Anxiety - Pathology
Most people who come to see me don't know what's triggering off their panic and want to be hypnotised to find out. This line of thinking relates back to analytical beliefs that some past trauma gets buried and bubbles up when we least expect it. Thanks to fMRI and CATscans we know the brain doesn't really work in this way.
The use of hypnosis in retrieving long term memory is contentious, as the brain does not store actual memories as such but retrieves elements of a memory and each time you remember it you reconstruct it a slightly different way - see memory and false memory for more explanation.
What we have to look at here is how the different parts of the brain behave. The part that deals with our fight or flight response is the part we share with most other species. Its use is to be alert for danger and respond so quickly we can escape without harm. This mechanism may be great when living out on the plains of Africa but not much use in Bristol, unless it's late and dark!
Our fight flight response happens like this:
Signals from our senses are filtered first through the amygdala which then checks the hippocampus for some suggestions what this might be and how to respond. The autonomic nervous system which oversees the body's functions originates in the anterior cingulated and is relayed to the hypothalamus and spinal cord. These send signals to the muscles to prime, the heart to beat faster and the digestive system to get rid of its load.
If there is no danger, it may leave you feeling a bit jittery and out of sorts. If however there is genuine danger - or what your brain perceives to be danger - then your body is flooded with cortisol and your pituity gland secretes hormones affecting every major gland of the body - remember animals including humans can smell fear.
However, like depression, in non life threatening situations, it's our experiences that determine how we react. People who are anxious develop an overly efficient neural pathway from the amygdala to the sympathetic response. This then gets into a loop whenever there is any knowledge a situation is about to occur - stage fright and driving test nerves are two such circumstances.
Where phobias are concerned, the response patterns get embedded in the hippocampus, along with the emotional response, so when we encounter the problem object it triggers the fight and flight response.
Some people however enjoy this rush of adrenaline - they find life without it dull and go looking for dangerous situations to make them feel more alive. So its our background, how we respond, and weighing up risks which has a lot to do with whether driving a car for example is immense fun or the most scary thing you've ever done.
Drug treatment
If you went to a GP and they prescribed drugs it's likely they would give you a drug that blocked adrenaline. The drugs called Propranolol and nadolol are known more commonly as beta blockers.
They also act to lower blood pressure and pulse, breaking the spiralling feedback between brain and body. Anti-depressants may also be used such as Temazepam, which is a type of medicine called a benzodiazepine. Benzodiazepines are used for their sedative and anxiety-relieving effects. Benzodiazepines work by acting on receptors in the brain called GABA receptors. This causes the release of a neurotransmitter called GABA (gamma amino butyric acid) in the brain. It is only used for short periods, and learning to change the way you think about anxiety is a better long term option.
If the GP suggests cognitive behavioural therapy for phobias or OCD then on the NHS you can receive 6 sessions, however talking to some CB therapists many reckon that it can take between 16 - 24 sessions to desensitise someone to the trigger.
Having experienced phobias and panic attacks myself I can honestly say the best method I found to tackle them were the techniques taught to me when training as a hypnotherapist. Alongside visualisation - how I'd prefer to respond - and having the motivation to achieve my results, I managed to eradicate my phobias.
Also see: Symptoms of Anxiety