The Resilient Brain

Coping with Concussion and Mild Traumatic Brain Injury

Understanding Anxiety as a Symptom, Not the Problem

When we treat anxiety as a problem, we are missing the real problem behind it.

Our body has limited ways of indicating that there is something wrong. What causes those symptoms can drastically vary. This is especially true for anxiety. This is where a differential diagnosis is extremely important to sift through what is truly the cause of these symptoms.  

I try to explain this concept to every patient who comes into the office through my “sweaty woman” example. Sweating is a symptom, but what is causing the person to sweat? My office has a huge front window. I ask my patients to picture themselves outside looking into my office. I have them picture a chilly fall day. My office has an awesome fireplace, and I have them picture the fire ablaze. Then I ask them to picture a 45 year-old woman who is sweating while sitting in an office chair. Here are the following probable causes:

1) She's sweating because the room is too hot.

2) She has a fever.

3) She is anxious.

4) She has food poisoning.

5) She has diabetes.

6) She’s having a hot flash.

7) She has Lyme Disease.

The potential answers range from having all seven issues individually or concurrently. Therefore, it is extremely important to differentiate which of the causes ranks the highest to find the appropriate solution (or methods and treatments) to help her.

Causes of Anxiety

Anxiety is a part of our primitive, emotional brain (the limbic system) that protects us from danger. This area of the brain, especially the amygdala, is the sensor to alert us of danger. It sends a message to our adrenal glands to give us the adrenaline to fight or flee from danger.

There are different causes of anxiety:

Genetics/Temperament

As mentioned in a prior blog, some individuals are born hearty, reactive, and sensitive. I joke with my patients that I label them by dogs, because most people have little knowledge about variability in horses, yet most people do about dogs. 

I explain that the most anxious Newfoundland dog is still calmer than the calmest Chihuahua. A young boy came into my office dealing with symptoms from a concussion, and I told him he was an anxious Chihuahua. He totally agreed. I said I could make him less anxious, yet he would always be a Chihuahua. He joked that his parents were Chihuahuas too, and they agreed. Here was a reactive, sensitive individual who could identify with his own temperament. In this situation, his anxiety was from an environmental factor–his concussion.

Parenting

In early stages of development prior to age 14, the connections to the frontal lobe (the responsive, logical brain) are still being developed. It is not until you are around 24 years old that these connections are fully developed. Hence, if your amygdala is activated at an early age from fear or discomfort, it is the mother or caregiver who becomes the soothing, holding environment to calm the infant. When there is no soothing, holding, comforting environment during the preverbal period of life, you see issues of attachment disorder, fearfulness, and lack of trust. 

There are variables even in this category which Rhonda Lettington shared in her book, The Alphabet of Wounded Cherubs: Individuals with Attachment Issues:

  • Parental/caregiver contributions
  • Child contributions
  • Environmental contributions

Parental/Caregiver contributions include the following:

  • Abuse and/or neglect
  • Ineffective and insensitive care
  • Depression, bipolar, postpartum
  • Severe and/or chronic psychological disturbances
  • Substance abuse
  • Intergenerational attachment difficulties
  • Prolong absences: prison, hospital, desertion

Child contributions:

  • Difficult temperament
  • Lack of “fit” with parents
  • Premature birth
  • Medical conditions, unresolved pain, colicky
  • Hospitalizations, separation and loss
  • Failure to thrive syndrome
  • Congenital and/or biological problems: fetal alcohol syndrome, physical handicap
  • Genetic factors, family history of mental illness, depression, aggression

Environmental contributions

  • Poverty
  • Violence: victim or witness
  • Lack of support or services
  • Multiple out of home placements
  • High stress/chaos in family and community
  • Lack of stimulation
  • Disease and brain injury

If you are one of the lucky individuals that did not have any of these situations growing up and your basic genetic temperament is hearty rather than reactive or sensitive, having any of the following environmental situations will still activate your fight/flight (anxiety) area of the brain:

Environment

  • Disease and chronic illness
  • Trauma and traumatic
  • Substance abuse
  • Anticipation of possible danger
  • World events and TV
  • Toxins in our food, the environment, and the electromagnetic field

I’ve been a board certified health psychologist and trauma specialist for over 37 years. Trauma, by definition, is something out of the ordinary for you. Seeing a person jumping from a building is probably traumatic to you and would cause your limbic system to go into fight or flight. If the needed connections to the frontal lobe have not been made or have been hijacked due to prior trauma, this produces Post Traumatic Stress Disorder (PTSD), resulting in even a small stimulus (event) being able to trigger the fight/flight area of your brain that causes you to feel anxious.

If you’ve had a brain injury from a stroke, concussion, MS, or Parkinson’s Disease, this too can cause the ability to make the connection to the frontal lobe (the emotional braking system) malfunction, and therefore cause an inability to regulate and control your anxiety. 

In my blog about the various categories of possible causes of stress, I included GMOs from food, chemical toxins, and electromagnetic fields from your phone, electrical wires, and your computer.

The bottom line is that the limbic system, your alarm system from danger, is being triggered. If the ability to regulate this system is interfering with your ability to decide whether the trigger is an actual danger or not–which is what the frontal lobe does–it causes chronic anxiety disorder. 

Hopefully, you now know that anxiety is a symptom, similar to the engine light on your dashboard lighting up to let you know that there is something wrong with your engine. Feeling anxious is signaling that there is danger to your survival. If that danger is not real or you're unable to know if it is real or not or unable to control the feeling, such as generalized anxiety or anxiety related to clinical depression, the anxiety itself is not the problem. The anxiety is a symptom of the actual problem. 

As mentioned in a prior post, in future posts I will be writing about my 5 Prong Approach and Solutions & ResourcesSM to provide help and hope. There is a Way!®

 

Diane Roberts Stoler, Ed.D., is a Neuropsychologist, Board Certified Health Psychologist, Board Certified Sports Psychologist, and Trauma Therapist with over 35 years experience.

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