Anxiety is in your body, not your mind | Hacker News Reader

Anxiety is in your body, not your mind

elemental.medium.com

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I noticed as young adult that I didn’t really worry or consciously stress, but my body had somewhat predictable reactions to situations that I would realize, in hindsight, were highly stressful. Those physical reactions sucked, and as they got worse over time, it really concerned me.

At some point I was encouraged to go to CBT, which I did, but honestly it made things worse. I became hyper aware of how anxious I was at any moment, and the more I noticed the more it worried me.

Years later I tried mindfulness meditation and found that it helped. But also, I finally hit a kind of turning point where I just realized that there was nothing I could really do about anxiety or the physical symptoms that came along with it. I decided to mostly try to quit noticing and thinking about it. And that really helped.

I still feel stress and anxiety symptoms sometimes. They still suck. My conscious mind is still the last to recognize what’s going on. But, overall, I feel I can handle a lot more stress now than I could ten years ago without it ruining my quality of life, and more importantly I can recognize the stress, not worry too much about it so I can get through it, and then rest and recuperate (as soon as possible) and recover much quicker than when I was younger.

I’ve concluded that the best advice is to learn not to worry about things. Unfortunately that’s easier said than done, and I’m not sure I have any advice on how to learn to do that :/

Reminded me of a passage from Sapiens on Buddah.

"...Gautama Buddah found that there was a way to exit this vicious circle.

If, when the mind experiences something pleasant or unpleasant, it simply understand things as they are, then there is no suffering.

If you experience sadness without craving that the sadness go away, you continue to feel sadness but you do not suffer from it. There can actually be richness in the sadness.

If you experience joy without craving that the joy linger and intensify, you continue to feel joy without losing your peace of mind.”

Sapiens is an apt book to quote for this.

There is also a chapter on brain chemicals:

"Some air-conditioning systems are set at twenty-five degrees Celsius. Others are set at twenty degrees. Human happiness conditioning systems also differ from person to person. On a scale from one to ten, some people are born with a cheerful biochemical system that allows their mood to swing between levels six and ten, stabilising with time at eight. Such a person is quite happy even if she lives in an alienating big city, loses all her money in a stock-exchange crash and is diagnosed with diabetes. Other people are cursed with a gloomy biochemistry that swings between three and seven and stabilises at five. Such an unhappy person remains depressed even if she enjoys the support of a tight-knit community, wins millions in the lottery and is as healthy as an Olympic athlete. Indeed, even if our gloomy friend wins $50,000,000 in the morning, discovers the cure for both AIDS and cancer by noon, makes peace between Israelis and Palestinians that afternoon, and then in the evening reunites with her long-lost child who disappeared years ago – she would still be incapable of experiencing anything beyond level seven happiness. Her brain is simply not built for exhilaration, come what may." https://erenow.net/common/sapiensbriefhistory/102.php

Is this the link to the actual book text, or a summary? Thanks.

I wonder if that is why we like music. We can experience emotions without worrying that they are permanent or need to be resolved.

If there's something sacred to me it's music (or harmony). It's weird because it's not as foundational as smell or vision but it revives my soul like nothing else. That's the closest substitute to drug I know of.

I have no idea why our emotions are so tangled with it and how comes it can untie knots in our minds like this.

> it revives my soul like nothing else.

Beautifully said.

I have numerous sayings about music, for example I used to do 20 mile runs every Saturday and Sunday and 10 miles every weekday. No David goggins but people always ask question, I tend to tell them I don’t run, I listen to music and the miles run themselves.

And I used to tell people that the music allows me to feel every single cell in my body and the music makes them happy. And truthfully I think there is something to that down to the quantum level, where the music causes your atoms to vibrate putting them in higher states of energy.

I don't subscribe to quantum / soul connection but I guess the abstract relationships between notes and rhythm tickles the brain very very deep.

I rely on music for emotional regulation. Not only does it help push me towards moods/states i want, like focus, energy, calm, etc - but it helps me manage moods i don't want. If i'm feeling sad, embracing the sadness with music can be enriching in a unique way. Almost like "having a good cry", but far easier to achieve, and with application for almost all moods and circumstances.

Music really is the center of my life, even though i don't play it. .. though i do dabble, and am currently learning Piano, so /shrug.

I dabbled and everybody should dabble, smoothly just for the thrill of hearing notes in time.

I wish I had a piano, weighted keys are so sweet. Another fun thing is large congas.. the depth of the sound is surprising.

> The inexpressible depth of all music, by virtue of which it floats past us as a paradise quite familiar and yet eternally remote, and is so easy to understand and yet so inexplicable, is due to the fact that it reproduces all the emotions of our innermost being, but entirely without reality and remote from its pain.

Schopenhauer, the father of philosophical pessimism, would agree with you: he thought of music as one of the few pure respites from the suffering of the world.

That’s exactly why the Pythagoreans were obsessed with music!

An arcane text which I highly recommend for those curious is The Manual of Harmonics by Nichomacus the Pythagorean. It’s a series of ancient lectures which dives into why the Pythagoreans were obsessed with how numerical the musical scales are.

Did pythagoreans have notions of chromatic scales ? I worry that without it you're losing a huge emotional space. I'll look your book at once.

He speaks profusely about tetrachords. I believe his best examination of the chromatic scale is in chapter 12.

I have a version translated and commentated upon by Flora R. Levin which provides exquisite anthropological background of how the ancient Greeks thought of music and provides context for what amounts to as lectures given by Nichomachus.

You said that perfectly. From beginning to end, it's amazingly spot on.

This touched a chord. For me it's a combination of both music and dance.

It's amazing to feel emotions I'd normally not want to express in everyday life and just let them flow out. Rage, jealousy, lust. The music is such a great trigger to tap into these primal feelings, and then expressing them through movement just feels incredible. It feels real and amazingly cathartic, but the transience of the experience leaves no consequences.

I guess that's why there's the saying dance like nobody's watching. Because for many people, that expression of feeling strips us down and leaves our feelings exposed and vulnerable .

This is along the lines of how I've come to think of music; music is a temporary emotional stimulant.

This resonates with me. A mistake I often made when I was younger was to try my hardest to make the anxiety go away. I'd employ all sorts of tricks to make it happen, but they never worked. If anything, I'd feel even more anxious.

At some point I got tired of this and just decided to allow myself to be anxious. To let the feeling completely envelope me, and basically say to myself "yes, I'm anxious, and I'm going to give the presentation anyway". Something about letting it happen takes its power away.

In the context of the article, perhaps this is a way of "closing the loop" on the initial anxiety response, because you're essentially choosing to fight the external object instead of looking for some other way out.

I’m too ignorant to know the origins of some of these ideas but this reminds me of a segment from a podcast with Joscha Bach. I’ve posted it here before, apologies for that, but i just like the way he describes it.

https://youtu.be/8mixT5_U0hk

This is profound and exactly what Jiddu Krishnamurti often talks about. When you do put a word to that emotion i.e., sad, angry, happy etc., you no longer suffer it. What's left is just the joy of life.

Great quote, thank you for sharing.

I had a friend who rather enjoyed being sad. He would purposely watch sad movies just to experience the tear jerker moments.

He was otherwise a generally happy person.

> I just realized that there was nothing I could really do about anxiety or the physical symptoms that came along with it. I decided to mostly try to quit noticing and thinking about it. And that really helped.

I think this is mission accomplished from your mindfulness practice, you realized that you're not really doing anything and that anxiety just appears, you accepted it and it felt better.

I had work related anxiety for awhile, and then one day I realized I could co-op that energy to go faster, by body and mind eventually decided they didn't like that mind hack and the anxiety subsided.

There are some problems with that type of approach - there are some things that won't vanish, if you stop thinking about them.

There is a big difference between having anxiety about something and the thing itself. Your anxiety can go away without the thing you are worrying about going away or not. So it doesn't matter whether or not something goes away, you can still lessen your anxiety about it.

There are major differences between attempting to forcefully stop thinking about something, and accepting that you're thinking about something and then able to move on to something else.

In the first case, you're working against your brain, and getting it to behave is more likely to require some kind of violence and cause some sort of damage.

The other way, where you accept and then can move on, is more like moving with your brain.

Instead of trying to stop the river, you redirect it.

One can either become the anxiety (you're wrapped up in it), or be conscious of it's presence as an observer (more like a third party observer).

Personally, I prefer the latter.

It won't vanish.

Acceptance just makes it hurt much less.

I have an extremely similar arc with regard to stress and anxiety. I've found exercise helped, but purely because it made my body better able to manage the physical symptoms. In talking things out with my therapist I eventually came to the conclusion that ignoring problems can actually be a very effective solution, despite what everyone tells you.

"Meditation helps with just about anything. Therapy helps you with figuring out why the hell you don't meditate"

I've realized a lot of the same things. My understanding now is that it is the physical feelings themselves that are the stress. Managing stress is about learning to identify it and then learning how to best take care of it (which you can only do when you are first aware of the stress and the toll it is having on you.)

> I’ve concluded that the best advice is to learn not to worry about things

If you can do something about it, go do it. No need to worry, act.

If you can’t ... well it’s out of your hands anyway, why worry about it.

Recent mentions of mindfulness have made it obsolete as it is something that akkktually does not work and it should not be advised as something that works(for everyone).

Well, the reason here is that I tried mindfulness(because I was probably extremelly stressed out from what was going on around me at that time) and it was not working and here is why(from REAL expert): https://www.psychologytoday.com/us/blog/do-the-right-thing/2...

Even though, some of the things mentioned in THIS article(by Emma Pattee) are written with right words, it should be mentioned, that Emma Pattee has not presented them as a medical expert on anxiety, but as a writer, so anything that is written in article should be taken as a (wishful) literature - not medical help.

It is best advice to not to worry about things - and the main thing here is that for everyone there is different path on how to achieve that... though, it is quite impossible task for really stressed out human, where even normal social reactions can be interpreted as hostile, that will add more cycles to stress and postpone getting out of worries.

Mindfulness has been removed from its traditional context, and some fundamental concepts and practices have been abandoned along the way. This has severely weakened most western mindfulness practices.

https://www.accesstoinsight.org/lib/authors/thanissaro/mindf...

Mindfulness based interventions outperform most of the mental health interventions we have for anxiety / stress-- across a variety of relatively high quality trials.

Nothing works for everyone.

I think mindfulness here is meant as a synonym for a particular type of meditation. This article is broadly correct from my perspective—we should approach meditation with some caution, because it is not a well-defined self-therapy modality. It's quite possible, with the wrong practice instruction, to end up hurting yourself, or just getting nowhere.

Meditation—and even just mindfulness meditation—is a domain of practice as broad as "exercise."

If you are interested in engaging with this type of practice, I recommend working with a qualified teacher in a spiritual tradition. These practitioners will have extensive training (at least decades) and will be drawing from a few thousand years of careful study of the effects of meditation (as found in Buddhist and Yogic/Hindu documents and oral traditions).

For working on emotional issues without dedicating years to practice, therapeutic modalities developed in the West are faster, more reliable, and safer.

I started to get stressed out when my sister got cancer. I had headaches, back pain, panic attacks, developed agoraphobia and so on - all the spectrum of mental issues. I tried to approach all of them with weeding them out one by one(and did not look on all of that as a whole picture), so I tried medications, that were meant to cure my insomnia, then headaches(some of them made it even worse), got brain scanned etc. and could not understand the reason and why nothing worked. I just could not calm down, because thoughts that were occupying my mind in background could not just go pooh and vanish. More or less ALL of those symptoms(in most severe states) now are gone and I am now almost back to normal ~1 year later after my sister died. Because now I can afford not to think about her state - now I am able to achieve mindfulness about that situation, that now has gone, and I can occupy my mind with other thoughts, but it has become possible only because now it is too late to worry.

So, it is perfectly correct, that author of this article is talking about mindfulness in regards with imaginary threats and that is very useless for me, as that type of threats actually does not make me stressed out, but inability to save close relative from death I can't perceive as imaginary threat, but it is (pardon my french) sh!t advice to suggest mindfulness in extreme cases(that require most help on anxieties), for example - for someone who would be freaking out over someone close who has died in car accident. The first step would be getting away from that place and not sing kumbaya on that spot.

Knowing that humans have evolved as most violent primates(with everyday aggression amongst themselves), I don't think that meditation is that good, compared to inability to release frustration and anger - from my experience I got a break after I had to deal with situations that required violent solution, so I realized, that for me it had better therapeutical effect and more properly wired to my brains, than "coping" with stress and staying alive and healthy by inability to do anything and trying to meditate.

They're not talking about anxiety that makes sense here. You being scared of your sister dying makes sense. They're talking about irrational anxiety, like having a panic attack, because your stomach feels slightly funny, or because you slept weird, etc. Those irrational anxieties are often times hard to pinpoint to an actual cause. Like your sitting at home on a sunday and suddenly have a panic attack, without any immediate cause or threat.

It applies to both. Being scared of one's sister dying has a definite cause you can pinpoint to, but that still doesn't explain the racing heart, or stomach sickness, or anything else. There's no "tiger in the bushes" reason why your body needs to dump a whole bunch of adrenaline in you right now.

Learning that you can calm your body down separately from wanting to think about the actual issue at hand is a good lesson.

> I recommend working with a qualified teacher in a spiritual tradition. These practitioners will have extensive training (at least decades) and will be drawing from a few thousand years of careful study of the effects of meditation (as found in Buddhist and Yogic/Hindu documents and oral traditions).

How many teachers actually have this, and how can one know that the one you’ve chosen is one of them?

I loved loopz's answer, but it's also important to grapple with the fact that you can never truly know whether a teacher is good. The path is always a risk. It's best to learn as much as you can and assess for yourself as you go.

In any event, the common wisdom is "you'll know." Or to put it plainly, do you like the person and feel like they have something to teach you?

I like the term "spiritual friend," because it's easy to understand the dynamic by analogy. How do you know one of your friends is truly your friend?

As for how many there are: I don't know. I live in the Bay Area, where the concentration of practitioners is perhaps highest in the US, and I'm aware of maybe a handful of teachers I would consider consider studying with. I'm aware of many more I would not.

I like the term "dangerous friend": https://www.shambhala.com/dangerous-friend-466.html

You will notice you have lots to learn and experience that gives you something. No teacher is forever, except life itself perhaps.

It has more to do with the "student".

You're hired!

You may find it productive to speak with your therapist about EMDR approach. It has shown to work with trauma, ptsd, anxiety.

Same story here, and when the physical symptoms get bad enough to induce fear (am I having a heart attack, is this constant pain in my stomach a bigger medical issue, etc.) you just also accept it because you can’t change it. “It’s probably not a heart attack, but if it is... oh well, worrying about it won’t help”

Last year my heart's AV nerves progressively stopped working, causing my ventricles to slow and decouple from my sinus node. Before figuring that out, I was getting panic attacks from relatively benign technical disagreements with coworkers. It was very much a visceral fight-or-flight response. A few days before I ended up in the hospital, I tried playing a level of Tomb Raider and 5 minutes in I had a notable feeling of dread from it, like I was going to vomit and lose consciousness. Good times!

Can you elaborate on your hearts AV nerves? I don't really get it, but I sometimes wonder if my vagus nerve is damaged and your situation has some familiarity to me.

Sure. There was inflammation on my heart around those nerves, causing them to cease working. There are three nerves there, that propagate the impulse from your atriums to your ventricles in a controlled manner. When those nerves don't work, some of the impulse still indirectly makes it to the ventricles through the muscle tissue, but it's significantly delayed. So the ventricles beat, but at a significantly slower rate. It seemed to go 2:1 then 3:1, and even 4:1 at times.

I had to get a pacemaker to solve the immediate issue of my heart not beating normally. With the inflammation taken care of a few months later, my nerves eventually started working again and my heart beats normally enough. They aren't 100%, but they're probably good enough that the pacemaker isn't necessary anymore.

It works even for physical pain. The way I see it, wanting the pain (or the anxiety) to go a away creates tension, which adds to the existing issue. You then want the tension and original pain to go away, so add on more tension… and it gets worse and worse. Not only does tension itself lead to pain in the long run, but if you tense around a painful place, you also immediately make it more painful.

By accepting the original issue, you are left with it only, and not all the added tension, which is much more bearable.

Microdose mushrooms. Seems silly but you can break your thought patterns by disconnecting your brain from well trodden paths.

I think Michael Pollan is onto something

This makes me curious, can you elaborate a bit please? How exactly would it work on anxiety? Does taking stuff produce a temporary relief or does it change the structure of your brain for a longer period? There is definitely things we still don't know about this, and it seems promising.

It's an active area of research, plenty of anecdotal evidence has been posted on the net.

Psychedelics can open up your senses to new experiences and methods of thinking. Over time this MAY help with troublesome thought patterns, which is prevalent in the depression/anxiety cycle.

There are therapies involving this if you dig around, or if you're brave you can experiment on yourself. Don't dive in too deep to start off :)

That's why you need to do yoga. Relaxing the body is so important and Meditation, without yoga, can be harmful. Simple, long holding, hatha yoga, beginning with deep part by part body relaxation and pranayama prepares you for meditation and allows you to handle the energies that can be released during mediation.

So much stress is held in the body. Western productization of more eastern traditional practices unfortunately often seems to divide them up into small consumable pieces and deliver them stripped of an awareness of both their larger context, their interactions and the importance of how you need to do some together. It also seems to teach people advanced techniques as if they were nothing, which can be extremely dangerous.

I meant to make this comment on that story about a woman who had committed suicide after a mediation retreat. Yoga is required if you're going to do mediation. Unfortunately, much of the yoga practiced in the west is nothing more than sort of an aerobic mindset, like pilates or calisthenics. Even when teachers stick to traditional sequences and focus on breath, they seem to miss the point of how important relaxation and only going to your limit is.

I was lucky that i had a fantastic teacher from India when i started yoga in Sydney 20 years ago. The difference an excellent teacher makes is amazing.

I watch videos on Gaia and see teachers doing advanced locks and hand positions, combined with meditative practices... These things can be extremely dangerous because you're unlocking and accessing all sorts of energies you're not used to. Doing advanced stuff before you're ready, or doing any stuff without a solid grounding in hatha yoga to allow your body to handle it, is toxic and unhealthy. In the productization of the yoga and meditation industry in the west people have forgot to focus on the basics, and have forgotten the advanced knowledge that allows you to do advanced techniques safely. Practices have been divided up, stripped of awareness of how to do them safely, and delivered in little consumable pieces. It's fucking dangerous, but everyone's out there practicing yoga and meditation like it's calisthenics or pilates or a warm up for rugby, and even the teachers who aren't mostly don't have the awareness or knowledge of the energies they're accessing to do it safely, or to do it with the most benefit.

This probably came across as saying yoga will cure your anxiety. I'm not saying that, just that if you do mediation, you also need yoga. But doing yoga well will probably make your anxiety better... Maybe an actual psych therapist can help unravel any beliefs and stories you have that you're reacting to but aren't actually true, or maybe if your fear has a rational basis (ie, you are actually in danger or at risk in some way, and the things you fear keep happening and you keep getting hurt) then you can adopt some practical strategies to create better boundaries for yourself so you feel safer and are safer.

People commit suicide for all sorts of reasons. Just because one woman attended a meditation retreat before committing suicide doesn't prove it was the cause. Is there a statistically significant increase in the suicide rate following meditation retreats?

> People commit suicide for all sorts of reasons.

That's sadly true. Sorry for you if you've faced a suicide of someone close. I definitely think some people can practice some forms of safe types of meditation safely without ill effects, even if they don't have any awareness of the dangers. While some types of meditation are dangerous (it's hard to say if that's most or all types because I don't know what everyone else is practicing) and I think you need yoga for all but the safest and shortest ones, I think if you don't try any additional techniques beyond a very simple, and short duration meditation, you might be OK, even without doing it yoga. it's definitely possible but I wouldn't recommend it just to be on the safe side to cover all the cases.

just as an example like you think something so simple is just focusing on the feeling of your breath at the tip of your nose you thing is going to be safe for you. But if you do that long enough or if you combine that with another type of breath or another type of sound the effects can be really really extraordinarily powerful and you can begin to open up your body to all sorts of things and draw all sorts of energy and information into yourself. So you need to be careful and you need to know what you're doing and keep it short and I think yoga helps you both handle the changes that can go on as well as it encodes a sort of relaxed mindset where you don't want to go beyond your limits so you not going to try to push some technique, you know, out of frustration because you think you don't get it and if you push it you might injure something. just like with a physical sport like if you push things in this mental you or energetic space you can definitely injure things as well.

Having said all that , i definitely think the same technique can affect different people to different degrees.

> Just because one woman attended a meditation retreat before committing suicide doesn't prove it was the cause. Is there a statistically significant increase in the suicide rate following meditation retreats?

No no no I wasn't saying that. Sorry for you that you felt that way about it, but the meaning I was trying to get across was reflecting my own reaction to that article.

When I read that article I had quite a reaction to it, and what I've said above is only a summary or one aspect of that.

To try to help you out with seeing my view of the reaction I had to that article, I'll just try to recall that here.

I read that article and was sort of deeply moved by it. I was skeptical that the meditation was her problem at first, but the more I read the article, and recalled my own knowledge of these things, and also read how retreat practitioners noted these symptoms in many people, I started to form an idea that I intended to post on that discussion but posted a sort of summary above. The idea is based around the reality of "kundalini sickness" (which in any case I see as just one aspect or symptom of what can go wrong) and the sort of mania that can attach itself to uncareful practice of kundalini related techniques, other techniques, things related to opening chakras, and other things.

There's a lot of detail that's probably too much to post here, and in any case I'm not inclined to right now, plus I'm allowing some ideas and clarity to form for myself, I guess, about a lot of this stuff...but basically, after reading that article, I concluded it was likely that unsafe practice of these techniques could overwhelm people with energetic bandwidth and information, as well as overwhelm their nervous system. One of the symptoms of such energetic overwhelming is the mania I believe was described in the article as one of her symptoms (staying up for days, not eating), and one of the symptoms of the information overloading is psychosis as I believe was also described in the article as one of her symptoms.

I'm not trying to say for sure that this caused her illness that contributed to her suicide decision, but it definitely contributed in my view.

Aside from the causal question of suicide (which, to be strict, has to be someone's decision, so their decision is the ultimate cause, but of course there can be all sorts of reasons and factors that they choose to contribute to their decision), I'm sure that practicing these techniques in the sort of careless and unaware way that I describe above, that I'm pretty sure is common in the West (and actually probably pretty common everywhere in the world in this age), is extremely fucking dangerous, as I've said, and also a direct cause of a lot of pathologies and illnesses (at least mental illnesses) that people report after meditation retreats. I really think it's that simple: that careless application of these techniques can lead to bad outcomes, really bad outcomes, sadly, for people. And I think that's a direct result of how the west has productized it, rather than keeping it in touch with its roots and all the knowledge and wisdom and safety that surrounded it.

To be totally clear I'm not saying that "caused" her suicide, and I'm not even sure it contributed in her case to her suicide decision, but I'm totally sure that it contributed to the cluster of symptoms she presented (mania, psychosis) around the same time.

Thanks for your time to read this and I'm sorry for you that you got me wrong the first time. Hope you have a good day. I do have a lot more to say about these topics but it's probably not appropriate for this board, and I definitely don't feel like chatting more about it now. If you want to know more about this or are interested in this stuff, I reckon you join a yoga class, and then maybe you could search for kundalini sickness, just as an example of the sorts of things that can go wrong, but I wouldn't recommend trying this stuff, without yoga! :) :P xx

> if you do mediation, you also need yoga Not sure Gautama Buddha did yoga? Don't get me wrong, i am not against yoga, but wondering if great saints who never did yoga also attained greater heights including moksha..

Haha, i don't know right now. but from the point of view that yoga is a systematiztion of techniques that is useful for connecting to energy, correcting the flow of and balancing the energy in the body, and opening the channels in the body to allow it to handle higher bandwidth of different sorts of energies safely, I suppose that perhaps these great saints already knew how to do that on some level even if they weren't following sort of formal practices. Of course that's just a theory we'd have to look back into the past to make sure.

another perspective is maybe they discovered or were taught techniques even more advanced than what's commonly know as yoga. Maybe that helped them somehow attain their heights as you said.

From another point of view I think there's an idea that yoga is probably for the common people, you know, everyone. Maybe there's some exceptional people whose bodies are already highly tuned somehow and they sort of don't need to do that...could be possible. But that would probably be rare like Olympic level athlete rare. And maybe some of those great saints weren't even human. So maybe techniques for the everyperson human form don't apply to them.

Harder to speculate about those things than it is to know that yoga is good for me from experience, and have a theory for why correct yoga would be good for most others as well, especially meditators.

Aside from what i already said, biomedically the long holding, and the precise poses, sooth and calm the parasympathetic nervous system, which helps correctly regulate many other systems, and help massage and promoting flow in the lymphatic system, i think. Even leaving aside the energy perspectives, relaxedly holding poses for a handful of breaths, is a great tune up for your body.

>there's some exceptional people whose bodies are already highly tuned somehow and they sort of don't need to do that...could be possible

ya, I too have read about that..

To the best of my knowledge, the only physical yoga he recommended was sitting cross-legged, and even that was likely just because he was teaching forest medicants (among others) who could not rely on having a chair.

Yoga is only very recently regarded as mostly physical exercise. Of the 8 limbs of yoga only one is Asana (postures)

If you read Patanjali (the foundational text) there is very little or no mention at all of posture.

Meditation without yoga may be problematic, but is there any problem with practicing yoga without meditating, in your opinion?

Yeah I think that's probably really safe, but you'll probably be missing out a little bit. Just 5 minutes or less of quietly sitting, eyes closed, and letting any thoughts, feelings, and sense impressions (sounds, feeling of weight of body on the floor, weight of the clothes on the body, feeling of breeze, etc), just come and go, and gently bringing your focus back to your breath (sound of your breath, or feeling of breath at your nostrils), at the end of a yoga session is good I think. You might find it helps quiet your mind and bring you back to the moment after the session, as well as sort of balance you and really sort of settle in that relaxed state to become part of you and your experience at that moment. Just that much, and no more is good I think. Mind will wander. Gently bring it back to the breath. Notice quiet at the end of in-breath or end of out-breath. If you want something to think or say to yourself, you could consider, as you are aware of the thoughts, feelings and sense impressions passing by, "These are my thoughts, they are mine, but they are not me. These are my feelings, they are mine, but they are not me. These are my impressions, they are mine, but they are not me. I am not my thoughts. I am not my feelings. I am not my impressions. I am. I am. I am what watches." and repeat :)

Have you checked out the book "When Panic Attacks" by Dr David Burns? It's a book that's helped a few friends of mine with severe social anxiety. It's CBT, but you may benefit from a book more tailored towards anxiety, as opposed to more generalised negative thoughts.

>I’ve concluded that the best advice is to learn not to worry about things

Any tips with doing this? The thoughts I try to avoid end up in my dreams even if I try my best to distract myself during the day

I don’t really have any advice, but what I can say is it’s not really about distracting myself or avoiding thoughts, it’s more like changing how I think about things. For example, when I get some random aches and pains, it worries me a little. But in the past I would fixate on things, try to treat them, see a doctor etc. After a certain amount of grappling with my own mortality, I kind of realized that sometimes my body will just hurt, and there’s nothing I can do about it, and so I have to sort of say, “ok, I have this pain, that’s fine,” and then just move on to whatever else I need to do. Although sometimes it may mean the opposite, accepting that I can’t just power through. “I’m just not going to be able to do all the things I wish I could do today, I need to rest instead. That’s fine.”

It’s still hard for me. But I think the biggest difference is that I have shifted my focus more towards the things that are here and now, and that I can actually control, and focusing attention on those things naturally means spending less time thinking about things that are far away or beyond my control. (Ie, applying attention elsewhere is not the same as distraction.)

Not super coherent, but I hope some part of that is helpful.

I read Marcus Aurelius, Meditations.

Written around 2000, it is surprising how many of his verses are relevant today. These are translations of the original, so have picked up some contemporary interpretation.

"If you are distressed by anything external, the pain is not due to the thing itself, but to your estimate of it; and this you have the power to revoke at any moment."

"The happiness of your life depends upon the quality of your thoughts."

"You have power over your mind - not outside events. Realize this, and you will find strength."

https://www.goodreads.com/work/quotes/31010

All this stuff really ignores some real advice that really works.

Anxiety comes from a lack of competence, confidence, or self-awareness. Lack any or all (and we all lack them to some extent) and you’re more nervous.

Get experience talking, presenting, comfort with how you look and sound, practice humor, gauge if you can maintain an audience. These are all practicable things. You can work on them.

I think meditation or mindfulness or any therapy tends to be good for realizing the importance of this, and perhaps some peripheral issues, but would never beat the cause of anxiety because the anxiety is rational. If someone asked me to fly a plane I’d be anxious - and that’s a good response, at a normal level, it means I’d have more cortisol and norepinephrine to react quicker and pay attention. But it’s not great for social things because it makes you shaky, so people see it as more of a fault than a good thing.

A lot of people today want to subscribe to “believe and you can” or “it’s all in your mind” type mantras but to me it’s really backwards to something like, “it’s ok that you can’t, accept it, and with hard work you can.”

> Anxiety comes from a lack of competence, confidence, or self-awareness.

This is oversimplified, anxiety isn’t just about social situations. My anxiety is none of these but comes from an overwhelming awareness of my own mortality.

I don’t feel like I’m going to die today or tomorrow, but the knowledge that I will die one day and wipe out all memory of me as I am now is permanently terrifying to me. I really believe that almost everyone else has some part of their brain to suppress this fact, that I am missing.

find out who the real "me" is, and that fear will no longer hold

Is your point that there is no such thing as "me"? Because I've tried meditating on that thought and it hasn't really helped. I think, therefore I am after all.

You can't meditate on that thought. Keep the search :)

I appreciate that you’re trying to help, but I’ve been searching for a long time and it only makes me feel worse.

Look into Ramana Maharishi

It doesn't have to be rational. I get anxious doing the most trivial things that people do thousands of times every day: talking on the phone, going the supermarket, even sending emails. It is awful and seems to get worse (and less reasonable) the older I get.

Some of the most accomplished stand-up comics still struggle with anxiety. So being comfortable with presenting, humor, and maintaining an audience isn't necessarily sufficient.

I say try facing those issues. Your thinking mind is trying to process and make sense of those anxious issues. Example, if you were in an IED explosion in Iraq...it’s okay to think about it. It’s okay to process it. It’s okay to understand that it happened. But it’s also okay to understand that was a one-time thing and your body reacted the way it did to protect yourself from that one-time event. You may have lost some friends from that bad event, and you may have even been damaged from it. But that trauma is OVER. It’s time to heal through acceptance, talking about it verbally, and saying goodbye to those emotions.

This works well, as long as not you’re not still in Iraq at risk of getting hit with IEDs.

This oversimplifies things a little. Many things can trigger your brain to react in a similar fashion than during a traumatic experience. You can also be aware that the experience is not the same or unrelated, but you'll still get a panic attack. Most likely because the actual anxiety or panic is not caused by your thinking brain.

That's exactly what the source said.

That’s a good observation, and I think the insight is that you still think these thoughts during the day, but you avoid fixating / worrying.

Like, if you are worried about an upcoming job interview, it’s natural that you’ll think about the interview during the day. However, those thoughts will appear and disappear. You are not trying to distract yourself and avoid the thoughts, you are just learning to avoid fixation/obsession/suffering.

Don't think about MONKEYS.

Did that help?

You start to think about MONKEYS, even though told not to.

So you have to do the opposite:

Embrace thoughts and feelings, then let them go, or be (Let It Be).

With meditation you can focus on breathing and not thinking. With physical exercise you bring refreshment to your system.

Watch your inputs and outputs! You'll have no time left for anxiety.

One solution is to make it so you don’t need to worry about things. Keeping a maintained calendar, to-do list, or simply dumping responsibility for some things (e.g. selling a car) can help.

you're not supposed to repress your thoughts, just change your relationship with them, like john nash at the end of a beautiful mind.

This is the reason I don’t like this whole “everyone should do therapy” movement and also the “mindfulness/meditation” movement.

It creates this hyper-awareness which creates more problems by making everyone over-analyze each other and overly-sensitive to things.

This over-sensitivity is such a negative for US culture. If you think long enough about things you can find everything triggering in some way.

Interesting. I've been reaching a similar conclusion recently.

Buddhism. Psilocybin.

I really wouldn't blindly recommend Psilocybin to people. I got the idea of trying to fix my health anxiety with it from HN about a year ago. Took half a dose, had a pretty good time for around 2 hours and then the worst panic-attack meltdown of my entire life. I started sweating all over, dripping sweat from my head, being 100% sure that I'm going to die - in the end ambulance fixed me up with an IV.

My anxiety disorder only got worse since then. Every time I see an ambulance I still get flashbacks and instant anxiety.

The drug isn’t gonna fix you by itself. It facilitates a state where you can fix your brain. I’m sorry you had a bad experience. Perhaps it is worth trying again in the company of a guide or others. It’s also worth preparing for your trip by determining what kinds of things you want to try and accomplish while you’re on it.

Psilocybin is a powerful tool but it seems counter to the adage of "set and setting" to use it when beset by anxiety. As a prophylactic for it is of course a different story.

Try Cissus, it blocks cortisol (the stress hormone).

Did you try medication?

For relaxation, see: post nut clarity

go back to reddit

Sorry if discussing normal human bodily function is offensive to your religion/beliefs. The brain releases oxytocin and dopamine, which induces relaxation and reduces anxiety.

Eh, a gross oversimplification.

Feeling troubled by being anxious in the modern world is a "cerebral" issue. The guy who mistook an innocent animal as a tiger and freaked out because of it didn't feel bad for feeling anxious for no reason. We do. Because it interferes with our daily functioning / responsibilities in the modern world.

Anxiety is also very frequently comorbid with other mental disorders. Especially OCD or OCD like tendencies, depression etc. I am medicated now and feel a lot better but when my anxiety was worse, the chatter of my "conscious" brain murmuring about "what if" scenarios was the worst. My point is, yes, anxiety manifests itself in a physical way, big time, but that is only half the problem. The discomfort with being anxious, constantly thinking about the possibility of having an anxiety attack even if you are not physically anxious "at that time", evaluating the "what if" scenarios, the constant planning to work around possible issues, all that torture are very cognitive pursuits and they were a lot of a bigger burden on my quality of life than experiencing an anxiety attack now and then.

I think there's a difference between anxiety and "worry". Anxiety has acute, uncomfortable physical effects. Things like heart palpitations, sweating, shortness of breath. Those are real things that can often be attributed to different kinds of panic disorders.

It's not the same as chronic "worry", or chronic "shame". These are things that live in the mind. Social media, the news, even local news, all contribute to this perpetual state of worry and shame. The "news", even (or maybe especially) local news, will never make you feel good. It will only ever make you feel worried, scared, or disheartened, or ashamed.

I've stopped this daily feeling of worry and shame by:

* Stopped watching the news

* Got my ass off Facebook

That's basically it. In the 3 years since I've done those 2 things my daily mood and outlook on life has increased dramatically. Your mileage may vary.

> Feeling troubled by being anxious in the modern world is a "cerebral" issue.

How do you know the modern world is behind your anxiety?

I'm more or less with the article (though I have no opinion about the supposed treatment). I think it's a mistake to think it's easy to tell that you're anxious. Anxiety is something you notice by observing yourself, it's not something you know by querying some inner state. And even if you observe anxiety in yourself, you don't have any insight as to why it's there.

You might think "the modern world should rationally make me anxious," which seems reasonable. But that's not the same thing as being anxious. I think a lot of people confuse these things. Conversely, I notice I have symptoms of anxiety that seem related (based on proximity) to things that I do not consciously think of as anxiety-causing at all.

I did not claim that modern world is behind my anxiety, just that, following the article's logic, feeling the physical effects of anxiety - even if the cause is not seemingly rational - is a crippling problem only because it interferes with out modern way of lives.

Experiencing a "fight and flight" misfire is not, in itself, a huge issue, even if it happens a couple times every day. The problem is you can't really function in the modern society with (or by anticipating) that.

That aside, I sometimes forget that everyone's experience is different. The thing I got treatment for (a modern SSRI was all it took) after wrestling with it for more than a decade was definitely easy to tell and query. And when I got an attack, people could tell. And when I was not in an attack, my cognition was 50% busy with worrying about when and in what situation I'd get my next attack.

The argument makes more sense when you realise that Valium/Diazepam is basically a muscle relaxant.

Edit: Source here, happy to hear from another domain expert refuting this

https://www.youtube.com/watch?v=CAOnSbDSaOw&list=PL848F2368C...

That's not really true. They act on GABA, which is the main inhibitory neurotransmitter throughout the central nervous system. So one of the effects is muscle relaxation, but that's only part of their effect.

Maybe it's not strictly true, but got this from Robert Sapolsky (Stanford neurobiology professor):

https://www.youtube.com/watch?v=CAOnSbDSaOw&list=PL848F2368C...

His opinion, or the best understandings on this, might have changed though.

From the YT transcript:

> Here's somebody taking Valium for anxiety, and here's somebody taking Valium to relax their muscles. What's up with that? It's the exact same thing. And it is a very James-Lange moment. What's part of anxiety about? It's monitoring the level of tension in your body. It's getting feedback from muscle tone.

He seems to be suggesting that the mode of action for Valium to reduce anxiety is that of reducing muscle tone. Not an expert, so I can't argue about it.

Going off of the quoted bit because I haven't watched the video, he isn't necessarily suggesting that is the mode of action, just that the mechanism of Valium does both. The mention of GABA enhancement from the comment above alludes to that.

Behavior and attitude can influence each other. For example, happiness makes you smile, but smiling can also make you happy (to some degree). The same works for anxiety in which your mental anxiety can make you physically anxious and vice versa. What he is suggesting here, especially considering the James-Lange mention, is that Valium's mode of action is targeting the behavior side of things for anxiety, but does not exclude it from influencing more than just muscle tension.

I think the general consensus in psychology is that it's neither the mental state nor the physical state (James-Lange) that create emotion, but rather both. Both can instigate responses from each other. Valium simply influences part of the CNS to affect both, but because it's a drug, it inherently affects the "physical state" more directly.

Normal muscle relaxants aren't as effective for anxiety as Valium because they don't have any action on the central nervous system, just the neuromuscular mechanisms. Valium does much more than simply relax muscles. It affects GABA throughout the whole body.

> Normal muscle relaxants aren't as effective for anxiety as Valium because they don't have any action on the central nervous system, just the neuromuscular mechanisms. Valium does much more than simply relax muscles. It affects GABA throughout the whole body.

Thanks for clarifying on this. A lot of people seem to think it's okay to just down-vote without providing some sort of counterpoint. I might be naive on a topic, but that's an opportunity to correct, not punish.

Agreed. I'm of the stance that I only downvote trolling or absurd claims without any form of supporting details. Otherwise, I prefer to take the route of elaborating/correcting/questioning/etc even if I'm not an expert on the subject because then it at least fosters a discussion and sets up a path for shorter corrective comments from those that don't have the time/motivation/energy to respond in more detail.

I rarely make the mistake of speaking with certainty about something I'm not sure of, so I guess the down votes were warranted. But I am surprised that a tenured professor at an elite university would be so wrong in his area of expertise. A cursory googling shows that there has been some decent research on muscle relaxation as a mechanism to reduce anxiety, though I concede that Diazepam probably has higher order effects that compound is efficacy:

https://scholar.google.com.au/scholar?hl=en&as_sdt=0%2C5&q=m...

Side note, alcohol also does things with GABA and that (plus its easy availability) is probably why so many people self-medicate with it for anxiety-type issues.

Yes, and that is a very bad idea as it often makes it much worse over time. Many people I have talked to who were or are drinkers, talked about their hangover as a certain weird feeling they can only stop by drinking. When asked a more detailed description, they describe full blown anxiety attacks. And they need more and more drink to stop them. I got many people to see a doctor and to stop drinking to attack anxiety that way. Liver damage apparently also makes it worse so... There are hard alcoholics who probably have this too but they also have physical withdrawel which is a much more difficult path; most people I mentioned above were having a few drinks per day to not feel like dying from this 'hangover' and could stop the same day without withdrawel (using alprazolam and therapy for instance).

Someone did the same for me a long time ago and I am very thankful for that still so I try to do it as well when I see possible sufferers. It is pretty crazy how little people know about it still, but they do light up when I describe all their symptoms.

Oh, I'm not saying alcohol is a perfect fix for anxiety issues by any means! Just that there are a bunch of mental states that people quite legitimately try to escape by any means necessary and that could probably be helped way more with appropriate psychiatric care.

I think the advice of focusing on how to turn anxiety symptoms down and moderate physical responses are fine, but it's kind of missing the point, at least for serious cases of anxiety. I suffered pretty badly from it in my early 20s (apparently typical age for this kind of stuff), and you go very quickly from particular anxiety attacks being the issue, to fear of anxiety itself being the bigger issue.

An anxiety/panic attack is physically scary the very first time, but by the tenth time what you're really afraid of is the loss of control and the anticipation of anxiety. Chronic sleeplessness is often the same way. Dealing with literally sleeping better is one thing, but at some point the real issue becomes the mental concern with sleep itself.

Dealing with physical anxiety symptoms is good, but if you're mentally anxious your first thought after dealing with an anxiety attack by breathing deeply is "okay, but what if it doesn't work the next time?". It's that mental attitude that I think many people have trouble dealing with.

I had my first panic/anxiety attack in my mid-20s, and then more frequently in my late 30s. It sucks, and especially the first couple of times you really may have no idea what hit you.

There were a couple of things that ultimately worked for me, although I think it's important to note they may not work for everyone since people are different. What helped was a combination of CBT and Buddha breathing and mindful breathing-focsed meditation. I also became (with the help of my counselor) more self-aware, so I could realize when I was starting to become anxious and use breathing techniques to intervene before it became a full-blown attack.

I don't do it as much now but for quite a while I had a serious journaling habit (I'd go through a Moleskine-sized hardbound notebook every couple of months) and that turned out to be surprisingly helpful; I could get the things that were stressing me out or depressing me written down on paper and out of my head. For me, at least, it worked.

All that said, for someone who's dealing with anxiety, I think the best thing is to talk to a professional.

As for me, things have gotten better; I don't get these attacks so much anymore and a lot of the time I'm able to keep them from escalating into a full blown one just by focusing on breathing for a while.

Interesting to see it framed this way. In July of 2020 (a high stress point in my life), following two weeks of job-related sleep deprivation (had to be up at 5 to get to work at 6:30 to troubleshoot an automation), noisy home environment making it impossible to sleep early, a night of high blood sugar, hung over, and following a two hour drive I had some kind of 'brain event' while pulling into my friend's driveway.

I call it a 'brain event' because at the time I thought I was going into DKA, after the event I was worried I'd had an aneurysm or something, the symptoms were similar to the negative parts of coming up on LSD, and I basically felt like I was tripping for about 3 days. I had to call out of work for that time and slept for about 12-14 hours the following few days.

My doctor told me that it was a panic attack, and that they can last three days. I've never had a panic attack before in my life, but I can't describe how much more fragile I feel now. Often when driving now the sensation of cresting a small hill during a turn will trigger something that will make me feel 'off', which leads to a deep fear. It doesn't feel like what I used to call anxiety, it's much closer to an external stimulus. Now I hate driving (for reference, I used to be a delivery driver, and I loved that job back in the day).

Anyway, I'm not sure what to do now. It seems like you're describing something similar to what I've experienced, though. I don't worry about 'what if it doesn't work the next time,' but I am distressed by anxiety that comes on completely disconnected from the reality of the moment or my thoughts at the time. Sometimes I think it just cracked the veneer of normalcy enough to make me understand on a deep level that driving is itself a terrifying thing to participate in, but I don't think that can possibly be true because I don't feel the same anxiety when riding a motorcycle, which should be much more terrifying.

What you described sounds a lot like what I’ve been going thru, especially the part about “fear of anxiety itself being the bigger issue”. Have things gotten better for you?

Thanks got a lot better for me, thanks for asking. When I was out of uni and started to work much of it resolved itself, I really wasn't happy with academia and it didn't help.

If you've got serious problems getting professional help is always a good thing but don't think it's not going to get better. Anxiety, even quite severe, is not uncommon.

Try changing your thought process a little bit. Tell yourself that you’re bigger than anxiety.

Remember friend, things aren’t happening to you, you’re happening to things.

Things ARE happening. Anxiety isn't just being nervous. There are strong physical symptoms due to the release of hormones to put your body on alert. You end up with things like palpitations and increased blood pressure. The mind goes on alert in a way that you have very little ability to control. Trying to consciously suppress the effects of cortisol and adrenaline on the brain is like trying to consciously stop yourself from being drunk. As long as the chemicals are still flowing through your blood stream, they will affect your brain.

> your first thought after dealing with an anxiety attack by breathing deeply is "okay, but what if it doesn't work the next time?"

It always will. Practice choosing various thoughts in your focus (thankful, calm, happy, etc) and watch how the feelings seem to follow ~15-30 minutes after. It will always work (in time) because it's literally a neurochemical reaction with physical laws equivalent to the guarantees of gravity. You're basically asking "what if the laws of physics and biology stop working for my body?"

Admittedly you can get yourself stressed enough over months or a single impactful event to really require some dedicated relaxation time, but the body will always over time respond to relaxation. And recovery is not linear, but moreso analog with ups and downs.

In my experience people struggling with anxiety (and everyone gets anxious) can be impatient and want their feelings to resolve in seconds to minutes. And typically that comes bundled with some perfectionist desire to avoid a past fear ("if I do X I'll never experience Y terrifying thing again") which winds themselves up further in the moment as they monitor for a calming outcome that takes longer than they wanted ("Oh God, I'm trying to relax but I'm not calming down!"). Literally start a stopwatch and give yourself 20-30 minutes to sit with the pain, focus on breathing/calm thoughts, and watch as it dissipates like the steam off a car after you turn it off.

I was almost 30 when I had my first ever panic attack. I was alone and convinced it was a heart attack, called 911, and felt fine by the time the ambulance reached the hospital. Embarrassed, I was ready to brush it off, but instead saw a therapist for the first time. She took out a stopwatch and had me breathe through a narrow straw. Within seconds, my face and limbs went completely numb; I couldn't move, and was amazed that I could form words. I sat with my head in my hands for what felt like forever. Eventually it passed, I felt utterly exhausted, and she asked what I thought the stopwatch said. "I dunno, 10-15 minutes?" Nope, 90 seconds. That experience made me start taking my mental health seriously.

Why did breathing through the straw cause that reaction?

Simply breathing through a straw may not do it. My therapist had me run up and down a flight of stairs for about 30 seconds and then breathe through a straw cut down to about 3 inches while holding my nostrils closed.

Your body thinks you're not getting enough oxygen. You're getting plenty, it's just that it all coming through that tiny hole tricks your body and that triggers panic sensations. Doing that several times exposes you to those sensations and you eventually get used to it and allows you to manage more intense sensations.

I'm not sure that's correct. I've heard that high CO2 levels trigger the parasympathetic nervous system which calms us down. One could get the same effect from breathing into a paper bag, I think.

Hmm. In the Apollo 13 movie, high CO2 levels triggered a panic/anxiety attack in one of the astronauts. (Which may not have happened, or not as severely, in reality – but that’s adifferent issue. For one, astronauts are trained not to panic.) A quick google seems to confirm this. As for breathing in a paper bag, I believe that is one common way to deal with hyperventilation, which may also induce anxiety and thus lead to more of the same.

Maybe relevant

> Klein is a professor of psychiatry who studies the delightful field of “experimental panicogens”, ie chemicals that cause panic attacks if you inject them in someone. These include lactate, bicarbonate, and carbon dioxide, all of which naturally occur in the body under conditions of decreased respiration.

https://slatestarcodex.com/2017/04/05/the-case-of-the-suffoc...

Isn't that the basic outline of a Batman villain? He could be one professional setback away from becoming the Scarecrow.

My first thought too, this guy is basically Scarecrow before the incident.

Try breathing through a straw (or two put together) just after your heart rate's been raised (i.e. via exercise). It's very anxiety inducing.

What did she do after the straw demonstration? Did she have something to help or she just wanted you to know what it feels like?

That is a very interesting event. Its like she knew exactly what was going to happen to you. The stopwatch and everything.

Of course the therapist knew. It would be horrible healthcare to do that to someone without a reason.

It is also unethical to do it to with a reason, without explaining the risks first.

So good to see a story about the physical aspects of anxiety at the top of hacker news!

I’ve struggled with anxiety my whole software career. I finally identified the big triggers for me - morning standup when I was late on a ticket, when a test would inexplicably fail, when a coworker wound comment in a PR asking me to redo a chunk of work that I knew would take more time. And I identified them based on how my BODY felt.

And once I could identify the actually environmental triggers, I could start to resolve them.

A lot like this article talks about! My conscious mind wasn’t in control of my anxiety, and the looping thoughts in my head didn’t even have much to do with the trigger. They were the symptom, not the cause.

Another software engineer friend and I are starting a company to help software engineers reduce stress and anxiety! We’ve seen some pretty miraculous results so far.

We’d love to hear from all of you anxious software engineers :)

Tinyurl.com/happyhackers

Thanks for sharing. Interesting to hear someone is trying to take care of this aspect. Especially since it's very much underplayed in our industry.

I'm nearly 40, and didn't relate to anxiety at all until I was 35. Until then, I would use lots of different words to describe how I simply wasn't good at being in a number of situations. I now believe that was a better way of thinking, because once I identified what was happening to me as anxiety, it actually got worse. "Anxiety" is something that should be treated and actively managed, which puts fuel on the fire. The less I frame my mental health in terms of anxiety, the better off I am.

I'm sure there are any number of reasons why this way of thinking won't help others, but I totally get why lots of ADHD sufferers have started calling it "bees in my head" instead of ADHD. What we call things affects how we think about it.

What a pleasant surprise to find this article at the top of HN! Minutes ago I finished a workshop on a somatic therapy technique. It's a relief to see these ideas gaining mainstream attention after so many years of making little progress on my own anxiety, depression, and procrastination.

For other relevant scientific perspectives, I recommend looking into the theory around "memory reconsolidation."

- Kaj Sotala does a good job of summarizing an important book in the field here: https://www.lesswrong.com/posts/i9xyZBS3qzA8nFXNQ/book-summa...

- How Emotions are Made also provides a perspective from neuropsychology on what's going on: https://www.amazon.com/How-Emotions-Made-Lisa-Barrett/dp/132....

- The Polyvagal Theory stuff mentioned in the article is also great, and some classic accessible books on the overall topic include The Body Keeps the Score and Waking the Tiger.

I'm personally a fan of a technique called Emotional Resolution (EmRes), which is notably simple and effective, and that you can learn to apply to yourself after a 90 minute course, but there are many other approaches: Organic Intelligence, somatic experiencing, cranio-sacral therapy, bioenergetics and core energetics, and many more. Effective self-therapy methods include Core Transformation, Focusing, and "self-therapy".

Keywords to search for are: "somatic therapy," "body work," "energy work" or "energy medicine."

Great summary, thank you for sharing!

Nutritional deficiencies should be part of this conversation.

A majority of Americans are magnesium deficient. Magnesium calms the nervous system.

“In healthy adults, magnesium sits inside the NMDA receptors, preventing them from being triggered by weak signals that may stimulate your nerve cells unnecessarily. When your magnesium levels are low, fewer NMDA receptors are blocked. This means they are prone to being stimulated more often than necessary.“ https://www.healthline.com/nutrition/what-does-magnesium-do#...

Mg L-threonate has helped my anxiety 2x more than years of talk therapy.

Not sure who downvoted you, you're absolutely correct. The usual culprits are magnesium, vitamin D and calcium. Those can result in moderate depression and anxiety in otherwise healthy individuals. Getting tested is pretty cheap, pretty much everyone with anxiety, depression or chronic fatigue should get some simple bloodwork done first to rule out the easily correctable causes.

What dose do you take? I might give this a shot.

One dose of magnesium l-threonate with l-theanine before bed.

One dose in the morning.

Each dose is usually 3 capsules, containing 144mg of elemental magnesium.

> Anxiety Is in Your Body, Not Your Mind

Yes, and, your mind is in your body, not just your brain.

That's why human consciousness is different to any common conception of computer consciousness. The difference between computers and humans is that human thoughts are driven by the needs of the body - to respirate, to eat, to defecate, to reproduce, to sleep, and to avoid being predated.

Exactly, and this is why all those "YOU don't do X, your brain does it" type things are so silly. "You" are your body. Your mind is something your body does to figure out where to get food and sex and how not to get eaten by tigers. Everything else is a crazy side-effect of this process.

How do you define mind? I would agree that the mind is regulated by brain inputs but not sufficiently. It is self-determining.

when it comes to anxiety, which doesn’t take place in your thinking brain, it [CBT] places the focus on the thought (“I thought there was a tiger!”) and not the physical response which preceded, and even caused, the thought (“my heart is racing and I’m full of adrenaline and I need tools to calm down”).

Inexplicably, the article seems to get CBT entirely wrong. A key part of CBT for anxiety is, in fact, about dealing with the body (e.g., the sympathetic nervous system) by activating the parasympathetic—through breathing, progressive muscle relaxation, and so forth. This glaring miss on one of the most effective therapies for anxiety made me question the entire article.

Didn't read the article in detail, but as someone who is super problematic as far anxiety goes, I can safely say that tai chi practice does help me for the very reasons you've given : activating parasympathetic system by breathing, active relaxation, connecting mind to body and vice versa, grounding myself (ie connecting my sensations to environment), being in movement (that is, your brain is not thinking about stress alone, but participates in a complete action with your body), etc. (and not the chi/spiritual thing that brings everything together and explains the roots of the stuff but is, often, totally transformed by occidental culture into nonsensical bullshit).

But that's my own sample point, just works for me. It's tough to push yourself to practice half an hour a day or so. You have to have the will and when you're tired it's difficult :-/

The title was the give away for me. The titles thesis is quickly abandoned to mean something like conscious vs unconscious thought.

I wish there were a little more examples of how this methodology deals with the stress/anxiety response.

The article seems to spend more time talking about why it thinks "thinking brain" CBT/talk therapy doesn't work rather than "surival brain" techniques which do work. It also brings up "mindfulness" as one solution, which I consider almost analogous to CBT, or at least a close relative.

It also seems counter-productive (to me) that the solution for one subject was to "strike out and defend himself within the safety of a therapy session". What is that person supposed to do in the moment? Ball up their anxiety and wait for therapy?

CBT seems very poorly suited to anxiety.

1. Most of the CBT literature is aimed at treating depression.

2. Anxiety is going to strike when you don't have the time or resources to sit down with pen and paper and analyze what's going on, and there is a lot of that in CBT.

I'm having therapy and CBT, and I wouldnt say thats my experience.

I think it is useful for dealing with anxiety. Learning to recognise triggers and having strategies in place to deal with the issues causing anxiety.

Anxiety, when it's a problem, is generally at an irrational level!

Anyway, everyone is different and has a differnt experience!

I think it depends on what techniques are applied.

There seems to be specialist branches of CBT such as MCBH and ACT which might be better suited to these scenarios.

However, my point is that the article seems to spend more time telling us that CBT doesn't work (without providing much evidence) than why "survival brain" techniques are better.

I haven't learned much from this article other than some people think CBT is not suitable for dealing with anxiety.

It’s certainly both. “Anxiety” it’s your brains response to given sensory input and tends to trigger a release of cortisol and in more extreme situations adrenaline. While cortisol and adrenaline are normal responses it’s a very slippery slope and they can have extremely negative effects on the body.

The dangers of to much of these hormones come from both chronic exposure for normal sensory inputs like stress at work or school on a daily basis or constant instability like parents fighting regularly to single acute episodes like an extreme traumatic event. Traumatic events tend to alter neural pathways so moving forward even non stressful sensory input can trigger these strengthened pathways putting people in non stressful environments in chronic states of stress.

It’s helpful “not to think about it” whatever “it” is, but it’s often involuntary especially for those that suffered a trauma, as there’s always the risk that you are unknowingly responding to it without even thinking about it and it’s often hard to connect the dots.

The other issue is everything in the body is a feedback loop and hard to break or change. For example even just sitting in a chair all day will shorten you hip flexors, causing unnoticeable discomfort but your brain will notice and respond with release of cortisol which will in turn cause tightening of muscles and myofacia, that will further release cortisol in response to those bodily stresses, and on and on it goes with all kinds of “referred pain” (I hate that term) you do notice in maybe your neck or shoulder(s) or back. And good luck at that point you’ll be treating the area in pain that’s not even actually causing the pain only leading to more chronic stress over the inability to make the pain go away. If you work in an office my guess is you have physical pain, and you can ask anyone else in the office and odds are they have physical pain, and my bet dollars to donuts from arthritis to bursitis to joint pain the vast majority with simply blame it on getting old or some posture issue and not a single one will realize the physical pain and bodily conditions are directly related to stress.

Is the body different from the mind?

Every experience of ours as a human, is rooted in the mind.

The author seems to confuse involuntary action with conscious thought.

"We" may not perceive the signals that drive the beating of the heart, but it is still driven by the mind.

Hindu yogic practices, especially those of Hatha Yoga [0] make it possible for one to feel even those involuntary processes.

[0] https://en.wikipedia.org/wiki/Hatha_yoga

I had anxiety for the first time in my life recently in the form of pain in my upper left chest. From a new job I hate (but pays well) and added to that my dad is very sick.

Worse still is I'm the age my grandfather and his son (my uncle) died.

I've read how people who have major stress in their lives develop a reduced ability to cope with stress. That seems like a terrible spiral downward.

Something seems contractictory to me with this. It's trying to say your thoughts don't affect it, yet it describes a scenario where only rational cognitive concepts cause the fight or flight response.

How does the "survival brain" know that Covid-19 is scary, dangerous and to be feared? How does it know how dangerous it is to gauge the response?

Similarly, how does it know the meeting at work is dangerous if you're late too it? That it's important for you to be there on time?

Etc.

I feel like statements like these do a disservice to the science behind them. The “fight of flight” is meant as a simplification of automatic behavior changes (which might involve different chemistry in the brain which increases alertness; and in evolutionary terms are beneficial to your survival and procreation). But it is a gross oversimplification. There is little evidence that the systems involved are a direct fight or flight response system. They are certainly involved in fight or flight but that is not by any means the only time they activate.

This article makes a passing mention of the term defensive response. I like that term a lot better as it catches things like potential embarrassment and failures as well.

We keep assuming body and mind are separated things, but separating the concept of ink and paper doesn't help you understand the full nature of a book.

I sometimes have random anxiety at night. I used to have a bad habit of drinking myself to sleep, but I've since discovered that hard exercise is the best medicine. I do pushups until I'm completely exhausted. When I lay down, I'm actually relaxed for a good 20 minutes. It's amazing.

Descartes and his duality strike again.

I also think it is silly that people don't think that "your body == your mind".

It is simple to discard neurons that are scattered through the body, but those are also neurons.

I think it's more complex than one equals the other; the two phenomena are inexplicably interconnected. The duality is a very non-helpful frame to use to analyze, well, basically anything.

This is a weird article. The headline doesn't really match it. Like it says the thinking brain is the last to know and the author suggests this is a physiological response. But all that's really saying is that anxiety isn't a conscious response. But that just means it's a subconscious response and not a physiological response somehow removed from the brain.

Also, what does "in your body, not in your mind" even mean? Let's face it, the distinction between your mind (or brain) and your body is a useful abstraction, nothing more. Nerve cells extend from your brain throughout your entire body. Where does your brain end and your "body" begin?

Life isn't software that lends itself to neat abstraction layers.

This was discovered thousands of years ago in the east(indian subcontinent) by meditation practitioners(i.e Buddha, Mahavira etc) solely through thousands of hours of practice and self-realization. These have been codified into various texts which form a major part of vipassana teachings.

Interesting how scientists in the west either conveniently pick up the theory, conduct some a/b tests and publish them as new discoveries without credit. Even if they had arrived on these conclusions, independently on their own, it's important to understand the mind boggling amount of progress in psychology, neuroscience that was made with the limited knowledge of scientific rigor in the east thousands of years ago.

I disagree. If it's not empirical, it doesn't count. There are millions of people with ideas, but ideas aren't good enough. Prove your idea is true, then we'll talk about deserving credit.

Exception: mathematical ideas which are difficult to come up with.

How is it fair to pick up/completely ignore published experiential observations, in continued practice for millennia from another culture elsewhere in the world, conduct a/b tests and publish results without credit? I'm pretty sure the western world is going to continue swindling wellness techniques/practices from ancient texts, quickly run half-baked experiments, cherry pick data to suit a result and "publish" findings.

When these techniques were in development, in the golden era for spirituality, most of the rest of the world were still hunter-gatherers. Empirical rigor was just not a thing.

It's a question of providing due credit for those who developed and practice these techniques as a way of life. If not share some of the capitalistic spoils in the billions from delivering stress relief(meditation based content) through shiny, addictive apps (Yes, meditation apps can be addictive! Surprise! i.e, Headspace, Calm), At least provide credit where it's due.

For anyone interested in this, I highly recommend the book The Body Keeps the Score by Bessel van der Kolk, a psychiatrist who studies PTSD.

He writes about this clearly and elegantly—must read for those dealing with anxiety, and certainly with any traumatic stress.

What essential this book tells? Can you explain more about what you have learned from it?

Another is “Widen the Window”

Non-authwalled link: https://outline.com/ycjSSm

Seriously, I've seen nothing on Medium that would be worth paying or registering for. It's LiveJournal dressed like a newspaper.

As a person who is currently in CBT (and seeing positive results), the biggest thing that helped me is to understand trauma, and cognitive distortions.

Just as this article says, your thinking brain is trying to piece together and digest what has happened. The problem is often that we repress it during the peaceful down time that our thinking brain is trying to make sense of it. We drown it out with drugs and alcohol, or we try to make ourselves so busy that we don’t think about it (hence creating more anxiety through work issues, family drama, or overstimulation). Best thing that works for me is to learn to accept it. Process it. Digest it. Learn and talk through examples of how it’s safe to experience the world again. This is part of the de-escalation process. Note, this goes against advice of “oh just don’t worry about it”. This approach is essentially “okay self, bad shit happened, let’s finally talk about it”. Your thinking brain is designed to keep bringing this up until it gets resolution. This is resolution.

And cognitive distortions helps me because I understand now how my mind plays tricks on me. When I say things like “this bad thing happened, I’ll never be able to get over it”, it’s giving too much power to that bad event. I don’t have to feel or think that way. I’m allowed to change my thought process and think “yeah that bad event happened, but I can’t let it be the end of the world for me.”

"Wait to worry" I tell my self. Can I do anything about the situation at this very moment? No? Wait to worry. Yes? The DO IT.

It's not perfect, but man, it helps me get through some stuff.

A form of CBT that has been shown to be particularly effective at anxiety and panic is Acceptance and Commitment Therapy (ACT). If you've been struggling with anxiety, I highly recommend seeking out a therapist who has been trained in ACT.

You can also read and watch anything produced by Dr. Stephen C. Hayes, one of the therapists who developed ACT. He did so himself due to panic and anxiety and this was after becoming a psychologist. The whole field is quite fascinating.

I believe that an inappropriate anxiety response is typically one element of a syndrome, and generally not a stand alone response. Most likely, if you are focusing on anxiety to the exclusion of other aspects of your life, and I mean past, present and future life, you are likely missing opportunities to effectively address it.

That said, one therapy that has worked for at least one person I know was Dielectical Behavior Therapy[0]. As they went through the program, they learned that their hyper-arousal to any unexpected event led to an anger response that led to saying terrible things to the person who had not behaved as expected. This led to a general mistrust of others and a dwindling supply of friends who transitioned to acquaintances who then stopped calling entirely.

DBT get them to recognize that their response was not typical and offered a path to practice alternate responses. They learned to defer their response and seek clarification or confirm intentions before reacting. They've become a much less unpleasant person to be around.

[0] https://www.verywellmind.com/dialectical-behavior-therapy-10...

Interesting article. I have occasional (every few years) periods of anxiety. Last time around I went through a course of CBT, some of which I found moderately helpful - don't try to suppress feelings of fear, just acknowledge it and move on - but I was certainly not cured.

Then my doctor suggested I try out the Alexander Technique. I wasn't convinced, but gave it a go. Something about it helped, and quite significantly. The logical part of me rebels against this, as AT is full of woo, but the effects were undeniable.

The practitioner I went to focused a lot on feeling the floor beneath you, the seat supporting you, and so on -- I don't know how typical that is for AT, but perhaps that was the part of it that was effective for me. It would certainly fit with what the article says.

I have a close friend with an autism diagnosis who has a very unusual relationship between their brain and the rest of their body. One of the consequences of this is that they become very anxious and get trapped in a nasty anxiety vicious cycle that can last several days.

If you have trauma/PTSD (even minor) that leads to physical reactions (sweating, heart racing, etc) in certain situations, take propanolol before you have the situation. After you do this a few times, or a few dozen, you'll be 90% fixed.

As someone who's been coming out of a lot of sexual trauma from my early childhood, I feel it's important to take a multi-pronged approach to alleviating the anxiety & pain, psychologically and physiologically. For me, pelvic pain was a huge impediment to having a healthy sex life. Left untreated, it got worse and worse, to the point that I had constant pain my body. Now I am seeing a pelvic floor physical therapist who is teaching me how to relax the muscles, and a psychoanalyst who is helping me deal with reframing the traumas that got me where I am.

The Body Keeps the Score is a pretty good book that covers how much trauma affects the body in myriad ways.

One other thing to consider, that I rarely hear anyone talk about, is that anxiety can sometimes be a symptom of an underlying physiological condition or disease. For example, hypoglycemia-related anxiety is a common complaint.

Also I thought I was developing anxiety attacks at one point but turns out it was just heart burn. Didn't find out until it got worse. The symptom was that it messes up your breathing to the point where you have to consciously start breathing and can't take deep breaths with your diaphragm. As soon as the heartburn goes away you're able to breath normally again.

LOL

I'm 99% anxiety free after I learned to manage my allergies and diet!

I make light of the situation now but at one point in my life I was confused and freaked out because of the symptoms you mentioned and everyone including the doctors thought it was stress. After thousands of dollars in medical all I really needed was Benedryl, a better diet and a new primary care physician.

This is true, but it’s more rare than it sounds. It’s a challenge for doctors because mental health still carries a stigma of weakness, whereas physical ailments don’t. Many patients are resistant to mental health diagnoses, instead insisting that they are suffering from undiagnosed physical ailments.

Doctors do consider physical causes for issues like anxiety, but they’ll avoid proposing it directly to the patient in order to avoid giving them the wrong idea.

There have been several studies performed on this topic, although they tend to focus on depression. The number of cases with identifiable physical causes are in the low single digit percentages.

In other words, keep an eye out for additional symptoms that may suggest a physical ailment, but start with the most likely explanation: That the disorder is best approached as a mental health issue

>, instead insisting that they are suffering from undiagnosed physical ailments.

It took me time to realize, that my headaches and back pain at the same time were not physical symptoms, but from the times when I was (even extremely) worried and it was hard to come to that conclusion, that they were not part of physical problems, because pain was real. So, it is more about how person is experiencing these symptoms.

If you discuss it with your doctor (and you should) they will run tests to try and rule out physiological causes. I know they did for me with both depression and anxiety, as I had other signs/symptoms of a thyroid disorder (turned out my thyroid was fine, I was just very stressed out and long term severe stress-induced anxiety, for me, leads to severe depression).

I've been on the keto diet for several years and one aspect of that is that you have to pay a little more attention to your sodium intake than you do otherwise, for various reasons I won't get into here. Suffice it to say, about two years into it I thought I was getting enough. I added salt to my meals, etc...

However, one day I noticed I had been getting REALLY anxious for no apparent reason. I have a history with panic and anxiety and have seen a therapist for it so I was able to sort-of detach and observe it, but it was still odd that it happened the way it did. Often, the causes of panic and anxiety aren't readily apparent and will only become so days or weeks later, but this felt different in a way I can't quite explain.

I decided to get some over-the-counter salt tablets to see if that might help. It was the craziest thing. The second that tablet touched my tongue, it tasted soooo good. Not at all what I was expecting! Within about 2-3 days of taking that supplement my anxiety went away almost completely. Now, interestingly, when I take the salt tablet, it is pretty bitter and almost overwhelming. Clearly my body was in need at the time.

This is true. Vestibular disorders in the inner ear can cause anxiety.

I personally think this was a very interesting reading, and after having tried multiple solutions for anxiety (prescribed pills, talk therapy, tips like focusing on our environment -- as explained in the highlighted paragraph), and being surrounded by people having also tried several solutions, it must be known that not everyone will react the same way to each of them.

While the content of this article will not make everyone agree, I think it's particularly important nowadays to pay attention to our mental health at least as much as we do to our physical health, and it's good to see this topic trending on HN.

Reminds me of the equation:

Pain x Resistance = Suffering

If you accept pain fully (Resistance = 0), then you won’t suffer. The more you resist, the more you suffer. And if Resistance is high, then even a little bit of Pain can cause a lot of suffering.

The article really tries to present cognitive behavioral therapy as something it is not.

Reconnecting with your body and mindfulness are part of the toolset you can expect to be introduced to when visiting a CBT therapist.

So good to see a story about the physical aspects of anxiety at the top of hacker news!

I’ve struggled with anxiety my whole software career and finally found something that really worked for me —- identifying the triggers of my anxiety, and focusing on my physiological sensations after I recall them, much as described by Pat Ogden in the article.

Another software engineer friend and I are starting a company to help software engineers reduce stress and anxiety! We’d love to hear from any of you.

Tinyurl.com/happyhackers

Sometimes. Sometimes not. I've seen both sides.

My anecdata:

My road rage was definitely my body and responded to therapy that targeted the sensations in the body.

My anxiety was not. It was a way of thinking. Ruminating thoughts. Cascades of potential disastrous outcomes. I needed medication and I needed to talk to a therapist.

She seems unqualified to be giving out misguided medical advice in such certain terms. Minds get in the way of comprehending other minds, and broad statements are difficult to make truthfully.

It was only when I was heavily medicated for depression and anxiety that I realised the physical symptoms of anxiety. Whenever I was expecting a negative outcome, or when I was surprised, my body would give me a jolt of pain along my vagus nerve. Literally any negative event would cause me pain, and it was this pain that my brain was seeking to avoid.

My current medication does not remove this pain altogether, though it diminishes the sensation significantly.

Out of curiosity, do you mind sharing what medication you're on? I feel like i have a strange vagus nerve dysfunction as well.

I've had a similar issue, and PPIs and H2 blockers have helped

I'm on Valdoxan (ago melantine).

I have few early memories because due to having so much anxiety from an early age. I remember a time before processing it as any synonym for 'anxiety', my father came to help me with something and I thought, in essence:

"Too bad my brain is doing that thing where my thoughts are not useful due to that thing (that I didn't yet think of as anxiety), but how nice of my father to spend some time with me."

> As Stephen Porges, PhD, a psychologist and the creator of the Polyvagal Theory

Funny. Just yesterday I googled "polyvagal theory" after accidentally stumbling upon it after googling for "HRV training" after hearing about it from Tim Ferriss on his youtube channel.

Anyway - a quick research yielded that PVT and Mr. Porges are both rather questionable. [1]

> The thinking brain isn’t what decides whether we’re stressed, whether we’re feeling threatened or challenged, whether we’re going to turn stress on, whether we’re going to turn emotions on,

I'd question that and bring thought loops forward as a counterexample. You can very well intensify a state of anxiety by dwelling on some thought.

> So if you want to track your anxiety, your body, not your thoughts, will be your most accurate map.

That is true, though - after all anxiety is a physical sensation. I can attest to that waking up now for several weeks almost every day with stomach aching, increased heart rate and shallow breathing.

> The problem is that when it comes to regulating our nervous system after a stress response (read: anxiety), our thinking brain is the absolute worst tool for the job

I'd also questin that. It's true that the thinking brain on its own will never find a solution for something like anxiety. But you need the thinking brain to identify the problem and come up with a solution. If the thinking brain is a hammer then your guts are a screw driver.

> talk therapy analyzing all the reasons you’re anxious, this is probably a hard pill to swallow. Not only did all that talking not do much to alleviate anxiety, but it could also even have made it more acute.

Talk therapy addresses the thinking brain and is hence limited. But a good talking therapy is not just being experienced by exchanging words. If the therapist is worth her money she'll connect on an emotional level.

> Is there any role for talk therapy, or trying to think logically about your anxiety? Absolutely. But only once your body is regulated, Stanley says: “After we have helped our survival brain feel safe and stable, then we can work on our thoughts.

This attitude is symptomatic of our misguided medical profession which always seeks to compartmentalize and modularize instead of integrate and connect. Both approaches can go very well hand in hand.

1: https://en.wikipedia.org/wiki/Polyvagal_theory#Criticism

> an increased interest in “brain science” and neurobiology along with continued research on mindfulness and mind-body connections are shifting our psychological understanding from focusing only on the mind to seeing the brain and body as a cohesive unit.

This is exactly what my talk-therapist is helping me with. So if these ideas appeal to you and you want to explore them keep an open mind about talk-therapy.

Totally anecdotal, but speaking as someone with Anxiety Disorder + occasional intense panic attacks, once I started Rock climbing heavily and Trail running 2x a week, my anxiety and Panic attacks basically went away completely.

This was following years of taking 5HTP, meditating/breathing, talk therapy etc, which helped somewhat but nothing like intense exercise.

The idea that anxiety and stress are phyisical things in your body is widely known by yogis for thousands of years!

After starting real home fitness 6 days per week my stress & anxiety level is unbelievable low. I don't think it helps in all cases but you definitely should try it.

Another suggestion: as long-term projects are inevitable always switch to short-term which can bring fast but realistic result.

> Not only did all that talking not do much to alleviate anxiety, but it could also even have made it more acute.

If you’re going to go counter to a large body of scientific evidence (re efficacy of CBT), ya need something stronger than the thoughts of some people trying to hawk products, ya know?

Anxiety is so general a diagnosis as to be useless in discussing treatment with exercise and breathing.

Personal anecdote. Just a few days ago, when I was feeling anxious, I just stayed firm at my desk, and firmly approaching the situation without the thought of giving up, even if I couldn't solve the problem, I felt, I could control my anxiety a little better.

There is a term I heard once for what you did: "Disobey the fear." You want to run from the anxiety, but at the same time, you logically know you're not really in any danger. Disobeying that urge to run re-trains your body such that after a little practice, the fear comes and goes, often barely registering in your conscious mind.

i seem to meet more and more people who have experienced acute anxiety / panic attacks than ever. it leads me to wonder if it's just more understood and easier to talk about now, or is there some phenomenon where the incidence is actually increasing?

Your body and mind are one.

It is scientifically inaccurate to believe otherwise.

This isn’t a pedantic point: the mind/body distinction is pseudoscience that used to be believed widely in scientific circles. This readjustment hasn’t really reached common practice yet.

It's both.

Approximately half of depression cases respond well to psychotherapy.

Approximately half of depression cases respond well to antidepressants.

The halves are (seemingly) independent: for about a quarter of all patients both work and for another quarter neither works.

i think no, it's not "not in my mind but in my body".

my take is that anxiety occurs first by warping a person's attention, and the mental and physical symptoms of that follow.

For those interested in the subject I suggest listening to this

https://youtu.be/ntfcfJ28eiU

First paragraph had a very interesting perspective about stress and the last paragraph had a solution, rest of the content is very repetitive.

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This reminds me of stella ganglion block that was shown to be effective against ptsd . Quite interesting

Just seeing the picture of the article made by throat getting bigger from the inside. Anxiety sucks.

I'm a bit puzzled as to why the article suggests we should imagine ourselves as Neanderthals instead of homo sapiens? I understand that homo sapiens interbred with Neanderthals and people today may have a few percent of Neanderthal DNA but the most relevant evolutionary context for us is just an earlier version of us, surely.

It's difficult to take advice from an article that has a statement like this mixed in:

"We are a cerebral culture, which makes us very equipped to deal with problems that require reason and logic"

A long time ago I read about a study which examined people’s physiological reactions to riding a rollercoaster. They compared coaster lovers to mildly-phobics. Their conclusion was the two groups experienced the same physiological reactions. What differed was their mental state, how they contextualized the event.

If that study was accurate (and god knows whether it was), then I would conclude that anxiety isn’t strictly “in the body.” It’s more like a feedback loop with the mental state.

This might come as a surprise to some, but it turns out your mind is also in your body

Mind is in the body

This link wanted me to login to read which IMO means I can and should only engage with the post title.

Anxiety is in GABA-a and GABA-b IMO. I would suppose they circulate throughout the body and mind. But most the work is getting the influence to take affect in the mind.

For people interested in addressing anxiety/depression disorders via "the body", check out SGB (stellate ganglion block) and ketamine treatments.

Here is an overview of the state of the art in GAD:

TL;DR Tofisopam appears to be the ideal long term anxiety medication except it's understudied despite being old, which is a real shame.

Pregabalin is likely the second best candidate however some people reports horrible anecdotes with it (brain breaker)

As always the best blog about the topic is from Scott Alexander: https://slatestarcodex.com/2015/07/13/things-that-sometimes-...

Best recent meta analyse of the SOTA https://pubmed.ncbi.nlm.nih.gov/30712879/

Anxiety is more prevalant than depression yet is extremely under reported. While ADHD and depression have relatively safe and effective medications for long term treatment, chronic anxiety doesn't.

Some antidepressants are safe long term treatment for anxiety however they are not very potent (compared to benzodiazepines)

Benzos are not a long term solution because of tolerance, of their sedative effect and of their persistent impairment of cognitive performance.

The ideal medication has the following properties: Required: 1) no persistent loss of cognitive performance Studies shows that popular benzos negatively affect cognitive performance even months (years?) after their use. 2) no hypnotic effect at normal dose

Desired: 3) no loss of cognitive performance while in use. 4) No or low tolerance 5) no sedative effect

It happens that there are at least 2 benzos derivatives that share those properties:

Tofisopam (Emandaxin and Grandaxin) and Hydazepam (Gidazepam IC) are drugs that are benzodiazepine derivatives. Like other benzodiazepines, they possesses anxiolytic properties, but, unlike other benzodiazepines, they do not have anticonvulsant, sedative, skeletal muscle relaxant, motor skill-impairing, or amnestic properties. Moreover Tofisopam (apparently) induce NO COGNITIVE PERFORMANCE LOSS! See e.g this DOI on scihub https://doi.org/10.1007/978-3-642-74031-2_13

The most interesting NON-benzos:

Pregabalin's anxiolytic effect appears after one week of use and is similar in effectiveness to lorazepam, alprazolam, and venlafaxine, but has demonstrated more consistent therapeutic effects for psychic and somatic anxiety symptoms. Long-term trials have shown continued effectiveness without the development of tolerance, and unlike benzodiazepines, it does not disrupt sleep architecture and produces less severe cognitive and psychomotor impairment. Pregabalin also exhibits a lower potential for abuse and dependence than benzodiazepines.[43][44]

Hydroxyzine has been shown to be as effective as benzodiazepines in the treatment of generalized anxiety disorder, while producing fewer side-effects.[13]

Moclobemide potentially more potent than SSRIs, however much slower to act than benzos.

CONCLUSION:

* Tofisopam appears to be the clear winner. Hydazepam might be as well but can't find information on cognitive performance. Pregabalin appears to be the best non-benzo * reversible Maois might be the safest/potent well studied medication for long term use and do not destroy libido contrary to SSRIs. This is a major issue because anxiety is a major commorbidity of ADHD and given that MAOIs increase norepinephrine/dopamine quantities it might interact badly with concurrent use of stimulants. However some anecdotal studies shows that it can be safe, however the use of beta blockers might be needed (for e.g 50mg of Vyvanse) A plausible and surprisingly understudied solution for the SSRIs effects on libido might be TRT.

"While ADHD and depression have relatively safe and effective medications"

I don't think administrating a neurotoxic agent like Vyvanse to be safe, in that regard even coke is effective for ADHD, but all those who takes stimulants chronically, will end up regretting it one day.

Can you back up your claims? Yes dextroamphetamine like all reuptake inhibitors have a neurotoxic risk. First of all I believe that long term studies does not shows neurotoxic harm. (but yeah are there studies that span more than 3 years?) Secondly stimulants are neurotrophic (promote neuron growth) and has been shown to fix abnormalities on ADHD brains.

To my knowledge neurotoxity is not an issue however stimulants loose their effectiveness after 2 years in the only more than 2 years study (are there been newer ones since then?) however this study contradict the perceived effectiveness that doctors and patients reports after two years. This paradox is a very poor state of knowledge and more research is really needed.

Here is a tip that works wonders. Delete FB and twitter, both are incredibly destructive to the mental well being of millions (and don't go to Reddit). The less time you spend on the Internet the better you will feel.

The body and mind are heavily intertwined. It's totally useless to compartmentalize them when discussing something like anxiety. One day somebody in the West will "independently" discover what Buddha and Vedic Rishis discovered centuries ago, and popularize those ideas. Unfortunately, this is the only way those ideas will regain acceptance in the East as well.

Who in their right mind would take their psychological advice from a fiction writer?!?

First, no, anxiety is not in your body. Fear, just like any other emotion is in your brain. You might get physiological responses in the form of chemicals in your body. That is an effect, not a cause.

Second, neocortex is not "thinking brain," its role is to manage social interactions. Cognition is a small part of that.

Third, mindfulness is the opposite of any therapy I can think of. It is an ego-depletion technique proven to be detrimental to people suffering from anxiety and depression.

Finally, I don't know who performed therapy on the author but some steps seem to be missing:

//> when you have an anxiety attack, the only thing you can do is to perform the grounding exercises. Yes, that is the moment you start counting and do square breathing exercises. If people in the military can do it while in stressful situations, you can do it from behind a macbook. Nothing is treated mid-episode.

//> once the episode is over, you can explore the trigger. Chances are that your response is healthy, you are in a situation you should be anxious, but your behavioural response is over the top. A trigger contains the stimulus, the circumstance and your personal patterns (e.g. personal experiences).

//> part of the role of the therapist is to help you figure out the patterns. The other is to see if your behavioural responses are productive for you or not. If loud sounds make you run like hell, that is a good thing in an active shooter situation or a war theatre. Not so much at a birthday party where a balloon popped.

/rant

> mindfulness is the opposite of any therapy I can think of. It is an ego-depletion technique proven to be detrimental to people suffering from anxiety and depression.

This is simply not true. Mindfulness-Based Stress Reduction (MBSR) and Acceptance and Commitment Therapy (ACT) are two evidence-based, heavily researched forms of therapy that are intimately connected with mindfulness.

Second, I encourage you to cite the studies that back your claim that mindfulness is detrimental to people suffering from anxiety and depression. I'm not saying your claim is untrue, but such a claim does warrant backing.

> when you have an anxiety attack, the only thing you can do is to perform the grounding exercises.

Also not true. There are many things you can do in addition to or instead of grounding exercises. One is to simply allow it to happen or even try to make the panic worse. Paradoxically, that has been shown to ease the panic attack. I have personally experienced this multiple times. It takes a little practice but it is very effective.

>One is to simply allow it to happen or even try to make the panic worse. Paradoxically, that has been shown to ease the panic attack.

Nope. Not working for me. Though, I might have stronger fight-or-flight reaction than other people. For example, I can't watch beheadings(but I could do them by myself and I am very sure about that). If I force myself to continue watching, then my mind just shuts my brain off and I lose consciousness.

Similarly I can't watch needle, when nurse is injecting it into my vein. When I am not watching and have my attention fixed on something else - I feel perfectly fine, and even can make myself not to notice anything. So, MBSR and ACT is completely shite to me and I would be really pissed off if someone would have suggested that I should try them.

I think, that johnsmith4739, who mentioned techniques has a point, that this article is basically a crap and has no medical value whatsoever. I think, I start to realize, what op is meaning by ego-depletion technique, as this is exactly what makes me anxious, when everything becomes unreal and where I lose control - that is the thing that makes me most anxious. So, somehow NOTHING that you have written is making sense to me in dealing with my anxiety. Do you actually have some medical background, or have read too much and are here to prove your "expertise" based on what you have read? Which is wrong place to do.

EDIT: I had not received any help from doctors on my anxiety issues - most of the issues I was complaining about are now gone and I do not need help in dealing with my other anxiety issues - because "fixing" them(with medications?) will rob me of other things, that I enjoy and where anxiety is just part of how my brain works. I have noticed, that I get really anxious if I am not in control. If I am in control - I feel perfectly fine - in fact I feel more than perfectly fine in such circumstances, where I am in control of everything that affects me and understanding about this relation has come after trying to deal and failing with all the offered techniques. So, I've wasted my time on experiments and failed, so it is time for me to draw the line, cut losses and decide on what is working and I am irritated on touching anything again, that I've tried and that had no effect on me.

No, I am not a medical provider. I am only speaking from years of experience practicing what I learned after seeing an ACT-trained therapist. So don’t take my word for it without verifying for yourself with a similarity trained therapist.

That said; while I don’t have a problem with needles I have had issues with getting my blood drawn before my annual physical. I would come quite close to losing consciousness each time. I asked my therapist about this because I too thought it was related to panic and anxiety and he explained that it is actually a different physiological response. Seeing people’s blood—especially our own—was usually a bad thing before modern medicine. What I did to resolve it was to watch videos of blood draws every day for about 1-2 weeks prior to getting my own blood drawn. That worked surprisingly well. I no longer have to ask them let me lie down during the procedure. Even still, I don’t watch them do it to me and that’s fine. I don’t need to.

As to beheadings... I don’t really see how watching such content could reasonably be in accordance with ones values. In fact, losing consciousness seems like a perfectly valid response to such a thing and doesn’t really seem to me to be related to panic or anxiety. I think it is quantifiable proof that you are not a psychopath.

Look, you’re right; people like you and me, if we’re in control, we are fine. The older I get the more I realize just how much and how often I’m not in control. What ACT taught me was to be comfortable with that fact. To embrace it and even enjoy it.

I hope you can find peace, regardless of the modality. I only encourage you to not give up just yet on either mindfulness or evidence-based therapy.

You have all my sympathy because living with this kind of sensitivity is not easy.

Ego-depletion is great when you are too much in your head and you feel stress over minor things. However to suggest mindfulness to somebody dealing with clinical forms of anxiety is cruel and unproductive because it promotes ignoring the cause of the episode: how your ego is interpreting the situation it is in.

If others feel ok in the same situation and I get triggered, isn't it clear where the work has to be done?

Also, psychotherapy is a difficult field because it deals with issues you cannot objectively measure (how one feels). I'm specialised in neuropsychotherapy, btw. Many techniques are promoted, some more effective than another. But there is no clear line between right and wrong.

> It is an ego-depletion technique proven to be detrimental to people suffering from anxiety and depression.

Got any recommended reading on this bit?

On the reduction of self control: https://www.sciencedirect.com/science/article/abs/pii/S10538...

> First, no, anxiety is not in your body. Fear, just like any other emotion is in your brain. You might get physiological responses in the form of chemicals in your body. That is an effect, not a cause.

Do you have a source for this? I remember seeing an article on (I think) HN about research indicating gut bacteria influences emotions which would seem to me to indicate cause rather than effect. Perhaps it’s impossible to definitively say either way. I can certainly see anxiety being the sort of thing where a feedback loop spirals out of control.

Yes: https://www.wired.com/2010/12/fear-brain-amygdala/

Gut bacteria influence the production of neurotransmitters therefore it can influence how you 'experience' an emotion. A misbalance in your gut microbiome and the brain's reactions ca be influenced - e.g. cannot transmit effective enough different signals.

To clear out any misunderstanding, your gut microbiome cannot 'make' you feel anything on its own. It can either make it easier or more difficult to experience certain emotions.

This is an emerging field - look at these 2 publications and see how questionable the conclusions can be:

https://www.nature.com/articles/nrgastro.2013.76

and

https://journals.plos.org/plosone/article?id=10.1371/journal...

Gut bacteria affects brain, by migrating from guts to brain - IT DOES NOT AFFECT BRAIN, WHEN IT IS IN GUT!

FFS, just, read those articles properly. I've read it as well, but somehow I don't think, that my gut is as smart as my brain...

Some of us have not found the psychological "advise" of experts to be helpful, and taking advise from a writer seems as potentially helpful as anything else.

The slate star codex blog has a post about the gulf between therapist book and reality

https://slatestarcodex.com/2019/11/20/book-review-all-therap...

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