Sunday, January 15, 2012

Instruction Manual 2: Is this going to eat me or not?

The instinct that drives anxiety is the Fight or Flight response.  I would differ with Walter Cannon here and call it the Fight or Flight REACTION, but he is unavailable for comment at the moment, as he named this phenomenon in the 1920’s.  Since then, it has in fact been suggested that the name is not quite descriptive enough, and most recently it has been called “Freeze, Flight, Fight, Fright, Faint” by Bracha and his gang.  To-maaa-to, To-mah-to. 

The major players in the fight or flight instinct are shown here.  There are actually two (ok probably more, but I’m a therapist not a neurologist) process happening simultaneously.  One of these is totally and completely unconscious.  We want it that way.  We don’t want to have to THINK about whether or not it’s a good idea to move our hand if we accidently touch a hot stove.  (“Hmmm . . . what’s that smell?  And it kinda hurts . . . sizzling sound . . . probably should move my hand. . . ready set go!”) The reactive part of our brain takes over there, and we have a reflex reaction to jerk our hand back.  This is a good thing.  Information comes in through our 5 senses, and runs through the command center for survival, our mighty amygdala.  Though tiny, this structure has a lot of power and primarily answers the question is “IS THIS GOING TO EAT ME OR NOT???”  If the answer is no, the information flows smoothly through to be processed by our highly developed cerebral cortex.  We think about it . . . we decide what to do with the information.  If your amygdala decides that whatever it is evaluating poses some sort of a threat, it hits the big red panic button and triggers a complex chemical chain reaction throughout your body with the activation of the HPA (Hypothalmic, Pituitary, Adrenal) axis.  Rapid fire, your body responds to the threat.  We all know this feeling.  Your heart races, your muscles tense, you breathe faster.  Every single thing that happens in your body is oriented toward responding to that threat.  We need to either get the heck out of there or be ready to defend ourselves.   At the same time, the incoming information is also being analyzed by other brain structures.  The hippocampus is in charge of more rational responses, and can settle the amygdala down a bit.  Here’s the interesting part.  The amygdala response happens TEN TIMES faster than processing through the hippocampus.

The super in my office building gives me frequent opportunity to demonstrate this principle.  I swear he wears crepe-soled shoes to sneak down the hallway for the sole purpose of watching me jump out of my skin when he says “BOO” or something similar.  That’s the amygdala response.  There is no recognition of WHO spoke, or that this is the same guy who regularly lets me in to my office when I forget my keys, simply a chemical reaction to an unexpected event.  It doesn’t take long, of course for my hippocampus to put Charlie in context and realize that my life is not in immediate danger.  As my heart rate returns to normal, we laugh about how easily startled I am, and get on about the business of living ... which is at that moment usually about me NOT resisting the urge to get a Diet Coke out of the vending machine.  Oh that stuff is so bad for me. 

What makes this problematic in today’s world is that the amygdala is a light switch.  It’s off, or it’s on.  There’s no in-between.  From a survival perspective, it makes a heck of a lot more sense to overreact to a rustle in the bushes that turns out to be a bunny than to underreact to a rustle in the bushes that turns out to be a wolf.  In our amygdala, there is only YES this is an immediate, life-threatening danger to which I must react or NO, it’s not.  There is no maybe.  Maybe is a yes, which explains why we experience the physiological fight or flight reaction in the face of things we clearly know are NOT life-threatening.  We have a shortage of true, life-threatening dangers in today's world.  When's the last time you ran into a lion in the elevator at work?  Gee … it’s kind of like our Amygdala just takes over … and our brain is temporarily HIJACKED …..

Sunday, January 8, 2012

Instruction Manual 1: Design Features

First of all, let’s look at how your brain is designed.  I am of the opinion that we are a well-designed, efficient, functional unit – even though we don’t come with a manual or schematics.  I think that our bodies WORK.  Perfectly.  Until we get in our own way. 
Years ago, I attended a lecture in which the presenter … who had my full attention because I was about 5 minutes out of graduate school and eating ramen and he was presiding over a catered drug-company sponsored luncheon.  Read:  FREE REALLY GOOD FOOD.  I would have gone to a lecture on watching paint dry… Ahem – so this presenter talked about a study out of Auburn University (and if anyone has a reference to this study I would LOVE to have it.  I’ve lost the paper) in which it was discovered that a decrease in serotonin levels was associated with the human immune response.  So much so, in fact that some physicians had begun getting an antidepressant on board PRIOR to major surgical procedures (like open heart surgery) to combat the post-surgical depression that created problems.  I thought that was SO COOL!!!  So let me get this straight . . . when we are trying fight off illness, our bodies respond chemically with depression.  “Depression” tells us to get under the covers and stay there.  That’s just good thinking when we’re trying to heal.  Pull back, lay low.  We don’t do it, of course.  We just keep going . . . and going . . . and going . . . 

Check this out.  What are the things we just simply can’t do without?  Heart rate, respiration, blinking, sweating, digestion – things we never consciously think about, but without which we would not last long.  Where are these things located in your brain?  In the very absolute center.  Far away from the outside where it can be bonked and damaged by a blow to the head.  Now that’s good design!  This red part of the diagram is called our reptilian brain.  We share these basic functions with just about every other living creature.  It is the most primitive and least developed part of the brain.  If this part of your brain is damaged, you’re pretty much toast. 

The next layer of the onion is the limbic system.  Here lies the heart of our fight or flight response.  Notice, still VERY WELL PROTECTED, which tells me that the engineers thought these functions were worth protecting.  Here lies reaction, not response.  On the outside is where higher order thinking happens.  We can live for a long time without speech, the ability to distinguish colors, or without logic and reasoning . . . not so much without breathing.  So if we’re going to get whacked in the noggin, this is the part that takes a licking and we keep on ticking.  (Someday perhaps I’ll write about the humiliation of the fact that only time I’ve been knocked out in a horse accident I was riding a PONY.  Insert helmet safety lecture here.  Without protective headgear, I wouldn’t be writing this blog).   

If our bodies are designed so perfectly, and are working correctly, how come I have a job?  How come people are flocking to their doctors and psychiatrists and therapists struggling with the debilitating impact of anxiety and depression?  For my money, it’s because we don’t know how to work the equipment.  We haven’t read the manual.  Ever tried to put together “ready to assemble” furniture without the directions?  Good luck!  Once we understand how our brains work, we can stop feeling like we are at the mercy of our emotions and reactions, and start making progress. 

Next up:  Is this going to eat me or not?