Anxiety and the Brain: The High Road and The Low Road

What does your brain do with sensory information it gathers from your body? It puts together sight with sound, taste with smell. Then what?

Once sensory information is gathered from your body, it’s sent to two main destinations, along two different paths: the high road and the low road. The high road leads to your prefrontal cortex (PFC) and Worry Loop, the low road leads to your amygdala and Fear Circuit.

In the second post of this series, “What is Anxiety?” we covered that anxiety is made up of two basic components: worry and fear. Worry and fear come out of two very different parts of the brain.

We’ve talked previously about your Worry Loop and described that aspect of anxiety which is based in worry and ruminations about the future. The other path in the brain is your Fear Circuit: the part of your brain that feels anxiety as fear, panic, and phobia.

While your Worry Loop’s job is to think, plan, and act, the purpose of you Fear Circuit is to keep you alive in imminent danger.

Fear is the emotion, sensations, and responses of the brain and body that help you suddenly cover your head and duck when a baseball comes flying at your head. Fear is what enables you to go from deep sleep to suddenly alert, awake, and out the door when the fire alarm goes off in your house.

The purpose of fear is to keep you alive in imminent danger.

Your amygdala is a small, almond-shaped part of your brain deep in your limbic system. Your amygdala is the core of your Fear Circuit: the parts of the brain and the nerves that trigger the body’s fear response.

In fact, the most common metaphor for the amygdala is a smoke detector. We call the amygdala the smoke detector of the brain because it does the same thing as the smoke detectors in your home. While you go about your normal day, your amygdala is screening your basic senses, your thoughts, and your memories for current threats.

When it senses a threat, it sounds the alarm in seven different areas of the brain, quickly taking your attention away from that conversation with a coworker and turning it to that car approaching too fast. This response that turns your attention away from everyday goings-on to an imminent threat is called the fear response.

The High Road and the Low Road

Your whole-body fear response is intended to save lives or prevent harm. So, it happens fast. Two signals are sent from your thalamus. We called your thalamus Grand Central Station in a previous post since it organizes all the sensations coming up from your body.

Your thalamus signals both your prefrontal cortex (PFC) (the thinking part of the brain) and your amygdala (the smoke detector). But the signal travels faster to your amygdala by a few milliseconds.

The trip from your thalamus (Grand Central Station) to your amygdala (smoke detector) is just a little faster than the trip from your thalamus (Grand Central Station) to your PFC (thinking, conscious part of the brain) involved in your Worry Loop.

We call the path from your thalamus to your amygdala “the low road” because it’s quick and dirty. It acts on a rough sketch of the information coming into your brain. The path to your thinking brain is “the high road” because it sends a better synthesis of all the information going on, but it takes longer to get there.

A lot of the time you end up talking yourself down from a fear response when you realize there is no actual threat.

To understand the difference between the low road and the high road, think of the quality of the information sent by the low road to your amygdala as looking like 1930s black and white film. It’s grainy and rough, and you sometimes can’t quite tell what’s going on.

Your amygdala receives and acts on the low road’s grainy footage. Later, the high road gets its information to your thinking brain in a version with 4K resolution and surround sound.

The thinking brain might come to a different, more accurate answer about whether a baseball bat is being used for sport or as a weapon. But it gets that high-res image a split second after your amygdala has already responded to the low-res version. A lot of the time you end up talking yourself down from a fear response when you realize there is no actual threat.

Why You Have Two Paths

You need both the low road and the high road. The difference between the low road and the high road can be seen in everyday life. This is what you see if you’ve ever dropped a hammer and jumped back to pull your feet out of danger before you even consciously realized you dropped the hammer. Your amygdala told you to step back before your thinking brain even noticed the hammer.

Your conscious mind plays catch up whenever your fear response is triggered. I recently dropped a teabag on the floor and pulled my foot back just as fast as if I’d dropped a hammer. By the time the teabag hit the floor, my conscious mind realized there was no threat, but it would have been too late if it had been a hammer and I hadn’t reacted.

We’ve all had plenty of times where the low road to the fast-acting amygdala has saved us from harm. And we’ve also had plenty of times where the amygdala wrong and we acted fast, then realized there was no threat.

Can you think of any such situations in your life?

Would you take a moment to send some gratitude to your fast-acting amygdala, that works to keep you safe and sound? Would you send some appreciation to your prefrontal cortex, that gets a clearer picture of what is going on around you?

Most of all, see if you can find compassion for yourself for times you’ve reacted fast in fear only to find out a fraction of a second later there was nothing to be afraid of.

Resistance

The writing had been going so well. Despite massive scheduling and parenting responsibilities, I’d managed to pile up blog posts. I started writing a book and had 20,000 words written in a month, mostly during baby nap time and after the kids were in bed.

And then it hit me full in the face. Precisely when the work was going well, I was smacked down by resistance.

I fumbled, I fussed, I fidgeted. I read the news, I played games on my phone. I complained about having the exact same tight schedule I’d had for a year.

I had looked forward to the first day my baby went to daycare. I was going to take my oldest for a walk, come home, and make to-do lists with a cup of coffee. Then I was going to execute those to-do lists. And I was going to read. And I was going to write. Quiet time was close at hand.

Relinquishing my baby into the arms of another woman was harder for me than I thought. He went happily and then tried to close the door on me. I tried to just laugh it off.

Now procrastinating, I took my oldest for that long, slow walk. We came home. It was quiet. That’s what I’d been longing for. But instead I curled up under the covers and cried. I cried that I was cut off from my child, and I was scared because I’d lost my excuse not to write.

I got up to make lunches. Part of me wanted to go back to sleep. Part of me told myself to write. I split the difference and read a book about resistance that a friend had recommended to me: The War of Art, by Steven Pressfield. When my friends are suggesting books on resistance, and I resist reading them, that should tell me something.

Turns out it’s a good book. And I realized I was resisting writing by lots of means. My resistance was pointing to exactly what I needed to write. And my resistance was fueled by fear.

I acknowledged, not for the first time, that I am much more afraid of success as a writer than I am of failure as a writer. If I fail, no one will even notice. If I succeed, people might have opinions about my writing, and even share them with me. I’m not sure I want that. I’m not sure what that would do to me.

Knowing that the only cure for this is to write, and to write NOW, I picked up pen and paper for the first icebreaker, to write a slightly vulnerable piece to name the resistance that is interfering with my writing. There is power in a name.

Anxiety and the Brain: What to Do About Worry

We’ve talked about the Worry Loop, and how it plays a critical role in our ability to carry out the sequence Worry, Plan, and Act, which we each need to use to make it through the day. We also learned that the Worry Loop is a tract of brain cells that goes through three different areas of the brain. And we’ve discussed that there is both a genetic and environmental component to how much we worry. Now we’re going to look at the problem of worrying too much and what to do about it.

When to Worry About Worry

I get asked, “When should I worry about my worry?” As we’ve seen, the Worry Loop has its purpose. It helps us make plans and act on them. A little bit of worry energizes us, helps us pay attention, and motivates us to prepare for the future. But clearly there is such a thing as too much worry – when it’s all-consuming and you can’t enjoy anything anymore, and you are frozen by your worry. At that point it’s gone way too far.

So, what is the line that separates too much worry from normal amounts of worry? See if you can listen to your gut for a moment. Turn your attention inward and ask yourself if you believe your worry has gotten out of hand. Listen to the answer. Give it a lot of weight. No one else can necessarily see your worry or the effect it’s having on you, so if you feel that your worry is out of control, trust that and find some help.

Another sign is whether multiple people around you are telling you to stop worrying. If they are, think about why they are telling you that. Do they have a good point? Next, look at how much time worry is taking from you. What would you be doing if you weren’t worrying? If it’s a significant amount of time or activities, you may be worrying more than is productive. Is it making you miserable? Are you having trouble enjoying things, feeling present for things, or getting around to doing things because you’re spending your energy worrying? If so, it may be time to find something else to do with that energy.

If you’re still on the fence about it, or if you are dismissing your gut and your friends as biased, try the Patient Stress Questionnaire. It combines four common screening tools for depression, anxiety, PTSD, and alcohol problems. Taken together with other information, the screening tools may help determine when it’s time to get professional help.

Taking Action

Before jumping to the conclusion that your worry is irrational, think about whether there is something in that Worry -> Plan -> Act sequence you can act on. Maybe some of your worry won’t go away because there is the nagging sensation you need to do something specific you don’t want to do.

Maybe you need to make an appointment with a dentist about that tooth pain instead of worrying about what might be wrong. Maybe you need to end a relationship you know deep down isn’t good for you. Maybe you need to take the risk of starting a relationship with someone you find interesting, even though it might not work out. Or maybe you need to go ahead and clean out that closet instead of worrying about how much time and effort it’s going to take.

A lot of the things we worry about can be addressed by taking action. We’re quick to just want to get rid of the worry. Maybe the action is hard and scary. But when possible, the best course to ending worry can be taking action, if it’s something within your control.

Taming Worry

That said, there are plenty of worries that taking action doesn’t work for. If you’re worried you’ve left the stove on, and you’ve checked it twice already, checking again is not going to make you feel better. If you’re worried about a parent or grandparent catching COVID, there’s very little in your power you can do to protect them that you haven’t already been doing. If you’re worried about an asteroid hitting the earth, you know you’re catastrophizing and that worrying isn’t going to do a damn thing to stop it.

So, what do we do with these kinds of worries? What works for you may be a matter of trial and error, but here are three basic strategies. Note that medication is an important tool, but we’re going to give it its own set of posts later in this series. Today we’re going to focus on these three:

  1. Cognitive Behavioral Therapy
  2. Mindfulness Practices
  3. Engaging the body
The CBT Triangle. CBT is based on the theory that our thoughts, feelings, and actions influence each other, and by changing any one point on the triangle, we can change all three.

Cognitive Behavioral Therapy

One of the most well-known forms of therapy practiced today is Cognitive Behavioral Therapy, or CBT. Nearly every licensed therapist is trained in CBT, usually along with other approaches. And if you don’t have the time, money, or need for professional help, there are quite a few self-help CBT books out there. Not only is CBT popular, but there is a version of CBT tailored to almost every kind of psychological ailment.

There are books you read straight through like Cognitive Behavioral Therapy Made Simple by Seth Gillihan, Ph.D., and workbooks like The Anxiety and Phobia Workbook by Edmund Bourne or The Cognitive Behavioral Workbook for Anxiety by William Knaus, Ed.D.

You can also find endless YouTube videos on the topic. Emma McAdam, LMFT, has a great channel called “Therapy in a Nutshell,” and she has an entire series centering on cognitive distortions.

And there’s even an app for that. I’m hesitant to recommend a specific one because they change so quickly, but there are thought diary tracker apps and all sorts of CBT apps to help you tame your worry, whether you decide to go it alone or find professional help.

CBT is based on a combination of Behavioral Therapy and Cognitive Therapy. Behavioral Therapy is modeled on the idea that simple – but not always easy – changes in a person’s behavior can bring relief from symptoms.

Cognitive Therapy was developed out of the theory that thoughts have strong effects on both our behaviors and our feelings, so if we could change the way we think to have more accurate thoughts, we can change our emotions and actions.

Combining Behavioral Therapy with Cognitive Therapy created what we know as CBT. This is the triangle familiar to anyone who has done formal CBT. Our thoughts, feelings, and actions affect each other, so a change in one will change the others and lead to progress in all areas.

Some of the key features of CBT are that it is goal-oriented and focuses on a specific problem or problems. It’s present-focused, so you’re not revisiting the past as much as you are changing the way you interact with the present. One of the goals is to teach self-reliance, so that you are independently able to address your own worries and aren’t dependent on staying in therapy forever. CBT teaches you how to identify and correct your negative automatic thoughts. It teaches you to address anxiety by breaking it down into a number of feelings, thoughts, and behaviors in the present, and addressing those systematically and in a structured way.

Over the years, many evidence-based techniques have been brought under the CBT umbrella, including cognitive restructuring, progressive relaxation, behavior activation, meditation, and exposure. Even mindfulness has been brought into CBT, but I consider it so important we’re going to look at it on its own. The goal is to find the techniques that work best for you and your situation.

CBT is perfect for cognitive-based, Worry Loop anxiety. It’s almost tailor-made for it. But some parts of CBT don’t work very well for amygdala-based, Fear Circuit anxiety.

For example, changing your negative automatic thoughts is unproductive if your negative thoughts are also accurate and based on evidence and personal experience. If you live in a war zone, it’s not going to reduce your anxiety to come up with a percent estimate of how likely it is you will lose a family member to violence.

But if you are worried about getting struck by lightning and you’ve never known anyone struck by lightning, looking up the statistics and reminding yourself of them when panic creeps in during a thunderstorm will help put things in perspective.

If you’ve tried CBT for your anxiety and it hasn’t worked, that’s okay. We’ll get to the Fear Circuit soon. Consider mindfulness and engaging the body in the meantime.

Mindfulness

One of the best ways to manage worry is mindfulness. Jon Kabat-Zinn is a name you’ll hear if you read about mindfulness. He has been instrumental in bringing it into the mainstream, and he defines mindfulness as, “the awareness that arises through paying attention on purpose, in the present moment, and nonjudgmentally.” His seminal book is Full Catastrophe Living, which is a thorough tome, and he has also written Mindfulness for Beginners, which is a approachable book that comes with a CD.

Mindfulness is the practice of going, “Oh, that’s just a thought going through my head,” observing it, and then gentling bringing your attention back to the present moment – often to the breath – not to the anxious thoughts, not to the future, not to the past. Teaching mindfulness is a little outside of the scope of this post, but a good place to start is mindful.org/mindfulness-meditation-anxiety/.

You don’t have to become a great yogi to benefit from mindfulness. It would be ideal to set aside twenty minutes first thing every morning for mindfulness meditation. And the more worry consumes you, the more strongly I recommend this. That said, I’m not consistent at taking even five or ten minutes at the same time every day to practice mindfulness. Instead, I’ve found that I can incorporate it into everyday tasks.

Whenever I wash my hands, I intentionally slow myself down. I pay attention to the sink handle’s feel, temperature, and resistance. Then I give my whole attention to the sound of the water, the feel of it. Same with the soap, the movements of my hands, and the towel at the end. After that I’m back to my normal train of thoughts and onto whatever I was doing.

It’s just twenty seconds or so of something I was already going to do, but with practice I’ve trained myself to recenter automatically every time I go to the sink. And that little bit of centeredness goes with me through the rest of my day.

Engage the Body

Either in conjunction with mindfulness, or as a practice on its own, engaging the reptilian brainstem can be very powerful against worry. Focusing on the breath, doing counted breathing exercises, progressive muscle relaxation, taking a walk with a change of scenery, dancing, and doing aerobic exercise are all ways to fully engage your body. Using the body is a good way to get out of your head. Simply feeling your feet against your shoes and the floor and noting the sensation of the ground will make you “grounded.”

Another option is to get your emotional limbic system directed toward something else. Music is a good outlet for a lot of people. Turn on music in the mood you want to feel and really let yourself get lost in it. German metal might not be a good choice, even it’s your favorite. Choose something with a slower beat and soothing tone. It could be as quiet as choosing the “Relaxing Reading” instrumental playlist in Spotify, or it could be simply calmer than you currently feel. If you have a habit of worrying while going about your daily routine, consider whether anyone will even notice if you keep an earbud in and listen to some good music.

Another thing to try, particularly if you have difficulty with anxious thoughts while you’re trying to get to sleep, is binaural beats. It can also be helpful, relaxing background noise if you are studying or working.

Shows and podcasts can have similar results of engaging your thoughts and changing your mood. Just be careful to pick something that isn’t intense and anxiety-provoking. Even if they’re things you enjoy, the news and political podcasts don’t count as calming. Find something uplifting and engaging, like a good novel. Look to engage your limbic system in something fun and positive.

The key is to break out of the Worry Loop and then stay out. Engage your body, change your emotions, or distract your mind long enough to break the cycle.

Worry has its reasons. It’s there to help us make plans and carry them out. If it’s doing that, great, let yourself worry a little and decide what you’re going to do. But once you’ve made the decision, or if you’re no longer making progress, it’s time to change the internal channel. Take action and explore CBT, mindfulness, and engaging the body to develop strategies that work for you.

Anxiety and the Brain: Nature, Nurture, and the Worry Loop

“There must be something wrong with me. I worry all the time. My best friend never worries and tells me to just relax. It’s not that easy!” I have heard this said to me dozens of times. And when people believe there is “something wrong with them” they often equate this with a moral failing, as if it’s some kind of failure as a human being to be more anxious than other people.

It’s not a moral failing.

The reasons some people are more anxious than others are complicated. But two of the causes of anxiety in the Worry Loop that you can’t change are your past and your genes. Nature and nurture. These vary infinitely between people, but there are overall patterns.

It’s important to understand a little bit about how your genetic material and your experiences interact. The more you know, the more you can accept yourself as you are and find a path forward that works for you.

There are very few resources that explain more than “genes are complicated.” Those that do dive so deep into the details that those of us without a Ph.D. in neuroscience just nod and smile, then back away slowly. This is my attempt to bridge that gap.

The Example of the COMT Gene

To illustrate this complex interaction of genes and experience – nature and nurture – let’s focus on just one gene that impacts the Worry Loop: the COMT gene.

The COMT gene makes a chemical, conveniently called COMT. One of the things COMT does is process dopamine, both in the Worry Loop and elsewhere in the brain. Dopamine is one of the key chemicals that makes the Worry Loop work.




The COMT gene has two variants, Met and Val. Met causes the body to produce more COMT. Val causes the body to produce less. More COMT means more dopamine processing in the Worry Loop.

There are two versions of the COMT gene: Met, which produces more COMT, and Val, which produces less. So, people with the Met genotype process more dopamine than people with the Val genotype.

To look at the differences between the Met and Val genotypes, let’s use an oversimplified example of four fictional women, who all have identical genes except for one, the COMT gene. These women are named Mettie, Amethyst, Valerie, and Evaline. Not only are the four nearly identical genetically, but all four had good enough childhoods and grew into healthy, loved, supported adults.

With no major adult stressors, Mettie has normal dopamine processing and Valerie doesn’t have enough.

As you might imagine from their names, Mettie has the Met genotype and Valerie has the Val genotype. These two imaginary women lead the exact same adult lives, free from major stressors. They are each happily married, with three kids, and have work they enjoy, that pays well, and has a positive work environment.

But because Mettie and Valerie have different COMT genes, they process dopamine differently. Mettie has what researchers would call “normal” dopamine processing. She does well, doesn’t worry too much, and she performs fine at complex cognitive tasks. We’d all like to be a Mettie.

But Valerie’s COMT gene means that she doesn’t have enough dopamine processing going on in her Worry Loop. She doesn’t worry a lot. But because of her COMT gene, her dopamine processing is like a weak Wi-Fi signal. She has trouble concentrating on complex tasks at work and home. Things just don’t always connect.

So, is the moral of this story that the Met genotype is better to have than the Val genotype? Nope. Mettie and Valerie had good childhoods and few major stressors as adults.

It turns out that if you have big stressors in your adulthood, the benefit of the Val and Met genotypes is reversed.

The Effect of Stressors

Stressors in adulthood increase dopamine processing in all people, regardless of the type of COMT gene they have. For people with the Met genotype, dopamine processing increases from normal to too high. For people with the Val genotype, it increases from too low to just right.

Amethyst and Evaline had good childhoods too, but as adults they went through messy divorces, became single parents to three kids, and were stuck in low-paying, unfulfilling jobs in toxic work environments. In short, Amethyst and Evaline have stressors.

Both their Worry Loops increase their dopamine processing as a result.


With major stressors in adulthood, both women’s dopamine processing increases. Amethyst’s becomes too high, but Evaline’s increases from too low to normal.

That means Amethyst’s dopamine processing goes from “normal” to too high. Like an extension cord with too much electricity going through it, it overheats and threatens to melt. All of this overactivates Amethyst’s Worry Loop, and she becomes a “Worrier.” She worries far more than her genetic clone, Mettie, who didn’t have any big stressors. Worry interferes with her concentration and sleep, and those problems cause other problems.

Then there’s Evaline. Without stressors, Valerie’s dopamine processing was too low, but major stressors have kicked up Evaline’s dopamine processing. In fact, they turn it up from too low to ideal levels. Evaline’s genetic twin, Valerie, had trouble with complex cognitive tasks. Not so for Evaline. Neither is she a Worrier like Amethyst. She has just the right level of dopamine processing to function well and adapt under stress. She may not enjoy it, but she handles it well. We call her the “Warrior” type.

Chart of our four fictional women and their dopamine processing in the Worry Loop.

Thanks to Mettie, Valerie, Amethyst, and Evaline, we’ve seen that there are not necessarily good and bad genes, and people don’t respond to stressors in adulthood the same way, at least in part because of their genes.

It Can Get Complicated

Please don’t go trying to type yourself as one of these four fictional women. This was an oversimplified example. For starters, we all have two copies of each COMT gene, one from each parent. You could have a Met/Met, Val/Val, or Met/Val combination. About half of us have a Met/Val combination and fall somewhere between Evaline and Amethyst when we’ve gone through stressors.

And there are several genes believed to affect anxiety, not just the COMT gene. Also, dopamine is only one of the chemicals in the Worry Loop; there are at least six neurotransmitters at work there.

Furthermore, all four women in this example healthy childhoods. Trauma deserves its own series of posts. While childhood trauma hurts everyone, regardless of genes, some people are more affected than others, and genes are part of the reason we respond differently.

In evolution, variants don’t become as common as the Met and Val variants and stay so common in the genetic code unless there is some benefit to both the individuals and the species as a whole. Our species and our societies need all four of these women. We need people who function at their best when times are good and when times are bad. And we need our “Worriers” who can be vigilant to dangers and warn the rest of us to be cautious. And we benefit from “Warriors” who perform best under pressures and forge ahead when most are a bit more wary.

My hope is to shed light on how we each got to be the way we are – a combination of nature and nurture – and show some appreciation for our uniqueness. It’s the interplay between genes and our environment that matters more than either one individually.

Where We Go from Here

Just as anxiety’s causes are highly individual and complex, the answers to what we do about it vary from person to person. Our sense of personal agency helps us know ourselves and chart our best course for the future.

And it’s important to remember that while it’s good to understand our genes and experiences to make sense of our tendency to worry, that doesn’t have to lock us into a lifetime of anxiety and worry. Our past and our genetics can help us make sense out of how we got to where we are and why we may be more vulnerable to the effects of stress than others. It points us toward the need for self-care and possibly therapy and medications to offset the challenges that life has given us.

If they were real people, Mettie and Evaline, who have normal dopamine processing, would be able to go through life without changing too much. They’d adapt all right. But Valerie, who needs a certain amount of stress to be her best, might find herself going back to school and becoming an ER nurse – and thriving.

Amethyst, who’s a Worrier, needs a calmer work environment and extra support with the kids. And if it’s bad enough she may benefit from medication or therapy to help her do those things. There’s nothing inherently wrong with her, she just got an uncomfortable nature-nurture combo that keeps her safe and ultimately benefits the larger society. All she can affect is where she goes from here.

In the next post I’ll be discussing how to know when worry has gone past the point of being helpful and it’s time to do something about it. I’ll also be talking about some of the things we can do to manage the anxiety in our lives when the Worry Loop starts to get the best of us.

Anxiety and the Brain: The Worry Loop

The Worry Loop brain circuit.

In the last post we talked about a model of the brain as having three parts, each part with its own goals and methods of existing in the world. Each part of the brain manifests anxiety in a different way. But the brain is much more than parts. There are also pathways of communication between different areas of the brain. Communication happens when nerve cells, also called neurons, “fire” and send signals from one area of the brain to the other. The pathways these nerve cells travel are important to our experience of anxiety and relief from it.

As we mentioned previously, there are two different circuits in the brain that control anxiety. One we call the Worry Loop, the other we refer to as the Fear Circuit. Whereas the Fear Circuit taps into the mammalian and reptilian brain parts we discussed in the last post, the Worry Loop primarily acts in the part of the brain that is most developed in humans.

The feeling can be broken down into the two brain circuits that create anxiety.

Worry, Plan, and Act

We’ve talked before about anxiety being something that has a positive purpose. We have anxiety to keep us safe, and the same is true for worry. As uncomfortable an emotion as worry is, it serves a function. Worry helps us plan for the future, so that we can take action. We need some measure of worry. This is why we have a Worry Loop, to carry out the sequence: Worry, Plan, and Act.

The Worry Loop is important in cognitive control, determining what is important to pay attention to and telling the rest of the brain what to do about it. The brain is hard-wired to zero in on a problem, turn it over a bit, come up with a plan, and act on that plan. Being able to carry out the sequence Worry, Plan, and Act is part of what makes us human.

The purpose of worry is to help us plan and act, not to keep on worrying.

Unfortunately, sometimes we worry, plan, say, “What if?” worry some more, plan some more, second-guess our plan, worry about our plan, worry about our second-guessing, then worry about how much we’re worrying. At this point, we’re stuck on repeat in the Worry Loop. Sometimes we never even get to action. Or we act, but still don’t stop worrying. Half the time, the part we are worrying about is completely out of our control to begin with.

Signs of the Worry Loop

The name pretty well sums up what this circuit does. It thinks about a problem – on loop. If you have a tendency to worry, you know the feeling well, and you are probably accustomed to three of worry’s components: anxious misery, dread, and obsessions.

Three components of worry are anxious misery, dread, and obsessions.

Anxious misery is that feeling that clearly separates worrying from delightful daydreaming. You have anxious misery when you worry about whether that cough is COVID, not when you daydream that you’re about to get a paid day off. It’s the gnawing feeling that separates the two thoughts. While hard to put into scientific terms, you know it when you feel it.

The second component is dread. You know dread. It’s that feeling that something awful is about to happen. Some people may have the experience of a specific thing (or many specific things) that is about to happen. Maybe every time the phone rings you dread somebody has just been in a car wreck. Or maybe it’s the vague feeling of expecting the worst in every situation.

Obsessions are what separate fleeting experiences of anxious misery or dread from worry. Obsessions mean that you are thinking about the same unpleasant thing over and over again. On a loop.

You may be able to break out of it eventually, but if you’ve gone through the same cycle of thoughts a few times, those are what we’re calling obsessions. We’ve all been there. You don’t have to qualify for a diagnosis of Obsessive-Compulsive Disorder to experience obsessions occasionally.

The opposite of obsessions is being able to let the worrying thoughts come into your mind once, observe them with a detached, “How interesting,” and let them drift out of your head again. Few of us can do that all the time, but some of us worry more than others.

The Worry Loop is a tract of neurons running in a circle between the prefrontal cortex, the striatum, and the thalamus.

The Worry Loop as a Nerve Pathway

The Worry Loop is a loop in more ways than one. Not only does it remind us of looping backward in the Worry, Plan, and Act sequence, but it foremost means the looping brain circuits that make the Worry, Plan, and Act sequence possible. It’s intriguing to me that what feels like thoughts on loop in our minds is also chemical signals on loop through circuits in our brains.

The tract we call the Worry Loop is a bundle of nerve cells that runs between three parts of the brain, the prefrontal cortex (the rational, thinking part of the brain), the striatum, and the thalamus, then back to the prefrontal cortex. Because of that pathway, the formal name for these nerve cell tracts are CSTC loops. We have a number of these loops, but like most structures of the brain, it’s easier to call it just one Worry Loop.

The part of the prefrontal cortex that involves the Worry Loop is a thin layer on the surface of the brain that sits directly behind your forehead called the dorsolateral prefrontal cortex. That’s a long term meaning “top-side part of the very front of the cortex.” This part of the brain is key in planning and cognition, with cognition basically being a fancy word for thinking.

It makes perfect sense that our worries loop over and over through the part of the brain that plans and thinks, because this is basically how we perceive worry. The Worry Loop is also commonly called cortex-based anxiety (since the cortex is involved), and both names describe important aspects of this brain circuitry.

After the nerve impulse leaves the prefrontal cortex, it travels to the striatum. The Worry Loop connects to the top part of the striatum, which seems to directly contribute to decision-making, particularly to choosing and starting actions. Think of this part of the brain as key to committing to a plan and carrying out the action in the Worry, Plan, and Act sequence.

From the striatum, the Worry Loop continues on to the thalamus. The thalamus sits in the very center of the head. It’s the control center of the brain. It’s like the old telephone call operators. You would pick up the phone and ask the operator to connect you to your mother’s house. She would then physically plug in a wire to connect your phone to your mother’s phone. The thalamus works a little bit like this. It takes in all the sensory information, thoughts, emotions, memories, everything that goes on in our brains, assesses where they need to go, and connects those signals to the other relevant parts of the brain.

You could also think of it as Grand Central Station. All trains of thought connect back to the thalamus eventually. The thalamus sends its conclusions to wherever they need to go and brings the prefrontal cortex images and input to worry about.

A nerve cell, also called a neuron.

Neurons that Fire Together Wire Together

There is a saying in neuroscience, “Neurons that fire together, wire together.” When we use neurons at the same time over and over, they start firing together more and more often. Without getting too technical, take this example. If you think about your boss’s critical tone while you take the elevator to go to lunch, you are more likely to think about your boss again tomorrow on the elevator. Once you’ve done it a few times, you’re likely to think about your boss every time you get on the elevator. You’ve built an association between your boss’s tone and the elevator. The neurons that recognize you’re on the elevator have wired with the memories and emotions of getting criticized by your boss.

Likewise, worry reinforces worry. We build associations when we worry, and the more we worry about something, the more we buy into the idea that it’s something worth worrying about. So we run through the Worry Loop more and more.

Fortunately, the brain is amazingly adaptable. Just because we have associations that keep us worrying instead of committing to a plan and acting on it (or deciding how to keep ourselves occupied if we can’t do anything about it) doesn’t mean we are stuck in those patterns forever. We can break them. But just like any bad habit, it takes intention, practice, messing up, and trying again to get out of the Worry Loop.