Understanding Anxiety: What Our Bodies Are Telling Us
Clay Acrobat, Tlatilco, Middle Preclassic, Olmec Influence, 22cm, 1200-600 BC National Museum of Anthropology, Mexico City / Public Domain
Anxiety! For some, it takes the form of trembling hands and a leaping heart. For others, it’s a cold stone in the belly. Some of us freeze when ambushed by fear. Others drip with sweat.
Whatever form anxiety takes—looking over your shoulder for the stranger with a gun or waiting for the other shoe to drop—you are not alone. We are a species wired for anxiety. Our brains are designed for prediction. To survive, our ancestors needed the perceptual capacity to scan their environment for threats and to imagine how to escape from present and future life-threatening events. If understood as our species’ protective mechanism, anxiety is purposeful and necessary, and a life-saving inheritance from our forebearers. But dysregulated anxiety can be debilitating. Our modern experience of anxiety is different. Talk to classmates, family or neighbors, and you will discover large swaths of the population who feel anxious much of the time.
According to the American Psychiatric Association’s 2024 annual mental health poll, anxiety among adults in the U.S. has increased.
“In 2024, 43% of adults say they feel more anxious than they did the previous year, up from 37% in 2023 and 32% in 2022. Adults are particularly anxious about current events (70%)—especially the economy (77%), the 2024 U.S. election (73%), and gun violence (69%). When asked about a list of lifestyle factors potentially impacting mental health, adults most commonly say stress (53%) and sleep (40%) have the biggest impact on their mental health. Younger adults (18-34 years old) are more likely than older adults (50+) to say social connection has the biggest impact on their mental health. Despite the increasing anxiety, most adults have not sought professional mental health support. In 2024, just one in four (24%) adults say they talked with a mental health care professional in the past year. Notably, younger adults (18-34) are more than twice as likely as older adults (50+) to have done so.”[1]
The good news is that research in psychiatry, psychology, neuroscience, and genetics has led to a greater understanding of the roots of anxiety. Like most human qualities, anxiety is a complex result of nature (biology) and nurture (conditioning). In recent decades, greater knowledge of brain function as well as of the role of inherited factors and the impact of stress and trauma has led to new intervention techniques like mindfulness-based stress reduction,[2] (becoming aware of triggering thoughts or experiences and not identifying with them) and cognitive behavior therapy, (questioning negative thoughts and catastrophizing worries and reframing them). Compassionate self-talk, journaling, and polyvagal exercises that calm the parasympathetic nervous system are other methods that also play a role and show positive outcomes for people with anxiety.[3]
These techniques are based on the premise that what we think, our anxious thoughts, affect how we feel. When we have an uncomfortable thought, distress arises from that thought, which we feel in our bodies. For example, we worry we will humiliate ourselves when giving a public talk—our stomach gets queasy. The fear provokes the sensation. In a top-down approach to anxiety, the mind directs the body.
More attention is now being given to the converse: how the body affects the mind. In a recent conversation with Scott Anderson, Ph.D. a researcher and kinesiologist at the University of Wisconsin-Madison Department of Orthopedics and Rehabilitation, I was startled to learn that people with General Joint Hypermobility (GJH), or joint laxity, which affects 10-25 percent of the adult population, have 8 to 16 times the incidence of anxiety not necessarily linked to psychological factors.[4]
Joint hypermobility and Hypermobility Spectrum Disorders (HSD) refer to an array of connective tissue disorders characterized by joint instability and pain. Hypermobile people may also experience fatigue and other physical ailments, including irritable bowel syndrome, chronic headaches, acid reflux disease, and light-headedness.
In a study of patients with joint hypermobility, anxiety was found in 70% of patients in comparison with a 20% incidence in the age- and gender-matched control group. In the follow-up reverse case-control study, joint hypermobility was found at 17 times the incidence in patients diagnosed with anxiety as compared with age- and gender-matched controls without an anxiety diagnosis. This correlation between affective state and heritable hyper-mobility conditions has recently been labeled the “neurocognitive phenotype.”[5]
In a recent study, researchers at the University of Sussex used fMRI scans to find that the predisposition to anxiety in people with Hypermobility Syndrome (HMS) reflected a dynamic interaction between neural centers processing threat (amygdala) and representing bodily state (insular cortex), which suggests that drugs that regulate amygdala reactivity may have a therapeutic benefit.[6]
Although the top-down mind-influencing body approach to anxiety has furthered our knowledge of anxiety and its treatments, there is still much to be learned about the connection between physiology and anxiety. Anxiety is also associated with higher inflammation in the body. Inflammation can cause pain, fatigue, poor sleep. Could these physical conditions be the cause of anxiety and not the other way around? More research is needed to uncover the deep mysteries of our human selves.
[1] American Psychiatric Association, “American Adults Express Increasing Anxiousness in Annual Poll; Stress and Sleep are Key Factors Impacting Mental Health,” May 1, 2024.
[2] Khan-Niazi, A, Khan-Niazi, S., “Mindfulness-based stress reduction: a non-pharmacological approach for chronic illnesses,” North American Journal of Medical Sciences, Jan 3, 2011.
[3] Mongrain, M., Keltner, D., Kirby, J., “Expanding the Science of Compassion,” Frontiers in Psychology, Sep 13, 2021
[4] Campayo, J. G., “Association between joint hypermobility syndrome and panic disorder: a case-control study,” Psychosomatics, Jan-Feb 2010.
[5] Atwell, K., et al., “Diagnosis and Management of Hypermobility Spectrum Disorders in Primary Care,” Journal of the American Board of Family Medicine, July, 2021.
[6] Kampoureli, C. N., “Neural processes linking joint hypermobility and anxiety: Key roles for the amygdala and insular cortex,” MedRxiv, October 10, 2024.
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