This Is What Happens in Your Brain When You’re Anxious, According to Experts

We all experience anxiety sometimes—and chances are, we're quite familiar with the way it manifests physically (think sweaty palms, a racing heart, sometimes even itchy hives). But have you ever wondered what's actually going on in your brain when you have anxiety?

A lot of it comes down to chemicals. “Anxiety and stress cause the brain to release cortisol (the ‘stress hormone’), which can help manage the moment but which wears us down over time,” says licensed clinical psychologist Amy Marschall, PsyD. “Chronic stress is linked to all kinds of physical and mental health issues.”

Read on to learn more about the neuroscience behind anxiety, the long-term effects of anxiety on the brain, and how to cope with anxiety.

Brain Structures Involved in Anxiety

Our brains process anxiety and stress in what’s called the limbic system, which is made up of the hippocampus, the amygdala, the hypothalamus, and the thalamus. The limbic system is the part of our brain that connects to emotion and memory, as well as fear, stress, and motivation. It’s one part of the brain that regulates “autonomic” (what you might call automatic or unconscious) processes.

Hippocampus

The hippocampus is the part of the brain that consolidates information, and is associated with the different forms of memory: short-term, long-term, and spatial. The way your hippocampus processes and stores memories can affect anxiety if this part of your brain has made connections between your memories of stressful or anxiety-inducing events and how you respond to them.

Amygdala

The amygdala processes your emotional responses, especially fear. Aggression and anxiety also live in the amygdala, which processes memory and decision-making as well. This is another way for your brain to make connections between past experiences and the way you react to stressful stimuli.

Hypothalamus

The hypothalamus regulates the autonomic nervous system, and is one third of the hypothalamic-pituitary-adrenal (HPA) axis, which controls stress reactions and stress management. Overall, it coordinates the endocrine system, which also includes temperature regulation and appetite—two things that can be noticeably affected by anxiety and stress.

How These Structures Process Emotions and Stress

The limbic system—also called the emotional nervous system—made up of these four parts of the brain regulates memory, behavior, and emotions. Basically, every survival behavior, including how to react to your surroundings, when to eat and drink, and the need to reproduce, is produced by this system.

It’s also in charge of the way your body reacts to stress. Your heart rate, blood pressure, and body temperature are all a part of the autonomic nervous system that the limbic system manages. 

Your limbic system allows you to take in information, process that information, and react accordingly, learning from each experience and influencing the way you will react to similar experiences in the future. Using these four parts of the brain, this system regulates how you feel about stimuli, how you respond to those stimuli, and what effect those stimuli will have on you in the future.

Neurobiological Mechanisms of Anxiety

Chances are you’ve heard of the “fight or flight” response—but did you know that two other responses to stress have also been identified? It’s actually the “fight/flight/freeze/fawn” response, which sums up every common reaction to an anxiety-inducing situation.

“When the anxiety response is activated, the amygdala takes over—this is the fight/flight/freeze/fawn response,” explains Dr. Amy Marschall. “When you are in immediate danger, it can be the difference between life and death to act quickly in a way that eliminates the danger. However,” she notes, “the amygdala overrides the frontal lobe (the part of the brain that controls rational thought, language, and impulse control), so we can act out when we are experiencing anxiety in ways that would normally be out of character.”

So what happens in your body and your brain when you have one of these responses?

Fight

For people whose automatic response to stress is “fight,” they might have a tendency to get into fights or even physical altercations when faced with heightened stress. In fight mode, you’ll feel an adrenaline rush and intense anger, as well as physical responses like a higher heart rate and blood pressure. You might also respond with hypervigilence, like you’re tuned in at a higher level to the threat you are facing; you could also feel agitated and jumpy.

Flight

The “flight” response is characterized by the immense urge to flee, to physically escape the situation rather than to stay and try to resolve the problem. You’ll likely feel trapped, like the world is closing in on you; this could make you panic. In flight mode, you are more likely to perceive threats, both real and imaginary, and to try to avoid them at all costs.

Freeze

To “freeze” in response to stress is to completely shut down rather than have an “active” response (like fight or flight, which both require mental and physical activation). People freeze when fighting or fleeing isn’t possible. This stress response is highly associated with trauma and extreme anxiety. 

In freeze mode, you might dissociate (feel like you’re not connected to your body or like you’re mentally detaching from the present moment), feel emotionally numb or confused, or feel like you can’t make a decision or take action in this situation. You could also feel physical symptoms like numbness, holding your breath, or feeling like you can’t move. You might even lose the ability to speak. This stress reaction is one of terror.

Fawn

Sometimes, in a stressful situation, it feels safer to back down than to take action—this is where the “fawn” response kicks in. When you “fawn,” you’re showing submission to the person you fear; you’re trying to please this person instead of taking care of your own well-being. This reaction happens often in people-pleasers and those who have trouble setting boundaries. You might pretend to agree with the other person or do what they say no matter how it affects you. If you feel the need to fawn, your instinct is to be obedient to mitigate punishment.

The Impact of Anxiety on the Brain

Anxiety and its effects on the brain take place in the emotional regulation centers of the brain rather than the higher cognitive centers; this means that your unconscious, “emotional” brain is experiencing all the stress, changing the way you react to sources of anxiety.

There are many different types of anxiety disorders, with some symptoms that overlap. And consistently experiencing any or all of these anxiety disorders kick your brain’s limbic system into high gear. And with consistent high gear functioning comes constant stress on your nervous system.

Physical issues include high blood pressure, heart problems, weight gain, and even chronic illnesses like diabetes and cancer; mental health issues include anxiety disorders (as in, a consistent unhealthy and unhelpful response to stress) and depression.

“One consequence of prolonged anxiety on brain function is increased activation of the fight-or-flight system in the brain,” explains Dr. Romanoff. “Research has found that prolonged anxiety causes the amygdala to grow—which is the part of the brain responsible for responding to threatening stimuli and creating the fear response. This leads to intensified reactions to threatening stimuli—especially with regard to those that elicit fear and anger.” This change in your “fear” circuitry also negatively affects the way your hippocampus (through which you process information and memory) and your prefrontal cortex (where your “personality” lies) do their jobs.

Long-term anxiety also affects your cognitive functioning. “It disrupts rational decision-making, as the stressed mind is processing information through a ‘life or death’ lens,” says Dr. Romanoff, “which tends to lead to more extreme decisions and causes individuals to overestimate the likelihood of threat.”

Coping With Anxiety

So, you’ve got anxiety—now what?

“One of the best treatment options for anxiety is talk therapy, combined with medication (depending on the severity of symptoms),” advises Dr. Romanoff. “Medication can help bring the anxiety down to manageable levels so you can begin to work through and gain control over symptoms in talk therapy.”

Anxiety Medications

You’ve got options when it comes to medications for anxiety. 

Your doctor might prescribe an antidepressant, many of which are approved treatments for anxiety. SSRIs (selective serotonin reuptake inhibitors) like Zoloft, Lexapro, and Paxil, and SNRIs (serotonin and norepinephrine reuptake inhibitors) like Effexor and Cymbalta are commonly used to treat anxiety.

There are also anxiety-specific medications called anxiolytics, which are benzodiazepines. These include Ativan, Klonopin, and Xanax, and they act as tranquilizers. However, unlike antidepressants, benzodiazepines are habit-forming, and are only meant to be taken as-needed (as opposed to taking an antidepressant every day). 

Beta-blockers are also prescribed to treat anxiety, though this is an off-label use (a use for which the drug was not developed). Beta-blockers are helpful at relieving the physical symptoms of anxiety, such as a racing heartbeat and high blood pressure.

Therapy Approaches for Anxiety

The most common therapeutic treatment for anxiety is cognitive behavioral therapy, or CBT. This is an approach that targets negative thoughts and reactions and teaches you to respond to stressors in a different and more helpful way.

“CBT can be helpful to gain concrete behavioral intervention skills and clear strategies to implement to manage anxiety,” says Dr. Romanoff.  

She also recommends psychodynamic therapy, or therapy that is more focused on the experiences of your past and long-term solutions for deep-set problems, rather than the short-term and skills-focused approach of CBT. “Psychodynamic therapy can help with deeper and a more thorough analysis of longer standing anxiety symptoms that may be related to early life or more complex challenges,” she explains.

Exposure therapy can also be helpful when treating anxiety, especially for phobias. This is a subset of CBT that slowly introduces you to the triggers of your anxiety in a safe and contained way and teaches you, through practice, to react differently to those triggers.

ACT, or acceptance and commitment therapy, is also helpful when dealing with anxiety disorders. Rather than trying to change your thoughts and reactions like in CBT, ACT helps you accept your challenging thoughts and reactions as things that do not need “fixing” or “control;” instead, they are recognized as part of your emotional world, and you learn to live your life according to your values with the understanding that you might face—and conquer—certain problems along the way by being flexible and accepting of your anxiety and anxious responses.

Tackling Anxiety Outside of Therapy

Outside of therapy, there are plenty of exercises you can practice at home to fight your anxiety.

“If anxious throughout the day, practice grounding exercises,” proposes Dr. Romanoff. “This means engaging in strategies to ground you in the present moment. The easiest way to do this is to ground yourself through your senses. When you find your thoughts are racing, list 5 things you can see, 4 things you can touch, 3 things you can hear, and so on throughout your senses,” she suggests. “The theory is that your senses help you reconnect with the environment, pull you out of the chaos that has been created in your mind, and provide tangible evidence that the smoke detector in your mind pulled a false alarm. Basically, it’s an exercise proving that the lack of threat in the environment doesn’t match your high-anxiety reaction.”

This might involve developing better sleep hygiene, such as not looking at screens right before bed and going to bed and waking up at the same time each day, or incorporating an exercise routine into your week, since regular exercise has been proven effective in helping to manage anxiety. Meditation can also be useful, as it gives you time to reflect on what you are feeling and approach those feelings with respect and mindfulness; a diet that involves less processed foods, sugar, caffeine, or alcohol has also been shown to help manage anxiety symptoms.

Dr. Romanoff also speaks to the benefits of routine. “Research has found that your morning routine sets the tone for your emotional functioning and productivity for the rest of the day,” she advises. “It starts with small steps. For example: making your bed, doing a skincare routine, and eating a healthy breakfast. All of these tasks create a sense of accomplishment and generate momentum to continue to make additional achievements throughout the day.”

Why It's Important to Address Your Anxiety

If you are living with anxiety, it’s very important to try to treat it—your mental health might depend on it. 

Not only does living in constant anxiety physically stress your brain, kicking your nervous system into overdrive, but the negative effects those stress reactions can have on your daily life can be at best disruptive and at worst debilitating. If left unchecked, your anxiety can make it difficult to work, to interact with people, and to enjoy things in your life that would otherwise make you happy.

If you’ve been dealing with untreated anxiety for a long time, you might not know or remember what life without anxiety would be like—but you don’t have to suffer in silence.