Mind over Matter

Breaking the anxiety wheel

Dear Dr. Ash,

For the past year or two I’ve been experiencing unbearably anxiety in the mornings. I wake up worried about the day, about all the things I have to do, and all the things I wish I’d already done. I feel I will never get on top of things and it’s absolute torture. I’ve always been a morning person and for most of my life I’ve bounced out of bed in a fantastic mood, so I really feel like something must be wrong. Am I having a midlife crisis? Is this an after-effect of the pandemic and lockdown? What can I do to feel better?

Yours sincerely,
Sleepless in Wiltshire

Dear Sleepless,

I share your pain! I too have lain in bed in the small hours of the morning, contemplating questionable life choices and revisiting ancient wounds, stretched out on a sateen-finished, cotton-clad torture rack while my brain fizzes over with all things I need to do, and could have done already had I not been so useless.

When it’s happening, it seems like the only way to get relief is to somehow slowly and carefully sort everything out. Exercise more, drink less, eat better, or generally be better. Make lists. Download a new app. Of course some of these solutions could help! But first recognise that the source of this toxic fizz is the brain itself.

In the early hours of the morning, typically something like 2 – 3am, your blood pressure and body temperature dip to their lowest levels of the day. As dawn starts to break, your brain prepares to wake itself up by triggering a surge of hormones like cortisol and noradrenaline, jump-starting the heart, rapidly increasing blood pressure and body temperature, and flipping on neural light switches all across the cortex.

This neurological banging-the-pots-and-pans routine is extremely effective, but it leaves a chemical residue. Those elevated levels of cortisol and noradrenaline mimic what you would experience during an anxiety attack, and if you allow your mind to wander freely during this time your thoughts will be coloured by the neurochemical residue in your brain. You’ll feel crippled by anxieties and worries, and since noradrenaline also powerfully regulates attention, you’ll be unable to shift your focus to anything else. The more you ruminate on everything that worries you, the more worried and adrenalised your brain will become.

The only way out of this toxic cycle is to recognise what’s going on and stop spinning the wheel. The next time you have anxiety in the morning, remind yourself that it’s probably a lingering chemical after-effect of sleep. Get up, brush your teeth, and have breakfast. If you really have things you need to think about and sort out, they will still be there after you’ve eaten. If they are, then by all means, worry away! But more often than not, the simple act of getting up and starting your day gives your brain time to clear away the detritus of sleep.

Personally, the only way I’d ever bounce out of bed in the morning is if I fell asleep on a trampoline, but after about a year of practising this technique I do notice a difference. Habits are hard to break, and habits of thought are the hardest of all. Be patient.

Best wishes,
Dr. Ash

Accepting anti-social behaviour

Dear Dr. Ash,

My husband and I have struggled for years with differing expectations of social life. I felt it was important, for us and our children, to have a lot of friends and be part of a community. But my husband hates dinners and socialising and would be quite happy to stay home reading on his tablet or watching television. He seems to find it so painful to meet people that eventually I gave up asking. I have recently been reading about autistic spectrum disorders like Asperger’s Syndrome, and I wonder if something like this isn’t affecting my husband. He is a scientist, extremely technical and analytical, and very much prefers to be on his own. Are there ways to know if this sort of thing might be in the mix? And are there ways I can help him?

Yours sincerely,
Worried in Somerset

Dear Worried,

As someone who prefers writing a letter to making a telephone call and greets his closest friends with a firm handshake, I’ve got to admit to finding dinner parties fairly exhausting too. I’m much more likely to be diagnosing the dogs than expanding my social network. That can be a little hard to explain to people, so I find your sensitivity to brain differences admirable and touching. The increasing awareness of autistic spectrum disorders has been wonderful for many people. “Neurodiversity” is the new buzzword, and the idea of cognitive differences is trending in education and business circles. This is profoundly good news for everyone who doesn’t feel they quite fit the box that society puts them into (by which I mean, everyone). But equally, it doesn’t mean that everyone who hates small talk is on the spectrum.

In the seventeenth century, when René Descartes thought and therefore was, he concluded that mental life couldn’t be made of physical stuff. Despite centuries of scholarship to the contrary, we still labour under the Cartesian illusion today. When the people we live with are difficult, annoying and keep putting the sugar back in the wrong cupboard so I have to spend ten minutes looking for it while my tea gets cold, it can be difficult to remember that every aspect of their personality and their behaviour is a result of a physical process happening in their brain.

This single insight – that behaviour comes from the brain – can enable a tremendous level of compassion and communication in a marriage. Once you see behaviour as biological, you won’t be so hurt by behaviours different to your own. Our brains are different, and even without diagnostic labels to describe those differences, we can be sensitive and appreciative of the diversity we find in each other. You should go out into the world and be as social as you like without any guilt. Your partner should also be allowed to be himself without any guilt. That may require compromises from both of you and it will take some time, but an awareness that different behaviours imply different brains can go a long way to reframing those conversations.

Best wishes,
Dr. Ash

Dr Ash Ranpura is a neuroscientist and clinical neurologist active in brain research for over 25 years. He qualified in medicine and general neurology at Yale University, and the Yale-New Haven Hospital, and trained in cognitive neuroscience at Queen Square, London. He recently co-authored a book on mindfulness and neuroscience with Ruby Wax and Gelong Thubten called, “How to Be Human: The Manual”