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Anxiety & Panic Attacks

Healthy Beginnings  Sept 2016
by Rutherford & Gates

Thirty Percent of the American Population experiences clinically diagnosed chronic anxiety. About 70 percent of patients who walk into our office experience anxiety. Anxiety is defined as an excessive fear response and/or worry that interferes with functioning or causes significant distress. This is according to the Diagnostic Statistical Manual, Volume 5 – the gold standard textbook for psychiatrists. In their world it’s a psychiatric disorder. But Dr. Ted Carrick, the developer of the discipline of functional neurology, feels it’s more important to emphasize the role of the abnormal functioning of the basal ganglia as the underlying functional causal mechanism as the personality disorder diagnosis label of “anxiety.”

The basal ganglia is a processing unit deep in the brain that decides whether we can have an action-like movement. It decides whether we can move our eyes, or have an emotion. When the basal ganglion is functioning well, technically, we are calm. However, when the basal ganglia starts to break down due to one of a variety of causes, tremors of the hand, restless leg syndrome or Tourette’s syndrome can occur. Anxiety is the result of some neurological phenomenon, except that a different part of the basal ganglion is involved in creating the disorder.

There are two types of anxiety -productive and non-productive anxiety responses. An example of a productive anxiety response would be the frail grandmother 1 who sees her grandchild trapped in a dangerous situation – i.e., the child pinned under a car. Without thinking, she runs over to the car, lifts the car off her grandchild and saves the day. This represents a productive action, and occurred because Grandma’s fear-based response flooded her system with stress hormones that allowed her to produce a maximum muscular contraction effort far beyond what would be expected of a senior citizen under normal circumstances.

Chronic fear-based anxiety responses are not productive. This is the person who has nothing fearful impending, and yet they’re constantly worrying about the future and what might happen. These are maladaptive fear-based responses and are not productive.

Panic attacks are neurologically similar in nature to anxiety. They too are not psychological, but are in fact fear-based physiological problems. Panic attacks occur when they are least expected  (making it difficult to legitimately classify them as a psychological disorder). This unexpected panic reaction in turn creates more fear. You get hit with a sudden “panic attack” and your heart races above 100, you begin to sweat, you have chest pain and you’re worried you’ve just had a heart attack. The reason these symptoms occur is that there are imbalances in the fear processing circuits in the brain and there is excessive activation of the amygdala (the fear center of the brain).

When you’re presented with a fearful circumstance, the amygdala sends different signals through the rest
of your brain activating your fight/ flight response. A response that is primarily intended to be a “survival” mechanism. This response is the igniting and causative factor of both anxiety and panic disorders. It’s an over-firing fear center in the brain that, in the panic attack/anxiety sufferer, is more hyperactive.and more sensitive to normal stimuli than in the average person’s brain. These igniting stimuli can be light, sound, exercise, autoimmune responses, surgeries, traumas, overwhelming infections and more. If your amygdala is over reactive, these stimuli can create sensitivity and, once it is stimulated by an emotional response, the fear-based attacks become chronic. Emotional or physical traumas can make the amygdala oversensitive. Traumas stimulate the amygdala and make it grow, thus increasing its ability to create fight/flight response at the drop of a hat.

Back to the basal ganglion and its relationship to anxiety and panic attacks. Your frontal lobe has many functions. One of its most prominent functions is associated with thoughts and emotions. These can be positive emotions or fear-based emotions. To have these emotions, the frontal lobe must get
its command from the basal ganglia. One of the neurological pathways of the basal ganglion shuts off unwanted thoughts, and is dependent on frontal lobe functions as well. In anxiety and panic disorders, this frontal lobe function becomes abnormal and loses its ability to help the basal ganglion put the brakes on the amygdala fear­based response. The frontal lobe itself becomes overactive and there we are, we have anxiety and panic attacks better known in the functional neurological and functional metabolic world as an over­firing frontal lobe.

So in summation, you have a brain that has been set up to be over reactive due to past emotional traumas enlarging your amygdala, that is then set off by one of the many triggers mentioned above that then overstimulate an already vulnerable amygdala, all of which overwhelms your frontal lobe which, along with the basal ganglion, loses its ability to put the brakes on the amygdala – and now you have anxiety and panic attack “disorders.” This same mechanism plays into generalized anxiety disorders, social anxiety, obsessive-compulsive disorders and phobias.

The standard approach in today’s world is drugs. But what the functional neurologists realized is that if you go deep into the brain and exercise and strengthen the weakened structures of the brain (frontal lobe, basal ganglion) then they become far more able to shut down these fight/flight responses (overactive amygdala) before they occur. Functional medicine came to realize that, by dealing with the major metabolic components of brain chemistry and normalizing them (blood sugar, Hashimoto’s, inflammation, food sensitivities), you could also decrease the above outlined neurological mechanisms and chemical responses to fear-based stimuli and reduce panic attacks and anxiety.

Although counseling and drugs can be good short-or long-term solutions to both, it would appear that the functional approach of getting the brain to work better on its own without medication is a superior long-term approach relative to not creating many of the side effects associated with “psych” drugs, and allows the person suffering from “anxiety” or “panic disorders” to also avoid the stigma of being labeled with psychological “problems.”


1.  Towards a mechanistic understanding
of pathological anxiety: the dorsal
medial prefrontal-amygdala ‘aversive amplification’ circuit in unmedicated generalized and social anxiety disorders. Robinson OJ, Krimsky M, LiebermanL, Allen P. Vytal K, Grillon C. Lancet Psychiatry. 2014 Sep 1;1(4):294-302. PMID: 25722962 [PubMed]
2.  Mood disorders. Jorge RE. Handb Clin Neurol. 2015;128:613-31. doi: 10.1016/ 8978-0-444-63521-1.00038-8. PMID: 25701910 [PubMed – in process]