Fight-or-Flight Response and how it is different with regards to anxiety disorders.
This is my attempt to explain the difference between normal people (God, I really hate having to use that term) and those who suffer from anxiety and panic disorders. I am a member of the latter group.
The Fight-or-Flight Response is a biological and psychological change that occurs in the body when a danger is perceived.
In anxiety and panic disorders, the brain is acting as if there is a threat or danger even if there is not, in reality, one present at all. The following should explain why we sufferers cannot just snap out of it and remain in our excited, agitated and nervous state.
Let's start by taking an example. If you are hiking through
the woods and suddenly come upon a wolf, your body and mind
stop for a split second and the body begins pumping chemicals
through your system and preps your body for the decision that
is being made in that split-second, do you fight the wolf or
run like a bat out of hell? This split-second decision is usually made while our bodies are "paralized by fear", or standing perfectly still, another instinctive reaction left over from years of evolution.
Your brain becomes highly alert, and your heart starts pumping
furiously and your breathing changes.
The following list of what happens physiologically is taken from the book
Principals of Anatomy and Physiology, by Tortura and Grabowski, eighth edition.
Stress excites the sympathetic nervous system, the hypothalamus,
pituitary gland, and adrenal cortex. This produces the following
- The pupils of the eyes dilate.
- Heart rate and force of contraction and blood pressure
- The blood vessels of nonessential organs such as the
kidneys and gastrointestinal tract constrict.
- Blood vessels of organs involved in exercise or fighting
off danger skeletal muscles, cardiac muscle, liver,
and adipose tissue dilate to allow faster flow of
blood. (The liver splits glycogen to glucose and adipose
tissue splits triglycerides to fatty acids, both of which
are used by muscle fiber to generate ATP.)
- The rate and depth of breathing increase and the airways
dilate, which allow faster movement of air in and out of
- Blood glucose level rises as liver glycogen is converted
- The medullae of the adrenal glands are stimulated
to release epinephrine (adrenaline) and norepinephrine
(noradrenaline). These hormones intensify and prolong
the sympathetic effects just described.
- Processes that are not essential for meeting the stress
situation are inhibited. For example, muscular movements
of the gastrointestinal tract and digestive secretions slow
down or even stop.
In today's society, in which we aren't threatened by wild
beasts very often, most people will have a fight or flight
response to things like taking a test.
To paraphrase from the book, if the stress remains for a long
period of time, the excitation becomes more prominent and
if it remains for weeks or months it can weaken the immune
system. In this state, there may be a reduction of the levels
of epinephrine and norepinephrine (also called adrenaline and noradrenaline) in the brain, which are
two neurotransmitters that many medications given to people
with anxiety and panic disorders try to alter.
The following image is taken from an article from Discover Magazine that was published on their website at http://www.discover.com/mar_03/gthere.html?article=gthere.html?article=featfear.html
Basically what this means is that your brain is changing the
way it communicates with itself to deal with a perceived threat.
Sufferers from an anxiety or panic disorder may have their
brain stuck in this on position.
I'm going to add a few quotes from a great book by Dr.Robert
M. Sapolsky called Why
Zebras Don't Get Ulcers. This book focuses on the stress
response and chronic stress, which is basically what the Fight-Or-Flight
response or an Anxiety disorder is.
During stress, sexual drive decreases in both sexes; females
are less likely toovulate or carry pregnancies to term, while
males begin to have trouble with erections and secrete less
testosterone. This explains why people with anxiety disorders
have difficult sex lives.
During the Fight-Or-Flight response, less saliva is produced,
which helps explain why people with anxiety disorders suffer
from dry mouth and dental problems.
...the longer the stressor lasts, the longer the cumulative
time of exposure to CRF, causing inhibition of appetite.
CRF is Corticotropin Releasing Factor, a hormone secreted
by the hypothalamus in the brain. This explains the poor eating
habits of people with anxiety disorders, and why I often eat
only one meal a day.
Another, ah, interesting facet of prolonged periods of the
Fight-Or-Flight response is diarrhea and other bowel disorders.
But why, to add insult to injury, is it so frequently
diarrhea when you are truly frightened? Relatively large amounts
of water are needed for digestion, to keep your food in solution
as you break it down so that it will be easy to absorb into
the circulation when digestion is done. The job of the large
intestine is to get that water back, and that's why your bowels
have to be so long-the leftovers slowly inch their way through
the large intestine, starting as a soupy gruel and ending
up, ideally, as reasonably dry stool. Disaster strikes, run
for your life, increase that large intestinal motility, and
everything gets pushed thorugh too fast for the water to be
absorbed optimally. Diarrhea, simple as that.
Irritable bowel syndrome (IBS) is a hodgepodge of disorders
in which there is abdominal pain (particularly just after
a meal) that is relieved by defecating and which, at least
25 percent of the time, includes symptoms such as diarrhea
or constipation, passage of mucus, bloating and abdominal
All this helps to explain why people such as me are sick
most of the time - our bodies are stuck trying to fight off
physical or more often psychological stressors that the body
simply doesn't have the time or resources to combat diseases
or digest food and get the proper nutrients to build new cells.
I have to learn to live with the fight-or-flight response
on a daily, on-going basis. Medications that alter brain chemistry
(usually) help greatly manage this bodily response. Other
ways I use to calm myself are to calmly tell myself there
is no danger, I am safe and surrounded by safe people. Also,
forcing myself to breath long, slow, deep breaths help. But
the bottom line is there is a chemical imbalance that is stuck
in the on position and all of the above methods are needed
in order to just make it through the day without running away
in fear or fighting in anger.
I hope this helps you all understand what goes on behind both
an acute panic attack and general anxiety disorders.