For starters, the brain mechanisms and chemicals involved in anxiety are not yet fully understood, but enough evidence exists that tells us a lot is going on within the brain. Anxiety, especially anxiety attacks, is complex, and many brain pathways (called neural circuits) and brain chemicals (called neurotransmitters) are affected.
Let’s begin with the amygdala, a structure within the brain where emotions, including fear, are processed. It makes sense then that this brain region is hyperactive during a burst of anxiety (or an anxiety attack). The amygdala has reciprocal connections to the prefrontal cortex (PFC), the brain region that regulates thought and that is responsible for focus, concentration, and attention.
If the amygdala is overactive, this may alter PFC functioning, which could be why we can’t seem to focus or concentrate when anxiety seizes control over us. Additionally, anxiety involves alterations in the processing of the anterior insula, the area of the brain that gives an emotional context for a specific sensory experience.
It could be that an over-active response to fear in this brain area leads to a prolonged, and inappropriate, response of anxiety, or an anxiety attack. As you can probably already see, just as the brain is complex and somewhat confusing, disorders of the brain, such as anxiety, are equally as complex.
Neuroscientists and psychologists propose that a region of the brain called the pariaqueductal grey region (PAG) is also hyperactive during anxiety. This is the area involved with fear response (defense reaction). When the PAG is stimulated, studies show that it leads to an “explosive fear reaction” that resembles a panic attack; but the hyper activation of the brain does not stop here!
Although several brain regions are described to be hyperactive during an anxiety attack or during some kind of stress, some regions (believe it or not) are hypoactive?they are working a little too slow to be helpful. Some of these underactive brain regions are the cingulate cortex and the medial prefrontal cortex (mPFC).
The cingulate cortex controls and manages uncomfortable emotions, such as anxiety, and is linked to the cognitive prefrontal cortex system and the emotional limbic system. If this area is underactive, then that means that whatever is making a person uncomfortable, nervous, fearful or stressed is not being managed very well. This lack of, or insuffient, ability to regulate or control stressful conditions may contribute to the sudden and severe anxious response of an anxiety attack.
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