The human brain is a complicated matter. Nowadays, we know a lot about it, but there are still some secrets it holds fast to. For example, we know that people can be neurologically predisposed to developing anxiety-related disorders. Yet, the secret is why some folks voluntarily enter the gray area between mental health and anxiety-related conditions. Is it something in our brain that hideously drags us right into that pitfall? The answer to this question is complex, as it consists of physiological, mental, and social factors. Today, we will look at what prompts people to move into a place just one step away from mental disorders.
To begin with, let’s acknowledge that people neglect the early signs of anxiety-related disorders. A set of extensive population-based surveys shows that up to 33.7% of the global population suffer from at least one anxiety disorder during their lifetime (Bandelow & Michaelis, 2015). When detected at early stages, anxiety-related disorders are highly treatable. Nonetheless, they are still defined as the most common mental illness among adults, which leads us to a preliminary, yet a solid statement that people are negligent about their mental health.
Talking specifically about the United States, generalized anxiety disorder and social anxiety disorder top the charts of unattended mental health conditions. The first affects 6.8 million adults, or 3.1% of the country’s population (ADAA, 2022). Meanwhile, only 43.2% of that 3.1% receive treatment. The latter affects 15 million adults, 7.1% of the country’s population. Out of these 15 million, at least 36% report having lived with its symptoms for more than 10 years before seeking help (ADAA, 2022). Furthermore, 19.3 million Americans live with specific unattended phobias (NIMH, 2022). Finally, nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder.
Those are some striking stats, especially given modern medicine’s unprecedented quality of mental disorders treatment. The problem is that too many people write mental health issues off as something secondary, taking proper care (not always) only about physical health. No need to explain how interconnected our psychological and physical health systems are. Hence, people enter the gray area voluntarily by thwarting their mental health needs and ignoring alarming symptoms.
People are reluctant to address their psychological issues because the very prospect of facing their fears repels them. This is the maladaptive avoidance principle at its very best: making sure that we harm ourselves by refraining from proactive behavior.
People end up in the gray area by starting to accept anxiety as an integral part of their lives. There are certain neurophysiological prerequisites for it as well. A study by Graeff et al. (1993) showcases it clearly that applying benzodiazepine to the amygdala and a periaqueductal gray area in the longitudinal organized neural system “leads to an inhibitory effect.” Meanwhile, when contacting with 5-HT, “benzodiazepine enhances conditioned fear in amygdala while inhibiting unconditioned fear in the periaqueductal gray area” (Graeff et al., 1993). Seems complicated, right? Let’s give a bit of an explanation of what is going on here.
First, benzodiazepine is a depressant – a drug that lowers brain activity. Second, the longitudinal organized neural system is responsible for the integration of behavioral and physiological manifestations of defensive reactions against innate and learned threats. Third, The 5-HT receptors’ (also known as the serotonin receptors) performance can be classified as the key determinant of human neural system stress reactivity (Yohn et al., 2017). As a result of benzodiazepine application, the scholars observed two completely different reactions.
Depressants are actually decreasing anxiety levels when faced with a system that commands our response to innate and learned threats. Meanwhile, when reacting with the organism’s pivotal serotonin (hormone of happiness) transmitter, benzodiazepine urges conditioned fear in the amygdala, also known as the brain’s integrative center for emotions.
An agent that is supposed to suppress anxiety and fear enhances it, which is a proof of the fact that the human neural system is innately predisposed to the development of conditioned mental disorders. The brain’s reaction to being soothed by the agent is something like: do not deprive me of the feeling of fear, as it is crucial to my survival. It is true, to some extent. However, as long as the depressing experiences are treated as normal, the beneficial and even joyful events and actions gradually become dubbed as something to refrain from.
Anxiety does have some positive features. It is our protector: foreseeing a threat incoming from the slightest signals is the basis of human self-preservation instinct; anxiety is our motivator: it is hard to imagine a successful person, who would not worry about their careers prospects, life choices, and future, in general. Yet, there is that thin line between guarding us and destroying our lives that anxiety is bound to cross. Ruined relationships, docked-down self-esteem, and inability to complete simple daily tasks are nothing else but a clear sign that anxiety is slowly taking over us.
No, this is not some kind of a major impairment that we’re talking about. However, inability to plan, lost self-control, dispersed attention or focus, as well as many other ‘maladies’ are quite characteristic of chronic anxiety. And the thing that is so noxious about chronic anxiety is that it instills the over-sensitiveness to threat in humans, making them worry even when it makes no sense at all. Eventually, it can lead to a state in which they find not worrying quite disturbing.
As a result, it can lead to anxiety-related disorders and worsen our overall mental and physical conditions. Such symptoms as insomnia, digestive problems, chronic pains, substance abuse, depression, social isolation, etc. are among the most widespread manifestations of anxiety-related disorders. When looked at cumulatively, they represent quite a solid ground for an eventual worsening of one’s quality of life and even the possibility of a suicide.
The point is, while occasional anxiety, caused by a particular trigger, is good for you, exorbitant anxiety damages your life and impairs daily functioning. Getting rid of anxiety should not be the goal, but not letting it push us into the aforementioned gray area is crucial. Being in the gray area means being in a state of mind where the positive aspect of the anxiety mechanism (keeping you safe and out of realistic danger) is suppressed by its negative effects, such as panic attacks, constant tension, and looped worrying.
Akin to many other mental health conditions, anxiety can be harder to treat if you wait for too long. It seems like an obvious rule of a thumb, right? The more you meander about, the more the condition progresses and translates into a chronic one.
So, how do you learn to understand your mental state and prognose the risks? First of all, get to terms with the fact that mental disorders development is a strongly personalized matter. It is dependent upon a number of factors, which might be either inherited or situationally acquired. For example, the Covid-19 pandemic has brought about a steep upswing in the spread of anxiety-related disorders (WHO, 2022). Every person has its own resistance threshold which defines his or her sensibility to things invoking anxiety.
In general, there are several risk groups that live with an inborn or acquired predisposition for developing an anxiety disorder. Also, there are some factors that may increase the risk of developing one. Let’s have a look at them.
Personal traits can impact one’s predisposition for the development of anxiety-related disorders. For example, neuroticism and extraversion have been dubbed as the primary grounds for anxiety disorder development. A study of 489 university students who were observed for six years showcases that baseline neuroticism predicted first-onset panic disorder, agoraphobia, generalized anxiety disorder, and major depressive disorder (Prince et al., 2020). Furthermore, participants who developed clinical depression, but were in remission by follow-up had a moderate increase in neuroticism.
Believe it or not, but predisposition for anxiety can be transmitted from parents to children. The study by Meier et al. (2019) highlights anxiety and stress-related disorders as complex heritable phenotypes with intriguing genetic correlations with regards to not only psychiatric but also physical and developmental traits.
It seems obvious and does not require additional explanation. Unprocessed stress and traumatic events, like becoming a witness or victim of a crime, domestic violence, death of a loved one, etc., can have a detrimental effect upon our mental health if not addressed on time.
Yes, your sex can impact how inclined you are to developing an anxiety-related disorder. Without further ado, females are more predisposed. A research by Christiansen (2015) showcases a cumulative body of empirical data on sex differences in agorophobia, autism specturm disorders, generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, separation anxiety, social anxiety disorder, and specific phobias.
Table 1. Lifetime prevalence of DSM-IV anxiety disorders in adult males and females
Another obvious fact is that alcohol and drug abuse can exacerbate one’s anxiety and lead to the development of a chronic condition. Yet, don’t be surprised, but a sudden decision to give up on alcohol or drugs can also lead to anxiety, as this is a huge stress for the human organism. So, the one and only right decision here: an occasional glass of wine is just fine; but do not develop any kind of addictions in your life, especially the ones associated with substances.
One element that is crucial to anxiety disorders progression is the so-called “loop of worrying”, which intensifies anxiety manifestations with every lap. Our memory works in a specific manner: every time a specific piece of information comes up, it enhances its presence in our mind, which then twists and transforms our memory and information processing algorithms. With emotions being a natural background for memory intensification, fear- and anxiety-saturated emotions literally become encrusted into the way we think and eventually act.
Figure 1. The anxiety cycle illustrated.
The sooner this pathological mechanism is broken, the easier it gets to prevent anxiety from developing into a full-fledged disorder. The longer one waits, the more they are at risk. Life is a complicated matter and you never know what can become an anxiety-causing factor. Self-management, therapy, and professionally-prescribed medication can change the rules of the game drastically. However, it can all be in vain if the patient refuses to get help early.
The trick that anxiety plays with people is making us think that feeling threatened is normal while coping with this state is the biggest danger to experience. The core of every treatment or prevention process boils down to efficient analysis and diagnosis. Finding the right tool to understand oneself is the first step to prevent you from entering the gray area. Unfortunately, as the stats show, too many people neglect the need for understanding their mental health, lest turning in for professional help, and live with anxiety-related syndromes for years, if not decades.
