The Real Happy Pill Page 5

  So is this solid proof that physical activity lessens stress and anxiety? No. We don’t know for sure if it was the training that made the Finnish men less stressed-out and worried. Maybe it’s a case where individuals who are less worried train more. You must use caution when drawing conclusions if you’re only looking at results from the Finnish and the Chilean studies. However, if you look at them together with all the other research that has been carried out, the picture becomes crystal clear: exercise has a dramatic impact on stress and anxiety throughout life, in both the young and the old.

  STRESS’S DOMINANT PLACE IN THE BRAIN

  It’s easy to think of stress as purely negative, but of course things are not quite that simple; on the contrary, stress is essential to our ability to function. Before learning how to better handle stress and worry—through exercise and other means—you must understand how important stress is and what it does for us.

  To find out how important something is, remove it. What would happen if we simply knocked out the stress response system? This was the question scientists sought to answer when they surgically removed the amygdala from a group of monkeys. They suspected that the surgery would interfere with the animals’ ability to feel fear, so to explore this hypothesis they brought in some company that most people and animals feel very uncomfortable around—snakes.

  Just like humans, monkeys normally have a deeply ingrained fear of snakes. But there was no trace of fear in the monkeys whose amygdalae had been removed—quite the contrary. Instead of keeping out of harm’s way, they were almost too interested in the snakes, playing with them and swinging them around.

  The woman who couldn’t feel fear

  The monkeys didn’t seem to care at all about the risk they were being exposed to, but was it because they could no longer feel fear, or did they misunderstand the entire situation? Had the surgery damaged their brains and made them unable to understand what they were doing? Did they not think the snakes were dangerous? It would have been incontestably difficult to ask monkeys how they perceived the situation; it would have been far simpler to study people without amygdalae, but such individuals are few and far between.

  This being the case, American scientists jumped at the chance to learn more about the amygdala and its stress response when they encountered a forty-four-year-old mother who suffered from Urbach-Wiethe disease, an extremely rare genetic disease. Less than four hundred cases have been reported since it first became known in the 1920s. This condition causes destruction in parts of the brain, including the temporal lobe (where the amygdala is situated), which for some reason is especially vulnerable. In this woman’s case, only her amygdalae—one in each side of her brain—were affected.

  This woman, who was of normal intelligence despite her condition, willingly took part in a series of tests to see if the absence of amygdala affected her sense of fear. The scientists brought her to a pet store to gauge her reaction to snakes, like they had done with the monkeys. They also tested her reaction to spiders. Before this field trip, the woman had asserted that she had always had an aversion to snakes and spiders. Even so, she walked right up to the terrarium, fascinated by a collection of very large snakes. They were lifted out so that she could pet them, and according to the staff she didn’t hesitate for a second to stroke them, even though she had been warned that the snakes could bite. The researchers asked the woman to grade her fear on a ten-point scale, zero representing no fear at all, and ten being most fearful. Playing with large, potentially life-threatening reptiles was rated a two.

  The same thing happened when she was left to pet large, hairy tarantulas. The store’s staff explained that she became almost obsessed with touching the animals without any precaution. She continued to play with them until the staff interrupted and stopped her because she ran the risk of being bitten and the situation wasn’t considered safe anymore. It didn’t seem to bother her in the least that this spider was especially aggressive and dangerous. As a matter of fact, she was almost careless with it in a way that was reminiscent of how the monkeys had played with the snakes.

  It’s very tempting to assume that the reason for her recklessness was her destroyed amygdalae. But before we reach this conclusion, it would be prudent, as in the case of the monkeys, to speculate whether there could have been another cause. Maybe it was only a fear of animals—even if those animals were the kind we tend to feel most anxious around—that had been affected. Perhaps she would feel frightened if confronted by something else? The next step was to have her watch disturbing scenes from horror films such as The Shining, The Ring, and The Blair Witch Project, movies that typically spook most people out. To ensure that the clips were creepy enough, they were first shown to a group of test subjects who were asked to rate their scariness on a scale of one to ten. Most of the clips scored between six and seven.

  But those same film clips failed to arouse any fear in the woman, who gave them a score of zero. Oddly enough, however, she seemed interested in the films and thought they looked exciting. She even asked for the title of one of them so she could rent it and finish watching the movie at home.

  Aside from participating in experiments featuring scary animals and horror films, the woman was followed for several years. The picture that emerged was clear: it appeared that she had become utterly fearless after her amygdalae were destroyed. But no other feelings had been affected—she could be happy, elated, or sad, depending on the circumstances. While showing the film clips, the researchers saw clues that other feelings were intact. The creepy clips were interspersed with excerpts from comedies and dramas to provoke other feelings besides fear. The woman reacted normally when watching these: she laughed at comedic moments and expressed sadness while watching a scene featuring an abandoned child. The absence of working amygdalae had not made her apathetic or emotionally disengaged to the point of not being able to feel anything. It had only taken away her ability to feel fear.

  It’s almost enough to make one jealous! Imagine never having to be afraid or worried, and being able to face most things in life without a care in the world. However, it wasn’t so easy for our test subject. Her inability to feel fright had severe repercussions, because she put herself into dangerous situations several times; she had been robbed and threatened both with a knife and a gun. Normally these types of experiences would lead to anxiety, and most of us would be more careful and avoid areas where we’ve been accosted and robbed at knifepoint. However, she quickly got over those events and kept going without changing her behavior in the slightest. She lived in an economically depressed area plagued by drugs and violence, yet she went out late at night to dangerous places. Despite the unsafe environment, she did not seem to have learned to avoid perilous situations.

  Our deepest fear

  Was she completely immune to fear, then? No, because scientists eventually found something that made her completely freak out, and that was dyspnea—shortness of breath or choking. Inhaling carbon dioxide awakened a terror she was previously unable to feel. If you don’t breathe in enough air, the level of carbon dioxide rises quickly in the body. It is actually the increase of carbon dioxide, and not the lack of oxygen, that the brain swiftly reacts to, since it interprets the inhalation of carbon dioxide as suffocation. This fear is probably more deeply rooted than any other type of dread. If you breathe in carbon dioxide, you will, sooner rather than later, be gripped by total panic. This is exactly what happened to the test subject, who for the first time in her life experienced such all-out terror that she screamed, shook, and gasped for air. Her brain alerted her to a life-threatening situation, and it did so without the amygdalae.

  Later, when asked about her experience, the woman explained that the feeling was not only the most intense she’d ever had, it was also completely new to her. So why did she feel panic at the prospect of suffocation, but not when facing snakes, spiders, and horror movies? One possible explanation is that the amygdala is necessary for us to gauge external dangers, such as a snake or a person
threatening us with a weapon, but not to internal threats. An external occurrence must be interpreted as such: the man in front of me with a knife is dangerous. On the other hand, the feeling of suffocation requires no explanation because that fear is deep-seated within us.

  The amygdala takes charge

  The examples with the monkeys and the woman illustrate the override function of the stress response in the brain. Moreover, they show the amygdala’s role as a warning flag in the face of danger and as an engine of the stress response. The amygdala is extremely powerful and can very quickly switch the heart and body into action mode, leaving no room to think of long-term consequences. The brake pedals available to the brain—the hippocampus and the frontal lobe, for instance—that engage deliberation and forethought don’t stand a chance in a truly dire situation. Quite simply, they are barreled over by the amygdala.

  When we lived in the environment out of which we have evolved—the savanna—it was critical that the amygdala be forceful. It was vitally important to be able make lightning-quick decisions if we were threatened by an animal.

  “Do I attack, or am I defenseless and need to run away from here?” In this type of situation, there’s no time to weigh the pros and cons for too long, or it could be too late. Instead, it’s important that the amygdala take charge and override the rest of the brain to be able to react immediately, either by attacking or scampering away.

  This mechanism isn’t needed as much in our current society, in which we’re seldom faced with life-and-death situations that require quick decisions. Now there’s the risk of the amygdala’s power targeting something that isn’t all that dangerous, to which we overreact emotionally. In the mid-1990s, the American psychologist Daniel Goleman coined the term amygdala hijack. This means an exaggerated emotional reaction, the result of the amygdala putting such strong emotional emphasis on an event that it’s perceived as being a far worse threat than it objectively is. The amygdala hijacks the brain and forces the individual into fight-or-flight mode where he or she no longer reacts rationally.

  It’s not enough for a strong emotional reaction to qualify as amygdala hijacking; it also needs to happen quickly and leave you feeling remorseful afterwards. One of Goleman’s prime examples was when the boxer Mike Tyson bit off Evander Holyfield’s ear during a bout. Tyson acted fast—probably more like a reflex—and he seemed to have met the criteria for exhibiting remorse to the fullest. Aside from the embarrassment, that bite cost him millions of dollars in fines and legal fees. According to Daniel Goleman, this is a typical example of amygdala hijacking.

  INCREASE STRESS TOLERANCE

  When we realize how powerful the brain’s amygdala and stress response are, we also come to understand why we can’t remove stress completely from our lives, since it’s far too deeply ingrained in the brain for that to be possible. We can certainly try to avoid the things that stress us out the most, but striving for a totally stress-free life would mean that you would have to move out into the wild and isolate yourself! Then you’d probably stress out because you’d be all alone!

  Since it’s impossible to eliminate all stress from life, a much better goal is to increase your tolerance to stress. That’s exactly what physical activity does; it won’t erase stress, but it’ll help you handle it better. Regular exercise strengthens the brain’s brake pedals, so it’ll take a lot more for you to enter that fight-or-flight mode. Let’s say that you get reprimanded at work for missing a deadline. If you’re fit, the likelihood of you entering panic mode—with its quickening heart rate, rising blood pressure, and muddled thinking—is lessened. Training increases the chance that you’ll be able to cope with such a situation and not overreact physically or psychologically.

  I also want to say to those of you who think you’re too stressed out to make time for regular training that it is precisely you who are most in need of physical exercise! And here’s a tip for anyone who believes they have too much on their plate to train: not only will you feel better and less stressed out if you make time to exercise, but it will also be time well spent with regards to your job performance. I dare say that if you swap an hour at work for an hour’s training from time to time, you’ll get a lot more done during the rest of the day. At any rate, that’s how it works for me.

  Stress shows up on the scales

  I have one ace left up my sleeve, just in case you’re still not convinced that exercising is a good way to manage stress. What most motivates people to begin running or visiting the gym is not that it will make them healthy, feel good, or handle stress better. It is what they see in the mirror! More than anything, weight loss or developing an athletic body is what prompts most of us to become physically active. And I’ve got some good news here: if you increase your tolerance to stress by training, it will show up on the scales and in the mirror, too.

  If you exchange a working hour, now and then, for an hour’s physical training, you’ll get much more done during the rest of the workday.

  This is because the stress hormone cortisol prevents the body from burning fat. Having high levels of cortisol leads the body to store abdominal fat. Moreover, it increases appetite, especially for calorie-dense foods. If you’re under a lot of stress and walk around with high cortisol levels, you’ll risk adding more pounds around your waist and experiencing major sugar cravings. Handling your stress levels through exercise means that you lower your cortisol levels, which, over the long haul, can decrease your appetite and fat storing, increase fat burning, and show appreciable results on the scales and around your waist!

  STRESS IS TRANSIENT—ANXIETY STICKS AROUND

  You’ve probably experienced anxiety at one time or another—everybody does—but likely without knowing what it was. When patients ask me to explain what anxiety is, I usually say it is an overwhelming feeling of dread, of not having peace of mind, of feeling that something is wrong and that you would like to crawl out of your own skin.

  It’s not always easy to make the distinction between stress and anxiety, but it is commonly said that stress is a reaction to something that happens here and now and that is perceived as a threat. On the other hand, anxiety is worry connected to something that isn’t a threat at present, or to something that has happened, or might possibly happen. When you are berated at work because of a mistake you’ve made, what you feel is stress. Anxiety is the tension you feel one week later, even if you’re not at work and the incident is long past. Stress is transient, while anxiety stays around. Basically, it is the same stress response (i.e., the HPA-axis) causing both states of mind.

  Is anxiety an illness, or does it fulfill a function? If we look at anxiety frankly, from a biological perspective, it is a feeling of fear and dread that follows an experience that we have perceived as a threat where there was none. The intensity of this lingering feeling can vary. Anxiety, just like stress, casts a wide net and can cover everything from being slightly uncomfortable to full-blown panic. Anxiety can come and go, as in the case of a panic attack, or lie low and simmer over time, as with generalized anxiety disorder. Anxiety can be brought on by traumatic memories, as with PTSD (Posttraumatic Stress Disorder), or flare up in social settings (social phobia). Although only a few anxiety disorders are officially recognized, in reality there are as many variations on anxiety as there are people.

  But is anxiety dangerous? Many who have experienced intense anxiety due to panic attacks believe that it is. Some even fear that they are going to die. Many also think that they are alone in their plight. They are all wrong. Even if anxiety is unpleasant, it is neither dangerous nor rare. Your heart will not stop if you are anxious, even if it feels like it might. And the sufferer is not alone; anxiety is both a common and benign reaction that most of us experience to a different degree, and that at times can go completely overboard for some of us.

  Unconscious fear

  We can inquire about what causes anxiety. We know that sufferers have an overactive and easily triggered amygdala that signals danger without any threat
being present; they see potential catastrophes on every street corner without being conscious of it. Individuals were tested by having pictures of angry and neutral faces shown during a time span of just two hundredths of a second. In the best-case scenario, people saw that it was a face but found it impossible to register the expression. Even though the face flashed too quickly for anybody to pick out a facial expression, anxiety-ridden people would react differently to the pictures.

  TRAINING OR RELAXATION?

  As you learn more about the research around how training affects stress, it becomes obvious that everybody, both children and adults, ought to engage in physical exercise in one form or another. It doesn’t mean that you should disregard relaxation, meditation, mindfulness practices, or yoga, which might also be good. However, if you don’t train, you might miss out on perhaps the most effective way to handle stress and anxiety. And if you have to choose between training and, for example, relaxation, training is always the better choice. If everybody just became more physically active—and I’m not talking about running a marathon—it would have mind-boggling consequences on the stress levels people are living with today. Fewer people would need psychiatric help and nearly everybody—whether they suffer from stress or not—would feel much better.

  When scientists examined individuals’ brains with MRI while they looked at the pictures of angry faces, the amygdalae of anxiety sufferers were visibly more easily activated. Moreover, the bigger the anxiety issue, the quicker the amygdalae were fired up by the angry faces, even though the viewer was not conscious of what he or she saw! However, for neutral facial expressions, which cannot be interpreted as a threat, there was no discernable difference between the amygdala’s reaction in healthy people and that of those suffering from anxiety disorder. People suffering from high anxiety have an amygdala that’s always in the starting blocks, ready to go and prepared to signal danger, and in so doing it activates the body’s stress response.