Panic Attacks and Anxiety: Recap of a Great Article on Temperament

I read a marvelous article several days ago entitled, “Understanding the Anxious Mind.” Written by Robin Marantz Henig, it appeared in the September 29, 2009 edition of The New York Times Magazine. The article was so good I knew I’d have to spread the word moments after I began reading it. And you can be sure I’ll keep it handy for future reference.

Henig wrote about the longitudinal anxiety studies of Harvard psychology professor Jerome Kagan. Also featured was the work of Harvard psychiatrist Carl Schwartz who conducted follow up research on Kagan’s work.

Kagan’s studies focused upon the role of temperament in the predisposition for anxiety. His methodology consisted of establishing anxiety baselines in infants and tracking the unfolding of anxiety as the subjects progressed into adolescence and adulthood. The work brought to mind the temperament-based personality theory of Hans Eysenck, which I’ve written about in the past.

As the research began, Kagan fully expected to confirm that “edgy” infants most often develop into inhibited, shy, and anxious adolescents and adults. Now, it’s of no great surprise that a baby’s emotional presentation varies in accordance with temperament. And the temperament of 15-20% of the infants involved in the study showed strong reactions to novel people and situations. And Kagan’s longitudinal observations, indeed, revealed these strongly reactive babies often grow up to be chronically anxious. This brings the point home that many of us are temperamentally predisposed to our anxiety. I don’t know about you, but that’s been no secret to me for years.

The article goes on to suggest emotions can be identified in three ways. Foundational, of course, is our physiological brain state. And our emotions go on to be defined by how we describe our feelings and by their behavioral result. It makes perfect sense that the physiological piece is beyond our conscious control. But, the feeling and behavioral presentations are very much within management’s reach. Yes, simply having the physiological markers of anxiety doesn’t have to equate to a subjective anxiety experience.

Now, anyone who suffers from chronic anxiety knows the malady of the “what-ifs.” Thoughts such as these are most likely generated by a highly over-reactive amygdala, which I’ve discussed time and again. This little almond-shaped mass of neurons located deep within both of our temporal lobes is programmed to react and respond to the concepts of novelty and threat. By the way, recall the temperament of 15-20% of babies that result in strong reactions to novel people and situations.

Structural magnetic resonance imaging (MRI) has revealed something remarkable in the brains of “high reactors.” It seems the prefrontal cortex presents with a very significant “thickening.” The prefrontal cortex, the executive functioning headquarters of our brains, is pivotal in the generation of anxiety. It receives messages from the amygdala during times of potential alarm, which may call for activation of our fight/flight response. The prefrontal cortex rationally processes the threat and has the power to trump the amygdala’s call to action and calm it down. But that’s only if it’s sufficiently convinced a crisis doesn’t exist.

Interestingly, the question becomes, is this thickening of the prefrontal cortex an overgrowth of neurons resulting from tons of overtime work holding the amygdala in check? Or does the thickening actually cause hyperactivity of the amygdala?

Curiously, only one-third of high anxiety prone individuals develop serious problems. And that appears to be grounded in environment issues, such as birth order and the anxiety-coping techniques taught by parents and caregivers. By the way, the best formula seems to be directing the child to manage his/her distress on their own, individually determining what works best.

You know, as much as we may rue the results of our genetic endowment and formative environment; if panic attacks, obsessions, compulsions, phobias, generalized anxiety, and a propensity toward overreaction to stress and trauma are a true part of it - so be it. It’s fact that, among many other things, chronic anxiety sufferers are envied and valued for their caution, ability to effectively work alone, introspection, preparedness, conscientiousness, thorough work, and warm friendship. I, for one, am proud of my anxiety; and reading articles such as this only underscores my identity; and my right to be who I am, not what others may expect.

In closing, here’s a wonderful quotation from the article…
“An anxious temperament might serve a more exalted function too. ‘Our culture has this illusion that anxiety is toxic,’ Kagan said. But without inner-directed people who prefer solitude, where would we get the writers and artists and scientists and computer programmers who make society hum?”