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  • We live in a culture that doesn't take mental health issues seriously.

  • There's a lot of stigma.

  • Some people tell you to just suck it up, or get it together, or to stop worrying, or that it's all in your head.

  • But I'm here to tell you that anxiety disorders, they're as real as diabetes.

  • Hi again.

  • It's Dr. Jen, and I've noticed something with my patients.

  • They often describe to me some classic symptoms of an anxiety disorder.

  • Constant worry, trouble sleeping, tense muscles and struggle with concentrating.

  • But they aren't getting treatment.

  • There's a lot of issues with mental-health care in this country.

  • Some people don't have insurance that would cover it.

  • Some have been dismissed or minimized in the past, and don't think seeking help will do any good.

  • Some worry about the stigma and whether it could affect future jobs or relationships.

  • But severe anxiety isn't a moral or personal failing.

  • It's a health problem, just like strep throat or diabetes.

  • It needs to be treated with the same kind of seriousness.

  • Before we can talk about anxiety disorders, let's talk about anxiety itself.

  • Anxiety is the very real and normal emotion we feel in a stressful situation.

  • It's related to fear.

  • But while fear is a response to an immediate threat that quickly subsides, anxiety is a response to more uncertain threats that tends to last much longer.

  • It's all part of the threat detection system, which all animals have to some degree, to help protect us from predators.

  • Anxiety starts in the brain's amygdala, a pair of almond-sized nerve bundles that alert other areas of the brain to be ready for defensive action.

  • Next, the hypothalamus relays the signal, setting off what we call the stress response in our body.

  • Our muscles tense, our breathing and heart rate increase and our blood pressure rises.

  • Areas in the brain stem kick in and put you in a state of high alertness.

  • This is the fight-or-flight response.

  • There are ways the fight-or-flight response is kept somewhat in check,

  • with an area of higher-level thinking called the ventromedial prefrontal cortex.

  • It works like this.

  • If a person sees something they think is dangerous, like a tiger, that sends a signal to the amygdala, saying "it's time to run."

  • The ventromedial prefrontal cortex can say to the amygdala, "Hey, look. The tiger's in a cage.

  • You know what a cage is? They can't escape from a cage.

  • It's OK to calm down."

  • It's a feedback loop that can help keep the response in check.

  • The hippocampus is also involved.

  • It provides context, saying things like, "Hey, we've seen tigers in cages before.

  • We're in a zoo. You are extra safe."

  • With anxiety, these threat-detection systems and mechanisms that reduce or inhibit them are functioning incorrectly

  • and cause us to worry about the future and our safety in it.

  • But for many people, it goes into overdrive.

  • They experience persistent pervasive anxiety that disrupts work, school and relationships and leads them to avoid situations that may trigger symptoms.

  • Anxiety disorders are not at all uncommon.

  • Based on data from the World Mental Health Survey, researchers estimate that about 16 percent of individuals

  • currently have or have had an anxiety disorder.

  • These include social anxiety disorder, panic disorder, agoraphobia and phobias.

  • Studies have shown that people with anxiety disorders don't just have a different way of reacting to stress.

  • There may be actual differences in how their brain is working.

  • One model describes possible mix-ups in the connections between the amygdala and other parts of the brain.

  • The pathways that signal anxiety become stronger.

  • And the more anxiety you have, the stronger the pathways become, and it becomes a vicious cycle.

  • The good news is there's treatment for anxiety, and that you don't have to suffer.

  • Remember, this isn't about weakness.

  • It's about changing brain patterns, and research shows that our brains have the ability to reorganize and form new connections all throughout our lives.

  • A good first step is to do the basics.

  • Eat a balanced diet, exercise regularly and get plenty of sleep, as your mind is part of your body.

  • It might also help to try meditation.

  • Instead of our heart rate rising and our body tensing, with mindfulness and breathing, we can slow down the fight-or-flight response and improve how we feel in the moment.

  • Cognitive behavioral therapy, a form of talk therapy, can also be fantastic.

  • In it, you learn to identify upsetting thoughts and determine whether they're realistic.

  • Over time, cognitive behavioral therapy can rebuild those neural pathways that tamp down the anxiety response.

  • Medication can also give relief, in both the short-term and the long-term.

  • In the short-term, anti-anxiety drugs can down-regulate the threat-detection mechanisms that are going into overdrive.

  • Studies have shown that both long-term medications and cognitive behavioral therapy can reduce that overreactivity of the amygdala we see an anxiety disorders.

  • High blood pressure and diabetes, they can be treated or managed over time.

  • And the same is true for an anxiety disorder too.

We live in a culture that doesn't take mental health issues seriously.

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