time they activate. This article makes a passing mention of the term defensive response. I like that term a lot better as it catches things like potential embarrassment and failures as well.
kumarvvr 5y ago
Is the body different from the mind? Every experience of ours as a human, is rooted in the mind. The author seems to confuse involuntary action with conscious thought. "We" may not perceive the signals that drive the beating of the heart, but it is still driven by the mind. Hindu yogic practices, especially those of Hatha Yoga [0] make it possible for one to feel even those involuntary processes. [0] https://en.wikipedia.org/wiki/Hatha_yoga https://en.wikipedia.org/wiki/Hatha_yoga
anewguy9000 5y ago
i seem to meet more and more people who have experienced acute anxiety / panic attacks than ever. it leads me to wonder if it's just more understood and easier to talk about now, or is there some phenomenon where the incidence is actually increasing?
throwaway_kufu 5y ago
It’s certainly both. “Anxiety” it’s your brains response to given sensory input and tends to trigger a release of cortisol and in more extreme situations adrenaline. While cortisol and adrenaline are normal responses it’s a very slippery slope and they can have extremely negative effects on the body. The dangers of to much of these hormones come from both chronic exposure for normal sensory inputs like stress at work or school on a daily basis or constant instability like parents fighting regularly to single acute episodes like an extreme traumatic event. Traumatic events tend to alter neural pathways so moving forward even non stressful sensory input can trigger these strengthened pathways putting people in non stressful environments in chronic states of stress. It’s helpful “not to think about it” whatever “it” is, but it’s often involuntary especially for those that suffered a trauma, as there’s always the risk that you are unknowingly responding to it without even thinking about it and it’s often hard to connect the dots. The other issue is everything in the body is a feedback loop and hard to break or change. For example even just sitting in a chair all day will shorten you hip flexors, causing unnoticeable discomfort but your brain will notice and respond with release of cortisol which will in turn cause tightening of muscles and myofacia, that will further release cortisol in response to those bodily stresses, and on and on it goes with all kinds of “referred pain” (I hate that term) you do notice in maybe your neck or shoulder(s) or back. And good luck at that point you’ll be treating the area in pain that’s not even actually causing the pain only leading to more chronic stress over the inability to make the pain go away. If you work in an office my guess is you have physical pain, and you can ask anyone else in the office and odds are they have physical pain, and my bet dollars to donuts from arthritis to bursitis to joint pain the vast majority with simply blame it on getting old or some posture issue and not a single one will realize the physical pain and bodily conditions are directly related to stress.
imvetri 5y ago
Mind is in the body
jimi_d 5y ago
I personally think this was a very interesting reading, and after having tried multiple solutions for anxiety (prescribed pills, talk therapy, tips like focusing on our environment -- as explained in the highlighted paragraph), and being surrounded by people having also tried several solutions, it must be known that not everyone will react the same way to each of them. While the content of this article will not make everyone agree, I think it's particularly important nowadays to pay attention to our mental health at least as much as we do to our physical health, and it's good to see this topic trending on HN.
74d-fe6-2c6 5y ago
> As Stephen Porges, PhD, a psychologist and the creator of the Polyvagal Theory Funny. Just yesterday I googled "polyvagal theory" after accidentally stumbling upon it after googling for "HRV training" after hearing about it from Tim Ferriss on his youtube channel. Anyway - a quick research yielded that PVT and Mr. Porges are both rather questionable. [1] > The thinking brain isn’t what decides whether we’re stressed, whether we’re feeling threatened or challenged, whether we’re going to turn stress on, whether we’re going to turn emotions on, I'd question that and bring thought loops forward as a counterexample. You can very well intensify a state of anxiety by dwelling on some thought. > So if you want to track your anxiety, your body, not your thoughts, will be your most accurate map. That is true, though - after all anxiety is a physical sensation. I can attest to that waking up now for several weeks almost every day with stomach aching, increased heart rate and shallow breathing. > The problem is that when it comes to regulating our nervous system after a stress response (read: anxiety), our thinking brain is the absolute worst tool for the job I'd also questin that. It's true that the thinking brain on its own will never find a solution for something like anxiety. But you need the thinking brain to identify the problem and come up with a solution. If the thinking brain is a hammer then your guts are a screw driver. > talk therapy analyzing all the reasons you’re anxious, this is probably a hard pill to swallow. Not only did all that talking not do much to alleviate anxiety, but it could also even have made it more acute. Talk therapy addresses the thinking brain and is hence limited. But a good talking therapy is not just being experienced by exchanging words. If the therapist is worth her money she'll connect on an emotional level. > Is there any role for talk therapy, or trying to think logically about your anxiety? Absolutely. But only once your body is regulated, Stanley says: “After we have helped our survival brain feel safe and stable, then we can work on our thoughts. This attitude is symptomatic of our misguided medical profession which always seeks to compartmentalize and modularize instead of integrate and connect. Both approaches can go very well hand in hand. 1: https://en.wikipedia.org/wiki/Polyvagal_theory#Criticism https://en.wikipedia.org/wiki/Polyvagal_theory#Criticism
Wump 5y ago
Reminds me of the equation: Pain x Resistance = Suffering If you accept pain fully (Resistance = 0), then you won’t suffer. The more you resist, the more you suffer. And if Resistance is high, then even a little bit of Pain can cause a lot of suffering.
wing-_-nuts 5y ago
I sometimes have random anxiety at night. I used to have a bad habit of drinking myself to sleep, but I've since discovered that hard exercise is the best medicine. I do pushups until I'm completely exhausted. When I lay down, I'm actually relaxed for a good 20 minutes. It's amazing.
stakkur 5y ago
when it comes to anxiety, which doesn’t take place in your thinking brain, it [CBT] places the focus on the thought (“I thought there was a tiger!”) and not the physical response which preceded, and even caused, the thought (“my heart is racing and I’m full of adrenaline and I need tools to calm down”). Inexplicably, the article seems to get CBT entirely wrong. A key part of CBT for anxiety is, in fact, about dealing with the body (e.g., the sympathetic nervous system) by activating the parasympathetic—through breathing, progressive muscle relaxation, and so forth. This glaring miss on one of the most effective therapies for anxiety made me question the entire article.
- SubiculumCode 5y ago
  The title was the give away for me. The titles thesis is quickly abandoned to mean something like conscious vs unconscious thought.
- wiz21c 5y ago
  Didn't read the article in detail, but as someone who is super problematic as far anxiety goes, I can safely say that tai chi practice does help me for the very reasons you've given : activating parasympathetic system by breathing, active relaxation, connecting mind to body and vice versa, grounding myself (ie connecting my sensations to environment), being in movement (that is, your brain is not thinking about stress alone, but participates in a complete action with your body), etc. (and not the chi/spiritual thing that brings everything together and explains the roots of the stuff but is, often, totally transformed by occidental culture into nonsensical bullshit). But that's my own sample point, just works for me. It's tough to push yourself to practice half an hour a day or so. You have to have the will and when you're tired it's difficult :-/
emerged 5y ago
This link wanted me to login to read which IMO means I can and should only engage with the post title. Anxiety is in GABA-a and GABA-b IMO. I would suppose they circulate throughout the body and mind. But most the work is getting the influence to take affect in the mind.
55555 5y ago
If you have trauma/PTSD (even minor) that leads to physical reactions (sweating, heart racing, etc) in certain situations, take propanolol before you have the situation. After you do this a few times, or a few dozen, you'll be 90% fixed.
up_and_up 5y ago
Totally anecdotal, but speaking as someone with Anxiety Disorder + occasional intense panic attacks, once I started Rock climbing heavily and Trail running 2x a week, my anxiety and Panic attacks basically went away completely. This was following years of taking 5HTP, meditating/breathing, talk therapy etc, which helped somewhat but nothing like intense exercise.
anonymouswacker 5y ago
As someone who's been coming out of a lot of sexual trauma from my early childhood, I feel it's important to take a multi-pronged approach to alleviating the anxiety & pain, psychologically and physiologically. For me, pelvic pain was a huge impediment to having a healthy sex life. Left untreated, it got worse and worse, to the point that I had constant pain my body. Now I am seeing a pelvic floor physical therapist who is teaching me how to relax the muscles, and a psychoanalyst who is helping me deal with reframing the traumas that got me where I am. The Body Keeps the Score is a pretty good book that covers how much trauma affects the body in myriad ways.
paulcarroty 5y ago
After starting real home fitness 6 days per week my stress & anxiety level is unbelievable low. I don't think it helps in all cases but you definitely should try it. Another suggestion: as long-term projects are inevitable always switch to short-term which can bring fast but realistic result.
pyjug 5y ago
The body and mind are heavily intertwined. It's totally useless to compartmentalize them when discussing something like anxiety. One day somebody in the West will "independently" discover what Buddha and Vedic Rishis discovered centuries ago, and popularize those ideas. Unfortunately, this is the only way those ideas will regain acceptance in the East as well.
jokowueu 5y ago
This reminds me of stella ganglion block that was shown to be effective against ptsd . Quite interesting
99_00 5y ago
> an increased interest in “brain science” and neurobiology along with continued research on mindfulness and mind-body connections are shifting our psychological understanding from focusing only on the mind to seeing the brain and body as a cohesive unit. This is exactly what my talk-therapist is helping me with. So if these ideas appeal to you and you want to explore them keep an open mind about talk-therapy.
dcanelhas 5y ago
I'm a bit puzzled as to why the article suggests we should imagine ourselves as Neanderthals instead of homo sapiens? I understand that homo sapiens interbred with Neanderthals and people today may have a few percent of Neanderthal DNA but the most relevant evolutionary context for us is just an earlier version of us, surely.
BiteCode_dev 5y ago
We keep assuming body and mind are separated things, but separating the concept of ink and paper doesn't help you understand the full nature of a book.
wodenokoto 5y ago
The article really tries to present cognitive behavioral therapy as something it is not. Reconnecting with your body and mindfulness are part of the toolset you can expect to be introduced to when visiting a CBT therapist.
xibalba 5y ago
For people interested in addressing anxiety/depression disorders via "the body", check out SGB (stellate ganglion block) and ketamine treatments.
mkrazzledazzle 5y ago
This was discovered thousands of years ago in the east(indian subcontinent) by meditation practitioners(i.e Buddha, Mahavira etc) solely through thousands of hours of practice and self-realization. These have been codified into various texts which form a major part of vipassana teachings. Interesting how scientists in the west either conveniently pick up the theory, conduct some a/b tests and publish them as new discoveries without credit. Even if they had arrived on these conclusions, independently on their own, it's important to understand the mind boggling amount of progress in psychology, neuroscience that was made with the limited knowledge of scientific rigor in the east thousands of years ago.
- contradistinct 5y ago
  I disagree. If it's not empirical, it doesn't count. There are millions of people with ideas, but ideas aren't good enough. Prove your idea is true, then we'll talk about deserving credit. Exception: mathematical ideas which are difficult to come up with.
  - mkrazzledazzle 5y ago
    How is it fair to pick up/completely ignore published experiential observations, in continued practice for millennia from another culture elsewhere in the world, conduct a/b tests and publish results without credit? I'm pretty sure the western world is going to continue swindling wellness techniques/practices from ancient texts, quickly run half-baked experiments, cherry pick data to suit a result and "publish" findings. When these techniques were in development, in the golden era for spirituality, most of the rest of the world were still hunter-gatherers. Empirical rigor was just not a thing. It's a question of providing due credit for those who developed and practice these techniques as a way of life. If not share some of the capitalistic spoils in the billions from delivering stress relief(meditation based content) through shiny, addictive apps (Yes, meditation apps can be addictive! Surprise! i.e, Headspace, Calm), At least provide credit where it's due.
ElijahLynn 5y ago
> You’ve read all your free member-only stories. Become a member to get unlimited access and support the voices you want to hear more from.
- bluewalt 5y ago
  Open your browser in private navigation
QuantumGood 5y ago
I have few early memories because due to having so much anxiety from an early age. I remember a time before processing it as any synonym for 'anxiety', my father came to help me with something and I thought, in essence: "Too bad my brain is doing that thing where my thoughts are not useful due to that thing (that I didn't yet think of as anxiety), but how nice of my father to spend some time with me."
anxiety554 5y ago
First paragraph had a very interesting perspective about stress and the last paragraph had a solution, rest of the content is very repetitive.

391 points by rainhacker 5y ago

baron_harkonnen 5y ago

This might come as a surprise to some, but it turns out your mind is also in your body

jfb 5y ago

Descartes and his duality strike again.

ozim 5y ago
I also think it is silly that people don't think that "your body == your mind". It is simple to discard neurons that are scattered through the body, but those are also neurons.
- jfb 5y ago
  I think it's more complex than one equals the other; the two phenomena are inexplicably interconnected. The duality is a very non-helpful frame to use to analyze, well, basically anything.

bananaboi 5y ago

Non-authwalled link: https://outline.com/ycjSSm https://outline.com/ycjSSm

Igelau 5y ago
Seriously, I've seen nothing on Medium that would be worth paying or registering for. It's LiveJournal dressed like a newspaper.

22c 5y ago

I wish there were a little more examples of how this methodology deals with the stress/anxiety response. The article seems to spend more time talking about why it thinks "thinking brain" CBT/talk therapy doesn't work rather than "surival brain" techniques which do work. It also brings up "mindfulness" as one solution, which I consider almost analogous to CBT, or at least a close relative. It also seems counter-productive (to me) that the solution for one subject was to "strike out and defend himself within the safety of a therapy session". What is that person supposed to do in the moment? Ball up their anxiety and wait for therapy?

Igelau 5y ago
CBT seems very poorly suited to anxiety. 1. Most of the CBT literature is aimed at treating depression. 2. Anxiety is going to strike when you don't have the time or resources to sit down with pen and paper and analyze what's going on, and there is a lot of that in CBT.
- 22c 5y ago
  I think it depends on what techniques are applied. There seems to be specialist branches of CBT such as MCBH and ACT which might be better suited to these scenarios. However, my point is that the article seems to spend more time telling us that CBT doesn't work (without providing much evidence) than why "survival brain" techniques are better. I haven't learned much from this article other than some people think CBT is not suitable for dealing with anxiety.
- firecall 5y ago
  I'm having therapy and CBT, and I wouldnt say thats my experience. I think it is useful for dealing with anxiety. Learning to recognise triggers and having strategies in place to deal with the issues causing anxiety. Anxiety, when it's a problem, is generally at an irrational level! Anyway, everyone is different and has a differnt experience!

Igelau 5y ago

Sometimes. Sometimes not. I've seen both sides. My anecdata: My road rage was definitely my body and responded to therapy that targeted the sensations in the body. My anxiety was not. It was a way of thinking. Ruminating thoughts. Cascades of potential disastrous outcomes. I needed medication and I needed to talk to a therapist. She seems unqualified to be giving out misguided medical advice in such certain terms. Minds get in the way of comprehending other minds, and broad statements are difficult to make truthfully.

burlesona 5y ago

I noticed as young adult that I didn’t really worry or consciously stress, but my body had somewhat predictable reactions to situations that I would realize, in hindsight, were highly stressful. Those physical reactions sucked, and as they got worse over time, it really concerned me. At some point I was encouraged to go to CBT, which I did, but honestly it made things worse. I became hyper aware of how anxious I was at any moment, and the more I noticed the more it worried me. Years later I tried mindfulness meditation and found that it helped. But also, I finally hit a kind of turning point where I just realized that there was nothing I could really do about anxiety or the physical symptoms that came along with it. I decided to mostly try to quit noticing and thinking about it. And that really helped. I still feel stress and anxiety symptoms sometimes. They still suck. My conscious mind is still the last to recognize what’s going on. But, overall, I feel I can handle a lot more stress now than I could ten years ago without it ruining my quality of life, and more importantly I can recognize the stress, not worry too much about it so I can get through it, and then rest and recuperate (as soon as possible) and recover much quicker than when I was younger. I’ve concluded that the best advice is to learn not to worry about things. Unfortunately that’s easier said than done, and I’m not sure I have any advice on how to learn to do that :/

danlugo92 5y ago
Interesting. I've been reaching a similar conclusion recently.
bamboozled 5y ago
> I just realized that there was nothing I could really do about anxiety or the physical symptoms that came along with it. I decided to mostly try to quit noticing and thinking about it. And that really helped. I think this is mission accomplished from your mindfulness practice, you realized that you're not really doing anything and that anxiety just appears, you accepted it and it felt better.
- osacial 5y ago
  There are some problems with that type of approach - there are some things that won't vanish, if you stop thinking about them.

sammalloy 5y ago

One other thing to consider, that I rarely hear anyone talk about, is that anxiety can sometimes be a symptom of an underlying physiological condition or disease. For example, hypoglycemia-related anxiety is a common complaint.

Sunspark 5y ago
This is true. Vestibular disorders in the inner ear can cause anxiety.
Jtsummers 5y ago
If you discuss it with your doctor (and you should) they will run tests to try and rule out physiological causes. I know they did for me with both depression and anxiety, as I had other signs/symptoms of a thyroid disorder (turned out my thyroid was fine, I was just very stressed out and long term severe stress-induced anxiety, for me, leads to severe depression).
hanniabu 5y ago
Also I thought I was developing anxiety attacks at one point but turns out it was just heart burn. Didn't find out until it got worse. The symptom was that it messes up your breathing to the point where you have to consciously start breathing and can't take deep breaths with your diaphragm. As soon as the heartburn goes away you're able to breath normally again.
- j8014 5y ago
  LOL I'm 99% anxiety free after I learned to manage my allergies and diet! I make light of the situation now but at one point in my life I was confused and freaked out because of the symptoms you mentioned and everyone including the doctors thought it was stress. After thousands of dollars in medical all I really needed was Benedryl, a better diet and a new primary care physician.
PragmaticPulp 5y ago
This is true, but it’s more rare than it sounds. It’s a challenge for doctors because mental health still carries a stigma of weakness, whereas physical ailments don’t. Many patients are resistant to mental health diagnoses, instead insisting that they are suffering from undiagnosed physical ailments. Doctors do consider physical causes for issues like anxiety, but they’ll avoid proposing it directly to the patient in order to avoid giving them the wrong idea. There have been several studies performed on this topic, although they tend to focus on depression. The number of cases with identifiable physical causes are in the low single digit percentages. In other words, keep an eye out for additional symptoms that may suggest a physical ailment, but start with the most likely explanation: That the disorder is best approached as a mental health issue

wombatmobile 5y ago

> Anxiety Is in Your Body, Not Your Mind Yes, and, your mind is in your body, not just your brain. That's why human consciousness is different to any common conception of computer consciousness. The difference between computers and humans is that human thoughts are driven by the needs of the body - to respirate, to eat, to defecate, to reproduce, to sleep, and to avoid being predated.

taneq 5y ago
Exactly, and this is why all those "YOU don't do X, your brain does it" type things are so silly. "You" are your body. Your mind is something your body does to figure out where to get food and sex and how not to get eaten by tigers. Everything else is a crazy side-effect of this process.
achillesheels 5y ago
How do you define mind? I would agree that the mind is regulated by brain inputs but not sufficiently. It is self-determining.

Barrin92 5y ago

I think the advice of focusing on how to turn anxiety symptoms down and moderate physical responses are fine, but it's kind of missing the point, at least for serious cases of anxiety. I suffered pretty badly from it in my early 20s (apparently typical age for this kind of stuff), and you go very quickly from particular anxiety attacks being the issue, to fear of anxiety itself being the bigger issue. An anxiety/panic attack is physically scary the very first time, but by the tenth time what you're really afraid of is the loss of control and the anticipation of anxiety. Chronic sleeplessness is often the same way. Dealing with literally sleeping better is one thing, but at some point the real issue becomes the mental concern with sleep itself. Dealing with physical anxiety symptoms is good, but if you're mentally anxious your first thought after dealing with an anxiety attack by breathing deeply is "okay, but what if it doesn't work the next time?". It's that mental attitude that I think many people have trouble dealing with.

neitherboosh 5y ago
What you described sounds a lot like what I’ve been going thru, especially the part about “fear of anxiety itself being the bigger issue”. Have things gotten better for you?
- Barrin92 5y ago
  Thanks got a lot better for me, thanks for asking. When I was out of uni and started to work much of it resolved itself, I really wasn't happy with academia and it didn't help. If you've got serious problems getting professional help is always a good thing but don't think it's not going to get better. Anxiety, even quite severe, is not uncommon.
dQw4w9WgXcQ 5y ago
> your first thought after dealing with an anxiety attack by breathing deeply is "okay, but what if it doesn't work the next time?" It always will. Practice choosing various thoughts in your focus (thankful, calm, happy, etc) and watch how the feelings seem to follow ~15-30 minutes after. It will always work (in time) because it's literally a neurochemical reaction with physical laws equivalent to the guarantees of gravity. You're basically asking "what if the laws of physics and biology stop working for my body?" Admittedly you can get yourself stressed enough over months or a single impactful event to really require some dedicated relaxation time, but the body will always over time respond to relaxation. And recovery is not linear, but moreso analog with ups and downs. In my experience people struggling with anxiety (and everyone gets anxious) can be impatient and want their feelings to resolve in seconds to minutes. And typically that comes bundled with some perfectionist desire to avoid a past fear ("if I do X I'll never experience Y terrifying thing again") which winds themselves up further in the moment as they monitor for a calming outcome that takes longer than they wanted ("Oh God, I'm trying to relax but I'm not calming down!"). Literally start a stopwatch and give yourself 20-30 minutes to sit with the pain, focus on breathing/calm thoughts, and watch as it dissipates like the steam off a car after you turn it off.

sampl 5y ago

For anyone interested in this, I highly recommend the book The Body Keeps the Score by Bessel van der Kolk, a psychiatrist who studies PTSD. He writes about this clearly and elegantly—must read for those dealing with anxiety, and certainly with any traumatic stress.

lovelyviking 5y ago
What essential this book tells? Can you explain more about what you have learned from it?
voisin 5y ago
Another is “Widen the Window”

aYsY4dDQ2NrcNzA 5y ago

A long time ago I read about a study which examined people’s physiological reactions to riding a rollercoaster. They compared coaster lovers to mildly-phobics. Their conclusion was the two groups experienced the same physiological reactions. What differed was their mental state, how they contextualized the event. If that study was accurate (and god knows whether it was), then I would conclude that anxiety isn’t strictly “in the body.” It’s more like a feedback loop with the mental state.

creamynebula 5y ago

The idea that anxiety and stress are phyisical things in your body is widely known by yogis for thousands of years!

hourislate 5y ago

Here is a tip that works wonders. Delete FB and twitter, both are incredibly destructive to the mental well being of millions (and don't go to Reddit). The less time you spend on the Internet the better you will feel.

ed-209 5y ago

Anxiety is so general a diagnosis as to be useless in discussing treatment with exercise and breathing.

dkarras 5y ago

Eh, a gross oversimplification. Feeling troubled by being anxious in the modern world is a "cerebral" issue. The guy who mistook an innocent animal as a tiger and freaked out because of it didn't feel bad for feeling anxious for no reason. We do. Because it interferes with our daily functioning / responsibilities in the modern world. Anxiety is also very frequently comorbid with other mental disorders. Especially OCD or OCD like tendencies, depression etc. I am medicated now and feel a lot better but when my anxiety was worse, the chatter of my "conscious" brain murmuring about "what if" scenarios was the worst. My point is, yes, anxiety manifests itself in a physical way, big time, but that is only half the problem. The discomfort with being anxious, constantly thinking about the possibility of having an anxiety attack even if you are not physically anxious "at that time", evaluating the "what if" scenarios, the constant planning to work around possible issues, all that torture are very cognitive pursuits and they were a lot of a bigger burden on my quality of life than experiencing an anxiety attack now and then.

h0l0cube 5y ago
The argument makes more sense when you realise that Valium/Diazepam is basically a muscle relaxant. Edit: Source here, happy to hear from another domain expert refuting this https://www.youtube.com/watch?v=CAOnSbDSaOw&list=PL848F2368C90DDC3D&index=16&t=4715s https://www.youtube.com/watch?v=CAOnSbDSaOw&list=PL848F2368C...
- dimal 5y ago
  That's not really true. They act on GABA, which is the main inhibitory neurotransmitter throughout the central nervous system. So one of the effects is muscle relaxation, but that's only part of their effect.
  - h0l0cube 5y ago
    Maybe it's not strictly true, but got this from Robert Sapolsky (Stanford neurobiology professor): https://www.youtube.com/watch?v=CAOnSbDSaOw&list=PL848F2368C90DDC3D&index=16&t=4715s https://www.youtube.com/watch?v=CAOnSbDSaOw&list=PL848F2368C... His opinion, or the best understandings on this, might have changed though. From the YT transcript: > Here's somebody taking Valium for anxiety, and here's somebody taking Valium to relax their muscles. What's up with that? It's the exact same thing. And it is a very James-Lange moment. What's part of anxiety about? It's monitoring the level of tension in your body. It's getting feedback from muscle tone. He seems to be suggesting that the mode of action for Valium to reduce anxiety is that of reducing muscle tone. Not an expert, so I can't argue about it.

johnsmith4739 5y ago

Who in their right mind would take their psychological advice from a fiction writer?!? First, no, anxiety is not in your body. Fear, just like any other emotion is in your brain. You might get physiological responses in the form of chemicals in your body. That is an effect, not a cause. Second, neocortex is not "thinking brain," its role is to manage social interactions. Cognition is a small part of that. Third, mindfulness is the opposite of any therapy I can think of. It is an ego-depletion technique proven to be detrimental to people suffering from anxiety and depression. Finally, I don't know who performed therapy on the author but some steps seem to be missing: //> when you have an anxiety attack, the only thing you can do is to perform the grounding exercises. Yes, that is the moment you start counting and do square breathing exercises. If people in the military can do it while in stressful situations, you can do it from behind a macbook. Nothing is treated mid-episode. //> once the episode is over, you can explore the trigger. Chances are that your response is healthy, you are in a situation you should be anxious, but your behavioural response is over the top. A trigger contains the stimulus, the circumstance and your personal patterns (e.g. personal experiences). //> part of the role of the therapist is to help you figure out the patterns. The other is to see if your behavioural responses are productive for you or not. If loud sounds make you run like hell, that is a good thing in an active shooter situation or a war theatre. Not so much at a birthday party where a balloon popped. /rant

sabellito 5y ago
> It is an ego-depletion technique proven to be detrimental to people suffering from anxiety and depression. Got any recommended reading on this bit?
- johnsmith4739 5y ago
  On the reduction of self control: https://www.sciencedirect.com/science/article/abs/pii/S1053810012000104 https://www.sciencedirect.com/science/article/abs/pii/S10538...
staticman2 5y ago
Some of us have not found the psychological "advise" of experts to be helpful, and taking advise from a writer seems as potentially helpful as anything else. The slate star codex blog has a post about the gulf between therapist book and reality https://slatestarcodex.com/2019/11/20/book-review-all-therapy-books/ https://slatestarcodex.com/2019/11/20/book-review-all-therap...

AlexTWithBeard 5y ago

It's both. Approximately half of depression cases respond well to psychotherapy. Approximately half of depression cases respond well to antidepressants. The halves are (seemingly) independent: for about a quarter of all patients both work and for another quarter neither works.

The_rationalist 5y ago

Here is an overview of the state of the art in GAD: TL;DR Tofisopam appears to be the ideal long term anxiety medication except it's understudied despite being old, which is a real shame. Pregabalin is likely the second best candidate however some people reports horrible anecdotes with it (brain breaker) As always the best blog about the topic is from Scott Alexander: https://slatestarcodex.com/2015/07/13/things-that-sometimes-work-if-you-have-anxiety/ https://slatestarcodex.com/2015/07/13/things-that-sometimes-... Best recent meta analyse of the SOTA https://pubmed.ncbi.nlm.nih.gov/30712879/ https://pubmed.ncbi.nlm.nih.gov/30712879/ Anxiety is more prevalant than depression yet is extremely under reported. While ADHD and depression have relatively safe and effective medications for long term treatment, chronic anxiety doesn't. Some antidepressants are safe long term treatment for anxiety however they are not very potent (compared to benzodiazepines) Benzos are not a long term solution because of tolerance, of their sedative effect and of their persistent impairment of cognitive performance. The ideal medication has the following properties: Required: 1) no persistent loss of cognitive performance Studies shows that popular benzos negatively affect cognitive performance even months (years?) after their use. 2) no hypnotic effect at normal dose Desired: 3) no loss of cognitive performance while in use. 4) No or low tolerance 5) no sedative effect It happens that there are at least 2 benzos derivatives that share those properties: Tofisopam (Emandaxin and Grandaxin) and Hydazepam (Gidazepam IC) are drugs that are benzodiazepine derivatives. Like other benzodiazepines, they possesses anxiolytic properties, but, unlike other benzodiazepines, they do not have anticonvulsant, sedative, skeletal muscle relaxant, motor skill-impairing, or amnestic properties. Moreover Tofisopam (apparently) induce NO COGNITIVE PERFORMANCE LOSS! See e.g this DOI on scihub https://doi.org/10.1007/978-3-642-74031-2_13 https://doi.org/10.1007/978-3-642-74031-2_13 The most interesting NON-benzos: Pregabalin's anxiolytic effect appears after one week of use and is similar in effectiveness to lorazepam, alprazolam, and venlafaxine, but has demonstrated more consistent therapeutic effects for psychic and somatic anxiety symptoms. Long-term trials have shown continued effectiveness without the development of tolerance, and unlike benzodiazepines, it does not disrupt sleep architecture and produces less severe cognitive and psychomotor impairment. Pregabalin also exhibits a lower potential for abuse and dependence than benzodiazepines.[43][44] Hydroxyzine has been shown to be as effective as benzodiazepines in the treatment of generalized anxiety disorder, while producing fewer side-effects.[13] Moclobemide potentially more potent than SSRIs, however much slower to act than benzos. CONCLUSION: * Tofisopam appears to be the clear winner. Hydazepam might be as well but can't find information on cognitive performance. Pregabalin appears to be the best non-benzo * reversible Maois might be the safest/potent well studied medication for long term use and do not destroy libido contrary to SSRIs. This is a major issue because anxiety is a major commorbidity of ADHD and given that MAOIs increase norepinephrine/dopamine quantities it might interact badly with concurrent use of stimulants. However some anecdotal studies shows that it can be safe, however the use of beta blockers might be needed (for e.g 50mg of Vyvanse) A plausible and surprisingly understudied solution for the SSRIs effects on libido might be TRT.

orsenthil 5y ago

Personal anecdote. Just a few days ago, when I was feeling anxious, I just stayed firm at my desk, and firmly approaching the situation without the thought of giving up, even if I couldn't solve the problem, I felt, I could control my anxiety a little better.

Zelphyr 5y ago
There is a term I heard once for what you did: "Disobey the fear." You want to run from the anxiety, but at the same time, you logically know you're not really in any danger. Disobeying that urge to run re-trains your body such that after a little practice, the fear comes and goes, often barely registering in your conscious mind.

tern 5y ago

What a pleasant surprise to find this article at the top of HN! Minutes ago I finished a workshop on a somatic therapy technique. It's a relief to see these ideas gaining mainstream attention after so many years of making little progress on my own anxiety, depression, and procrastination. For other relevant scientific perspectives, I recommend looking into the theory around "memory reconsolidation." - Kaj Sotala does a good job of summarizing an important book in the field here: https://www.lesswrong.com/posts/i9xyZBS3qzA8nFXNQ/book-summary-unlocking-the-emotional-brain https://www.lesswrong.com/posts/i9xyZBS3qzA8nFXNQ/book-summa... - How Emotions are Made also provides a perspective from neuropsychology on what's going on: https://www.amazon.com/How-Emotions-Made-Lisa-Barrett/dp/1328915433/ https://www.amazon.com/How-Emotions-Made-Lisa-Barrett/dp/132.... - The Polyvagal Theory stuff mentioned in the article is also great, and some classic accessible books on the overall topic include The Body Keeps the Score and Waking the Tiger. I'm personally a fan of a technique called Emotional Resolution (EmRes), which is notably simple and effective, and that you can learn to apply to yourself after a 90 minute course, but there are many other approaches: Organic Intelligence, somatic experiencing, cranio-sacral therapy, bioenergetics and core energetics, and many more. Effective self-therapy methods include Core Transformation, Focusing, and "self-therapy". Keywords to search for are: "somatic therapy," "body work," "energy work" or "energy medicine."

fblp 5y ago
Great summary, thank you for sharing!

scorxn 5y ago

I was almost 30 when I had my first ever panic attack. I was alone and convinced it was a heart attack, called 911, and felt fine by the time the ambulance reached the hospital. Embarrassed, I was ready to brush it off, but instead saw a therapist for the first time. She took out a stopwatch and had me breathe through a narrow straw. Within seconds, my face and limbs went completely numb; I couldn't move, and was amazed that I could form words. I sat with my head in my hands for what felt like forever. Eventually it passed, I felt utterly exhausted, and she asked what I thought the stopwatch said. "I dunno, 10-15 minutes?" Nope, 90 seconds. That experience made me start taking my mental health seriously.

QuercusMax 5y ago
Why did breathing through the straw cause that reaction?
- sooheon 5y ago
  Try breathing through a straw (or two put together) just after your heart rate's been raised (i.e. via exercise). It's very anxiety inducing.
- Zelphyr 5y ago
  Simply breathing through a straw may not do it. My therapist had me run up and down a flight of stairs for about 30 seconds and then breathe through a straw cut down to about 3 inches while holding my nostrils closed. Your body thinks you're not getting enough oxygen. You're getting plenty, it's just that it all coming through that tiny hole tricks your body and that triggers panic sensations. Doing that several times exposes you to those sensations and you eventually get used to it and allows you to manage more intense sensations.
  - moldavi 5y ago
    I'm not sure that's correct. I've heard that high CO2 levels trigger the parasympathetic nervous system which calms us down. One could get the same effect from breathing into a paper bag, I think.

WWGaussDo 5y ago

So good to see a story about the physical aspects of anxiety at the top of hacker news! I’ve struggled with anxiety my whole software career and finally found something that really worked for me —- identifying the triggers of my anxiety, and focusing on my physiological sensations after I recall them, much as described by Pat Ogden in the article. Another software engineer friend and I are starting a company to help software engineers reduce stress and anxiety! We’d love to hear from any of you. Tinyurl.com/happyhackers

madrox 5y ago

I'm nearly 40, and didn't relate to anxiety at all until I was 35. Until then, I would use lots of different words to describe how I simply wasn't good at being in a number of situations. I now believe that was a better way of thinking, because once I identified what was happening to me as anxiety, it actually got worse. "Anxiety" is something that should be treated and actively managed, which puts fuel on the fire. The less I frame my mental health in terms of anxiety, the better off I am. I'm sure there are any number of reasons why this way of thinking won't help others, but I totally get why lots of ADHD sufferers have started calling it "bees in my head" instead of ADHD. What we call things affects how we think about it.

WWGaussDo 5y ago

So good to see a story about the physical aspects of anxiety at the top of hacker news! I’ve struggled with anxiety my whole software career. I finally identified the big triggers for me - morning standup when I was late on a ticket, when a test would inexplicably fail, when a coworker wound comment in a PR asking me to redo a chunk of work that I knew would take more time. And I identified them based on how my BODY felt. And once I could identify the actually environmental triggers, I could start to resolve them. A lot like this article talks about! My conscious mind wasn’t in control of my anxiety, and the looping thoughts in my head didn’t even have much to do with the trigger. They were the symptom, not the cause. Another software engineer friend and I are starting a company to help software engineers reduce stress and anxiety! We’ve seen some pretty miraculous results so far. We’d love to hear from all of you anxious software engineers :) Tinyurl.com/happyhackers

peach 5y ago
Thanks for sharing. Interesting to hear someone is trying to take care of this aspect. Especially since it's very much underplayed in our industry.

deleted 5y ago

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11thEarlOfMar 5y ago

I believe that an inappropriate anxiety response is typically one element of a syndrome, and generally not a stand alone response. Most likely, if you are focusing on anxiety to the exclusion of other aspects of your life, and I mean past, present and future life, you are likely missing opportunities to effectively address it. That said, one therapy that has worked for at least one person I know was Dielectical Behavior Therapy[0]. As they went through the program, they learned that their hyper-arousal to any unexpected event led to an anger response that led to saying terrible things to the person who had not behaved as expected. This led to a general mistrust of others and a dwindling supply of friends who transitioned to acquaintances who then stopped calling entirely. DBT get them to recognize that their response was not typical and offered a path to practice alternate responses. They learned to defer their response and seek clarification or confirm intentions before reacting. They've become a much less unpleasant person to be around. [0] https://www.verywellmind.com/dialectical-behavior-therapy-1067402 https://www.verywellmind.com/dialectical-behavior-therapy-10...

CyanLite4 5y ago

As a person who is currently in CBT (and seeing positive results), the biggest thing that helped me is to understand trauma, and cognitive distortions. Just as this article says, your thinking brain is trying to piece together and digest what has happened. The problem is often that we repress it during the peaceful down time that our thinking brain is trying to make sense of it. We drown it out with drugs and alcohol, or we try to make ourselves so busy that we don’t think about it (hence creating more anxiety through work issues, family drama, or overstimulation). Best thing that works for me is to learn to accept it. Process it. Digest it. Learn and talk through examples of how it’s safe to experience the world again. This is part of the de-escalation process. Note, this goes against advice of “oh just don’t worry about it”. This approach is essentially “okay self, bad shit happened, let’s finally talk about it”. Your thinking brain is designed to keep bringing this up until it gets resolution. This is resolution. And cognitive distortions helps me because I understand now how my mind plays tricks on me. When I say things like “this bad thing happened, I’ll never be able to get over it”, it’s giving too much power to that bad event. I don’t have to feel or think that way. I’m allowed to change my thought process and think “yeah that bad event happened, but I can’t let it be the end of the world for me.”

hivacruz 5y ago

Just seeing the picture of the article made by throat getting bigger from the inside. Anxiety sucks.

singingfish 5y ago

I have a close friend with an autism diagnosis who has a very unusual relationship between their brain and the rest of their body. One of the consequences of this is that they become very anxious and get trapped in a nasty anxiety vicious cycle that can last several days.

franklyt 5y ago

Your body and mind are one. It is scientifically inaccurate to believe otherwise. This isn’t a pedantic point: the mind/body distinction is pseudoscience that used to be believed widely in scientific circles. This readjustment hasn’t really reached common practice yet.

Zelphyr 5y ago

A form of CBT that has been shown to be particularly effective at anxiety and panic is Acceptance and Commitment Therapy (ACT). If you've been struggling with anxiety, I highly recommend seeking out a therapist who has been trained in ACT. You can also read and watch anything produced by Dr. Stephen C. Hayes, one of the therapists who developed ACT. He did so himself due to panic and anxiety and this was after becoming a psychologist. The whole field is quite fascinating.

monkeydreams 5y ago

It was only when I was heavily medicated for depression and anxiety that I realised the physical symptoms of anxiety. Whenever I was expecting a negative outcome, or when I was surprised, my body would give me a jolt of pain along my vagus nerve. Literally any negative event would cause me pain, and it was this pain that my brain was seeking to avoid. My current medication does not remove this pain altogether, though it diminishes the sensation significantly.

defterGoose 5y ago
Out of curiosity, do you mind sharing what medication you're on? I feel like i have a strange vagus nerve dysfunction as well.
- monkeydreams 5y ago
  I'm on Valdoxan (ago melantine).
- darkerside 5y ago
  I've had a similar issue, and PPIs and H2 blockers have helped

comeonseriously 5y ago

"Wait to worry" I tell my self. Can I do anything about the situation at this very moment? No? Wait to worry. Yes? The DO IT. It's not perfect, but man, it helps me get through some stuff.

cletus 5y ago

This is a weird article. The headline doesn't really match it. Like it says the thinking brain is the last to know and the author suggests this is a physiological response. But all that's really saying is that anxiety isn't a conscious response. But that just means it's a subconscious response and not a physiological response somehow removed from the brain. Also, what does "in your body, not in your mind" even mean? Let's face it, the distinction between your mind (or brain) and your body is a useful abstraction, nothing more. Nerve cells extend from your brain throughout your entire body. Where does your brain end and your "body" begin? Life isn't software that lends itself to neat abstraction layers.

lampington 5y ago

Interesting article. I have occasional (every few years) periods of anxiety. Last time around I went through a course of CBT, some of which I found moderately helpful - don't try to suppress feelings of fear, just acknowledge it and move on - but I was certainly not cured. Then my doctor suggested I try out the Alexander Technique. I wasn't convinced, but gave it a go. Something about it helped, and quite significantly. The logical part of me rebels against this, as AT is full of woo, but the effects were undeniable. The practitioner I went to focused a lot on feeling the floor beneath you, the seat supporting you, and so on -- I don't know how typical that is for AT, but perhaps that was the part of it that was effective for me. It would certainly fit with what the article says.

babarganesh 5y ago

i think no, it's not "not in my mind but in my body". my take is that anxiety occurs first by warping a person's attention, and the mental and physical symptoms of that follow.

johndoe42377 5y ago

Bullshit. Brain runs the body. Anxiety is a bodily state driven by processes in the brain. Autistic people know it best.

aantix 5y ago

Nutritional deficiencies should be part of this conversation. A majority of Americans are magnesium deficient. Magnesium calms the nervous system. “In healthy adults, magnesium sits inside the NMDA receptors, preventing them from being triggered by weak signals that may stimulate your nerve cells unnecessarily. When your magnesium levels are low, fewer NMDA receptors are blocked. This means they are prone to being stimulated more often than necessary.“ https://www.healthline.com/nutrition/what-does-magnesium-do#brain-benefits https://www.healthline.com/nutrition/what-does-magnesium-do#... Mg L-threonate has helped my anxiety 2x more than years of talk therapy.

ddlutz 5y ago
What dose do you take? I might give this a shot.
- aantix 5y ago
  One dose of magnesium l-threonate with l-theanine before bed. One dose in the morning. Each dose is usually 3 capsules, containing 144mg of elemental magnesium.
Asooka 5y ago
Not sure who downvoted you, you're absolutely correct. The usual culprits are magnesium, vitamin D and calcium. Those can result in moderate depression and anxiety in otherwise healthy individuals. Getting tested is pretty cheap, pretty much everyone with anxiety, depression or chronic fatigue should get some simple bloodwork done first to rule out the easily correctable causes.

deleted 5y ago

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peteretep 5y ago

> Not only did all that talking not do much to alleviate anxiety, but it could also even have made it more acute. If you’re going to go counter to a large body of scientific evidence (re efficacy of CBT), ya need something stronger than the thoughts of some people trying to hawk products, ya know?

dghughes 5y ago

I had anxiety for the first time in my life recently in the form of pain in my upper left chest. From a new job I hate (but pays well) and added to that my dad is very sick. Worse still is I'm the age my grandfather and his son (my uncle) died. I've read how people who have major stress in their lives develop a reduced ability to cope with stress. That seems like a terrible spiral downward.

ineedasername 5y ago

It's difficult to take advice from an article that has a statement like this mixed in: "We are a cerebral culture, which makes us very equipped to deal with problems that require reason and logic"

gerash 5y ago

For those interested in the subject I suggest listening to this https://youtu.be/ntfcfJ28eiU https://youtu.be/ntfcfJ28eiU

didibus 5y ago

Something seems contractictory to me with this. It's trying to say your thoughts don't affect it, yet it describes a scenario where only rational cognitive concepts cause the fight or flight response. How does the "survival brain" know that Covid-19 is scary, dangerous and to be feared? How does it know how dangerous it is to gauge the response? Similarly, how does it know the meeting at work is dangerous if you're late too it? That it's important for you to be there on time? Etc.

runarberg 5y ago
I feel like statements like these do a disservice to the science behind them. The “fight of flight” is meant as a simplification of automatic behavior changes (which might involve different chemistry in the brain which increases alertness; and in evolutionary terms are beneficial to your survival and procreation). But it is a gross oversimplification. There is little evidence that the systems involved are a direct fight or flight response system. They are certainly involved in fight or flight but that is not by any means the only time they activate. This article makes a passing mention of the term defensive response. I like that term a lot better as it catches things like potential embarrassment and failures as well.

kumarvvr 5y ago

Is the body different from the mind? Every experience of ours as a human, is rooted in the mind. The author seems to confuse involuntary action with conscious thought. "We" may not perceive the signals that drive the beating of the heart, but it is still driven by the mind. Hindu yogic practices, especially those of Hatha Yoga [0] make it possible for one to feel even those involuntary processes. [0] https://en.wikipedia.org/wiki/Hatha_yoga https://en.wikipedia.org/wiki/Hatha_yoga

anewguy9000 5y ago

i seem to meet more and more people who have experienced acute anxiety / panic attacks than ever. it leads me to wonder if it's just more understood and easier to talk about now, or is there some phenomenon where the incidence is actually increasing?

throwaway_kufu 5y ago

It’s certainly both. “Anxiety” it’s your brains response to given sensory input and tends to trigger a release of cortisol and in more extreme situations adrenaline. While cortisol and adrenaline are normal responses it’s a very slippery slope and they can have extremely negative effects on the body. The dangers of to much of these hormones come from both chronic exposure for normal sensory inputs like stress at work or school on a daily basis or constant instability like parents fighting regularly to single acute episodes like an extreme traumatic event. Traumatic events tend to alter neural pathways so moving forward even non stressful sensory input can trigger these strengthened pathways putting people in non stressful environments in chronic states of stress. It’s helpful “not to think about it” whatever “it” is, but it’s often involuntary especially for those that suffered a trauma, as there’s always the risk that you are unknowingly responding to it without even thinking about it and it’s often hard to connect the dots. The other issue is everything in the body is a feedback loop and hard to break or change. For example even just sitting in a chair all day will shorten you hip flexors, causing unnoticeable discomfort but your brain will notice and respond with release of cortisol which will in turn cause tightening of muscles and myofacia, that will further release cortisol in response to those bodily stresses, and on and on it goes with all kinds of “referred pain” (I hate that term) you do notice in maybe your neck or shoulder(s) or back. And good luck at that point you’ll be treating the area in pain that’s not even actually causing the pain only leading to more chronic stress over the inability to make the pain go away. If you work in an office my guess is you have physical pain, and you can ask anyone else in the office and odds are they have physical pain, and my bet dollars to donuts from arthritis to bursitis to joint pain the vast majority with simply blame it on getting old or some posture issue and not a single one will realize the physical pain and bodily conditions are directly related to stress.

imvetri 5y ago

Mind is in the body

jimi_d 5y ago

I personally think this was a very interesting reading, and after having tried multiple solutions for anxiety (prescribed pills, talk therapy, tips like focusing on our environment -- as explained in the highlighted paragraph), and being surrounded by people having also tried several solutions, it must be known that not everyone will react the same way to each of them. While the content of this article will not make everyone agree, I think it's particularly important nowadays to pay attention to our mental health at least as much as we do to our physical health, and it's good to see this topic trending on HN.

74d-fe6-2c6 5y ago

> As Stephen Porges, PhD, a psychologist and the creator of the Polyvagal Theory Funny. Just yesterday I googled "polyvagal theory" after accidentally stumbling upon it after googling for "HRV training" after hearing about it from Tim Ferriss on his youtube channel. Anyway - a quick research yielded that PVT and Mr. Porges are both rather questionable. [1] > The thinking brain isn’t what decides whether we’re stressed, whether we’re feeling threatened or challenged, whether we’re going to turn stress on, whether we’re going to turn emotions on, I'd question that and bring thought loops forward as a counterexample. You can very well intensify a state of anxiety by dwelling on some thought. > So if you want to track your anxiety, your body, not your thoughts, will be your most accurate map. That is true, though - after all anxiety is a physical sensation. I can attest to that waking up now for several weeks almost every day with stomach aching, increased heart rate and shallow breathing. > The problem is that when it comes to regulating our nervous system after a stress response (read: anxiety), our thinking brain is the absolute worst tool for the job I'd also questin that. It's true that the thinking brain on its own will never find a solution for something like anxiety. But you need the thinking brain to identify the problem and come up with a solution. If the thinking brain is a hammer then your guts are a screw driver. > talk therapy analyzing all the reasons you’re anxious, this is probably a hard pill to swallow. Not only did all that talking not do much to alleviate anxiety, but it could also even have made it more acute. Talk therapy addresses the thinking brain and is hence limited. But a good talking therapy is not just being experienced by exchanging words. If the therapist is worth her money she'll connect on an emotional level. > Is there any role for talk therapy, or trying to think logically about your anxiety? Absolutely. But only once your body is regulated, Stanley says: “After we have helped our survival brain feel safe and stable, then we can work on our thoughts. This attitude is symptomatic of our misguided medical profession which always seeks to compartmentalize and modularize instead of integrate and connect. Both approaches can go very well hand in hand. 1: https://en.wikipedia.org/wiki/Polyvagal_theory#Criticism https://en.wikipedia.org/wiki/Polyvagal_theory#Criticism

Wump 5y ago

Reminds me of the equation: Pain x Resistance = Suffering If you accept pain fully (Resistance = 0), then you won’t suffer. The more you resist, the more you suffer. And if Resistance is high, then even a little bit of Pain can cause a lot of suffering.

wing-_-nuts 5y ago

I sometimes have random anxiety at night. I used to have a bad habit of drinking myself to sleep, but I've since discovered that hard exercise is the best medicine. I do pushups until I'm completely exhausted. When I lay down, I'm actually relaxed for a good 20 minutes. It's amazing.

stakkur 5y ago

when it comes to anxiety, which doesn’t take place in your thinking brain, it [CBT] places the focus on the thought (“I thought there was a tiger!”) and not the physical response which preceded, and even caused, the thought (“my heart is racing and I’m full of adrenaline and I need tools to calm down”). Inexplicably, the article seems to get CBT entirely wrong. A key part of CBT for anxiety is, in fact, about dealing with the body (e.g., the sympathetic nervous system) by activating the parasympathetic—through breathing, progressive muscle relaxation, and so forth. This glaring miss on one of the most effective therapies for anxiety made me question the entire article.

SubiculumCode 5y ago
The title was the give away for me. The titles thesis is quickly abandoned to mean something like conscious vs unconscious thought.
wiz21c 5y ago
Didn't read the article in detail, but as someone who is super problematic as far anxiety goes, I can safely say that tai chi practice does help me for the very reasons you've given : activating parasympathetic system by breathing, active relaxation, connecting mind to body and vice versa, grounding myself (ie connecting my sensations to environment), being in movement (that is, your brain is not thinking about stress alone, but participates in a complete action with your body), etc. (and not the chi/spiritual thing that brings everything together and explains the roots of the stuff but is, often, totally transformed by occidental culture into nonsensical bullshit). But that's my own sample point, just works for me. It's tough to push yourself to practice half an hour a day or so. You have to have the will and when you're tired it's difficult :-/

emerged 5y ago

This link wanted me to login to read which IMO means I can and should only engage with the post title. Anxiety is in GABA-a and GABA-b IMO. I would suppose they circulate throughout the body and mind. But most the work is getting the influence to take affect in the mind.

55555 5y ago

If you have trauma/PTSD (even minor) that leads to physical reactions (sweating, heart racing, etc) in certain situations, take propanolol before you have the situation. After you do this a few times, or a few dozen, you'll be 90% fixed.

up_and_up 5y ago

Totally anecdotal, but speaking as someone with Anxiety Disorder + occasional intense panic attacks, once I started Rock climbing heavily and Trail running 2x a week, my anxiety and Panic attacks basically went away completely. This was following years of taking 5HTP, meditating/breathing, talk therapy etc, which helped somewhat but nothing like intense exercise.

anonymouswacker 5y ago

As someone who's been coming out of a lot of sexual trauma from my early childhood, I feel it's important to take a multi-pronged approach to alleviating the anxiety & pain, psychologically and physiologically. For me, pelvic pain was a huge impediment to having a healthy sex life. Left untreated, it got worse and worse, to the point that I had constant pain my body. Now I am seeing a pelvic floor physical therapist who is teaching me how to relax the muscles, and a psychoanalyst who is helping me deal with reframing the traumas that got me where I am. The Body Keeps the Score is a pretty good book that covers how much trauma affects the body in myriad ways.

paulcarroty 5y ago

After starting real home fitness 6 days per week my stress & anxiety level is unbelievable low. I don't think it helps in all cases but you definitely should try it. Another suggestion: as long-term projects are inevitable always switch to short-term which can bring fast but realistic result.

pyjug 5y ago

The body and mind are heavily intertwined. It's totally useless to compartmentalize them when discussing something like anxiety. One day somebody in the West will "independently" discover what Buddha and Vedic Rishis discovered centuries ago, and popularize those ideas. Unfortunately, this is the only way those ideas will regain acceptance in the East as well.

jokowueu 5y ago

This reminds me of stella ganglion block that was shown to be effective against ptsd . Quite interesting

99_00 5y ago

> an increased interest in “brain science” and neurobiology along with continued research on mindfulness and mind-body connections are shifting our psychological understanding from focusing only on the mind to seeing the brain and body as a cohesive unit. This is exactly what my talk-therapist is helping me with. So if these ideas appeal to you and you want to explore them keep an open mind about talk-therapy.

dcanelhas 5y ago

I'm a bit puzzled as to why the article suggests we should imagine ourselves as Neanderthals instead of homo sapiens? I understand that homo sapiens interbred with Neanderthals and people today may have a few percent of Neanderthal DNA but the most relevant evolutionary context for us is just an earlier version of us, surely.

BiteCode_dev 5y ago

We keep assuming body and mind are separated things, but separating the concept of ink and paper doesn't help you understand the full nature of a book.

wodenokoto 5y ago

The article really tries to present cognitive behavioral therapy as something it is not. Reconnecting with your body and mindfulness are part of the toolset you can expect to be introduced to when visiting a CBT therapist.

xibalba 5y ago

For people interested in addressing anxiety/depression disorders via "the body", check out SGB (stellate ganglion block) and ketamine treatments.

mkrazzledazzle 5y ago

This was discovered thousands of years ago in the east(indian subcontinent) by meditation practitioners(i.e Buddha, Mahavira etc) solely through thousands of hours of practice and self-realization. These have been codified into various texts which form a major part of vipassana teachings. Interesting how scientists in the west either conveniently pick up the theory, conduct some a/b tests and publish them as new discoveries without credit. Even if they had arrived on these conclusions, independently on their own, it's important to understand the mind boggling amount of progress in psychology, neuroscience that was made with the limited knowledge of scientific rigor in the east thousands of years ago.

contradistinct 5y ago
I disagree. If it's not empirical, it doesn't count. There are millions of people with ideas, but ideas aren't good enough. Prove your idea is true, then we'll talk about deserving credit. Exception: mathematical ideas which are difficult to come up with.
- mkrazzledazzle 5y ago
  How is it fair to pick up/completely ignore published experiential observations, in continued practice for millennia from another culture elsewhere in the world, conduct a/b tests and publish results without credit? I'm pretty sure the western world is going to continue swindling wellness techniques/practices from ancient texts, quickly run half-baked experiments, cherry pick data to suit a result and "publish" findings. When these techniques were in development, in the golden era for spirituality, most of the rest of the world were still hunter-gatherers. Empirical rigor was just not a thing. It's a question of providing due credit for those who developed and practice these techniques as a way of life. If not share some of the capitalistic spoils in the billions from delivering stress relief(meditation based content) through shiny, addictive apps (Yes, meditation apps can be addictive! Surprise! i.e, Headspace, Calm), At least provide credit where it's due.

ElijahLynn 5y ago

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bluewalt 5y ago
Open your browser in private navigation

QuantumGood 5y ago

I have few early memories because due to having so much anxiety from an early age. I remember a time before processing it as any synonym for 'anxiety', my father came to help me with something and I thought, in essence: "Too bad my brain is doing that thing where my thoughts are not useful due to that thing (that I didn't yet think of as anxiety), but how nice of my father to spend some time with me."

anxiety554 5y ago

First paragraph had a very interesting perspective about stress and the last paragraph had a solution, rest of the content is very repetitive.