Making Sense of Medicine: Are you a bundle of nerves?

It’s normal, and common, to be somewhat anxious when joining a group of people you don’t know, or when you have to give a speech, or perhaps when you’re about to tell someone your private feelings.

You may feel anxious about paying your mortgage, finishing your schoolwork on time and countless more such situations.

For these examples, you may feel a bit tongue-tied and nervous or even shaky. Regardless, you plunge ahead and give your speech or introduce yourself, and it’s OK. This anxiety is important, as it marshals all of your energy successfully to focus on a particular task.

When anxiety is a problem

Some of us are more given than others to such run-of-the-mill anxieties and may spend almost an hour a day with such mild anxiety. For the more dedicated worriers among us, however, such worrying becomes a disruptive way of life, demanding five or six hours a day of obsessive anxiety. This is called a generalized anxiety disorder.

For others of us, some kind of trauma may have set up a pattern of anxiety that is triggered by specific sounds or places or other events in one’s external or internal environment. The one that is most commonly described is post-traumatic stress disorder. We hear of this mainly as it has affected military personnel returned from battle, but any serious trauma in any walk of life can result in PTSD.

In addition to these, there are phobias, obsessive-compulsive disorders, panic and more. Medically speaking, there are about eight types of anxiety disorders that affect close to 30 percent of the adult population in the U.S. This makes anxiety disorders the most common form of mental illness in our country. Except for PTSD, women are twice as likely as men to experience an anxiety disorder.

What’s happening in your body

The anxiety response is the result of a complex of neuronal and biochemical processes. They begin deep within your brain and affect every muscle and organ in your body.

It all begins in a tiny part of your brain called the amygdala. The name comes from ancient Greek by way of Latin, and it means almond. This is appropriate, as they are almond-shaped.

The amygdala is a group of neuron nuclei and is the primary place in your brain where you find decision-making; the processing of memories; and, for our purposes, emotional reactions. Anxiety begins here.

You actually have two amygdalae, left and right. The right amygdala is responsible for taking action. This tends to be more active in men than in women. Conversely, the left one is mainly focused on storing traumatic memories and is associated more with thought than action. This one tends to be more active in women and in people with anxiety disorders, regardless of gender.

Once triggered, the amygdala sends distress signals to other structures in your brain with names like medulla oblongata, nucleus ambiguous, hypothalamus and more; don’t try to remember those. It also activates centers in your brain and kidneys that release adrenaline.

The end result of all this is the activation of your fight-or-flight response, which prepares your body for any emergency, real or imagined. Your muscles, lungs, heart and more are prepared for the worst.

Modulating anxiety

There are at least two activities that can help get a hyperactive amygdala under control.

The amygdala doesn’t think, it only reacts. One modulating activity is using the part of your brain that does think, the prefrontal cortex. When behaving irrationally, the prefrontal cortex may be what’s triggering your hyperactive amygdala with dangers that are only imagined.

Here is where psychological counseling and therapy are effective. That is, by consciously working out what memories, fears, beliefs and more may be responsible for over-activating your amygdala, you can persuade your prefrontal cortex to be more responsible in its activation of your amygdala.

A second activity is to slow down fight-or-flight. Doctors may try to do this with various medications like antidepressants and beta blockers. However, a better way is to stimulate your rest-and-digest response.

There are many self-help activities that can help with this. Foremost among these are relaxed deep breathing, humming or singing, and regular meditation.

Anxiety resolved

A few weeks ago, a woman came to me for help in reducing her anxiety attacks.

One troublesome situation is related to her work as a checkout clerk at a grocery store. When able to keep the line of waiting customers very short, she has no problem. However, if things begin to slow down for whatever reason and the line starts to lengthen, she begins to get the symptoms of an anxiety attack that, untreated, becomes disabling. She has a medication that she can take as needed, and this seems to quiet the anxiety temporarily.

As mentioned above, treatments for anxiety include medication, psychotherapy and other mind-body disciplines. For her, however, these did not solve the problem. The anxiety attacks continued to occur.

After just one myokinesthetic, or MYK, treatment, however, she reported being in several situations that formerly would have brought on anxiety, but in which she was able to respond rationally and without anxiety. What appears to have happened is that the MYK treatment stimulated the rest-and-digest response in her body, countering the fight-or-flight response that research has shown to be integral to the experience of anxiety.

What’s to be done?

I don’t mean to imply that my MYK treatments are necessarily the last word in treating anxiety or that only one treatment is needed. In fact, it’s likely that some form of counseling or other psychologically based therapy is important, as well. The psychological work is likely to be more effective, however, if rest-and-digest has been stimulated.

The point is that anxiety disorders are almost always treatable, and your life is likely to be a lot more satisfactory when you are not preoccupied with anxiety.


Bob Keller maintains a holistic pain management practice in Newburyport. His book, “Making Sense of Medicine: Medical Matters Made Simple,” is available locally or online. He can be reached at 978-465-5111 or