Anticipating Fear

“[The] only thing we have to fear is fear itself” – Franklin D. Roosevelt, 32nd US president

You probably heard this quote or something similar and perhaps even wondered what this might mean. In Franklin D. Roosevelt’s first inaugural address, he elaborates further with “nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance.” And although he was speaking to a nation, he could have easily been speaking to all of us as individuals.

Fear is an emotion that is at the base of our existence. Our brains and extended nervous systems are tuned and highly reactive to fear, as it has driven animals to advance to where they are to this day. We humans are no exception. Imagine if you will hearing a rustling in a nearby bush. It could be nothing or it could be the stirrings of a predator. Those who were afraid and sought shelter survived just a little more often than those who had no fear or chose to ignore it (because every so often, it was a tiger in the bush, and now your genes will no longer be represented in the gene pool). Although most of us reading this text live in peace and general prosperity, we can’t ignore that fear plays a role in our lives. This fear is often what causes us to retreat from the path that leads to a happy life, when instead we should convert into advance.

hailey-kean-111977-unsplash-300x226 Anticipating Fear
hailey-kean-111977-unsplash-300x226 Anticipating Fear

“Some things torment us more than they ought; some torment us before they ought; and some torment us when they ought not to torment us at all. We are in the habit of exaggerating, or imagining, or anticipating, sorrow.” – Seneca 

Neuroscience has shown in experiments what stoics like Seneca have preached for centuries; our habits are a product of a negativity bias that has develop during thousands of years of evolution (remember those who choose to interpret the rustle in the bush as a tiger) – negative experiences carry more weight. I’d like to focus on one aspect of this tormenting cycle in this article, namely, anticipation.

Experiments using brain imaging have shown that the anticipation of a painful experience and the actual experience are similar but distinct in the areas of the brain they activate. Anticipation activates areas associated with pain, as though it was similar to the pain itself. In the real world, we experience a great deal of anxiety in any impeding painful or negative experience. Although useful in a more threatening environment full of tigers, in a world of relative safety this intense anticipation becomes maladaptive.

Not only pain, but the anticipation of pain can alter your mood. It is believed that this anticipation of pain is relevant to the development of chronic pain disorders. Becoming tenser in the anticipation of pain will make pain often much worse. Think of someone telling you about a painful dental procedure in excruciating detail, and then slowly examining every instrument in preparation for the actual procedure, yikes. Conversely, distracting someone with questions or applying a heavy cognitive load (like counting back from 500 in steps of 7) can make the experience of receiving a shot relatively painless. Now the good news, if we gain control of our minds we can exert control on how we experience any number of negative situations.

We dread the anticipation of pain to such a degree, that we would volunteer to accept higher levels of pain immediately instead of having to wait for lesser pain. This was shown through an experiment where participants were asked to choose just that, higher levels of pain now or lesser pain delayed for a few seconds – isn’t science fun! 70% of participants preferred a more painful experience right away over waiting for a less painful experience; they just wanted to get it over with.

In life we may want to quickly rip of the bandage and simply get our pain and fears over with, but in the case of this experiment you would have been given perfect information about what you will be choosing – more pain right now or less pain after waiting. We rarely receive such a luxury in life, instead we are plagued with uncertainty, and this is where pain is bridged with fear. Uncertainty is ripe with fear. Anticipating a situation wrought with uncertainty is a tormenting experience, and leaves many people in a frozen state, anxiously waiting for some uncertainty to be resolved. Unfortunately the worse we feel, the greater the effect fear has on our mood and ability to take control over the negative effects of anticipation.

To this end, people suffering from major depression disorder experience pain differently. In an experiment comparing depressed patients with healthy controls, depressed patients showed more neural activation (via brain imaging) in response to the anticipation of pain. They also showed an increase in neural activation for experiencing pain, and a greater activation in the right amygdala (an area classical involved in fear responses) during anticipation of pain, which was associated with greater levels of perceived helplessness.

This is an example of a depressed brain being more active than a healthy brain, which is not always what we might assume when we think of being depressed. What this illustrates is also a mind that is overactive in the anticipation of negative experiences, and therefore bogged down in outward behavior. If you let fear, and particularly future fear, take control of your mind, you’ll often be frozen in state of agitation, expecting tigers when no such threat exists.

In the same letter to Lucilius (On Groundless Fears) as the above quote, Seneca quotes another great stoic, Epicurus: “the fool, with all his other faults, has this also, he is always getting ready to live”. Don’t let fear stop you from living. If you are free from pain and are safe, take a moment to enjoy what you have. If the future holds something grim, know that anticipating how grim it might be is worse than actually experiencing it. Do you want to exert some control over fear? Exercise your fears by grounding them. Name the fears, list them out; pull them into the light so you can see them for what they are.  Allow your fears to be a trigger to go deeper into yourself, and you may find that you are simply waiting on something that may never come to pass. If you find yourself confronting the fear of anticipating uncertainty, then forgive yourself and your fearful ancestors, thank them for trying to keep you alive. Now, let that fear go. Stop getting ready to live and just live.

 

References:

Ploghaus, A., Tracey, I., Gati, J. S., Clare, S., Menon, R. S., Matthews, P. M., & Rawlins, J. N. P. (1999). Dissociating pain from its anticipation in the human brain. Science, 284(5422), 1979-1981.

Welman, F. M., Smit, A. E., Jongen, J. L., Tibboel, D., van der Geest, J. N., & Holstege, J. C. (2018). Pain Experience is Somatotopically Organized and Overlaps with Pain Anticipation in the Human Cerebellum. The Cerebellum, 1-14.

Story, G. W., Vlaev, I., Seymour, B., Winston, J. S., Darzi, A., & Dolan, R. J. (2013). Dread and the disvalue of future pain. PLoS computational biology, 9(11), e1003335.

Strigo, I. A., Simmons, A. N., Matthews, S. C., Arthur, D., & Paulus, M. P. (2008). Association of major depressive disorder with altered functional brain response during anticipation and processing of heat pain. Archives of general psychiatry, 65(11), 1275-1284.

Cover Photo by Ian Froome on Unsplash

In-Text Photo by Hailey Kean on Unsplash

© Rebecca Böhme & Andrew Wold, 2018. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is prohibited. Excerpts and links may be used, provided that full and clear credit is given to the authors with appropriate and specific direction to the original content.

Exercise for your body and mind

Most of us should exercise more, and most of us know that. More exercise would be good for our health – but also improves our mental health dramatically.

The general recommendation is that we should exercise for 150 min per week. That’s not so bad – sounds like with half an hour a day, we might be fine. We can even break this up into 10 minute intervals and still get the same benefits. Kids and teens should move more, for them the recommendation is 60 minutes of intensive aerobic a day, at least 3 times a week.

 

Are you an active couch potato?

However, if we work out for half an hour per day and then sit for the rest of it, the benefits of the exercise does not outweigh the negative effects of the sitting. On average, adults only exercise 1 % of their day and sit for more than 8 hours! Unfortunately, the adverse health effects of sedentary behavior is independent of leisure time exercise. Only if you exercise more than 1 hour a day, and that means a moderate to intense work out – not just going for a walk – only then can you counteract the increased mortality rates due to chronic sitting. So, other physical activity is needed in addition to the planned training session at the gym during your lunch break.

Now, what are these adverse health effects of sitting? Most of us know that too much inactivity has negative consequences for the cardiovascular system; many have probably heard that also the risk for other diseases like cancer may be reduced by working out more. Lesser known is the relationship between sitting around too much and mental health problems.
e2b49f7cce0f43f3934f69b70bf2911f Exercise for your body and mind

 

Too much sitting can make you feel depressed

The risk for depression is increased by 15% for people who don’t move enough. This in turn relates back to increased mortality rates: people with depression die 8-10 years earlier (which is mostly due to somatic comorbidities). Of course, this is a catch-22: when you feel depressed, it is especially hard for you to motivate to work out.

One study was even able to show, that there is a causal link between sitting too much and depression: participants in this study were asked to sit for just additional 30 minutes per day – and these people showed an increase in their negative mood as well as greater stress induced inflammation.

The threshold for too much sitting seems to lie somewhere around the 6 hours per day. People who work eight-hour jobs might run into problems. Maybe you can ask for a standing desk or get yourself a yoga ball to sit on. It is also highly recommended to break up long periods of sitting. Take extra walks to the coffee room, the bathroom or the copy machine.

Exercise can even prevent future depression, as some prospective studies were able to show. One of them even claims that 12% of future episodes of depression are preventable with only 1 hour exercise per week!

One recent meta analysis  showed that exercise was as effective as psychological therapy and pharmacological treatment! The intensity of the work out didn’t matter, but the frequency did. Aerobic and resistance training both seem to be effective; the best results were found for a combination of both kinds of workouts.

If you feel motivated to start working out more after reading this blog post, take your training level into account. Don’t jump into a highly strenuous exercise program right away, because it will be a lot harder for you to stick with it. If you feel a lot of pain right after you worked out, you will start connecting exercise with feeling bad. Therefore, it will be harder and harder for you to get going again. If you start with a very light work out and increase it slowly, you can condition yourself to connect exercise with feeling good afterwards.

Whatever you choose to do, if you lift weights, run, do Yoga or even just go for brisk walk – as long as you get moving, you will feel happier!

e2b49f7cce0f43f3934f69b70bf2911f Exercise for your body and mind

Scientific literature:

Zhai, L., Zhang, Y., & Zhang, D. (2015). Sedentary behaviour and the risk of depression: a meta-analysis. Br J Sports Med, 49(11), 705-709.

Endrighi, R., Steptoe, A., & Hamer, M. (2016). The effect of experimentally induced sedentariness on mood and psychobiological responses to mental stress. The British Journal of Psychiatry, 208(3), 245-251.

Schuch, F., Vancampfort, D., Firth, J., Rosenbaum, S., Ward, P., Reichert, T., … & Stubbs, B. (2017). Physical activity and sedentary behavior in people with major depressive disorder: a systematic review and meta-analysis. Journal of affective disorders, 210, 139-150.

Mammen, G., & Faulkner, G. (2013). Physical activity and the prevention of depression: a systematic review of prospective studies. American journal of preventive medicine, 45(5), 649-657.

Bjerkeset, O., Romundstad, P., Evans, J., & Gunnell, D. (2007). Association of adult body mass index and height with anxiety, depression, and suicide in the general population: the HUNT study. American journal of epidemiology, 167(2), 193-202.

Phillips, A. C., Hunt, K., Der, G., & Carroll, D. (2011). Blunted cardiac reactions to acute psychological stress predict symptoms of depression five years later: evidence from a large community study. Psychophysiology, 48(1), 142-148.

Wen, C. P., Wai, J. P. M., Tsai, M. K., Yang, Y. C., Cheng, T. Y. D., Lee, M. C., … & Wu, X. (2011). Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. The Lancet, 378(9798), 1244-1253.

Brown, H. E., Pearson, N., Braithwaite, R. E., Brown, W. J., & Biddle, S. J. (2013). Physical activity interventions and depression in children and adolescents. Sports medicine, 43(3), 195-206.

Cooney, G., Dwan, K., & Mead, G. (2014). Exercise for depression. Jama, 311(23), 2432-2433.

O’Connor, P. J., Herring, M. P., & Caravalho, A. (2010). Mental health benefits of strength training in adults. American Journal of Lifestyle Medicine, 4(5), 377-396.

 

Photos by Jason Briscoe and Alex wong on Unsplash

 

 

© Rebecca Böhme & Andrew Wold, 2018. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is prohibited. Excerpts and links may be used, provided that full and clear credit is given to the authors with appropriate and specific direction to the original content.