Understanding Anxiety: Physiological and Psychological Perspectives

The brain's anxiety loop is fueled by incorrect usage, leading to continuous anxious feelings and physical symptoms, requiring targeted interventions for improvement.

### Understanding and Addressing Anxiety from a Physiological Perspective
* 🧠 Dr. Fang explains that anxiety is a natural function of the brain, necessary for survival, but **excessive anxiety can be detrimental**.
* 🔄 The brain operates on three levels: **survival, emotional, and belief**, with resources distributed **unevenly among individuals**.
* The brain's default mode network, responsible for **continuous rumination**, can amplify anxiety, especially in those with a **well-developed frontal lobe**.
* 🔁 Dr. Fang describes anxiety as a loop that continuously ponders recent **good and bad events**, particularly in those with an **overactive imagination**.
* 💭 Excessive anxiety is often due to **incorrect brain usage**, such as being **too idle**, having **insufficient frontal lobe capacity**, or lacking **clear beliefs**.
* 💊 While medication can help stabilize serotonin and dopamine levels, Dr. Fang emphasizes the importance of **changing the brain's usage pattern** to effectively address anxiety.
* 🏋 Practical strategies to combat anxiety include **tiring out the brain through physical activity**, **converting worries into images**, and using **slow breathing to counteract physical symptoms**.
* 🎨 Dr. Fang recommends treating anxiety like a muscle, knowing where to exert force (e.g., **stopping useless imagination**) and where not to (e.g., **not pondering vague causes**).

Today we have an online themed sharing session, which is our Don't Look More Anxious EP15. Dr. Fang mentioned facing anxiety and presented 6 paths: the first 3 are roads that lead away from home, and the last 3 are paths that lead back home. Today, we will talk about the 5th path in facing anxiety, which is looking at it from a physiological perspective. Why does our brain feel anxious? The brain is naturally an organ that experiences anxiety. If a person does not feel anxious, they lack a sense of crisis; even survival becomes an issue. It's like not feeling pain is also a kind of illness. There is a disease called leprosy where the pain nerves are damaged, resulting in the person not feeling pain, even when they have a fracture, causing survival issues. However, an intelligent yet not intelligent enough brain generates excessive anxiety, using up the entire brain to worry, which only disrupts the normal functioning of the brain. Confucius once said, If a man takes no thought about what is distant, he will find sorrow near at hand. Dr. Fang rephrased it as:

People who are cautious will have worries. In fact, when facing environmental pressure, it's probably quite similar. So why do some people feel particularly anxious while others don't? Is anxiety in the brain a physiological issue? Many say it's because of insufficient serotonin. Will using medication to increase serotonin levels solve the problem of anxious moods? Is it that simple? Is anxiety in the brain a psychological issue? Even without external pressure, some still feel ongoing anxiety. Dr. Fang says it's because the brain is not using the right approach. If you want to change the brain's way of functioning to reduce anxiety, how should the brain exert itself? All of this needs to start from the evolution of the brain. The brain can be divided into three levels. The lowest level is called the primal brain, which is our brainstem, our cerebellum, the primitive brain. It is responsible for breathing and heartbeat. We call it the survival brain, the essential conditions for survival: breathing, heartbeat, and movement.

We can think of this part of the brain as an organic being, just like the robots of us humans. The organic robot is the survival brain, and the layer above is called the emotional brain. Mammals start to have emotions. Look at your dogs and cats at home; you will observe their emotions sometimes not being good. When something very good or very bad happens, that is an important matter. When something very good or very bad happens, it is an important matter. Important matters must be pondered on a bit and then stored. This allows our brain to have the ability to seek good and avoid harm. If it only reaches the emotional brain, our brain would become like a replica of the brain's environmental information, and we would respond reflexively. This becomes a fixation of another type of behavior. So, the fixation of behavior evolves into another kind of consciousness that can analyze and judge. It's not just that when the emotions are bad, our mood is bad, when the environment is bad, our mood is bad, and when the environment is good, our mood is good. It is the belief of the brain cortex.

It can help to stabilize or guide restless emotions, but constantly holding onto these fixed values or beliefs can be cautious and even become a kind of superstition, turning into another fixation of the brain. Therefore, the brain operates at different levels from the most basic survival brain, emotional brain, to the belief brain. Today, Dr. Fang will mention the anxiety loop of the brain. Moderate anxiety can enhance our survival skills and strengthen our ability to seek good and avoid bad. However, excessive anxiety can hijack our entire brain. How does the emotional brain work? How is anxiety maintained by the brain? This needs to be explained from the anatomical aspect of the brain. There is a loop on the inner side of the brain. When the brain is not dealing with external tasks, that is, when we are daydreaming or resting, this loop will be activated, called the default mode network. This network includes the anterior, middle, and posterior cingulate cortex, followed by the hippocampus and amygdala.

If we use a grammar to explain a sentence, it would be: Recently, there is something new and a bit dangerous related to me. So, in this inner loop, this inner loop keeps iterating this sentence: Recently, there is something new and a bit dangerous related to me. What are the benefits? It can record dangerous situations for a long time. The downside is that it doesn't stop. If we look at the beginning of this inner loop, there is something called the ventral tegmental area, which is considered a center of happiness. A new grammar is when there is something new and a bit joyful recently. You will also ruminate on these happy and joyful little things. The default mode network of the endless loop is to help us record some bad things, small things, and good things in daily life for a long time. Our brain only remembers emotional things. This loop can magnify for some people because our frontal lobe has an amazing imagination. It adds possible dangers to this loop.

The loop that cannot stop, constantly rotating, putting us in an anxious state. Why can't this loop break free if it's not released? Why can't it stop? It's because it's not stored in images. Without being stored in images, continuously adding new fuel, without images to conclude, maintaining an anxious state for a long time. All of this has an anatomical structure. Our brains are inherently wired this way to keep us in a state of anxiety. Within this loop, constantly pondering recent good and bad events. If your frontal lobe is well-developed, and you add more imagination, this loop won't stop. If your ability to generate images in the back is turned off, not used properly, this continuous state of anxiety. We always encounter bad things, strange things, inexplicable things.

Things that cannot be found reasons for. Originally, the brain's setting is just to simply record such dangerous situations with images to remind us not to repeat the same mistakes next time. It doesn't mean to investigate the root cause, but the clever brain always wants to dig deep and add more imagination. However, it still can't figure out the reason, so it keeps spinning in a blurry loop. As for the evolution of the human brain, our emotional brain has become very developed, but the brain's cortex is not that perfect. We don't think much, but we like to think, so we keep adding fuel to the blurry crisis. Therefore, most crises are vague and cannot withstand scrutiny. Things just happen like this. If you encounter it, quickly pack up and close the case, save it with images, so that next time a similar situation occurs, an immediate response can be generated. Because not knowing to use images to close the case.

Misusing the thinking ability of the brain and desperately analyzing it thoroughly, this is the anxious loop of the brain that operates continuously, resulting in anxiety. I divide the brain into three types of people. The evolution of the brain has three levels, step by step, from bottom to top, differentiating into three brains with different goals. The first is the survival brain with the goal of survival, the second is the clever and sensitive emotional brain, and the third is the rational brain good at analysis and judgment, also known as the belief brain that creates something out of nothing. Brain resources need to be allocated to these three goals, not evenly. Some people prioritize survival, working and living all day, just seeking a meal to eat, seeking survival. Some people focus their brain resources on emotions, which Dr. Fang calls emotional people. Some people act on their inner beliefs, becoming belief people. Each of these has its own strengths and weaknesses, without any intention of belittling.

First, let's talk about this survival type of person. Look at this picture. Their main resources are all focused on survival. So, who is this survival type of person? They have to deal with work every day, have to go to work early in the morning, work until they are tired before going home. When they get home, they eat, watch TV, take a shower, and then rest. Even if they don't go out to work, some housewives are busy all the time, it seems like they never stop. They are all dealing with external tasks and don't have the leisure to return to the default mode network mentioned earlier. Therefore, they usually don't even have time for anxiety, reducing emotional distress. Most of the functions of the entire brain cortex are used to deal with the difficulties of the external environment, to solve the difficulties of the external environment. So, simply put, they are a carefree working person. This is the appearance of a survival type of person. Some people live carefree lives, considered lucky individuals. They don't need to do too much work usually, have leisure all day. The real test is during their leisure time, where all the brain's resources are focused on emotional disturbance.

Thinking and worrying all day long, unable to find inner peace. The advantage of emotional people lies in observing words and expressions, being attentive to details. They are very sensitive to interpersonal relationships, so their brain resources are focused on observing others, which also includes self-observation. What about the downside? Being overly sensitive to these relationships can bring about an excessive emotional burden. So, what kind of people are emotional people? They are emotional workers in interpersonal relationships. Let me elaborate on this point a bit more. Some people's emotions are too overwhelming. We can divide them into introverted and extroverted individuals. Introverted individuals often focus on their own reactions to things rather than others' reactions. Even those who are very extroverted and want to express themselves to others are still expressing themselves. Therefore, whether it's paying close attention to one's own inner reactions or strongly wanting to express oneself, these are all parts of oneself. Dr. Fang mentioned this type of situation.

Placing myself as the most important person will increase a lot of emotional burden. Dr. Fang suggests that in our second life, we shouldn't label ourselves as introverted or extroverted. We should only categorize ourselves into the small self, the big self, or the non-self, or the self. You shouldn't keep emphasizing personal emotions; instead, observe and care more about others' emotions. For example, when you participate in an activity, observe whether your partners feel satisfied or unhappy, and try to observe and help others' emotions. Some people don't pay much attention to eating and drinking, don't care about enjoying things, and don't like complex interpersonal relationships. They just like to think all day. If things can be thought through clearly and logically, just as Confucius said, To learn as though one were to live forever. They don't care much about their bodies, don't feel the need for health preservation, as long as they are full and satisfied, that's enough. They also don't care much about what others think, as long as there are no conflicts, that's fine. In life, they only want to make one friend. Who is that friend?

He is a friend of the universe, nature, or science. His brain does put in all kinds of details of nature. He only cares about these scientific principles. His brain values consistency very much, hoping to include and organize all these details of nature with a consistent idea. Through this process, his only friend is the universe, nature, or God. Dr. Fang calls this kind of person who only cares about transcendent things a believer. When a believer is extremely extreme, they may not recognize their relatives, even neglecting friends and family. Why do they continue to feel anxious? Even without much pressure, there is no significant pressure in the past, present, or future, yet they still feel a continuous sense of inexplicable anxiety. Why is this happening? Is the brain in chaos? We often get anxious first and then look for the cause of the anxiety. Whether it's a minor problem, we worry if it's cancer, or if a small matter will turn into a big deal.

We all need to think thoroughly. We can't stop even if we want to. In fact, we don't want it to be this way, but our limited brains are like this. So, I want to ask a question: why does our brain keep ruminating and feeling anxious? It's because the emotional brain keeps burning, using up all the resources of the brain, focusing on the emotional brain. The continuous rumination and anxiety are due to the incorrect use of the brain. What are the wrong ways to use the brain? Firstly, being too idle. There's no need to use the brain's resources on external environmental difficulties, so being idle all day without any survival crisis. How to reduce anxiety caused by being too idle? Find something to do, even something slightly challenging. So, solve the problem of being too idle first, don't let yourself be idle all the time and anxious. Secondly, the frontal lobe is inherently insufficient. We are not very intelligent people.

We are only in the middle of the evolution of the human brain. We are not very good at using it, not good enough, but we like to force ourselves to think about the results we can't come up with. When a random bad thing happens, we come up with a bunch of conspiracies and imagine a lot of possible outcomes. This inability to think but love to think, adding fuel to anxiety, Dr. Fang calls it smart disease. Therefore, the smarter a person is, the more likely they are to feel anxious because they turn a bad thing into a bigger one. A bad thing should be reflected upon slightly and then left with a record. But this record is not a written one, not a record of inner dialogue, but a record of images. Otherwise, when you recall the bad things that happened before, you often only remember those images. If you don't know how to conclude your bad things with images and keep wanting to use textual logic, you will fall into a trap, a pit, and won't be able to get out. So, without using images to conclude your bad things, you will remain in those confusing logics.

Then there is your lack of clear belief. You don't have a desire to accomplish something significant. If you really want to accomplish something with conviction, there is not enough time to do it. How could you be trapped in those self-disturbing imaginations? For example, if you park briefly on the side of the road, and then a police officer comes over to issue a ticket, saying, Sir, you can't park here. You will be fined. If you have nothing to do all afternoon, you might argue or even fight with the officer. But if you have to go sign a contract worth tens of millions or even hundreds of millions later, you will probably leave immediately and thank the officer for being diligent. Mother Teresa of India helped many people and did a lot of good deeds. Some people questioned her, saying it was for fame or with ulterior motives. Mother Teresa never paid attention to them because she said, This is my covenant with God. I am not doing this for show. So, these people are considered to have conviction. Their beliefs guide their actions in life.

There is not enough time to devote to these beliefs, and yet we still get caught up in those self-disturbing imaginations. So, I say without the guidance of beliefs and the urgency to fulfill them, it's easy to fall into the mire of emotions. Let's review once again, why do we constantly feel anxious? Clearly, there isn't a huge amount of pressure, but we still feel very anxious and uncomfortable. Let me tell you, in life, there are always some vague and trivial matters. Sometimes when walking on the road, we might accidentally stumble. Yes, it's possible. Could we be walking by the roadside and get hit by a reckless drunk driver, even fatally? Yes. And if there are some minor health issues or symptoms, could it be a sign of cancer or other incurable diseases? It's also possible. Therefore, we are constantly living in a vague sense of crisis, especially in modern society. When it comes to these vague matters, if you want to thoroughly investigate each and every one of them, you have to be prepared for any eventuality.

You need to control this sense of fuzziness. You are so paranoid. You will only have one result - putting yourself in and maintaining this sense of anxiety, focusing on the crisis of fuzziness, enlarging it with imagination, and not knowing how to conclude it with visual thinking. This is not knowing how to use the brain correctly, putting all the brain's resources into the emotional brain. The emotional brain finally ignites. You see the emotional brain in the middle burning like a charcoal. The emotional brain will also command its subordinates, which are in the brainstem. The brainstem has an autonomic nervous system center that makes you palpitate, makes your chest tight, makes your shoulders stiff, makes your stomach uncomfortable, and a bunch of physical symptoms. So, psychological anxiety comes from the burning of the emotional brain, and physical anxiety comes from the emotional brain directing the autonomic nervous system center of the brainstem to produce many uncomfortable symptoms.

Anxiety is like the brain burning up with emotions. Anxiety is about getting to the bottom of vague crises. Anxiety is the imagination of vague crises. So how can we improve anxiety? Dr. Fang talked so much, and we always need to do something to help ourselves improve anxiety. First, force yourself to shut down your imagination. If you can't do it, what should you do? If you still like to think of a bunch of possible outcomes or conspiracies, what should you do? Tire your brain out, make it very tired. How to tire it out? Go for a walk, walk for two hours. If you're not tired yet, walk for four hours. Exhaust yourself until you can't imagine anything, until you can't use your brain. You will also achieve temporary peace. If you don't want to immediately take a sedative to knock your brain out, just go for a walk until you're tired. Secondly, stop digging to the root cause, don't become a literary person who wants to worry about things.

Continuously engage in inner dialogue and quickly become a painter, an artist. Turn worries into images. Keep looking at that image. Therefore, to resolve the crisis of imaginary monsters, never become a literary person in words, but become an artistic painter. Anxiety produces physical symptoms. It is anxiety that creates physical symptoms. For example, it makes your heart race, makes your chest tight, makes your muscles stiff. But we cannot control the palpitations, cannot control the heartbeat, but we can control our breathing. So, we use slow breathing, gentle breathing, to counterattack this symptom. Anxiety causes chest tightness. Use slow breathing to provide feedback to the brainstem, and then let the brainstem feel calm because the breathing has slowed down. This is a way to deceive the brain with slow breathing, but it will succeed. Although chest tightness is the result of anxiety.

Instead of reasons, when we feel chest tightness, intentionally breathing slowly will give feedback to the brain to feel calm. This also has a therapeutic effect. The key point is, when the emotional brain ignites, it will maliciously use serotonin and dopamine. If serotonin and dopamine are too low or too high, these two molecules are tools, not the mastermind. It should be said that the emotional brain has ignited, and you are using the brain incorrectly, then it kidnaps serotonin and dopamine to maintain this continuous sense of anxiety. It's not that serotonin and dopamine change afterwards and create sustained anxiety. Of course, for some people, serotonin and dopamine are inherently more unstable and prone to imbalance. But Dr. Fang regards them as tools, not the mastermind, just like a suicidal person.

A person who commits suicide, suicide is their own will. They just want to die. They can jump off a building, they can buy charcoal, they can use a rope to strangle themselves. But you cannot say that their suicide was caused by charcoal, nor can you say that suicide was caused by the rope. Serotonin and dopamine are like charcoal and rope. They are tools used by the emotional brain to maintain the burning of the emotional brain. Although serotonin and dopamine are tools for anxiety, if we use medication to adjust serotonin and dopamine, isn't that also a way of counterattack? Dr. Fang said, anxiety makes us feel suffocated, but if we slowly breathe, sit quietly for five minutes or ten minutes, we can counterattack and improve our anxious suffocation. Today, anxiety makes our serotonin and dopamine unbalanced. We can also counterattack by using medication for serotonin and dopamine to calm our anxious brain, just like saying, it is stipulated that charcoal and rope cannot be easily obtained.

Folding them up, will it increase the difficulty of suicide? Yes, it will. Just this act of obstruction can prevent some suicides because sometimes suicide is impulsive. When one finds it difficult to commit suicide and the moment passes, they change their mind about suicide. Finally, when it comes to improving anxiety, you must have methods. You can't just wait for anxiety to spread because it hijacks your whole brain, making your brain dysfunctional. We go to the gym to exercise. We need to train our muscles. You need to know where to exert force and where not to. If you go to the gym and randomly exert force happily, you'll end up hurting yourself. Not only will you not train the muscles you should, but you'll also injure yourself. So, what is the correct way to use the brain? You also need to know where to exert force and where not to. Where should the brain exert force?

Just stop useless imagination with force. If you shouldn't think about it, then don't. It's like this place, you shouldn't put effort into it. Don't exert yourself in random imagination. If it shouldn't be thought of, then don't. What you shouldn't think about, you don't need to think about. Like recently, when the cold spell comes, why does it come? It's not for you to ponder. What you should think about is dressing warmer, and then turning the vague things that happened into images. Use images to conclude. If anxiety symptoms have already arisen, you should meditate, breathe slowly, observe your images. Serenely look at the images, that's where you put effort, as Dr. Fang just mentioned, where you should put effort and where you shouldn't. As for the serotonin imbalance in the brain that maintains anxiety and dopamine, this is a very effective method to stabilize the brain. We can use this type of medication to force it into balance. As a result of practicing changing the way you use your brain, you can simultaneously use effective methods, such as meditation and slow breathing.

Then look at the picture of your own inner self. For example, using medications such as serotonin and dopamine to counterattack anxiety. This is what Dr. Fang shared today about the causes of anxiety and how the brain exerts force. Thank you all! Do you want to understand life's problems from a medical perspective? Remember to like, subscribe, turn on the notification bell, and share with all your friends and family. Let's together improve Taiwan's medical culture!

【不看更焦慮 EP15】為什麼大腦會焦慮？原來是不正確地使用大腦？？

未來健康研究院

Understanding Anxiety: A Physiological and Psychological Perspective

The brain naturally experiences anxiety as a survival mechanism, but excessive anxiety can disrupt its normal functioning.

Anxiety is influenced by the brain's evolution, operating at different levels: the survival brain, emotional brain, and belief brain.

The brain's default mode network, including the cingulate cortex, hippocampus, and amygdala, plays a key role in maintaining anxiety.

The Continuous Anxious Loop: An Explanation of the Brain's Operation

The brain has an innate loop that continuously dwells on recent good and bad events, fueled by imagination and a lack of image-based closure, leading to anxiety.

This loop is a result of the evolved emotional brain's strong development and the cortex's tendency to overthink, creating vague crises that cannot withstand scrutiny.

The continuous anxious loop is the product of the brain's three levels of evolution, prioritizing survival, emotions, and beliefs, with resources allocated unequally to each goal.

This operation leads to different types of people, each with their own strengths and weaknesses in how they process and respond to the world around them.

The Two Types of Individuals: Survival Workers and Emotional Workers

Survival workers are constantly busy with external tasks, reducing their emotional distress and anxiety.

On the other hand, emotional workers focus on interpersonal relationships, being sensitive to others' emotions, which can lead to an excessive emotional burden.

Believers are individuals who prioritize transcendent things, such as nature and science, often neglecting personal relationships, while experiencing a continuous sense of unexplained anxiety.

The brain's tendency to ruminate and feel anxious is due to excessive use of resources by the emotional brain.

This can be caused by idleness, a lack of clear beliefs, and a failure to prioritize important tasks.

To reduce anxiety, one should engage in meaningful activities, establish clear beliefs, and prioritize urgent matters over trivial concerns.

Persistent anxiety is driven by the brain's focus on vague and trivial matters, creating a constant sense of crisis in modern society.

Managing Anxiety: A Different Perspective

Anxiety is the result of the emotional brain burning up with emotions, causing both psychological and physical symptoms.

Fang suggests exhausting the brain through physical activity and shifting focus to creating mental images.

Additionally, using slow and gentle breathing can help counteract physical symptoms by providing feedback to the brainstem.

It's important to understand that serotonin and dopamine are tools manipulated by the emotional brain, rather than the sole cause of sustained anxiety.

The Role of Serotonin and Dopamine in Managing Anxiety

Serotonin and dopamine are tools used by the emotional brain to maintain its function, and adjusting them with medication can be a way to counteract anxiety.

Obstructing access to means of suicide, such as charcoal and rope, can help prevent impulsive suicides.

Fang recommends using meditation, slow breathing, and visualization to improve anxiety symptoms and stabilize the brain, while also emphasizing the importance of knowing where to focus the brain's efforts.