Fear, Anxiety, and the HPA Axis

To begin it must be made evident that Fear and Anxiety are in a sense necessary. We as humans thrive as a species because we have this innate response to fearful experiences. Our fears are responsible for activating the Hypothalamic-Pituitary-Axis (HPA) to elicit a stress response. This stress response allows our bodies to meet the needs of the stressful system to survive. The sympathetic response accounts for the adrenaline-like feeling we experience that can be described by elevated heartrate, respiratory rate, dilated pupils, and several other visceral responses. Most often, these responses are successful in helping us in acute fear eliciting instances.

The issue arises from the constant state of a fearful response which derives from anxiety. Anxiety is the state of worry that we might encounter our fears throughout our normal day of life. In some respects, this is a very helpful tool because it aids in keeping us alert when we are performing stressful tasks such as driving in the winter. The problem comes when our minds hold on to the anxious state during times that we should be in a parasympathetic state, or rest and digest as many might say. Many soldiers that come home from war experience this constant state of anxiety or in other diagnostic terms, post-traumatic stress disorder (PTSD).

PTSD is a common unfortunate burden soldiers bring home from wars that without proper coping or diagnosis can lead to severe issues. The problem in many cases of PTSD is the sudden sounds that elicit trained responses in these men and women causing them to act as they may have been trained to be prepared for combat. Furthermore, this issue leads them to further disorder such as chronic stress and depression.

Anxiety for most can be treated using several different methods, behavioral as well as pharmaceutical. Most commonly benzodiazepines are used as a treatment method for anxiety because it acts as an inhibitor of the system that activates sympathetic responses, leaving a more relaxed feeling instead of a stressful one.

Paired with anxiety that makes it such a harsh disorder is the fact that anxiety plays a huge role in memory formation. Being that fear is an innate trait we all have keeping us prepared for a stressful situation, we rely on memory to aid in recognizing dangerous situations. Long term potentiations play a dire role in memory formation due to the fact that they increase the ease of communication between our neuronal synapses especially in the hippocampus where we store our memories. The issue comes into play as we are not able to turn off these memories when we feel that they are causing great anxiety when a restful state is what should be called for. This is the ultimate unfortunate fact that those with great anxiety face as there is no cure for overactive memories especially those that cause us the greatest distress. Thankfully, behavioral therapy as well as mindfulness can help us cope with this burden as we attempt to carry on with normal day to day tasks.

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