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Anxiety is a Symptom - Not a Diagnosis

Every living creature on this planet survives by avoiding threats and gravitating towards rewards. The driving force is staying alive and survival of the species. This is accomplished by the nervous system taking in data from the environment through each body sensor and analyzing it every millisecond.

Every living creature on this planet survives by avoiding threats and gravitating towards rewards. The driving force is staying alive and survival of the species. This is accomplished by the nervous system taking in data from the environment through each body sensor and analyzing it every millisecond. All of the senses count and are in constant competition. The highest concentration of receptors is in the eyes in the form of rods and cones and the lowest is in the skin, which has several different types.

Reality

The first step in this process is for your brain to define reality. There is nothing inherent in any receptor that defines anything. A cat is a cat because your brain has unscrambled visual signals and has determined the nature of this animal. A cat's meow is analyzed from the auditory receptors and the signals travel to a different area of the brain. Your nervous system then has to link these two inputs together to associate this sound as one that emanates from a cat. This complex sequence occurs for every aspect of your reality. Whatever you call "real" is only your individual interpretation of the world. Although there are close similarities, no one sees even one object exactly the same.

Next, all of your senses keep combining input to determine other properties of objects, such as hot, cold, smooth, red, yellow, loud, bright, etc. Other people are a basic part of this identification process. Your infant has to first recognize you as a human before other layers are added.

Identity

At some point, a child recognizes that he or she is separate from others and then realizes that the closeness of the bond with mother/ father hopefully not only represents a haven of safety, but also the link to life itself. Any threat to this connection is unacceptable. Identification of self, relationship to others, social awareness, ideas, concepts and abstract thinking all will progressively follow with age.

Anxiety is a Symptom - Not a Diagnosis

It is only so if I say it's so

The reason why I am presenting the obvious, is to make the point that nothing exists without your brain gathering data, unscrambling it, and determining what is. (1) It is based on your prior programming. Somewhere in the midst of all of this, babies have to learn to survive on their own, which means that one basic function is determining what is and isn't safe. However, that can't happen until some sense of separation and definition of the world has happened. A newborn can't determine that a hot stove is dangerous until it knows what a stove is. He or she can only instinctively pull away from too much heat but can't know enough yet to avoid it in the future.

This is how every creature stays alive, with many species being able to care for themselves much more quickly than humans. The essence of this skill is avoiding danger and gravitating towards rewards. What drives this action? One of the main factors is the state of your body's chemical makeup. If the brain has determined something or someone is a threat, it will compel you to take action to solve the problem.

Compelled

One of the responsibilities of the central nervous system is to maintain the delicate balance of the body's chemistry. There are numerous chemicals to monitor. When there is a threat, hormones will be secreted that increase your chances of survival. Some of the core stress response hormones are adrenaline, noradrenaline, endorphins, histamines and cortisol. I won't list the effects of each of these, but the net result is an increased capacity to flee from danger. Much of this is modulated through the autonomic nervous system, which also has many direct effects such as increased heart rate, rapid breathing, dilation of certain blood vessels and constriction of others.

All of these allow you to leap into action, but what compels you to do so? It is a feeling of dread that we call anxiety. It is so deep and uncomfortable that you have no choice but to take action. Once the threat is gone and the body is back in balance (homeostasis), you can go on with your life. Anxiety describes the cumulative sensation of a threat. It is symptom, not a diagnosis, disease, or disorder. Therefore, it isn't treatable by primarily addressing it as the problem. Once you understand it is only a warning mechanism, you can address the root causes that are unique to you.

Anxiety is a Symptom - Not a Diagnosis

Seeking rewards

Conversely, survival also depends on engaging in behaviors that allow you to flourish and procreate. It is enjoyable to eat, quench your thirst, inhale a breath of fresh air, take a nap, empty a full bowel or bladder, make love and spend time with close friends and family. When you are lying in the sun or holding your newborn baby, your body is full of reward chemicals such as oxytocin (love drug), dopamine (rewards), serotonin (mood elevator) and GABA chemicals (anti-anxiety). Your heart rate is slower and your muscles are loose. What a great chemical bath. It isn't as critical to survival to be in this state, and we aren't urgently compelled to act. We aren't avoiding an imminent threat. Many words encapsulate this scenario and I will choose, "relaxed." Relaxed is a description of this state and also not a diagnosis, disorder or disease.

These shifts in your body's balance occur by the millisecond. Disease does occur when this balance is disrupted by sustained levels of stress hormones. This data has been known for decades. (2)

"The Curse of Consciousness"

The universal problem of being human is what I call, "The Curse of Consciousness." Recent neuroscience research has shown that threats in the form of unpleasant thoughts or concepts are processed in a similar area of the brain as physical threats with the same chemical response. (3) The "curse" is that none of us can escape our thoughts, so we are subjected to an endless stress chemical assault on our body. This translates into more than 30 physical symptoms and many disease states. These include autoimmune disorders and early death. (4, 5) However, the worst symptom is relentless anxiety. In my personal experience and working with thousands of patients in pain, the mental pain, manifested by anxiety, is beyond words, intolerable. It is the reason why the only description I could come with for this state of being was, "The Abyss." It is the essence of human suffering and the additional physical symptoms are the final insult. It is a universal phenomenon, varying only in intensity and styles of coping - some much better than others.

Since this unconscious survival mechanism has been estimated to be a million times more powerful than your conscious brain, it isn't responsive to rational interventions to manage or control it. The solution lies in the fact that this is an unsolvable problem. Without anxiety that is unpleasant enough so as to compel you take action, you wouldn't survive. Neither would you or the human species survive without the drive to seek physiological rewards.

Solution principles

The first step is to understand the nature of anxiety, and it is simply feedback indicating the levels of your stress hormones. View it as the fuel gauge in your car. It simply lets you that you are being threatened, whether it is real or perceived. It doesn't matter. But, you do have to allow yourself to feel it before you can deal with it.

Anxiety is a Symptom - Not a Diagnosis

Second, if anxiety is the measure of your body's survival hormones, then the only way to decrease it is to lower them. This can be accomplished in two ways with each category requiring different tools:

  • Directly through relaxation techniques
  • Indirectly by lowering the reactivity of your brain to dampen the survival response. This is accomplished by stimulating your brain to rewire so the response to a threat results in a lower chemical surge and is of shorter duration. The term for this is, "neuroplasticity." Your brain changes every second with new cells, connections and myelin.

By not wasting energy trying to treat or solve your anxiety, you now have the energy to pursue a new path with a remarkable surge in energy, life forces and creativity.

DOC is a framework

How is this accomplished? Learning tools to calm and rewire your nervous system is the core of the DOC (Direct your Own Care) project. These are approaches have been known for centuries and have been buried under the weight of modern information overload and pace of life. The DOC process is a framework for you to understand the nature of pain, your relevant issues and you can figure out your own version of a solution. The clarity will allow you to connect to your own capacity to heal by developing skills to auto-regulate your body's chemistry from anxiety to relaxed. Consider anxiety as the fuel needed to take quick action and relaxation and is what we want for our baseline and cruising.

Success in learning to adjust your body's chemical makeup is based on awareness and openness to learning so change can occur. It is remarkably simple and consistent. Join me in living your life in a manner that you could not conceive was possible - even better than before you were crushed by pain.

Anxiety is a Symptom - Not a Diagnosis

Is "relaxed" a diagnosis? No!! Is "anxious" a diagnosis? No!!!! To read your body's chemistry gauge, you first have to allow yourself to feel.

References:

  1. Feldman Barrett, Lisa. How Emotions are Made. Houghton Mifflin Harcourt Publishing Company. New York, New York, 2017.
  2. Rahe R, et al. "Social stress and illness onset." J Psychosomatic Research (1964); 8: 35.
  3. Eisenberger N. "The neural bases of social pain: Evidence for shared representations with physical pain." Psychosom Med (2012); 74: 126-135.
  4. Torrance N, et al. Severe chronic pain is associated with increased 10-year mortality: a cohort record linkage study. Eur J Pain (2010);14:380-386.
  5. Song, H, et al. Association of stress-related disorders with subsequent autoimmune disease. JAMA (2018); 319: 2388-2400.
Dr. David Hanscom, MD, Orthopedic Spine Surgeon, Founder, Vertus, Inc.

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Depression is anxiety. It is the constellation of symptoms caused by relentless anxiety. This is critical to understand because anxiety is simply the sensation you feel when your body is full of stress chemicals, such as cortisol, adrenaline and histamines. It is the essence of your body’s neurochemical unconscious survival response, which is approximately a million times stronger than your conscious brain.

“I know better”

So, anxiety is not primarily psychological and not solvable by your rational brain. Have you ever wondered why so many people (maybe all of us) act badly when we know better? How successful are we at keeping our New Year’s resolutions? Why would you treat your loved ones worse than you would treat a stranger? What about the atrocities that are commonly committed at a societal level? This list is endless because you can’t outrun or overpower your mind and need to survive.

I have known for many years that anxiety is the driving force behind depression, and have seen smatterings of it being discussed in the literature and news. I suffered from a major depression for over 15 years with the last eight of them being extreme. In 2002, I was actively suicidal, and am still not quite sure why I didn’t go through with my plan. I got lucky and have been given a second chance. About 18 months later, I pulled out of my downward spiral of anxiety and major depression. Little did I know that they were the same entity.

I eventually was able to live a fuller and richer life than I dreamed was possible. It is also the experience of many of my patients who escaped from the grips of chronic pain in that their quality of life is even better than before they developed chronic pain.

Why is depression just the expression of sustained anxiety?

  • All people with depression have anxiety (although it can be suppressed by anger), but not everyone with anxiety has depression.
  • One of the earliest signs of depression is waking up in the morning and not being able to fall back asleep. This is usually from racing thoughts – connected to anxiety.
  • Then you can’t fall asleep. Again, from disruptive thoughts, but also from your body being full of stress chemicals. You are on high alert, which isn’t conducive to falling asleep.
  • You’re not sleeping – a cardinal symptom of depression.
  • Eventually, you have trouble concentrating, which is a combination of your racing thoughts and not being able to sleep.

You have already defined a minor to moderate depression – and the relentless anxiety continues and becomes increasingly intolerable. It was by far and away the worst part of my ordeal. From a survival perspective, the intention is to create such an unpleasant feeling that you are compelled to take action that to escape the threat. But I couldn’t escape my thoughts and they progressed to vivid, obsessive thought patterns, which is the core of OCD (obsessive compulsive disorder). I was introduced to another realm of suffering I never would have imagined. It is beyond words, and that is why I use the term, “The Abyss.” I watched my patients try to describe how deep their suffering was, and all that kept coming up for me was the word, “dark”, and without any hope of light. The next word was, “despair.”

None

I also experienced the more advanced symptoms of a major depression (anxiety).

  • Loss of appetite and weight loss – adrenaline decreases the blood supply to your GI tract.
  • Lack of energy – being full of these chemicals keeps your body on high alert and it just wears you down. It is similar to attempting to sprint a mile.
  • Multiple diffuse physical symptoms – direct effect of your body’s hormones on the different organ systems. I was experiencing over 17 of them at the worst phase of my ordeal.
  • Social isolation – the one worst part of my journey, besides the anxiety, was loneliness. It was crushing and many self-deprecating thought patterns emerged. This occurred in spite of the fact that I am normally extremely social. It still took me down.
  • Suicidal ideation – and action plan.

You get the point. What we are calling depression is a set of symptoms created by sustained levels of stress chemicals (anxiety).

Anger – stepping it up a notch

Then the story gets worse – a lot worse. One antidote to anxiety is control, and normally when a physical threat is solved, the anxiety drops, and you’ll live another day. However, when you can’t escape (your thoughts for example), your body will secrete more adrenaline, cortisol and histamines in an effort to regain control, and you’ll feel angry (trapped). So, anger is anxiety with a chemical kick and is the same entity. The problem is that anger is truly the last-ditch effort to survive and is destructive. An animal will do whatever it has to do to stay alive. Humans have the same need, but the destructive behavior doesn’t have an endpoint because we have consciousness. Additionally, it is self-destructive.

Sustained anger will drive you deep into the hole, cause more intense physical symptoms, and to me felt like a pile driver was driving my soul right into the center of the earth. Then, since you may be beyond caring, you might neglect your health. Complete disregard for your physical health is akin to a slow suicide. Talk about knowing better and then doing something different, is the classic illustration of the unconscious behavioral patterns winning out over willpower. Why else would you not want to feel physically great and live life to the fullest?

Medicine has missed it

I will get a lot of push back on this article from almost every corner of the medical world. But, they have missed this one – badly. Anxiety and depression are conceptualized, labeled and treated differently. They are not only the same entity, but neither are truly solvable with isolated psychological interventions. Although, psychological treatments are important aspects of care by providing support, wisdom, guidance and symptom control they must be combined with other strategies that teach you how to develop your own individualized way of regulating your body’s chemistry. Learning how to change your hormonal profile to “play”, which includes oxytocin (love drug), dopamine (rewards), GABA chemicals (anti-anxiety), and serotonin (antidepressant) is simple, effective, easily learned and will change your life.

Anxiety and depression are the same entity. The core driver is anxiety, which is not primarily a psychological problem. We can’t get rid of it or we wouldn’t survive. Understanding the nature of any problem will allow you to address the root issue. It is a solvable problem using strategies that stimulate your brain to rewire.

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