Why “Just Calm Down!” Doesn’t Help Anxiety & Panic

If you’ve ever been anxious, or had a panic attack, you might have heard,

“Just calm down.” Or, “Relax, stop thinking about it” from well-meaning people. You probably found that this felt impossible.

Wouldn’t it be nice if it were that simple?

Unfortunately, anxiety doesn’t work like that. You have probably tried to “just stop thinking about it.” Instead, your thoughts race and the physical symptoms feel uncontrollable. Physical symptoms of panic and anxiety include:

• Difficulty stopping worried thoughts
  • Increased heart rate
  • Sweating
  • Fatigue
  • Hyperventilation
  • Light-headed/dizziness
  • Disassociation (“out-of-body” sensations or experiences)
  • Tunnel vision
  • Tightness in chest/perceived difficulty breathing
  • Tingling/numbness in hands and feet
  • Racing thoughts, preoccupation with thoughts
  • Difficulty sleeping and/or eating
  • Nausea or GI issues
  • Hypervigilance
  • Increased startle response
  • Discomfort in social situations/crowds
  • Difficulty relaxing

It’s frustrating. It can feel terrifying. You might have asked yourself “Why can’t I just calm down?!” Although panic and anxiety attacks feel terrible, they aren’t dangerous. But what is happening?

Well, say hello to your amygdala and your pre-frontal cortex.

The Neurobiology of Survival

The amygdala is an almond shaped structure that is very close to your brainstem. It is part of the limbic system. The amygdala is involved in emotional and sensory responses, especially those necessary for survival, including  anxiety and the fight-flight-freeze response.

The pre-frontal cortex is located in the front lobes of the brain. It is most developed in humans. It provides us with logic, critical thinking, analytical skills, and higher reasoning.

When the amygdala perceives a threat, it sends signals to your brain to release adrenaline, increase your heart rate and blood flow to your vital organs, and to shut down immediately unnecessary processes like rational thought (bye bye pre-frontal cortex!). This is why rational thought is hard to process during anxiety and panic.

The amygdala is much faster at processing information than the pre-frontal cortex. You are usually not conscious of your amygdala working in the background. It responds to a threat quickly and without conscious thought. This is an important feature! Anxiety (and therefore your amygdala) keeps you safe. If you were living 5,000 years ago, and your most important daily task was not being eaten by a larger animal, anxiety was very useful, and in fact, extremely important to your survival. You needed your amygdala to respond fast, to tell you “RUN! DON’T LOOK BACK!” You didn’t have time to think about it! People who had well-honed fight or flight responses were good at surviving!

Helpful vs. Unhelpful Anxiety

Anxiety serves us well in modern times too. Anxiety keeps us aware of our surroundings. It alerts us if something in the environment isn’t normal and tells us that there might be danger ahead. Anxiety keeps you from stepping on poisonous snakes, and tells you to cautiously investigate strange noises at night. A low level of anxiety can improve your attention to some tasks like taking a test or driving a car. This kind of anxiety is ok to have and is usually manageable. Everyone gets a little nervous during tests and it is good to pay close attention when you are driving.

Unfortunately, the amygdala hasn’t totally caught up to life in the 21st century. Anxiety becomes a problem when your amygdala incorrectly perceives a threat where there is none, or when the fight-or-flight response is out of proportion to the threat. People with anxiety disorders might experience overwhelming anxiety in situations in which other people would not, such as:

• Going to a friend’s house
• Meeting new people
• Driving
• Sending an email
• Raising a hand in class
• Meetings at work
• Spending time with family
• Traveling
• Talking on the phone
• Answering the door
• Going to a party
• Going shopping
• Being in a crowd
• Being alone

Remember, your amygdala is emotion-based. It does not respond to reason. It operates in the background, like internal processes on your computer, that are functioning without you being aware of them. It doesn’t respond to language. It responds to emotions and sensations. It immediately gives you the tools to escape a bad situation. And it’s much faster at responding than the part of your brain that does respond to reasoning, the pre-frontal cortex. This is great if you’re trying to outrun a bear. It’s not so great if you are trying to sleep at night and can’t stop worrying about all the things you have to do tomorrow. Anxiety might be due to overwhelming stress, previous experience, trauma, or it might not have a specific cause that you can identify.

When the amygdala is in charge of your brain, emotions rule. That’s why thoughts like “This isn’t a big deal, I shouldn’t be so anxious,” and “Even if something bad happened before, that doesn’t mean it’s going to happen again,” don’t immediately stop anxiety.

How Therapy Can Help

People seek therapy for anxiety when they can’t immediately identify the cause of their anxiety, or their anxiety response is getting in the way of living life. This is where therapy can help!

Anxiety is real. It is not just “in your head.” Since the amygdala doesn’t respond to reasoning or language, and you aren’t in conscious control of your amygdala, saying “Just calm down!” to your brain doesn’t stop panic and anxiety attacks. The amygdala has already released all of those fight-or-flight response chemicals and you feel hyper-vigilant and pumped up on adrenaline, which creates the unpleasant but medically harmless sensations of anxiety and panic attacks.

So how does a therapist help?

When working through anxiety, we use a “bottom-up” approach. We address emotion and sensation first (the amygdala), and then thoughts and rationalizations (the pre-frontal cortex). Your therapist can help you understand and process the root cause of your anxiety. You will learn brain-body and sensation based strategies to first to calm and soothe your body and your amygdala during panic and anxiety attacks, then to work though the unhelpful thoughts that come with it once your body is able to process these thoughts. When you know that you are in charge of your anxiety and it is not in charge of you, your panic and anxiety will decrease. You will be better at managing stress and you will be empowered to do the things you may have been avoiding or dreading. With your therapist’s support, you will learn coping skills to use now and in the future, and gain a better understanding of yourself. Your therapist can help you explain to important people in your life that “Just calm down,” isn’t helpful, and provide you with coping skills and strategies that you and your friends and/or partners can use to help you feel better.

Source:

Pittman, C.M. (2022).Taming Your Amygdala: Brain-based strategies to quiet the anxious mind. PESI Publishing, Inc.

If you are struggling with your anxiety or panic, please don’t hesitate to reach out! I specialize in treating anxiety and panic disorders in all ages. Taking the first step towards treatment can feel overwhelming. Know that you are not alone. When you feel ready, reach out to me to schedule an appointment. I am happy to answer any initial questions you may have and help you get started on the road to feeling better and more in control of your anxiety.