Anxiety Disorder and Perceptions of Reality
Anxiety disorders can take on many forms and can have multiple causes often acting together to create the neurological disorder. Among the different types of anxiety disorder are panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder, social phobia, specific phobias, and generalized anxiety disorder (GAD).(1) Life experiences, psychological traits, and genetic factors all play a role in developing anxiety.(2) Different forms of anxiety disorders receive different amounts of influence from each of these different factors. Panic disorder for example, is influenced more by genetic factors than other types.(2) Symptoms often include sudden attacks of terror accompanied by a pounding heart, sweatiness, weakness, faintness, or dizziness.(1) People who suffer from panic attacks are overcome by a strong sense fear that distorts their reality or distances them from it. They also have a fear of their inexplicable symptoms leading them to believe that they are very possibly about to die. This disorder blurs the lines of reality for many who suffer from it and serves as an example of how the human brain is capable of manifesting reality without being under control of the individual.
Common to all forms of anxiety disorders is an increased state of arousal or fear. Generally, arousal or fear is a response of the nervous system to an external stimulus, usually referred to as the stressor in this case. In individuals with anxiety disorder the presence of an external stressor is lacking. A signal is activated internally in the brain to trigger the stress response. In order to understand how and why this seemingly spontaneous signal is generated, it is important to understand the neurological structures in the brain that are taking part in the process. Research involving brain imaging technology and neurochemical techniques has shown that the amygdala and the hippocampus are important role players in generating stress responses.(1)
The amygdala is an almond-shaped structure in the brain that governs emotions and acts as a communication hub for processing and interpreting signals.(1) This structure alert the brain that a threat is present, initiating a fear or anxiety response in the nervous system. Sensory information is processed in the lateral amygdala, which passes information along to the central nucleus of the amygdala. The central nucleus sends output signals to brain systems that regulate physiological and behavioral responses to fear. The hypothalamus, which is among those systems receiving signals, activates the sympathetic nervous system causing the release of stress hormones. The released hormones lead to the release of glucocorticoids. Pathways are then initiated throughout the nervous system causing defensive responses.(2)
The hippocampus is a part of the brain that governs memory and, in particular, encodes threatening events into memories.(1) Victims of traumatic events are sometimes found to have smaller hippocampus because of the stress they undergo. The decrease in size is attributed to the atrophy of dendrites of the neurons in the structure. Research indicates the atrophy is caused by the release of glucocorticoids that is triggered by stress hormones from the sympathetic nervous system. Impairment of this part of the hippocampus may limit the ability of an individual to draw on memory to evaluate the nature of stressors.(2) This is why people with anxiety and panic disorders experience fear without receiving any external input to trigger it.
Anxiety disorders demonstrate the power of the brain to create reality in the mind of an individual. These disorders are viewed as neurological problems in the brain that result in a person having a skewed perception of reality. It draws to mind an important question: Can the brain be trusted to accurately translate the inputs it receives into a reasonable reality? Perhaps there is no definite answer to this question because the brain seems to be in control of reality. However, if we can accept the assumption that what a typical brain, that is one without anxiety disorder, perceives is actually reality then we can attempt to take back control of the brains ability to perceive reality. Usually this is done by using drugs to try to correct the imbalances in neurotransmitters such as "serotonin, norepinephrine, gamma-aminobutyric acid (GABA), corticotrophin-releasing hormone (CRH), and cholecystokinin,"(2) which when perturbed can result in anxiety disorder. Correcting these imbalances is one way for an affected individual to take back his/her sense of reality from the brain. In the end, however, we must admit that our perceptions of reality are ultimately decided unconsciously in the brain and we must accept and trust them in order to continue on with our lives.
(1) "Anxiety Disorders." National Institute of Mental Health. 2006. 8 May 2007. http://www.nimh.nih.gov/publicat/anxiety.cfm.
(2) "Etiology of Anxiety Disorders." Mental Health: A Report of the Surgeon General. 8 May 2007.