Understanding the Anxious Mind - NYTimes.com - 0 views
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But some people, no matter how robust their stock portfolios or how healthy their children, are always mentally preparing for doom. They are just born worriers, their brains forever anticipating the dropping of some dreaded other shoe. For the past 20 years, Kagan and his colleagues have been following hundreds of such people, beginning in infancy, to see what happens to those who start out primed to fret. Now that these infants are young adults, the studies are yielding new information about the anxious brain.
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Four significant long-term longitudinal studies are now under way: two at Harvard that Kagan initiated, two more at the University of Maryland under the direction of Nathan Fox, a former graduate student of Kagan’s. With slight variations, they all have reached similar conclusions: that babies differ according to inborn temperament; that 15 to 20 percent of them will react strongly to novel people or situations; and that strongly reactive babies are more likely to grow up to be anxious.
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In the brain, these thoughts can often be traced to overreactivity in the amygdala, a small site in the middle of the brain that, among its many other functions, responds to novelty and threat. When the amygdala works as it should, it orchestrates a physiological response to changes in the environment. That response includes heightened memory for emotional experiences and the familiar chest pounding of fight or flight. But in people born with a particular brain circuitry, the kind seen in Kagan’s high-reactive study subjects, the amygdala is hyperreactive, prickly as a haywire motion-detector light that turns on when nothing’s moving but the rain. Other physiological changes exist in children with this temperament, many of them also related to hyperreactivity in the amygdala. They have a tendency to more activity in the right hemisphere, the half of the brain associated with negative mood and anxiety; greater increases in heart rate and pupil dilation in response to stress; and on occasion higher levels of the stress hormones cortisol and norepinephrine.
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The physiological measurements led them to believe something biological was at work. Their hypothesis: the inhibited children were “born with a lower threshold” for arousal of various brain regions, in particular the amygdala, the hypothalamus and the hypothalamic-pituitary-adrenal axis, the circuit responsible for the stress hormone cortisol.
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At age 4, children who had been high-reactive were four times as likely to be behaviorally inhibited as those who had been low-reactive. By age 7, almost half of the jittery babies had developed symptoms of anxiety — fear of thunder or dogs or darkness, extreme shyness in the classroom or playground — compared with just 10 percent of the more easygoing ones. About one in five of the high-reactive babies were consistently inhibited and fearful at every visit up to the age of 7.
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By adolescence, the rate of anxiety in Kagan’s study subjects declined overall, including in the high-risk group. At 15, about two-thirds of those who had been high-reactors in infancy behaved pretty much like everybody else.
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PEOPLE WITH A nervous temperament don’t usually get off so easily, Kagan and his colleagues have found. There exists a kind of sub-rosa anxiety, a secret stash of worries that continue to plague a subset of high-reactive people no matter how well they function outwardly. They cannot quite outrun their own natures: consciously or unconsciously, they remain the same uneasy people they were when they were little.
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Teenagers who were in the group at low risk for anxiety showed no increase in activity in the amygdala when they looked at the face, even if they had been told to focus on their own fear. But those in the high-risk group showed increased activity in the amygdala when they were thinking about their own feelings (though not when they were thinking about the nose). Once again, this pattern was seen in anxiety-prone youngsters quite apart from whether they had problems with anxiety in their daily lives. In the high-risk kids, even those who were apparently calm in most settings, their amygdalas lighted up more than the others’ did.
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Behaviorally inhibited children were much more likely to have older siblings: two-thirds of them did, compared with just one-third of the uninhibited children. Could having older siblings, he and his co-authors wondered, mean being teased and pushed, which becomes a source of chronic stress, which in turn amplifies a biological predisposition to inhibition?
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high-reactive babies who went to day care when they were young were significantly less fearful at age 4 than were the high-reactives who stayed home with their mothers.
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The predictive power of an anxiety-prone temperament, such as it is, essentially works in just one direction: not by predicting what these children will become but by predicting what they will not. In the longitudinal studies of anxiety, all you can say with confidence is that the high-reactive infants will not grow up to be exuberant, outgoing, bubbly or bold. Still, while a Sylvia Plath almost certainly won’t grow up to be a Bill Clinton, she can either grow up to be anxious and suicidal, or simply a poet. Temperament is important, but life intervenes.
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This is a good article that looks at how anxiety happens- it is more or less something you are born with, but you learn to live with, if you are intelligent about it. Liked it. Good writing.
