Understanding the brain circuitry of anxiety, stress and anxiety (2023)

Understanding the brain circuitry of anxiety, stress and anxiety (1)

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Anxiety disorders (such associal anxiety) ystressdisorders (such asexpected) are among the most common mental health diagnoses, with a lifetime prevalence of nearly 30%. New technologies such as fMRI, which allow us to scan the brain in real time, have greatly increased our knowledge of the brain circuitry that underlies anxiety and anxiety.temer. Experts now consider anxiety disorders and PTSD to be "whole brain" disorders that involve the complex interaction of neurons in different areas of the brain. More specifically, anxiety and stress disorders appear to involve hyperactivation of brain areas that help us detect and respond to threats, along with reduced activation of brain areas that help us modulate our reactivity to fear and stress. These brain areas and circuits will be described in more detail below.

two paths of fear

neuroscientistJoseph LeDoux's research with rodents has helped us understand the brain circuitry of fear. LeDoux suggested that there was a "low path" and a "high path" to fear. The “lower road” involved activating the amygdala, a structure in the midbrain that serves to detect a threat to our survival and trigger a biobehavioral response that would facilitate fight or flight. This response involves faster breathing, rapid heartbeat, sweating, and other physiological reactions that we subjectively experience as fear. This “emergency” fear reaction is too quick to maximize our chances of survival. LeDoux also identified a "highway" in which information travels to the prefrontal cortex (the CEO orexecutive functioningcenter of the brain) first where it is processed before being relayed to the amygdala. This path was slower, allowing time for a more complete analysis of the situation. In this way, the prefrontal cortex could "rule" an overactive amygdala, resulting in a more modulated and differentiated fear response to various levels of threat.

In people with anxiety or stress disorders (PTSD), the amygdala is hypersensitive to threats, while the prefrontal cortex is underactive or lacks enough neural connections with the amygdala to calm things down. The result is a more intense and/or prolonged fear response.

(Video) Neurobiology of Anxiety, Worrying, and Fear

fear versus worry

More recently, brain researchers have discovered that fear and anxiety/worry may have different neural circuits. Fear can be thought of as a response to immediate and present danger, while anxiety/worry implies a response to uncertain and possibly negative future events. Although fear arousal comes from the amygdala, it appears that anxiety is associated with a part of the brain known as the bed nucleus of stria terminalis (BNST). The BNST is a structure in the basal forebrain with extensive connectivity to many other brain regions involved in bodily functions, threat response,memory,adjunctand information processing. The BNST is more active than the amygdala under conditions of uncertainty where something bad might happen (for example, waiting for the result of a medical test or a job interview), while the amygdala is more active in the face of a present threat.

Other areas of the brain involved in fear, stress and anxiety

The medial prefrontal cortex

Understanding the brain circuitry of anxiety, stress and anxiety (2)

Source: Tumisu/Pixabay

The medial prefrontal cortex (MPFC) is a part of the prefrontal cortex involved in processing information about ourselves and other people. Studies of PTSD patients have found less overall MPFC activation in this group compared to healthy controls. However, people with PTSD have more MPFC activation than controls in response to fear faces. Similar effects are found in people with social anxiety: less arousal from threats and more arousal from social tasks. The low activation in response to the threat can be considered as a deficit in theemotional regulationwhile high arousal may be an attempt to compensate for excessive fear by responding in lower brain regions, although more research is needed to clarify this.

(Video) Neuroscience of Anxiety

Other studies have looked at the degree of connectivity between the MPFC and the amygdala in people with anxiety and stress disorders compared to healthy controls. These studies found less connectivity between the amygdala and the MPFC in people with PTSD and social anxiety disorder. This suggests that the MPFC is less able to regulateanxiousrespond under these conditions.

The island

The insula is a small area of ​​cortex located deep in the lateral sulcus of the brain and is not visible from the surface. It has multiple functions, including high-level thinking, emotional response, andsensory processing. In people with social anxiety disorder or PTSD, fMRI studies have shown that the insula is overactive in response to threats. In social anxiety disorder, bothmedicineypsychotherapyDecreased it on activation. Thus, the insula appears to be an area that generates fear and threat responses and a potentially promising focus in the search for new ways to decrease fear.

The anterior cingulate cortex

The anterior cingulate cortex (ACC) is located between the neocortex and the emotional areas of the brain (amygdala, hippocampus). Its functions are complex, but seem to include tracking the results of socially motivated situations and interactions.

Different parts of the ACC seem to have different functions when it comes to fear and anxiety. The dorsal part of the ACC (dACC) appears to be involved in amplifying our threat response and is hyperactivated in people with panic disorder, phobias, and PTSD.cognitive behaviorThe therapy has been found to decrease dACC activation in people with social anxiety, perhaps helping to change the way we perceive ourselves and others in social situations (although this is speculative).


(Video) Your Brain on Stress and Anxiety
  • What is Anxiety?
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The rostral part of the ACC (rACC), on the other hand, appears to be involved in fear regulation and threat response. Reduced activation in the rACC in response to threat (ie, less regulation of the fear response) has been demonstrated in people with social anxiety disorder, PTSD, and generalized anxiety disorder.

the hippocampus

The hippocampus, which is our verbal memory center, communicates directly with the amygdala and the prefrontal cortex. Thus, the hippocampus can help us calm fear by producing memories that serve to calm us down or increase our awareness.trustto deal with the situation. For example, we might remember that the last time we had a panic attack we didn't die and feel better after a while, or we might remember that we survived the attack.traumaand they are no longer trapped in a life-threatening situation. On the other hand, the hippocampus can increase our anxiety or worry by reminding us of other negative memories when we are faced with similar situations. For example, when we are about to talk to a new person at a party, we may recall being rejected or excluded from a previous meeting.

Essential reading on anxiety

3 tips to keep your catastrophic thoughts under control

(Video) Anxiety Pathophysiology

11 Signs You're An Anxious Avoidant

In studies of people with anxiety disorders and PTSD, the hippocampus is smaller in volume and density compared to healthy controls. The hippocampus is also more activated in response to threats in people with PTSD, phobias and social anxiety disorder compared to healthy controls.


New research using functional MRI to scan the brain in real time has shown that anxiety and stress disorders appear to be "whole brain" conditions, rather than just one or two areas of the brain. The brain areas involved in generating fear and threat responses are the amygdala, insula, and dorsal anterior cingulate. Regions involved in modulating and altering the fear and threat response include the medial prefrontal cortex, anterior rostral cingulate, and hippocampus. The new understanding of the brain circuitry that underlies fear should inspire new ways to treat anxiety and stress disorders, or at least help us understand which treatments work and why.


What brain circuitry is involved in anxiety? ›

Key components of fear circuitry including the amygdala (and its subnuclei), nucleus accumbens (including bed nucleus of stria terminalis BNST), hippocampus, ventromedial hypothalamus, periaqueductal gray, a number of brain stem nuclei, thalamic nuclei, insular cortex, and some prefrontal regions (mainly infralimbic ...

What are the 2 pathways to anxiety? ›

Each of these components contribute to the experience of fear, anxiety, and stress. However, there are two primary pathways to anxiety that create a chain-like reaction thus triggering an emotional and physiological response. The two pathways occur via the amygdala and the pre-frontal cortex.

How does the brain deal with anxiety and stress? ›

Anxiety happens when a part of the brain, the amygdala, senses trouble. When it senses threat, real or imagined, it surges the body with hormones (including cortisol, the stress hormone) and adrenaline to make the body strong, fast and powerful.

What chemical deficiency causes anxiety? ›

Serotonin Serotonin may be the most well-known neurotransmitter. Low levels of serotonin are linked to both anxiety and depression. Like most neurotransmitters, low or unbalanced serotonin levels can occur genetically/naturally, and can also be created by your emotions.

How does anxiety rewire your brain? ›

Therapy is one way to rewire the brain. It helps you build new neural pathways that are healthy and help control anxiety symptoms. Mindfulness is another way to rewire the anxious brain. Mindfulness helps retrain the brain through mindfulness meditation, which will effectively help with anxiety.

What part of the brain does anxiety damage? ›

Summary: Pathological anxiety and chronic stress lead to structural degeneration and impaired functioning of the hippocampus and the PFC, which may account for the increased risk of developing neuropsychiatric disorders, including depression and dementia.

What system controls anxiety? ›

Your sympathetic nervous system is a network of nerves that helps your body activate its “fight-or-flight” response. This system's activity increases when you're stressed, in danger or physically active.

What is the major neurotransmitter for anxiety? ›

The role of the inhibitory neurotransmitter GABA has long been regarded as central to the regulation of anxiety and this neurotransmitter system is the target of benzodiazepines and related drugs used to treat anxiety disorders.

What are the 4 components of anxiety? ›

Abstract. Over the past decade, a number of well-controlled studies have supported the validity of a cognitive model of generalized anxiety disorder (GAD) that has four main components: intolerance of uncertainty, positive beliefs about worry, negative problem orientation, and cognitive avoidance.

How do I reset my brain from anxiety? ›

Your Brain Fog May Be an Anxiety Symptom — Here's How to Deal with It
  1. Find the source.
  2. Prioritize sleep.
  3. Make time to relax.
  4. Meditate.
  5. Feed yourself.
  6. Move your body.
  7. Take a break.
  8. Make a plan.
Mar 27, 2020

Is anxiety a chemical imbalance in the brain? ›

But researchers don't know exactly what causes anxiety disorders. They suspect a combination of factors plays a role: Chemical imbalance: Severe or long-lasting stress can change the chemical balance that controls your mood. Experiencing a lot of stress over a long period can lead to an anxiety disorder.

What triggers anxiety? ›

A big event or a buildup of smaller stressful life situations may trigger excessive anxiety — for example, a death in the family, work stress or ongoing worry about finances. Personality. People with certain personality types are more prone to anxiety disorders than others are.

What vitamin is associated with anxiety? ›

Vitamin B9 (folic acid) and B12 (cobalamin)

Folic acid has many uses in the body, and B9 deficiency has been linked to higher levels of anxiety and depression. When taken in conjunction with B12, these B super-vitamins help metabolize serotonin, which is important for mood regulation.

How do you fix a chemical imbalance from anxiety? ›

Therapy may involve different treatments such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), or family-focused therapy. Medications used to treat chemical imbalances include antidepressants, antipsychotics, and mood stabilizers.

Is GABA high or low in anxiety? ›

GABA is the primary neurotransmitter responsible for providing calming effects. Research has found that people who experience anxiety disorders and major depression often have lower levels of the chemical.

How do you find the root of anxiety? ›

How to explore the root of your anxiety
  1. Keeping a kind mindset. ...
  2. Getting acquainted with your anxiety. ...
  3. Listing your fears. ...
  4. Diving into the fear rabbit hole. ...
  5. Pinpointing a pattern. ...
  6. Exploring your home life. ...
  7. Honing in on your habits. ...
  8. Getting a checkup.

How long does the nervous system take to recover from anxiety? ›

A nervous breakdown can last from a few hours to a few weeks. If your breakdown has been going on for a while, and you need some relief, the following ten tips are for you.

How do I train my brain to stop overthinking? ›

Here are six ways to stop overthinking everything:
  1. Notice When You're Stuck in Your Head. Overthinking can become such a habit that you don't even recognize when you're doing it. ...
  2. Keep the Focus on Problem-Solving. ...
  3. Challenge Your Thoughts. ...
  4. Schedule Time for Reflection. ...
  5. Learn Mindfulness Skills. ...
  6. Change the Channel.

Is brain damage from anxiety reversible? ›

The sooner you start managing your stress effectively, the easier it will be to keep unexpected stress from causing damage in the future. Luckily, the plasticity of the brain allows it to mold, change, and rebuild damaged areas as you practice new behaviors.

How do you calm your amygdala? ›

Keep your amygdala as healthy as possible by doing the following:
  1. Practicing stress-reduction techniques such as meditation, deep breathing, and exercising.
  2. Work through symptoms of PTSD, severe anxiety, or panic with a trained professional.
Sep 1, 2022

How do I get my body out of fight or flight mode? ›

Deep breathing, relaxation strategies, physical activity, and social support can all help if you are feeling the effects of a fight-or-flight response.

Can GABA worsen anxiety? ›

Too much GABA can cause an increase in anxiety, a shortness of breath, numbness around the mouth and tingling in the extremities. When you start taking GABA you might experience drowsiness or lightheadedness (so don't take it before driving), and in some individuals, skin hives or a rash may appear.

Who should not take GABA? ›

For this reason, it's best to play it safe and not use GABA if you are pregnant or breastfeeding. Interactions. Not enough is known about how GABA may interact with drugs, foods, or other herbs and supplements, but use with caution if taking with blood pressure medications.

What are the symptoms of low GABA? ›

The symptoms for an individual with GABA-T deficiency can include: psychomotor retardation (a slowing down of thought and activity), low muscle tone, hyperactive responses, lethargy, seizures, and EEG abnormalities.

What is the 5 5 5 method for anxiety? ›

First, you may want to start with a simple deep breathing exercise called the 5-5-5 method. To do this, you breathe in for 5 seconds, hold your breath for 5 seconds, and then breathe out for 5 seconds. You can continue this process until your thoughts slow down or you notice some relief.

What is the ABC model for anxiety? ›

The Alarm, Belief, Coping (ABC) theory of anxiety describes how the neural circuits associated with anxiety interact with each other and domains of the anxiety symptoms, both temporally and spatially. The latest advancements in neuroimaging techniques offer the ability to assess these circuits in vivo.

What are the five steps to calm anxiety? ›

Once you find your breath, go through the following steps to help ground yourself:
  1. 5: Acknowledge FIVE things you see around you. ...
  2. 4: Acknowledge FOUR things you can touch around you. ...
  3. 3: Acknowledge THREE things you hear. ...
  4. 2: Acknowledge TWO things you can smell. ...
  5. 1: Acknowledge ONE thing you can taste.
Apr 10, 2018

What is the mindless habits that cause anxiety? ›

Neglecting yourself and not taking care of your personal needs can be an anxiety trigger. Whether you're not showering regularly, skipping meals, staying up too late or not going to the doctor, it's important to evaluate these behaviors and work to take better care of yourself.

What foods reduce panic attacks? ›

Carbohydrates are thought to increase the amount of serotonin in your brain, which has a calming effect. Eat foods rich in complex carbohydrates, such as whole grains — for example, oatmeal, quinoa, whole-grain breads and whole-grain cereals.

Is anxiety all in the mind? ›

Anxiety is not “all in our heads”, it's very much in our bodies too and that's important to acknowledge and treat, as her second doctor did. Anxiety and panic attacks can cause severe, very real physical symptoms, including heart problems, chest and stomach pain, headaches, dizziness and numb tingly limbs.

What is the new medication for anxiety 2022? ›

MM-120. The FDA has approved a phase 2b study of an optimized form of LSD for the treatment of anxiety. The drug, called MM-120, is being developed by MindMed and is intended to treat generalized anxiety disorders and other mental conditions. MindMed is expected to begin clinical trials in 2022.

Can anxiety go away without medication? ›

The even better news: Many people respond well to anxiety treatment without medication. They find that their condition can often be managed entirely, or at least in part, with lifestyle changes and holistic therapies.

Is there a blood test for anxiety? ›

To diagnose an anxiety disorder, a doctor performs a physical exam, asks about your symptoms, and recommends a blood test, which helps the doctor determine if another condition, such as hypothyroidism, may be causing your symptoms. The doctor may also ask about any medications you are taking.

What part of the nervous system controls anxiety? ›

Your sympathetic nervous system is a network of nerves that helps your body activate its “fight-or-flight” response. This system's activity increases when you're stressed, in danger or physically active.

What structures in your brain are involved in the circuitry of fear? ›

Many of their studies begin with the amygdala, an almond-shaped structure that is considered the hub for fear processing in the brain. While the amygdala was once thought to be devoted exclusively to processing fear, researchers are now broadening their understanding of its role.

What are three major neurotransmitters associated with anxiety? ›

The other major neurotransmitter systems most strongly associated with anxiety are norepinephrine, serotonin, and γ-aminobutyric acid (GABA), particularly the GABA subsystem associated with the benzodiazepine receptor.

How do I reset my nervous system for anxiety? ›

Work on repairing your nervous system naturally by using deep breathing techniques. Box breathing, diaphragmatic breathing, and alternate nostril breathing are all awesome ways to invite calm during a state of panic. You can also try meditation or yoga paired with deep breathing, even if you only have 5 or 10 minutes.

What vitamins calm the nervous system? ›

B-complex, vitamin E, vitamin C, GABA, and 5-HTP are 5 vitamins commonly used to help with anxiety and stress.

How do you desensitize your nervous system from anxiety? ›

Breathing deeply, with a slow and steady inhalation to exhalation ratio, signals our parasympathetic nervous system to calm the body down. Long, deep breaths can also manage our stress responses to help decrease anxiety, fear, racing thoughts, a rapid heartbeat and shallow chest breathing.

How do you reset your amygdala? ›

You can do this by slowing down, taking deep breaths, and refocusing your thoughts. These steps allow your brain's frontal lobes to take over for the irrational amygdala. When this happens, you have control over your responses, and you won't be left feeling regret or embarrassment at your behavior.

What part of the brain plays the biggest role in fear and anxiety? ›

The amygdala is responsible for the expression of fear and aggression as well as species-specific defensive behavior, and it plays a role in the formation and retrieval of emotional and fear-related memories.

What is the fear loop of anxiety? ›

The anxiety loop: anxious about being anxious

But when misdirected, it is so powerful that it can create mental scenarios that cause us to worry excessively. This activates our fight or flight response at a physical level, which in turn signals to the mind that there must be an imminent threat.


1. Neuroscience of anxiety (April 2017)
2. Science Documentary: Mental Disorders, Brain Trauma, Stress and Anxiety, a Documentary on the Brain
3. How Depression Affects The Brain - Yale Medicine Explains
(Yale Medicine)
4. Neuroscience of Anxiety
(The Dyslexia Foundation)
5. Anna Beyeler - Studying Brain Circuits Of Anxiety
6. Tools for Managing Stress & Anxiety | Huberman Lab Podcast #10
(Andrew Huberman)


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