The Science of Anxiety: How to Rewire Your Stress Response

Raise your hand if you consider yourself anxious?

That’d be me in the back of class joining y’all. Anxiety has powerful effects on the brain. If there’s one thing I’ve done to make my life better in the last year to two it has been a focus on mindfulness. Mostly for my anxiety. Today, let’s look at how anxiety effects our brain and what we might do about it.

In This Edition

1. Decoding Anxiety

2. Brain Hack of the Week

3. Reflections from the OR

4. Neuroscience Insight

5. Final Thoughts

🧠 New Brain Study Shows How Anxiety Takes Root in Early Life

A fascinating look at how our brain's wiring can make us more likely to develop anxiety, especially during childhood.

Scientists have made a breakthrough in understanding why some people are more prone to anxiety than others. The key lies in something called "behavioral inhibition" - basically, how cautious or fearful we are in new situations, especially as kids.

The research team used monkeys (whose brains work similarly to ours) to look at a specific part of the brain called the posterior orbitofrontal cortex (pOFC). This area talks to other brain regions that handle fear and anxiety, kind of like a control center for our stress responses.

What makes this study special is how it connects the dots between our genes, brain structure, and behavior. The scientists found that when we're stressed, certain molecules in our brain change how our nerve cells work. One molecule they spotted, called caldesmon, seems particularly important - it might help explain why some people get anxious more easily than others.

They also found something interesting about cortisol, our main stress hormone. The way it works in the brain might explain why some kids who are naturally more fearful often develop anxiety problems later in life.

This isn't just interesting science - it could really help people. By understanding exactly how anxiety develops in the brain, doctors might be able to spot kids at risk early on and help them before anxiety becomes a bigger problem. It's like having a map of anxiety in the brain that could guide new treatments.

Think of it this way: if anxiety is like a plant, this research helps us understand its roots. And just like you can help a plant grow better by taking care of its roots, understanding these brain mechanisms might help us better support people who struggle with anxiety.

According to the study, published in the Proceedings of the National Academy of Sciences, this could lead to new ways to treat anxiety that work better than what we have now, because they'd be targeting the exact spots in the brain where anxiety begins.

TLDR:

• Scientists studied how anxiety develops in the brain using monkey research

• Found specific brain areas and molecules linked to anxiety, especially in early life

• Discovered how stress hormones might make some people more prone to anxiety

• This could lead to better ways to spot and treat anxiety early in life

• Research opens doors for new, more targeted anxiety treatments

Brain Hack of the Week

🛋️ Hack:
Box Breathing to calm your nervous system and regain control during moments of anxiety.

⏳ Time Required: 4 minutes

💭 Why It Works:
Box breathing activates the parasympathetic nervous system, helping lower cortisol and shift your body out of “fight or flight” mode. It’s used by Navy SEALs and athletes to stay calm under pressure.

How to Do It:
1️⃣ Sit or lie down comfortably with your eyes closed.
2️⃣ Inhale through your nose for 4 seconds.
3️⃣ Hold your breath for 4 seconds.
4️⃣ Exhale slowly through your mouth for 4 seconds.
5️⃣ Hold again for 4 seconds.
6️⃣ Repeat the cycle 4 times, focusing only on your breath.

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Reflections from the OR

Some of my anxiety doesn’t come from the cases themselves—it comes from the eyes on me. The peers watching me. The team reading my tone. The patient’s family waiting for a perfect outcome.

I’ve realized: part of that pressure sharpens me. It forces preparation. It keeps the stakes clear. But taken too far, it distorts the moment. Makes me rehearse what people might think instead of focusing on what I know to be right.

You can’t hand over your sense of self to someone else’s passing judgment.
I’m learning to ask a better question: Did I show up with clarity, intention, and skill—by my standards?

Because your identity as a surgeon—or as a person—can’t be up for a vote.

The Prefrontal Cortex

The prefrontal cortex is the front-most part of your brain, just behind your forehead. It’s responsible for executive functions like planning, impulse control, attention, and emotional regulation. Think of it as your brain’s “wise manager”—balancing short-term emotions with long-term goals and helping you pause before reacting.

🔍 In anxiety, especially chronic stress, the PFC often becomes underactive or disconnected from the amygdala. That means your logical brain can’t “talk down” your emotional brain effectively. You know the fear is irrational—but you still feel it in your body.

🧠 What helps?
Practices like cognitive behavioral therapy (CBT), journaling, and focused attention meditation help strengthen the PFC-amygdala connection, increasing emotional control and decreasing overreaction to stress.

Final Thoughts

I honestly don’t think anything has helped me more than working on my anxiety. There are so many tools to do it. Imperfect meditation and breath work. Other forms of mindfulness like journaling. Therapy. Medications. Chronic anxiety is bad for your brain and your health. Working on it is one of the strongest things you can do to keep your brain healthy and live a more fulfilled and happy life.

Stay sharp,

Colin