How to Treat Cortex Based AnxietyAnxiety can originate primarily from the cortex the thinking part of the brain as opposed to originating in the amygdala (see Amygdala Based Anxiety).
The human cortex can think, imagine and construct scary and anxious thoughts about things, situations and possible scenarios for the past and about the future, everyone can do this but what happens in someone with cortex based anxiety is scary and anxious thoughts constructed in the cortex become more than just the imaginations that everyone can have, in the anxious brain these thoughts become misinterpreted as facts, imaginary thoughts become real experience this is called cognitive fusion. An analogy I make is in schizophrenia hallucinated voices become real or indistinguishable from reality and in cognitive based anxiety scary and anxious thoughts become real experience; if your cortex believes you are in a really scary and dangerous situation it will really the threat to the amygdala which then triggers a state of hyper arousal and emergency throughout our brain and body. The amygdala responds to anxious thoughts from the cortex in the same way it responds to signs of real danger coming from our senses.
For example if the imaginary thoughts that you will die getting onto an aeroplane becomes a real believable felt experience i.e. cognitive fusion than trying to get on an aeroplane will produce and you are fear response appropriate for a real immediate life-threatening step. Furthermore in the anxious brain these thoughts often persist and escalate, and cannot easily be switch off.
Elsewhere I talk about how to increase GABA and serotonin with natural remedies to dampen down overactivity in the anxiety circuits the brain and switch off anxious thinking at least temporarily but here I’m talking about how to go beyond simply rebalancing neurotransmitters and physically change the wiring or circuits in the brain involved in anxiety states.
Rewiring the brain offers an additional way to treat anxiety problems which goes beyond simply adjusting the level of neurotransmitters in the synapses, rewiring the brain provides long-term if not permanent improvements and my experience it’s an essential component of successfully overcoming an anxiety condition
When you are ‘inside’ an anxious state (just as when a person is in a depressed, psychotic or manic state) it feels completely real but we know from neuroscience that “reality” is literally constructed in the brain, the brain doesn’t just give two people a different opinion it can literally construct to alternative realities. Just as the hallucination is real to someone with schizophrenia the feeling of danger is real to someone with anxiety, and painful low hopeless mood state feels real to someone with depression. The wiring and neurotransmitter balance in our brain alters the reality we construct, you’ll be familiar with the possibility that you can alter how you feel by changing your neurotransmitter balance, here were discussing how you can change how you feel and your psychology by changing the wiring in your brain with brain training techniques.
Left Hemisphere Anxiety versus Right Hemisphere AnxietyIt’s a bit simplistic but the left and right sides of the cortex do different things.
The left cortex is involved in generating thoughts, logic and language so if your anxiety is characterised by ruminating on details and developing logical analytical explanations as to why your anxious thoughts are correct left cortex. I’ve noticed for people with left cortex based anxiety the Internet can be turned into a major source of anxiety, do spend a lot of time online researching and digging into scary possibilities like heavy-metal toxins or Wi-Fi/mobile phone radiation can damage your brain and then when you find a treatment for say heavy metal detoxification do you then research how the treatment can go wrong and convince yourself that in your case it’s going to go wrong as opposed to using the Internet to work out a way that you can treat your problem. If you find yourself burrowing down into the Internet in a way that is adding to your anxiety and increasing your belief that you can never get well, if you are using the Internet in a way that ends up inhibiting or paralysing you so that you don’t try new therapies that have the possibility of getting you well so-called anxious apprehension that’s the anxiety disorder warping your perception of reality.
I notice for example when I treat people with depression they’re just in terrible pain and want the pain to end so they’ll go straight ahead and follow my prescription unless the depression is causing a significant lack of energy and motivation but that’s a different problem, when I treat people with left cortex based anxiety on the other hand they’ll spend hours online looking for side-effects and negative stories about each remedy I’ve prescribed; Don’t get me wrong I think you should do a safety check before you swallow anything but with left cortex based anxiety you end up filtering out all the positive safety information and only and disproportionately home in on the what if it all goes wrong information. I’ve also seen patients that have had their DNA tested and every time I recommend a remedy they’ll say oh no I can’t take that because I have this or that gene mutation so in the end we they don’t try any treatment at all and FYI at this point in time with the possible exception of the MTHFR gene mutation you can’t work out from a DNA test exactly how your body will react to specific medicines or supplements, I actually recommend not having a lot of laboratory tests if you have left cortex based anxiety but instead start taking some simple steps to diminish the problem such as mindfulness meditation, better sleep better exercise better diet and some simple GABA/serotonin boosting remedies.
Remember any part of the brain you use a lot grows and develops more connections so eventually after years of repeatedly worrying and ruminating your brain will have grown well developed circuits that create anxious apprehension and to overcome this you going to have to grow alternative circuits with brain training until eventually the anxiety circuits are not what dominates your thinking; I know if you have anxiety it probably doesn’t mean much when I say don’t worry but don’t worry because it is possible to rewire the anxious brain so that anxiety producing neurological circuits do not dominate your mind.
The brain is complex and interestingly the left cortex also gives us the capacity to construct optimistic thinking i.e. how things could work out for the best, as part of the meditation brain training treatment you should practice short intense bursts of constructing optimistic thinking by artificially for example believing that all the treatment today I’m going to work out for the best and trusting that logically the brain can he let’s self by you doing this thing and then the next thing and then the next thing; simply by repeatedly artificially constructing optimistic thinking you hardwire the circuits into your brain. Conversely the right cortex is involved in identifying what could go wrong, threats and risks. When the right cortex is overactive our brain changes our perception of reality, it exaggerates real risks and may even invent and construct completely hypothetical risky scenarios in a way that serves no useful purpose; when unopposed by a strong left hemisphere hypothetical danger and threats are perceived as real.
The right cortex is involved in creating images, it sees the whole picture intuitively rather than the small details analytically, it recognises patterns in things, faces and emotions, visual images daydreams etc. I used to suffer from anxiety/paranoia whenever I left a group situation my mind would go into overdrive spotting patterns of connections between people and facial expressions people made not just to me but also to each other about me and then construct elaborate paranoid anxious feelings so for example if I said something and two people looked at each other at the same time I would remember this analyse their facial expressions my anxiety would construct paranoid interpretations. When I learned how to rewire my brain with a combination of meditation brain training exercises augmented with natural remedies to speed up the process of change I completely switch this off a few years ago which feels great :-) the fact that I could do this after having lived with it for over thirty years showed that the neuroplastic ability of the brain genuinely enables us to treat mental health problems even though the thinking pattern from neurological circuits had been deeply entrenched in my brain for decades.
I believe free-floating anxiety, that kind of strong sense of arousal and pervasive fear not associated to any particular worries is most likely to originate in the right hemisphere, as may hypervigilance and a constant general sense of danger not attached to any specific phobias.
Fear in the Cortex Signals the AmygdalaWhether it’s your left or your right cortex that’s ‘deciding’ that you are under threat the threat signal is sent to the amygdala which in turn initiates a state of emergency/stress response throughout our body and brain, so even cortex based anxiety has to go through the amygdala and it's interesting to note people with a damaged amygdala from a stroke for example cannot produce normal fear and stress responses.
How to Treat Cortex Based AnxietyIf you want to permanently overcome cortex based anxiety you need to change the way you think i.e. the psychology constructed in your cortex and hardwire the change permanently into your brain, to achieve this goal you can:-
- Undergo an intensive course of mindfulness-based meditation brain training exercises to change the wiring and size of parts of the cortex that dominate how you construct your reality. See my Meditation Brain Training for Mental Health Programs
- Use psychotherapy techniques to dig into and reveal how you construct or trigger anxious psychological states in your mind, what of the key steps that initiate anxiety and restructuring your psychological processes.
You can enhance the rate of change stimulated by both of the above by naturally increasing your neuroplasticity at the same time, we can increase our neuroplasticity by:-
- Boosting BDNF levels with natural remedies see my Neuroplasticity/BDNF Protocol.
- Boosting neurogenesis in the hippocampus with natural remedies (the hippocampus learns and stores new memories).
- Eating an anti-inflammatory diet.
- Engaging in regular HIIT exercises (short bursts of very high-intensity exercise).
- Getting enough sleep especially REM dreaming sleep (we consolidate things we just learned in the day into new long-term memories during REM sleep.
Re-Wiring Cortex Based Anxiety with Meditation Brain TrainingThe brain changes its shape and grows new connections in response to brain training exercises and the new exciting treatment for anxiety spectrum disorders is to deliberately grow and strengthen the parts of the brain that construct calm balanced thinking and put the brakes on the parts of the brain that construct anxious thinking, we can even diminishes the size and thin out the connections in the regions of the brain that produce anxiety and had previously been dominating the way our brain constructs reality; in so doing your brain will automatically construct an alternative reality with less or no anxiety.
Numerous studies have shown that with sufficient practice of mindfulness-based meditation and stress reduction techniques we can increase the size and density of connections in the cortex, you may worry -especially because you have anxiety- that doing mindfulness could strengthen the wrong side or circuits of the cortex we don’t want to strengthen just as much the bits we do want to strengthen so you either don’t get better or you could actually make things worse,
but that is just not what happens, mindfulness-based meditation improves anxiety.
Mindfulness brain training balances and strengthens the weaker systems in the brain, furthermore the way I teach mindfulness meditation integrates short bursts of artificially imagining optimistic thinking, it has been shown artificially thinking optimistically activates the circuits in the left hemisphere that generate optimistic thinking and as I’ve said before any part of the brain that we exercise starts to grow new connections so this exercise favourably stimulates the growth and re-wiring part of the brain we want to build up to switch off cortex based anxiety.
When properly individually applied the right technique of mindfulness-based meditation brain training is an amazing safe and effective way to reduce anxiety; it’s easy to dismiss mindfulness is not real medicine but it can be. I’ve never seen anybody completely cure themselves of anxiety your depression using meditation on its own however everyone I’ve seen that completed an intensive course of meditation has received significant benefits anecdotally reporting a reduction in the symptoms of between 25 to 50% and these benefits are more or less permanent. I believe everyone with an anxiety condition should do this treatment as part of their overall cure; studies have shown it takes as little as 30 hours spread over three months to achieve therapeutic changes in brain structure that can be seen in brain scans although I recommend going beyond the minimum 30 hours between 45 to 50 spread over five months.
Maximising the Re-Wiring by Increasing NeuroplasticityAlthough you can achieve significant results in just a few months of meditation studies have shown more significant changes in the brain is a very long term meditators and I believe that we can use natural remedies to boost neuroplasticity and achieve greater changes in our brain in a shorter period of time than if possible through meditation alone.
Neuroplasticity is our brains ability to grow new connections, there are specific supplements, diets and physical exercises that increase neuroplasticity. Meditation brain training and psychotherapy stimulate our neurones (brain cells) to grow new connections and re-wire the brain, if we use supplements and diets that increase the brains ability to grow new connections at the same time as we engage in meditation and psychotherapy we speed up and maximise the changes. It’s just the same thing as when you exercise a muscle in the gym you stimulate the muscles to grow now bodybuilders know that if they combine the exercises with diet and supplements that increase the rate muscles can grow it increases the results.
Re-Wiring Cortex Based Anxiety with Cognitive RestructuringAnother tool that you should use to overcome cortex based anxiety is to change your psychological thinking processes; in psychotherapy we can explore the memories and past associations our mind accesses that trigger anxiety states and we can bring these memories and connections up to the surface and remodel them. We can dig into how we construct our anxious thinking and at what precise point in our thinking we start to trigger an anxious thought process then we can explore alternate ways of thinking that do not trigger anxious responses. When we do this we not only create new ways of thinking -called cognitive restructuring- but this actually stimulates the brain to create new neural pathways, in other words it begins to rewire the brain. Eventually by repeatedly trying out this new way of thinking we repeatedly re-activating these new neural pathways which then become hardwired into our brain and the new psychology becomes automatically ingrained; good therapy really works.
Cortex Based Anxiety Treatment PlanTo overcome cognitive based anxiety I recommend beginning with a prescription of natural remedies to balance your neurotransmitters together other measures to improve the health of your brain, should include sufficient exercise, getting sufficient quality sleep, eliminating any and every source of inflammation with the anti-inflammation diet and microbiome diets, you should rule out heavy metal toxicity, leaky gut syndrome/SIBO, food allergies; this should already improve your neuroplasticity so that you can begin to rewire your anxious brain.
Next engage in several months of mindfulness-based meditation enhanced by a prescription of natural remedies to increase your neuroplasticity/boost BDNF. Begin and continue with the focused-attention mindfulness meditation technique until you have made significant reductions in your condition at which point you can begin to explore briefly engaging in open monitoring mindfulness meditation, allowing anxious thoughts if they are there to briefly enter your mind whilst remaining in a neutral observer position and immediately discontinuing the open monitoring technique and returning to the focused attention technique if the anxiety begins to hijack your mind. I repeatedly performing this exercise to strengthen the very systems and circuits in your brain that will enable you in the future to be able to switch off anxiety thinking permanently.
Also as soon as you can find a therapist and start restructuring your anxious thinking processes, finding a therapist can be a challenge, I believe having a good rapport with a therapist is often more important than the specific method they are trained in. You need to find someone you trust but that’s not the same thing as feeling comfortable or completely safe with, a good therapist may challenge you in ways that do not feel completely comfortable and this challenge may provoke your anxiety and therefore you don’t feel completely safe however bringing to the surface uncomfortable and challenging feelings and memories enables us to remodel them before refiling them in an altered way so look for good rapport and trust, your anxiety may make you feel uneasy but that could be a good sign that your with a therapist that can help you to bring up and work with your uncomfortable thinking processes, I hope that makes sense.
Cortex based anxiety is curable, with enough work you can change the way you think and rewire the circuits in your cortex to the point at which your cortex stops sending signals to your amygdala that you’re under threat.
I know what it’s like when you’re suffering from a mental health problem it feels totally real and that it cannot be changed but that’s the illness talking, it’s just the imbalance your neurotransmitters and the wiring in your brain distorting your perception; when you change these things the distortion stops and the condition disappears. Changing the brain is a gradual process and successfully switching off anxiety using these techniques will require somewhere between 6 to 18 months of work.
Anxiety is treatable, good luck :-)
For a tailor made individual prescription using these treatment methods I offer face to face consultations in London and long distance appointments via Skype
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