Trauma and chronic anxiety disorders have an intricate relationship. While both conditions are independent, they always present together. The symptomatic expressions of each disorder can overlap and trigger the other. The interconnectedness stems from shared mood pathways in the brain. Here is a detailed analysis of the interplay of the two conditions, their distinct characteristics, and practical guidance on their management.
The Science Behind Trauma and Anxiety
Both trauma and anxiety occur in similar neuron networks and brain structures. Anxiety is the immediate response to trauma. The adjustment cascade that ensues as the brain rewires itself into perpetual survival mode produces trauma and its related disorders.
The Stress Response
Your body has mechanisms to defend itself against stress, fear, and threats known as the stress response, anxiety, or the fight-flight-or-freeze mechanism. The stress response begins in the brain and eventually leads to action. It could be maneuvering through oncoming traffic, removing your hand from a hot surface, or catching a falling toddler. The amygdala and hypothalamus are the brain structures behind this process.
The Amygdala
The amygdala is the brain’s center for sensing, interpreting, and processing distressing and fearful cues. It signals the activation of stress response pathways and begins the process of restructuring neuron networks to prioritize survival. Ordinarily, the system should reset once the threat or danger ends. However, chronic stress or prolonged distress can lead to a perpetually active stress response and the oversensitization of the amygdala.
A hypersensitive amygdala is hypervigilant to internal and external distress cues and can sometimes respond to phantom triggers. Chronic stress modifies the size and function of the
amygdala. The alteration increases neuron connections to the hypothalamus, hippocampus, and prefrontal cortex, setting the stage for a traumatized brain primed for survival.
The Hypothalamus
The physiological sensations associated with anxiety are a direct result of processes occurring within the hypothalamus. Once the amygdala senses danger or fear, it sends signals to the hypothalamus, which activates the sympathetic nervous system responsible for amassing energy needed for fight-or-flight. Autonomic nerves in the sympathetic system send signals to the adrenal glands, stimulating them to release adrenaline, a primary stress hormone.
Adrenaline’s action increases breathing, blood flow, and heart rate to increase oxygen intake and transportation into the brain and muscles. Oxygen is the fuel that burns glucose in cells to release energy. The muscles require energy for fight or flight, while the brain uses it to heighten alertness to counter the threat. This surge in energy is what people popularly regard as the adrenaline rush.
Adrenaline also stimulates the release of cortisol, the long-acting stress hormone that sustains the longevity of the stress response, ushering in the traumatic state or the brain’s survival mode.
- Cortisol initiates and maintains the breakdown of stored carbohydrates, fats, and proteins into glucose.
- It also oversees the transportation of glucose molecules to the muscles and brain.
- It also suppresses energy consumption in other body organs and systems, such as the digestive and immune systems. Its action in the digestive system causes nausea, stomach irritation, a sudden urge to empty your bowels, and constipation because the hormone triggers the system to terminate any digestion process. Immune system inhibitions leave you vulnerable to sickness and disease.
- Cortisol interferes with serotonin levels and receptors in the nerve synapses, increasing vulnerability to mood depressive and anxiety mood disorders. Serotonin is a feel-good brain chemical. It inhibits the stress response and maintains emotional stability and calmness.
- Cortisol also triggers rumination, a vicious cycle of uncontrollable negative thinking that sustains the stress response.
The Hippocampus
Chronic stress or frequent exposure to stress affects hippocampal functioning. The hippocampus processes short- and long-term emotional memories. Stress augments neuron connections between the amygdala and the hippocampus, increasing distressing memories.
However, these memories lack the right cues and other essential elements present in healthy memories. They manifest as intrusive and vivid memories, flashbacks, and nightmares, which sustain the stress response.
The Prefrontal Cortex
Changes in neuron connections and brain chemicals also suppress the cognitive aspect of the prefrontal cortex, while amplifying emotional reactivity from memories retrieved from the hippocampus.
How Trauma Triggers Chronic Anxiety
Trauma sustains chronic anxiety through intrusive thoughts and memories, nightmares, and flashbacks, which sustain the stress response. The repression of logic, decision-making, problem-solving, and reasoning in the prefrontal cortex hinders rationalization or introspection, forcing you to react instinctively in distressing situations.
Trauma also heightens emotional reactivity, even on seemingly light or unrelated triggers. A hypersensitive amygdala can mistakenly perceive harmless situations as threats, triggering your body’s defense mechanisms.
How to Manage Trauma and Prevent Chronic Anxiety
EMDR Therapy
Trauma is a complex psychological condition requiring professional mental health care services. Eye movement desensitization and reprocessing (EMDR) therapy is an evidence-based intervention that resolves trauma, anxiety, and depressive disorders. EMDR therapy employs the Adaptive Information Processing (AIP) model, which targets the reprocessing of faulty, fragmented emotional memory from the hippocampus.
Through bilateral stimulation using visual, audio, or tactile techniques, moving from the left to the right side of the body and focusing on a particular problematic memory, the intervention activates memory reprocessing. The reprocessed memories no longer evoke intense feelings, intrusive thoughts, or disrupt mood regulation. The brain safely incorporates them into healthy memory networks.
Acknowledge Distressing Thoughts, Feelings, and Memories
Avoid suppressing or ignoring intrusive thoughts, feelings, and memories. Suppression triggers a phenomenon known as the rebound effect, which increases your obsession with the thing you are trying to forget. Those flashbacks, recurring memories, and intense thinking and emotional patterns are pointers. They indicate an internal conflict needing resolution.
Increase your awareness of your thoughts and emotional patterns. Find out what they reveal and evoke. Reason through the content with factual information.
Face Your Fears
The best way to conquer your fears or neutralise a threat is to face it. Courage does not mean the absence of fear, but acting even when you are afraid. Exposure therapies employ this philosophy to develop resilience. The therapist introduces the fear factor gradually in a controlled environment to enhance safety and comfort.
Stay Active
Depression and anxiety thrive in idleness. Keep your mind constructively occupied to prevent it from dwelling on negativity. Engage in hobbies. Take regular walks, cycle, or volunteer for a cause in your free time. Action produces feel-good brain chemicals, which counter the stress response.
Embrace Mindful Living
Mindfulness practices are key to managing your thoughts and emotions effectively. By shifting your attention from fear to the present moment, they also help you recognize and cherish the little pleasures in everyday life.
Remind yourself of what you have going on instead of mulling over things you cannot change. Appreciate and enjoy the meal you made. Take a walk and soak in the beauty of nature. Relish the company of friends and loved ones.
Surround Yourself with Loved Ones
Resist the urge to isolate. Science shows that a sense of belonging releases feel-good brain chemicals that counter the stress response. Leaning on friends and loved ones provides crucial accountability and support, helping you stay on track when life presents challenges.
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