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So anxiety is rooted in biology. It’s evolutionarily
based in that we have our own fight or flight responses. Some of it is very old and triggered
from the deep part of our brain that is the oldest part, the fight or flight response.
And then some of it comes from the cortex which evolved much later and that’s worry.
And that might be 21st century anxiety because there’s a lot we can find to worry about
these days. Are we going to make enough money? Are we going to get the right job? Are we
going to provide for our families? Are we going to do the right thing? What could go
wrong in the world? So many things can trigger anxiety just by walking through everyday life.
But the good news is our systems are also set up to handle it. The beauty of anxiety
and the system that we have of anxiety that’s all throughout our nervous system is that
it evolved to protect us. So there’s two components to it. The oldest being the amygdala
which is deep in the brain in the reptilian part of our brain signals whether we should
fight something, flee something or freeze. When it goes awry is when it’s perceiving
immediate danger that really isn’t there. Somebody’s heart starts to race and they
think oh my goodness, is something wrong with me? That’s panic and that can send somebody
into a panic attack which is the clinical manifestation of the fight or flight response.
The other thing with anxiety is again as we evolved and became thinking human beings and
started building communities and cities and civilizations is our brain evolved and there’s
the cortex. It’s within the cortex that we think. It’s within that system that we
worry. And so we can worry ourselves into states of anxiety where we are fraught in
not knowing what to do and we actually get stuck with anxiety and so we’re tense and
irritable and upset. So what makes the difference between everyday anxiety which we all experience
– anxiety is perfectly normal. In any form it’s perfectly normal. Having your heart
racing because somebody is walking behind you and you don’t know who it is is kind
of normal. But if you let that happen to you when you’re sitting alone at home and you
start having panic then that gets out of control. And worry about what to do in the future is
normal for all of us. But if we can’t move our minds off of that and onto what do I need
to take care of here and let me enjoy my family while we’re doing this thing and activity
and I’ll problem solve that later then that becomes a problem and that might become an
anxiety issue. What was great from the 1990s all the way through to now is it sort of was
the age of anxiety in terms of mental health treatment development. The 1990s opened up
lots of treatment funded here in the United States by the National Institutes of Mental
Health. And then also in other countries did similar things where cognitive behavioral
therapy became the most tested and developed treatment and found to be the most effective
psychological or talk therapy for managing anxiety. And managing anxiety of all kinds.
Obsessive compulsive disorder, panic disorder, generalized anxiety disorder and so forth.
Social phobia, the number one anxiety disorder in kids and adults. Cognitive behavioral therapy
is great for that. So we put a lot of work into developing these treatments and perfecting
them. And then also there are great medications actually that were developed through that
time. The combination of the two treatments works best for many people who are debilitated
by anxiety. But these treatments are excellent and they
are available but not widespread. So this is where again technology comes in because
technology has allowed us to put some of the skills training and some of the aspects of
cognitive behavior therapy into apps, into online programs and such that then can reach
hard to reach individuals and people who don’t have access to services. There’s some very
exciting work being done today throughout the country and around the world in terms
of anxiety research looking at in different ways what aspects of the brain are working
with the amygdala and the cortex in terms of turning anxiety on when it doesn’t need
to, keeping it going. What are the triggers for anxiety on all different levels from genetic
all the way through to what’s in the environment. And then helping to sharpen our treatments
to direct themselves to those mechanisms and tamp down those mechanisms so that can help
a person probably earlier in the cycle of anxiety, earlier in life in such and to manage.
So neuroscience is coming on with all sorts of ways of looking at what are some new technologies
including different types of computer apps and stuff that target anxiety processes. And
then there are also ways of disseminating treatments and reaching people that we are
working with. So I think the big exciting part of what we’re seeing over the next
ten to 20 years is going to be much more dissemination of more targeted and I think more effective
treatments for people that are going to be coming on board and going to be disseminated
through many different means. Not just through your local therapist like me but also through
many different types of technologies that are going to be made available.

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