Imagine getting a bad review at work, or finding out that a suspicious mole might actually be cancerous. Your heart races, your chest tightens, your mouth feels cottony dry, and your skin feels sweaty. These are all classic physical symptoms of anxiety. And unless you’re like Alex Honnold, anxiety is nearly universal.
But the human body’s consistent response to anxiety actually hides two distinct psychological (and biological) phenomena. The first, let’s call it “growth anxiety,” arises in response to unpleasant but manageable challenges. The second, let’s call it “toxic anxiety,” arises from situations that exceed your ability to cope. It’s the difference between discovering a leak in your basement and losing your home to a hurricane.
Growth and harmful anxiety have strikingly different effects on the brain and body. Over the past decade, anxiety of any kind has gained a reputation for being harmful to health. Americans of all stripes are run away Anxiety can be reduced through medication and a lifestyle that promotes calm. In fact, harmful anxiety is biologically and psychologically harmful. However, developmental anxiety can promote health and resilience in the same way that exercise promotes health.
A key feature of growth anxiety is that, although it may feel uncomfortable, it does not exceed adaptive capacity. In general, performance under pressure follows an inverted U-shaped function: as stress increases, performance peaks and then declines. This relationship, called the Yerkes-Dodson law, was first described in 1908. Since then, dozens of studies have the study It turns out there is an optimum level of stress that produces the best boardroom speeches or baseball hits. White-collar professionals and baseball players may not realize it, but this is the sweet spot for growth anxiety.
When I was the Director of Student Mental Health at Weill Cornell Medical College, I often met with students seeking to ease their anxiety in the face of tough academic demands. One freshman told me that he had never studied so hard in his life, but he was still worried that he would not perform well. He wanted me to take away that anxiety with medication. However, as I talked to him, I learned that he was successful academically, if not spectacularly successful in exams. He was stressed, but he was handling the situation well and not sliding down an inverted U-curve toward overwhelming stress and failure. Because he was a competitive runner, I asked him how he felt during the race. He said he was nervous and a little sick. I pointed out that it was the same as you feel before an important exam. He immediately understood. It was a great relief for him to know that his anxiety was a normal reaction to a new challenge and not a sign of a mental illness that required treatment.
What’s remarkable about growing anxiety is that it can foster resilience in mind and body alike. evidence Results from both animals and humans suggest that the experience of controllable stress, compared with uncontrollable stress or no stress at all, can protect individuals from the negative effects of current and future stress. Acute anxiety It triggers a brief surge in two stress hormones, cortisol and norepinephrine. Cortisol causes the body to release glucose for energy and boosts immune function, while norepinephrine, a close relative of adrenaline, increases heart rate and blood pressure, prepares you to fight or flight, and improves focus. That’s why stimulants like Adderall and Ritalin, which increase norepinephrine more powerfully than everyday anxiety, have a powerful energizing effect.
Almost everyone knows from experience that walking around with your heart pounding, ready to pounce on any threat you come across, feels unpleasant in the moment, but as long as the effects aren’t long-lasting, it can be extremely beneficial. CortisolCombined with other physiological responses to acute stress, it can strengthen connections between neurons in the hippocampus, a brain region essential for memory and learning; and evidence Studies in stressed rodents and humans suggest that brief exposure to cortisol can prevent the emergence of anxiety- and PTSD-like behaviors.
in contrast, Chronic Stress and the anxiety it causes are not healthy or beneficial. Continued elevation of cortisol and norepinephrine increases the risk of developing diabetes, obesity, and hypertension, and also reduces cognitive function. Short-term stress causes neurons in the hippocampus to grow, but chronic exposure to cortisol causes them to shrink. 2009 StudyThe researchers followed 20 healthy medical students for a month as they studied for a major exam, a period during which they experienced near-constant stress. The researchers found that students in the high-stress exam group performed slower on tests of cognitive flexibility and had lower functional connectivity in the prefrontal cortex (the brain’s master of reasoning) compared to students in the control group. These negative effects had resolved when the students were reassessed one month after taking the exam.
Stress in response to ongoing threats is one form of toxic anxiety. Another form occurs in people who experience high stress in situations where there is little or no threat, such as those with social anxiety disorder or generalized anxiety disorder. This hyper-threat perception of threats would probably have been advantageous in a Paleolithic world full of threats, but in modern times, this stress is usually maladaptive. Except in the rare cases where modern life poses a real threat, many people overreact. On 9/11, a former patient of mine with generalized anxiety disorder was in his office in the South Tower of the World Trade Center. After the North Tower was attacked, an announcement sounded in the second tower informing people that it was safer to remain inside the building. Even after evacuation orders were issued, many people delayed leaving. ExitBut my patient, who was prone to anxious and disastrous thinking, ignored the initial announcement and fled just minutes before the buildings hit. The anxiety disorder that had plagued him until then saved his life.
Sometimes harmful anxiety is unavoidable. Certain work environments or relationships can relentlessly cause harmful stress. In these cases, the solution may require finding a different job or partner. Also, people who experience severe anxiety in the absence of stressors can benefit from a professional evaluation to treat a possible anxiety disorder.
But for most people, it’s within our power to transform harmful anxiety into growth anxiety. Another patient of mine had recently had a series of health problems that left him feeling overwhelmed and panicked. He was chronically anxious and socially isolated. He felt defeated, gave up on his diet and exercise habits, and even avoided follow-up appointments with his internist for prediabetes. Together, my patient and I broke down his cascading problems into challenges with manageable solutions. First, we chose the most immediate plan of action that would produce immediate results: cataract surgery. Then we identified actionable long-term interventions, like gradually increasing his activity level and introducing healthier foods. Soon he felt a sense of control, and the feeling of being overwhelmed disappeared.
Everyone has a different sensitivity to stress. The same task, even a public presentation, may be frightening for one person and exciting for another. But whatever your stress tolerance, even small interventions like getting enough sleep and exercising can help keep you from slipping down the inverted U-curve. There’s no need to fear growth anxiety any more than you fear the pain that comes with healthy exercise. Though both are uncomfortable, they make us stronger in the long run.
