Understanding Different Neural Pathways

If you have ever experienced feelings of anxiety, then you know how difficult it can be to just “calm down” even when you realize that you might be overreacting. You might also have quite literally felt anxious (racing heart, sweaty palms, adrenaline rush, etc.) out of the blue after hearing a song, smelling something that reminded you of your childhood or being in a location that reminds you of a triggering event.

If you have ever encountered either of these scenarios, then you will take solace in knowing that you aren’t alone. In fact, we actually have different neural pathways that are involved in the anxiety response.

Pathways That Create Anxiety

Thanks to research in the field of neuroscience, we are starting to understand that anxiety is a multifactorial and complex response that involves a variety of areas of the brain.

Two main pathways are primarily responsible for the anxiety response—the cerebral cortex and the amygdala. Additional brain regions involved in anxiety, fear and threat detection include the insula, the thalamus and the anterior cingulate cortex (ACC).

Simply put, these different pathways can create different anxiety responses. They are one of the main reasons we experience different kinds of anxiety and why reasoning and logic doesn’t always work and why even conventional treatment, such as cognitive behavioral therapy (CBT) and benzodiazepines, don’t always work.

Two Main Neural Pathways

Older research in the theories around anxiety focused largely on the amygdala, which is a principal brain region involved in fear and anxiety. However, the cerebral cortex is now becoming an area of focus in anxiety research as newer neuroimaging studies repeatedly show abnormalities in the prefrontal cortex in anxious individuals.

Anxiety can be initiated by two different neural pathways of the brain and in two different manners:

• The Cortex Pathway—through what we think about and perceive
• The Amygdala Pathway—through reactions to our environment

Some individuals may find that they experience anxiety through one pathway more frequently than the other. However, anyone and everyone can experience anxiety through both pathways.

The Cortex Pathway

The cortex pathway involves the cerebral cortex and is divided into two halves, the left hemisphere and the right hemisphere. The frontal lobes are also involved in the cortex pathway.

The cerebral cortex is the largest and more developed portion of the brain and is said to be its control and information process center. The cortex deals with how we perceive the world based on the sensory information we come in contact with and is responsible for higher brain functions, such as sensation, perception, memory, association and thought (Jawabri & Sharma, 2021).

The cortex pathway to anxiety begins with the sense organs, which include your eyes, ears, nose, taste buds and even your skin.

Thoughts that originate in the cortex may impact anxiety overall, as this is the part of the brain that allows someone to “worry about worry” or to think of things, thoughts, worries, fake scenarios and create “stories” and narratives around things that have not actually occurred yet.

In regard to anxiety, the cortex helps one evaluate and logically assess situations and perceived threats and dangers. It can help evaluate which response would be most useful when facing a dangerous situation (this is when we can logically try and talk ourselves out of feeling anxious).

The cortex allows you to make appropriate emotional decisions based on logic, reasoning and facts. The cortex can also be problematic in anxiety, as it can create and anticipate fears and worries that don’t truly exist. Thoughts produced in the cortex, not an actual event, can create anxiety.

The cortex can produce and create unnecessary anxiety, as well as worsen anxiety that originated in the amygdala. The cortex can contribute to anxiety due to the fact that it processes sensory information (such as smells, sounds and sights), which it can interpret incorrectly, taking a safe situation and making it appear as a threat to the body.

The cortex can imagine future anxieties and worries, create language and a narrative around it and even produce images (making up scenarios in one’s mind) with no logical explanation or solid reasoning.

Classical CBT therapy deals with cortex-based anxiety, which largely focuses on changing thoughts and logically trying to deal with anxious thought patterns. Other approaches that can be helpful with cortex-based anxiety include thought interruption and reframing coping mechanisms, utilizing brain dumps and practicing watching one’s thoughts.

The Amygdala Pathway

The amygdala is part of the limbic (emotional) system and is made up of two small almond-shaped structures. The amygdala is located in a central area of the brain, giving it immediate access to information from the senses, and it influences parts of the brain that can change body functions quickly.

The location of the amygdala is also the reason we might over-react to something initially, as we don’t give our logical cortex brain a say in the matter; once the situation has de-escalated, we might allow reasoning and lucidity to set in and we realize we might have acted too quickly.

The amygdala pathway generally triggers the fight or flight response in the body and includes physically feeling anxious. It also helps to form emotional memories.

The amygdala causes the physical sensations of anxiety to occur, including racing or pounding heart, perspiration and muscle tension, and it can create anxiety responses without your conscious knowledge or control. An amygdala-based anxiety response could also make someone feel as if they are not in control of a situation or their reactions.

The amygdala can unconsciously attach anxiety to situations and objects and is based on associations and pairings. This can include “triggers” that cause the amygdala to initiate physical feelings of anxiety, such as increased heart rate. It produces a fear response and reacts to potential dangers.

Tranquilizing medications, or benzodiazepines, are very effective at quickly reducing anxiety and physical symptoms of anxiety related to the amygdala pathway. However, they do not work as well on changing the actual circuitry of the amygdala, which is why long-term use might not be a beneficial treatment option.

The ability of the amygdala to override the cortex can be helpful at times, as our brain is hardwired for survival, especially in times of danger. However, this can make CBT and reason-based logical thinking approaches toward dealing with this kind of anxiety unsuccessful, as that would be a function for cortex-based anxiety.

Physical exercise, walking, swimming and body movement in general can all be beneficial tools in working with individuals who experience amygdala-based anxiety.

Why This Matters for Individual Treatment

Explaining and understanding the differences between the two main pathways can give health care practitioners an opportunity to create individualized treatment plans which can help manage symptoms of anxiety in a practical manner.

Identifying which neural pathway is favored during anxious states can be a novel approach toward developing individual anxiety treatment plans and coping mechanisms. Techniques used to target these specific sources of anxiety can help one become more effective in managing, treating and even possibly preventing anxiety.

Befriending Anxiety

If you are interested in learning more about the origins of anxiety, neural pathways and protocol then be sure to check out my Befriending Anxiety E-Learning Course! The course provides more than two hours of self-paced learning, interactive videos and handouts, which will give you the tools to develop healthy coping mechanism to manage anxiety. Learn more at www.briannadiorio.com. VR

References:

Jawabri, K. H., & Sharma, S. (2021). Physiology, Cerebral Cortex Functions. In StatPearls. StatPearls Publishing. www.ncbi.nlm.nih.gov/books/NBK538496/.

Karle, E., & Pittman, C. (2015). Rewire Your Anxious Brain how to use the neuroscience of fear to end anxiety, panic & worry. New Harbinger Publications, Inc.

Martin, E. I., Ressler, K. J., Binder, E., & Nemeroff, C. B. (2009). The Neurobiology of Anxiety Disorders: Brain Imaging, Genetics, and Psychoneuroendocrinology. The Psychiatric Clinics of North America, 32(3), 549–575. https://doi.org/10.1016/j.psc.2009.05.004.

McEwen, B. (2007). Physiology and Neurobiology of Stress and Adaptation: Central Role of the Brain | Physiological Reviews. https://journals.physiology.org/doi/full/10.1152/physrev.00041.2006.

Szalavitz, M. (2002). The Brain-Immunology Axis. Dana Foundation. https://dana.org/article/the-brain-immunology-axis/.

Brianna Diorio holds a PhD in integrative medicine from the University of Natural Medicine and is a clinical nutritionist with a Master’s of Science in Human Nutrition from the University of Bridgeport. She is also a functional diagnostic nutrition practitioner (FDN), an herbal practitioner through the Herbal Academy, a family herbalist through The School of Natural Healing, a NASM certified personal trainer, and a holistic lifestyle coach from the C.H.E.K Institute. Diorio is the host of the Brianna Approved Podcast, which is a podcast for people who like a holistic approach to real science and clinical research on all things nutrition, botanicals and balance. She currently works as a clinician with her private practice that specializes in alternative health, functional medicine and dietary supplements. Diorio works with a vast array of clients and businesses to educate and improve their health and dietary needs.