You’re Wired for Anxiety. And You’re Wired to Handle It :: Big Thinkers on Mental Health

Dr. Anne Marie Albano, Director of Columbia University Clinic for Anxiety and Related Disorders, traces the biological and evolutionary origins of anxiety, the unique features of anxiety in the 21st century, and the powerful research and tech-driven treatments that have emerged in recent decades.
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Transcript - So anxiety is rooted in biology. It’s evolutionarily based in that we have our own fight or flight responses. Some of it is very old and triggered from the deep part of our brain that is the oldest part, the fight or flight response. And then some of it comes from the cortex which evolved much later and that’s worry. And that might be 21st century anxiety because there’s a lot we can find to worry about these days. Are we going to make enough money? Are we going to get the right job? Are we going to provide for our families? Are we going to do the right thing? What could go wrong in the world? So many things can trigger anxiety just by walking through everyday life. But the good news is our systems are also set up to handle it. The beauty of anxiety and the system that we have of anxiety that’s all throughout our nervous system is that it evolved to protect us. So there’s two components to it. The oldest being the amygdala which is deep in the brain in the reptilian part of our brain signals whether we should fight something, flee something or freeze. When it goes awry is when it’s perceiving immediate danger that really isn’t there. Somebody’s heart starts to race and they think oh my goodness, is something wrong with me? That’s panic and that can send somebody into a panic attack which is the clinical manifestation of the fight or flight response. The other thing with anxiety is again as we evolved and became thinking human beings and started building communities and cities and civilizations is our brain evolved and there’s the cortex. It’s within the cortex that we think. It’s within that system that we worry. And so we can worry ourselves into states of anxiety where we are fraught in not knowing what to do and we actually get stuck with anxiety and so we’re tense and irritable and upset. So what makes the difference between everyday anxiety which we all experience – anxiety is perfectly normal. In any form it’s perfectly normal. Having your heart racing because somebody is walking behind you and you don’t know who it is is kind of normal. But if you let that happen to you when you’re sitting alone at home and you start having panic then that gets out of control. And worry about what to do in the future is normal for all of us. But if we can’t move our minds off of that and onto what do I need to take care of here and let me enjoy my family while we’re doing this thing and activity and I’ll problem solve that later then that becomes a problem and that might become an anxiety issue. What was great from the 1990s all the way through to now is it sort of was the age of anxiety in terms of mental health treatment development. The 1990s opened up lots of treatment funded here in the United States by the National Institutes of Mental Health. And then also in other countries did similar things where cognitive behavioral therapy became the most tested and developed treatment and found to be the most effective psychological or talk therapy for managing anxiety. And managing anxiety of all kinds. Obsessive compulsive disorder, panic disorder, generalized anxiety disorder and so forth. Social phobia, the number one anxiety disorder in kids and adults. Cognitive behavioral therapy is great for that. So we put a lot of work into developing these treatments and perfecting them. And then also there are great medications actually that were developed through that time. The combination of the two treatments works best for many people who are debilitated by anxiety. (Find full transcript here: )