First, let’s acknowledge that the goal of understanding anxiety is not about learning to remain calm and perfectly centered at all time. Even a healthy nervous system is not intended to work that way.  However, better understanding about how our bodies respond to perceived stress, and learning to practice a sense of grounded centeredness in the body can help us channel stressful energy in the best ways possible.

Many disciplines can help us in our gentle approach to understanding anxiety. In this article, we will draw insights from the following fields of study:

• Polyvagal theory – neuroscience explanation of our nervous system responses to stress

• Interpersonal neurobiology – therapies that blend neuroscience with relationship patterns

• Somatics – body-centered practices that involve the intentionally noticing internal sensations

• Underlying health conditions that contribute to anxiety.

We need multiple lenses to understand anxiety because our experiences are rarely one dimensional. Nervous system responses are complex, wise, and adaptive.  

Insights from Polyvagal Theory: Anxiety, Aggression, Avoidance, + Calm

Polyvagal theory offers us a powerful framework for understanding how our bodies respond to stress and trauma. Originally developed by psychologist and neuroscientist Dr. Stephen Porges, this theory describes how our autonomic nervous system, and particularly the vagus nerve, is constantly regulating our nervous system and influencing our behavior, without our conscious awareness.  This unconscious, automatic interpretation of threat is referred to as neuroception. 

Perceived threats to our nervous system may be physical, endangering our sense of personal safety, or much more often, threats are neuroceptive signals that come as subtle social cues. Sometimes an anxious nervous system state is a response to perceived slights against our core human needs for belonging and dignity.

Polyvagal theory outlines three main nervous system states. These include:

• Social Engagement Response (Ventral Vagal State): In this state, the nervous system is calm and allows for genuine social connection and free-flowing communication. We feel safe and socially engaged; we are able to access play, a sense of humor, creativity, and our bodily systems operate optimally.

• Fight or Flight Response (Sympathetic State): When faced with a threat, the sympathetic nervous system activates, increasing heart rate and energy to prepare for action – either to confront an aggressor (fight) or leave the scenario (flight). This state is useful for short-term responses but can be harmful and self-limiting if chronic. Anxiety is one way our brains express the fight or flight response.

• Freeze or Shutdown Response (Dorsal Vagal State): In extreme stress or perceived inescapable threat, the dorsal vagal system activates, leading to a shutdown response. This can manifest as dissociation, numbness, or a sense of disconnection. Freeze shares many attributes with depression, but actually involves a high degree of anxiety combined with an inability to take any productive action to relieve the anxiety or fear.  Freezing or shutting down may be an intelligent and adaptive state chosen by the nervous system for short periods of time. For more on the freeze state, check out the full article on Understanding Functional Freeze.

Bottom-Up Processing: The Body Is in Charge

The important thing to understand about polyvagal theory and the various states that the nervous system takes is the idea that traits follow state; that is to say, that our experience is determined by our bodies and our nervous system. In fact, 80-90% of threat signaling and perception comes from the peripheral messages from the body and is relayed to inform the brain unconsciously. So much happens to us precognitively, rather than vice-versa.

Polyvagal theory explains that our perceptions of threat are more dependent upon our bodily states rather than what we choose to think or the specific words we hear. Thus, becoming aware and attuned to your body is key to understanding our response to the world. As an example, many people experience extreme digestive symptoms such as diarrhea or constipation but can’t point to a specific food or ingredient trigger. A precognitive emotional response can often be involved in symptoms like this. (Check out the full article on Healing the Gut-Brain Axis here.)

We Are Often More Than One State at a Time: Blended Nervous System States (Fawn or Appease)

Most people are familiar with the fight or flight and even freeze response.  But our nervous systems are often more complex than this, engaging additional blended states to navigate complex social scenarios, particularly those with embedded power dynamics.  When faced with inescapable social threats or stressors, the nervous system may not have the opportunity to escape or confront the interpersonal conflict and may choose a mixed nervous system response such as fawn or appease. 

• Fawn Stress Response (Fight-Flight + Freeze without Social Engagement): Fawning involves feigning compliance with a perceived aggressor to diminish a possible threat. This might involve adopting softer tone of voice or a meek or unimposing physical posture.  A person with a fawning stress response will be heavily focused on pacifying, pleasing, and catering to the needs of others, rather than their own. Someone might declare themselves as non-confrontational, when really they're fawning. It's a learned habit from traumatic experiences.

• Appease Stress Response (Fight, Flight, Freeze, Social Engagement): Appeasing a perceived aggressor is an attempt to convince the perpetrator that the victim is actually on their side in order to evade violence, hostility, or some form of punishment.  Appeasement recruits all of the above listed nervous system states.

  
  
  
  

Our Nervous System State Is a Survival Response

Anxiety is a prevalent experience, often stemming from constant stressors that keep our sympathetic nervous system activated. The emotional and stress hormone stew that our body systems and brain are exposed to daily can be many times more powerful than any supplement or healthcare routine you could adopt. This state of hypervigilance can disrupt stress hormone balance (the hypothalamic-pituitary-adrenal axis, or HPA axis), leading to elevated cortisol, insulin resistance, inflammation, and increased susceptibility to autoimmune disease. Chronic habituated anxiety can deplete energetic reserves and cause burnout and fatigue.

Exposing the Roots of Anxiety

In addition to nervous system states, other conditioned patterns can be involved in patterns of anxiety.

(1)   Adverse Childhood Events, Early Childhood Conditioning, and Anxiety

Adverse Childhood Experiences (ACEs) are an important cause of anxiety.  A landmark research study that assessed the impact of adverse childhood experiences (ACEs) found that any number of 10 adverse childhood events increases your risk of mental and physical health conditions (www.acestoohigh.com).  One in 8 people have 4 or more ACEs.

In addition to ACE scores, many people have been conditioned from early childhood to perceive states of ease or restfulness as unsafe or unavailable, especially if their primary caregiving relationships were marked by instability or stress. Being expected to take on too much responsibility too early in life, often without adequate guidance or certainty, fosters a default state of hypervigilance and overfunctioning. This conditioning can lead to a highly mobilized anxious state, which may feel more familiar even if it is not peaceful or healthy in the long term. Understanding this conditioning is crucial for breaking the cycle of chronic anxiety and stress.

(2)   Overfunctioning as a form of Anxiety
Overfunctioning describes a specific subtype of anxiety that involves habitual and automatic absorption of excessive responsibilities, often to the detriment of one's own health. This pattern, often rooted in social conditions, can lead to burnout and further dysregulation of the HPA axis. Overfunctioning behaviors include:

• Worrying about others' responsibilities

• Taking over tasks to ensure they are done "right"

• Absorbing others' feelings

• Difficulty saying no and setting boundaries

• Overworking and over-scheduling

• Leaping into action before considering whether involvement is needed or called for

• Rescuing

Addressing core beliefs and coping mechanisms underlying these behaviors is essential for restoring balance.

(3)   ‘Complex Equivalency’: Anxiety Gives the Illusion of Productivity

For some people, the feeling of anxiety gives the illusion that we’re doing something productive and proactive about uncontrollable events.  Complex equivalency is the psychological term for believing that worrying will keep bad things from happening. Again, it feels productive and caring, but on the other hand, many people spend the middle of the night worrying when rest may be the most deeply productive thing to be doing.

(4)   Family Patterns, Genetics, Ancestral Trauma

This is a huge topic that perhaps deserves its own treatment in a future post, but we do know that susceptibility to anxiety-related conditions can be, in part, genetic or part of inherited family patterns.

A big part of unraveling conditioned anxiety is learning to discern the difference between making decisions from an activated prefrontal cortex (anxious state), versus remaining present and calm and trusting your ability to respond fluidly and creatively to situations as they arise.

Relief from Anxiety

When we are worrying or anxious we are not present in our own lives. This can affect our health, our relationships, and our sense of wellbeing and ability to enjoy life. Check out this four-part exercise to find relief from anxiety:

(1)   The Power of Pausing: The first part of that exercise is to pause and identify what is the worry. Ask yourself what is the story you are telling yourself.

(2)   Name It to Tame It: Give a word or a label to the worry or story that is arising. This is essential and helps you to ground your observer self as separate from the wave of anxiety that is arising.

(3)   Move from Thinking to Feeling: When you are clear on the worry, move down into your body and try and feel what the emotions are connected to that story. Try to stay in your body and feel the sensations related to the difficult feelings. A wave of emotion typically rises to its fullest intensity in 90 seconds if allowed to be experienced fully. So the key here is allow the sensations to arise, feel them, without adding on additional stories.

(4)   Self-soothing + Offering Comfort: When you are ready, comfort yourself. Extend compassion to yourself, specifically to the part of your body that is experiencing the big feelings. Wait until you can feel the deep sense of compassion meet the anxious feeling. [How to offer yourself compassion.]

More Practical Recommendations for Supporting Anxiety

To support yourself in navigating anxiety and stress, consider the following:

• Rest and Boundaries: Give yourself permission to rest and practice saying "no" to unnecessary commitments. Create unstructured time in your schedule to decompress.

• Intentional Pauses: Be intentional about taking frequent pauses throughout the day to notice whether your internal anxiety state matches the level of demand or stress being placed on you. Use these pauses to recenter and calm down.

• Calming Strategies: Be proactive about learning calming strategies that work for you. Examples include walking in nature, acupuncture, bodywork, craniosacral therapy, mental health therapy, journaling, self-compassion practices, and deep-breathing exercises.

• Keep a soft breath, ribcage, and abdomen: Tightness and reactivity in these areas is a good indication that your nervous system may be carrying excess tension.  Check out hands-on work for the abdomen or incorporating therapies for the breath or digestive system to help yourself re-regulate.

• Get Out of Your Head and Into Your Body: To overcome waves of anxiety, you do not need to completely understand its cause; the aim is to regulate the nervous system in the present moment.  Know that anxiety is an over-protective feeling.  Practice self-compassion towards your overly cautious, fearful impulses, but do not feed into them.

• Re-orient: Anxious thoughts fuel tunnel vision and a tight visual focus.  Break this up by pausing to slowly turn your head from side to side until you can appreciate the three-dimensionality of the space around you.  Actively turning your neck muscles, softening into the peripheral gaze, and being able to appreciate something beautiful in your surroundings physiologically interrupts run-away anxiety and promotes the safety reflex.

• Ground: Engage and tire out the biggest muscles in your body in your glutes and legs by doing lunges or squats.  Do a few repetitions until you feel deeply connected to your legs, gravity, and the earth. Practice regular and frequent movement and physical exercise to break cycles of anxiety and rumination.

• Lengthen the Exhale: Focus on lengthening the out breath. You can add a gently humming or ‘ooo’ sound to help tone the vagus nerve even more.  

• Herbal Allies: Work with calming nervines as herbal allies. Herbs known for their calming properties include: Lavender, Chamomile, Lemon Balm, Passionflower, Valerian Root, Skullcap, Ashwagandha, Holy Basil (Tulsi), Rhodiola, Oat Straw, Blue Vervain. Work with your individual doctor to select herbal therapies safe and appropriate for you.

• Evaluate Your Well-being: Especially for over-functioners, make a point to reflect on your definition of happiness and well-being, ensuring it aligns with your true desires rather than pressures that you may be carrying from loved ones or an invisible audience.

• Social Support: Engage in meaningful social connections that offer co-regulation and a sense of safety. This can significantly impact your ability to manage stress and anxiety.

  
  
  

Underlying Health Conditions that can Increase Anxiety

When we view our health holistically, there are many different health conditions and physiological causes that contribute to anxiety.  It may be helpful to consider these aspects before and/or in addition to pharmaceutical approaches to anxiety.

• Disturbances in the Microbiome: Alterations in the gut microbiome can lead to changes in the availability of neurotransmitters, including serotonin, norepinephrine, dopamine, and GABA which directly influence mental health.  For example, research studies have shown significant increases in anxiety and depression in the weeks following exposure to several classes of antibiotics (Dinan et. al, 2022). There are also correlations between anxiety and digestive conditions like irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), GERD, gastritis, and dyspepsia (Zhang et. al 2016).

• Methylation Defects (genetic deficiencies in pathways affecting neurotransmission): We all need bioavailable forms of B12 and folate in our diet. Many people (up to 66% of the population) lack fully functioning copies of enzymes that make the most efficient use of these essential nutrients. Genetic testing for MTHF and COMT genes can help determine if a genetic deficiency may be contributing to a host of neurological symptoms, including anxiety, OCD, cognitive issues but also hormone, immune, and cardiovascular issues.

• Hormonal Imbalances: Hormonal changes related to menstruation, pregnancy, or menopause can cause anxiety levels particularly ovulatory disturbances or low progesterone. [For more on this, check out my full article on The Quiet Power of Ovulation]

• Blood Sugar Imbalances: If you struggle with anxiety, make sure your blood sugar is well-balanced and your diet and digestion is attended to. The peaks and valleys of dyregulated blood sugar can worsen anxiety and contribute to panic attacks.

• Shallow Breathing, Respiratory Conditions

• Thyroid disorders

• Interrupted sleep and sleep disorders

• Medications and Substances: Certain medications and substances, including caffeine and nicotine, can trigger or worsen anxiety symptoms.

• Anemia / Iron Deficiency: Iron is a key nutrient that plays a role in how the body produces neurotransmitters like serotonin, dopamine, and norepinephrine, which are important for mental health. Low iron levels can lead to behavioral changes that can manifest as chronic psychiatric conditions, including anxiety, depression, and sleep disorders. Check out the full post on Iron Deficiency Anemia here.

• Compromised Physical Health and Living with Chronic Pain are associated with higher levels of anxiety.

• Neurotransmitter Imbalances: Imbalances in brain chemicals like serotonin, dopamine, and gamma-aminobutyric acid (GABA) can contribute to anxiety.

• Personality Factors: Certain personality traits, such as being highly sensitive or perfectionistic, can predispose individuals to anxiety.

These factors, along with lifestyle and environmental stressors, can contribute to the development and maintenance of anxiety.

Understanding the intricate layers of anxiety—from its roots in early childhood conditioning and overfunctioning patterns to the nuanced states of our nervous system—empowers us to make informed choices about how we respond to stress. We can be in better and deeper relationship with ourselves and have more agency over our choices, rather than being driven by compulsion. By exploring these dynamics, we can cultivate healthier habits, foster deeper self-awareness, and ultimately, restore resiliency in our lives. As you move forward, remember that true well-being involves both recognizing and responding to your body's signals and committing to practices that support the life you want to create.

REFERENCES

o   Burke, Harris N. (2014) How childhood trauma affects health across a lifetime. www.ted.com,

o   Dinan K, Dinan T. Antibiotics and mental health: The good, the bad and the ugly. Journal Internal Medicine. 2022 Dec;292(6):858-869. doi: 10.1111/joim.13543. Epub 2022 Jul 12.

o   Levine, P. (2010) In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness.  Berkeley, CA: North Atlantic Books.

o   Porges, S. (2016) Co-Regulation. www.relationalimplicit.com

o Porges, S. (2017). The Pocket Guide to Polyvagal Theory: The transformative power of feeling safe. W W Norton & Co.

o   Zhang AZ, Wang QC, Huang KM, Huang JG, Zhou CH, Sun FQ, Wang SW, Wu FT. Prevalence of depression and anxiety in patients with chronic digestive system diseases: A multicenter epidemiological study. World Journal of Gastroenteroly. 2016 Nov 14;22(42):9437-9444. doi: 10.3748/wjg.v22.i42.9437.

[1] Svadhyaya in yogic studies;