“Is anxiety a chemical imbalance?”
“If anxiety is a chemical imbalance, then I need medication to treat it, right?”
I am asked these questions all the time, so let’s take a closer look at this.
What really causes anxiety? That depends on who you ask.
Nature or Nurture?
We know that risk for anxiety is increased if anxiety runs in your family, but scientists have not identified any “anxiety genes.” The correlation could be genetic or it could be environmental, or both. Many children are conditioned to be anxious if they live with anxious adults, or if they live in chaotic, stressful home environments.
Below are three of the main theories about the causes of anxiety. All have been scientifically studied. Nobody knows for sure that one theory is right, or that other theories are wrong.
The “Chemical Imbalance” Theory
This theory says that anxiety is caused by a chemical imbalance in the brain and you have to take a pill (likely for the rest of your life) to alter the chemical balance. Much of the scientific research to support this theory is paid for by drug companies, whose existence depends on the Chemical Imbalance Theory. They have trained doctors about it, and trained us through millions or billions of dollars worth of commercials and advertising.
The “Avoidance” Theory
Avoiding the things you fear is what causes anxiety. If you’re afraid of being trapped or closed in, you may avoid things like elevators and airplanes, and make sure you sit near doors or exit routes. When you’re anxious, you are likely avoiding a problem that’s bothering you and you’re not aware of it. The problem will have power over you as long as you keep avoiding it.
The “Thoughts Create Feelings” Theory
The feeling of anxiety is caused by negative thoughts: conscious and particularly sub-conscious. When you feel anxious, it is because you are telling yourself that something bad is going to happen. For example, if you have a fear of going into social situations where you would have to meet new people, you may panic and think “I’m going to make a fool of myself.” Your feeling of fear does not result from the actual social interaction, but from the negative messages you give yourself before, during and after.
Which Theory is Right?
Naturally, supporters of each theory believe they’re right. We can find scientific research to support many different theories.
Some people have a hard time believing anything other than the Chemical Imbalance Theory because it is so widely promoted. And because “my doctor said so.”
But the research also shows there is a “placebo” effect with pills, where many people think they feel better even when they are taking a sugar pill instead of the real medication.
Many neuroscientists no longer believe the Chemical Imbalance Theory. They are researching the neural circuits in the brain instead…and discovering how the neurons in our brain have the amazing ability to change and form new, anxiety-free thoughts.
Toolkits for Different Theories
When you see a doctor, counselor, or other practitioner for anxiety, the tools they have to offer you depend on what theory they believe in.
Chemical Imbalance Theory
–> Solution for anxiety = Take a pill to correct imbalance
–> Toolkit: Prescription medication (indefinitely)
–> Solution for anxiety = Stop running and face the problem/fear
–> Toolkit: Exposure Therapy
Cognitive Behavioral Therapy (CBT)
Thoughts Create Feelings Theory
–> Solution for anxiety = Change your brain and the way you think
–> Toolkit: Cognitive Behavioral Therapy (CBT)
I work with lots of people who don’t want to take drugs for the rest of their lives. For some, anxiety medication is fine and provides the symptom relief they want. Others seek a more holistic and preventative approach, as medication does nothing to stop the source of anxiety or prevent it from returning again.
I’m a very practical person. I’m more focused on WHAT WORKS than on any particular theory or figuring out which one is right.
I see a lot of people who have taken medication for anxiety and still have anxiety (that’s why they come to see me!). Many also dislike the negative side effects of drugs, and would prefer a drug-free approach.
And people are overcoming anxiety every day without drugs. It is happening right before my eyes in my office.
I see people take control over anxiety and make lasting changes with a combination of holistic tools that teach people effective ways to manage anxiety symptoms, along with Cognitive Behavioral Therapy (CBT) to change the brain and thinking patterns, addressing the root cause of anxiety.
What Fits for You?
Know that there are different theories. Check in with yourself and see which theory makes sense to you. Be practical…what seems to work for you and what doesn’t? We are each unique. I don’t think that one generic solution fits all. Be open and willing to explore and you might find solutions for your anxiety that you never thought possible!