The Fight or Flight response, which is the body’s hard-wired way of reacting to immediate danger, plays a role in clinical anxiety. It is characterized by a release of adrenalin, causing heightened alertness and vigilance, a feeling of being on guard, and a number of physical changes including increased heart rate and breathing rate. Apropos to the name “Fight or Flight,” this response revs up the nervous system and body to either repel an attack or run the heck away in the face of an immediate threat or danger. However, this limited, stereotyped response to stress is not well-suited to the stressors of modern society. Some of these stressors are extreme or out of the ordinary, but some are simply related to navigating the path of everyday life and responsibility.

Nonetheless, because the body has this limited way to respond to any kind of stress, the nervous system still reacts to these chronic problems as if they were immediate, dangerous threats. This causes disproportionate anxiety, fear, and panic, and partly explains “catastrophizing” which is when the person reacts to an everyday problem as if a catastrophe is taking place. Why do some people take everyday problems in stride and others feel overwhelmed? What causes this Fight or Flight reaction to be triggered much more readily in some than others? For some, the Fight or Flight reaction may be more sensitive and take very little to be triggered.

Some seem to inherit a nervous system that is simply more resilient than others. As there is no one without any stress, it has been said that it rains everywhere, but some have umbrellas and some don’t — some have biological or psychological predispositions or tools to respond to stress more than others. We know that there is a strong inherited or genetic component to these differences, and are not simply caused by a weakness of character or something that someone should “just get over” or be able to “pick yourself up by your bootstraps.” With Panic disorder, which has a strong genetic component, there can be times the Fight or Flight reaction goes off with no trigger at all, causing a panic attack out of the blue. For others, chronic stress itself can lower resilience and increase the sensitivity of the Fight or Flight response. The Fight or Flight response is just one factor that helps explain anxiety.

The good news is that treatment helps. Overall, the best treatment approach seems to be a combination of medication (to reduce the sensitivity of the Fight or Flight response or treat any specific underlying anxiety disorder) and psychotherapy, usually, Cognitive-Behavioral, to teach the mind and body to respond to and view stress differently. Sometimes, just one of these approaches alone is extremely effective. Treatment is best tailored to the individual and their unique circumstances.

Best Regards, Dr. Ranen (Psychiatry Baltimore, Baltimore County, Owings Mills) DrNealRanenBaltimorePsychiatrist.com