WEBVTT - Anxiety Is Old Habit! 0:00:08.560 --> 0:00:11.360 This is the Anxiety Bites podcast, and I am your host, 0:00:11.480 --> 0:00:17.319 Jen Kirkman. Well, this is my first episode, so I 0:00:17.320 --> 0:00:19.560 think I'll just talk off the cuff, off the top 0:00:19.600 --> 0:00:22.160 of my head for a few minutes to just let 0:00:22.200 --> 0:00:25.599 you know what we're doing here with this podcast. Anxiety 0:00:25.640 --> 0:00:28.800 Bites as a little generation X nod to the movie 0:00:28.840 --> 0:00:32.640 Reality Bites, but there is nothing bite sized about this podcast. 0:00:32.720 --> 0:00:36.360 I'll be having long conversations with all kinds of experts 0:00:36.360 --> 0:00:41.120 who can help us understand our anxiety, where it comes from, 0:00:41.159 --> 0:00:44.199 what we can do about it, whether it's a neuroscientist, 0:00:44.240 --> 0:00:48.200 a psychiatrist and author, a researcher, a meditator and artist, 0:00:49.280 --> 0:00:52.720 anybody who has experienced anxiety who works in the field 0:00:52.720 --> 0:00:57.200 of helping others cope with anxiety. Now, I don't want 0:00:57.200 --> 0:00:59.400 to make this podcast about me, because it's not about me. 0:00:59.440 --> 0:01:04.720 It's about everybody. It's about anxiety. But a little background 0:01:04.800 --> 0:01:08.480 on me. I am, in my other life a comedian. 0:01:08.600 --> 0:01:11.440 I have comedy specials on Netflix. I'm also a TV 0:01:11.600 --> 0:01:14.639 writer and I've been working in entertainment for about twenty 0:01:14.680 --> 0:01:18.200 five years. But something happened during the Great Lockdown of 0:01:19.200 --> 0:01:22.320 where I was no longer on tour. I wasn't on stage, 0:01:22.720 --> 0:01:25.399 and I was fine with it, but I wanted to 0:01:25.520 --> 0:01:29.640 use my voice somehow, maybe in a way that just 0:01:30.200 --> 0:01:34.680 didn't distract people with jokes, but maybe helped people. And 0:01:34.720 --> 0:01:36.640 I was noticing on social media that a lot of 0:01:36.680 --> 0:01:40.160 people were discovering that they had anxiety for the first time, 0:01:40.280 --> 0:01:43.399 or they were actually just becoming an anxious person for 0:01:43.440 --> 0:01:45.560 the first time, and I realized, hey, you know, I 0:01:45.560 --> 0:01:49.480 actually feelt pretty good. I have had generalized anxiety disorder, 0:01:49.520 --> 0:01:52.600 panic disorder, multiple phobias since I was eight years old, 0:01:53.160 --> 0:01:56.040 and none of it was diagnosed or handled properly until 0:01:56.080 --> 0:01:59.920 I was twenty two. But as a kid, I sat 0:02:00.000 --> 0:02:03.559 around having panic attacks in school. I remember, at age twelve, 0:02:03.640 --> 0:02:06.000 thinking I was having a heart attack. But there was 0:02:06.040 --> 0:02:07.920 also a part of me that knew this has to 0:02:07.920 --> 0:02:10.320 do with mental health, even though I had never heard 0:02:10.360 --> 0:02:12.880 the expression mental health. But I knew, or I thought 0:02:12.880 --> 0:02:17.600 I knew. If I tell people what I'm feeling, if 0:02:17.639 --> 0:02:20.400 I tell people that I feel like I can't breathe 0:02:20.600 --> 0:02:23.720 and I feel like I'm going crazy, they will lock 0:02:23.840 --> 0:02:25.560 me up for life in a padded room. And I'm 0:02:25.600 --> 0:02:28.160 not ready for that yet. And so I just had 0:02:28.240 --> 0:02:32.360 a grand plan, which was, whatever this is going on 0:02:32.400 --> 0:02:35.040 inside of me that seems to be getting worse every year, 0:02:35.240 --> 0:02:37.799 I will just ride it out until it gets so 0:02:37.880 --> 0:02:40.160 bad that I want to live in a padded room. 0:02:40.400 --> 0:02:43.600 And that is how I will deal with this thing. 0:02:44.520 --> 0:02:46.200 I never had to go live in a padded room 0:02:46.280 --> 0:02:50.600 because I got help. Ironically, there is padding in the 0:02:50.680 --> 0:02:52.440 room I am in right now, but that is just 0:02:52.520 --> 0:02:56.079 because it makes a podcast sound better. But I began 0:02:56.200 --> 0:02:58.960 therapy in my early twenties. I've done it all, from 0:02:59.080 --> 0:03:04.040 therapy to medication to meditation, and I'm telling you everything 0:03:04.080 --> 0:03:09.120 I have tried to help my anxiety has worked. But 0:03:09.280 --> 0:03:12.359 different things work at different times. But the one thing 0:03:12.400 --> 0:03:16.160 that really tipped me over the edge into being able 0:03:16.240 --> 0:03:20.000 to say I no longer have a phobia of flying, 0:03:20.080 --> 0:03:22.760 of driving alone on the freeway, of getting in subways. 0:03:22.919 --> 0:03:27.040 My silb a fear hides what helps my circular thinking, 0:03:27.080 --> 0:03:30.680 my rumination, all of the thought processes that are anxiety. 0:03:30.720 --> 0:03:35.920 What helped was when I realized I can apply the 0:03:36.040 --> 0:03:39.920 sense of humor I have in my job to my anxiety. 0:03:39.960 --> 0:03:44.440 I used to take anxiety so seriously and say things 0:03:44.480 --> 0:03:48.040 I suffer from anxiety. I just thought it was this scary, 0:03:48.200 --> 0:03:50.880 terrible thing, and I gave it so much weight, you know, 0:03:50.960 --> 0:03:53.200 I almost gave it so much respect in a way. 0:03:53.240 --> 0:03:56.760 And now I try to laugh about my anxiety. You know, 0:03:56.840 --> 0:03:59.040 I don't have suffer from anxiety. So I have a 0:03:59.080 --> 0:04:02.480 friend called anxiety, and it loves to get in the 0:04:02.480 --> 0:04:05.000 passenger seat of my car and try to give me 0:04:05.040 --> 0:04:07.320 suggestions about terrible things I should think about. And I 0:04:07.360 --> 0:04:11.600 just don't let anxiety weigh in on any decisions I'm making. 0:04:11.600 --> 0:04:13.200 But it's allowed to be there if it needs to 0:04:13.240 --> 0:04:17.000 be there. You know, I learned to live with it, 0:04:18.240 --> 0:04:21.359 but it is not anything like it used to be, 0:04:21.480 --> 0:04:26.159 and it doesn't control my decisions or my life. I 0:04:26.200 --> 0:04:27.920 know that might not sound appealing to people. I think 0:04:27.920 --> 0:04:30.400 people want to just get rid of anxiety, But it 0:04:30.640 --> 0:04:32.680 feels like I've gotten rid of it, if that makes sense, 0:04:32.720 --> 0:04:37.000 by accepting it and poking a little fun at And 0:04:37.040 --> 0:04:39.160 so I want to have honest conversations with people. I 0:04:39.160 --> 0:04:41.880 don't want to come from some lofty place of you know, 0:04:42.000 --> 0:04:44.480 peace and love. And I'm whispering, and you know I've 0:04:44.560 --> 0:04:47.800 changed my life. I still swear and and and yell 0:04:48.000 --> 0:04:51.479 fuck you at people if I'm driving in a bad mood. 0:04:52.520 --> 0:04:55.640 This is real people talking. This is not self help, 0:04:55.720 --> 0:05:00.640 this is not wellness, This is not anything on relatable. 0:05:00.720 --> 0:05:02.960 Unless you don't have anxiety, then you know, congrats, you 0:05:02.960 --> 0:05:05.920 won't relate. But yeah, during the lockdown, I was noticing 0:05:05.920 --> 0:05:09.040 people on social media and I thought, wait, why don't 0:05:09.040 --> 0:05:12.960 they just type anxiety into the internet, like like this 0:05:13.320 --> 0:05:15.360 thing I wished I'd been able to do so many 0:05:15.400 --> 0:05:17.320 years ago. And I realized people don't know where to start. 0:05:17.640 --> 0:05:20.080 Some people don't even know if they're allowed to claim 0:05:20.520 --> 0:05:23.200 that it's anxiety because they don't know what it is. 0:05:23.520 --> 0:05:25.599 And doesn't a doctor have to tell them they have it? 0:05:25.680 --> 0:05:27.960 And oh, maybe I'm just stressed, or it's the state 0:05:28.000 --> 0:05:30.240 of the world, or you know, once this goes away, 0:05:30.279 --> 0:05:33.799 I'll be better. And and so I started teaching breathing 0:05:33.800 --> 0:05:37.520 classes over zoom for fun, and I wrote a newsletter 0:05:37.560 --> 0:05:41.320 about anxiety. And when the response was frankly more overwhelming 0:05:41.320 --> 0:05:43.720 than the response to my last tour as a comedian, 0:05:43.920 --> 0:05:48.080 I realized, I think I have something here, and so 0:05:48.520 --> 0:05:50.599 I pitched this podcast I did to I Heart Radio. 0:05:50.640 --> 0:05:54.279 They said, yes, so here we are together now, and 0:05:54.320 --> 0:05:57.000 I actually thought at one point, Oh, I hope, um, 0:05:57.839 --> 0:06:00.480 I hope everyone still wants to talk about anxiety by 0:06:00.480 --> 0:06:03.120 the time this podcast comes out. I had no idea 0:06:03.160 --> 0:06:06.240 that it would be the next epidemic. Anyway, I hope 0:06:06.240 --> 0:06:09.840 you enjoy Anxiety Bites. There will be new episodes every week, 0:06:09.880 --> 0:06:12.240 and I'm sure over the course of the episodes, I'll 0:06:12.240 --> 0:06:15.240 reveal more and more about my personal experiences with anxiety. 0:06:15.279 --> 0:06:17.320 But you don't need the whole story right now. And 0:06:17.360 --> 0:06:20.680 it's frankly again, it's not about me. It's about all 0:06:20.720 --> 0:06:23.600 of us, and it's about anxiety, and it's about not 0:06:23.720 --> 0:06:26.400 feeling so alone, because that was always the worst part 0:06:26.400 --> 0:06:29.440 of it for me, was that I felt so alone 0:06:29.480 --> 0:06:32.960 when I had it, and even after I found out 0:06:32.960 --> 0:06:35.760 what I had was normal, I still felt alone because 0:06:35.800 --> 0:06:38.119 not a lot of people were talking about it. So 0:06:38.400 --> 0:06:42.280 let's talk about it, Anxiety Bites. But you're in control, 0:06:42.680 --> 0:06:47.360 and now let's talk to our guest today on Anxiety Bites. 0:06:47.760 --> 0:06:52.080 I am talking to Dr Judd Brewer. He's a New 0:06:52.160 --> 0:06:55.640 York Times bestselling author. He's a neuroscientist. He's the director 0:06:55.760 --> 0:06:59.480 of Research and Innovation at the Mindfulness Center and Associate 0:06:59.480 --> 0:07:02.760 professor and Behavioral and Social Sciences at the School of 0:07:02.800 --> 0:07:06.080 Public Health and Psychiatry at the School of Medicine at 0:07:06.120 --> 0:07:09.800 Brown University, as well as a research affiliate at m 0:07:09.800 --> 0:07:13.280 I T. He's a wicked smartt you guys. His latest 0:07:13.320 --> 0:07:17.040 book is called Unwinding Anxiety, a clinically proven, step by 0:07:17.040 --> 0:07:20.239 step plan to break the cycle of worry and fear 0:07:20.320 --> 0:07:24.880 that drives anxiety and addictive habits. So in this book, 0:07:25.000 --> 0:07:28.840 Dr Judd is basically saying anxiety as a habit and 0:07:28.920 --> 0:07:32.600 we can approach treating it the way we might approach 0:07:32.880 --> 0:07:38.520 quitting smoking. Dr JEDD's book was called Craving Mind From 0:07:38.520 --> 0:07:42.360 Cigarettes to Smartphones to Love, Why we get hooked and 0:07:42.400 --> 0:07:45.559 how we can break bad habits. Doctor Jedd has done 0:07:45.760 --> 0:07:49.200 a ton of TED talks, He's written articles. All of 0:07:49.240 --> 0:07:51.679 the places that you can find him will be linked 0:07:52.040 --> 0:07:55.240 in the show notes. And he's also the creator of 0:07:55.280 --> 0:07:58.600 the Unwinding Anxiety app. It's a step by step program 0:07:58.840 --> 0:08:01.239 for your smartphone or tab it. It helps you uncover 0:08:01.640 --> 0:08:05.440 your triggers, break the cycle of worry and panic, identify 0:08:05.520 --> 0:08:10.720 your anxiety habits, and learn specific anti anxiety tools. So 0:08:10.800 --> 0:08:12.880 I've been a fan of doctor Judd for a while now. 0:08:12.880 --> 0:08:14.960 I've just heard him on other podcasts and I've read 0:08:15.000 --> 0:08:19.040 his books and the way he approaches anxiety as something 0:08:19.080 --> 0:08:21.920 that we do have control over, and that in a 0:08:21.960 --> 0:08:28.200 weird way, the way we've been habitually having anxiety, and weirdly, 0:08:28.240 --> 0:08:30.360 there's a little bit of a reward system there, even 0:08:30.400 --> 0:08:35.520 though it's a disordered reward. We're getting something out of worrying, 0:08:36.240 --> 0:08:38.840 and so we have to change that and replace it 0:08:38.880 --> 0:08:42.240 with something. So it's not easy, and I think a 0:08:42.240 --> 0:08:44.440 lot of people don't want to look at it that 0:08:44.480 --> 0:08:46.240 way because you want to think, no, I don't have 0:08:46.320 --> 0:08:48.520 any control. Anxiety is just something that's happening to me. 0:08:49.160 --> 0:08:52.120 And yet isn't that what all of us anxious people 0:08:52.120 --> 0:08:54.880 want is control. I think we want control over the 0:08:54.880 --> 0:08:57.839 world and other people's actions. But when we're told, oh, 0:08:58.000 --> 0:09:00.440 you have control over your own actions or well, I 0:09:00.440 --> 0:09:04.880 didn't want that's not a fun kind of control though. Anyway. 0:09:04.920 --> 0:09:07.520 In my interview with Dr Judd, I talked to him 0:09:07.559 --> 0:09:11.560 about his personal experience with anxiety that he actually thought 0:09:11.720 --> 0:09:15.720 was ib s, how he gets anxious about his patients 0:09:15.720 --> 0:09:18.760 who have anxiety, and what he's learned over the past 0:09:18.760 --> 0:09:22.360 twenty five years studying the mind and how anxiety is driven, 0:09:22.920 --> 0:09:25.480 and we talk about why his dream for his app, 0:09:25.600 --> 0:09:29.800 Unwinding Anxiety is that people eventually unsubscribed from it. So 0:09:30.000 --> 0:09:36.400 let's talk to your new favorite person, doctor Jedd, doctor 0:09:36.520 --> 0:09:40.199 Judd Brewer, thank you for being on anxiety Bites. I'm 0:09:40.200 --> 0:09:43.160 going to ask you what is your past relationship to 0:09:43.200 --> 0:09:47.240 anxiety and what's your current relationship to anxiety today? Be 0:09:47.320 --> 0:09:51.839 happy to explore my relationship with anxiety. You know it 0:09:51.960 --> 0:09:54.120 started way back in the day. Actually, I didn't even 0:09:54.160 --> 0:09:58.160 know I had anxiety. In college. I remember having let's 0:09:58.160 --> 0:10:00.120 just say, some g I issues, you know, I'd talk 0:10:00.160 --> 0:10:01.720 a little bit about this at the end of my book, 0:10:02.320 --> 0:10:06.439 and I thought, you know, your new book on my anxiety. 0:10:06.559 --> 0:10:08.640 And I, you know, done a bunch of backpacking in 0:10:08.720 --> 0:10:11.760 college and was also, you know, always concerned about you know, 0:10:11.800 --> 0:10:16.400 getting back curely infections from not you know, carefully filtering 0:10:16.440 --> 0:10:20.000 my water. And so my senior year, I remember going 0:10:20.040 --> 0:10:23.320 to the student health in the doctor there you know, 0:10:23.400 --> 0:10:24.960 these g I issues, and he said, oh, could you 0:10:25.000 --> 0:10:27.760 be stressed out? And It's like, no, not me, I'm 0:10:27.760 --> 0:10:29.360 not stressed. I played the violet and I run I'm 0:10:29.400 --> 0:10:36.319 a vegetarian, blah blah blah, and he goes, Okay, it's 0:10:36.320 --> 0:10:39.000 a long story short. It turned out that I had 0:10:39.040 --> 0:10:43.120 irritable ball syndrome, which is totally stressed and anxiety related. 0:10:43.400 --> 0:10:48.240 And so so that was my first encounter, let's say, 0:10:48.440 --> 0:10:52.120 with anxiety, not even knowing it. And so I think, 0:10:52.480 --> 0:10:54.199 you know, I think anxiety can really be a shape 0:10:54.200 --> 0:10:57.520 shifter in many ways. A long story short. I went 0:10:57.559 --> 0:11:01.960 on to get panic attacks during residency, and you know, 0:11:02.080 --> 0:11:05.559 in my psychiatry residency, which was really fun because then, 0:11:05.880 --> 0:11:07.640 you know, after I have a panic attack, I could 0:11:07.640 --> 0:11:10.800 go down the diagnostic checklist and be like check check, check, check. Yeah, 0:11:10.800 --> 0:11:15.000 I just had a panic attack, you know. And and 0:11:15.120 --> 0:11:17.640 today I would say, you know, a lot of what 0:11:17.720 --> 0:11:19.800 I've learned about my own mind has helped me work 0:11:19.800 --> 0:11:23.240 with anxiety. I certainly get sensations and feelings that come up, 0:11:23.840 --> 0:11:26.760 but it's I'm much more able to manage and work 0:11:26.800 --> 0:11:30.840 with it. And um, I can you know, I jokingly say, well, 0:11:31.200 --> 0:11:33.160 you know, I I wrote this book because I was 0:11:33.200 --> 0:11:36.640 anxious about how to help my patients with anxiety, because 0:11:36.920 --> 0:11:39.119 you know, what I learned in medical school and residency 0:11:39.240 --> 0:11:43.080 was to prescribe medications and the gold standard medications out there. 0:11:43.120 --> 0:11:45.600 There's this term in medicine called number needed to treat, 0:11:45.600 --> 0:11:47.280 which gives us a quick and dirty estimate of how 0:11:47.320 --> 0:11:49.640 well something works. So the higher than number of the 0:11:49.640 --> 0:11:52.800 worst it is. So with medications, that number needed to 0:11:52.800 --> 0:11:55.120 treat is five point two, meaning you have to treat 0:11:55.160 --> 0:11:58.760 five patients before one person shows a significant reduction and symptoms. 0:11:59.080 --> 0:12:02.160 So you can imagine, for five patients come into my 0:12:02.240 --> 0:12:04.079 office in one day, I don't know which of those 0:12:04.120 --> 0:12:06.640 five is going to benefit, so I'm basically playing the 0:12:06.679 --> 0:12:09.679 medication lottery with them, and I don't know what I'm 0:12:09.679 --> 0:12:12.199 gonna do with the other. So I'm getting anxious about 0:12:12.440 --> 0:12:16.080 to help my patients with anxiety. So those that's that's 0:12:16.120 --> 0:12:20.240 my you know, my previous and I guess current relationship is. 0:12:20.360 --> 0:12:23.000 I've been blown away with what I've learned about my 0:12:23.040 --> 0:12:25.160 own mind. So I started meditating at the beginning of 0:12:25.160 --> 0:12:27.640 medical school, first day of medical school, and over the 0:12:27.720 --> 0:12:31.160 last twenty five years have learned so much about how 0:12:31.160 --> 0:12:33.080 my mind works and all these twists and turns and 0:12:33.160 --> 0:12:37.280 serendipity around how anxiety can be driven. That that's where 0:12:37.280 --> 0:12:40.440 we started developing programs and then as a researcher testing 0:12:40.480 --> 0:12:43.000 them to see how well they can work. And long 0:12:43.040 --> 0:12:45.160 story short, that's why I wrote this on Running Anxiety 0:12:45.160 --> 0:12:48.280 book was to make it accessible, make these these tools 0:12:48.280 --> 0:12:51.480 accessible to anyone. Man, I wish you'd been around when 0:12:51.480 --> 0:12:56.720 I was a teenager with anxiety and no Internet and 0:12:56.760 --> 0:12:59.400 didn't know what it was. And I was afraid to 0:12:59.440 --> 0:13:01.520 ask the Life arian if they had any books about 0:13:02.320 --> 0:13:04.920 the brain, because I thought she was going to say, Oh, 0:13:05.000 --> 0:13:07.040 I have to call the hospital and you're going to 0:13:07.120 --> 0:13:08.600 have to live there the rest of your life. Are 0:13:08.600 --> 0:13:11.520 you perhaps anxious? That's very bad? You know? Can you 0:13:11.600 --> 0:13:18.160 hold for one minute please? And then she starts whispering, Well, okay, 0:13:18.160 --> 0:13:19.400 so let me get into this. And I want to 0:13:19.400 --> 0:13:21.960 talk about obviously your book and your app, but I 0:13:22.040 --> 0:13:24.600 have a question about the brain because you are also 0:13:24.640 --> 0:13:29.080 a neuroscientist. Is that right? Okay? First of all, when 0:13:29.120 --> 0:13:31.440 the hell are our brains going to evolve past this? 0:13:31.600 --> 0:13:33.680 Because if I hear one more time, oh, it's left 0:13:33.720 --> 0:13:36.640 over from being a caveman. Well okay, but when when 0:13:36.679 --> 0:13:39.880 will this change? When will this default setting to being 0:13:39.920 --> 0:13:43.920 anxious and overreacting? You know, when in our lifetime now, well, 0:13:44.000 --> 0:13:48.400 right from a genetic perspective, not in our lifetime. From 0:13:48.559 --> 0:13:52.720 a functional perspective, I think it can happen. You know, 0:13:52.760 --> 0:13:56.000 this evolutionary process can happen pretty quickly. So you can 0:13:56.040 --> 0:13:59.280 look at to see how quickly we have learned to 0:14:00.559 --> 0:14:03.600 use technology as a way to leverage attention. Right, So 0:14:03.679 --> 0:14:07.000 that happened pretty darned quickly, you know. Within you know, 0:14:07.400 --> 0:14:12.000 eighteen hundreds, there were you know, first researchers showing that 0:14:12.120 --> 0:14:14.360 animals could learn how to get out of cages by 0:14:14.559 --> 0:14:17.320 you getting a food reward. So that was you know, 0:14:17.400 --> 0:14:20.680 late eighteen hundreds. That was a hundred and twenty years ago. 0:14:20.920 --> 0:14:23.720 And now you can look at social media and how 0:14:23.760 --> 0:14:26.720 they are totally getting us all addicted to those things. 0:14:26.760 --> 0:14:32.120 So this process has been understood and people have adapted 0:14:32.160 --> 0:14:36.520 it to capture our attention. And this is also driven 0:14:36.640 --> 0:14:39.320 our anxiety, and so that as soon as we learn 0:14:39.440 --> 0:14:41.560 how that works. You know, the way I think of 0:14:41.600 --> 0:14:43.240 it is, if we can learn how our minds work, 0:14:44.080 --> 0:14:48.120 then we can start to work with our minds. And 0:14:48.120 --> 0:14:52.240 so in that sense, just like you know, it's capturing 0:14:52.240 --> 0:14:56.320 our attention, it's capturing our the uncertainty you know around um, 0:14:56.360 --> 0:14:58.280 I think of it this way. The only certain thing 0:14:58.320 --> 0:15:00.840 is that there's always going to be uncertainty. So that's 0:15:00.840 --> 0:15:03.720 not actually something that we want to evolve beyond because 0:15:03.720 --> 0:15:07.000 that helps to survive. But what we can learn is 0:15:07.040 --> 0:15:10.800 how that uncertainty drives anxiety, and that's something that we 0:15:10.840 --> 0:15:13.600 can learn to work with within months. You know. For example, 0:15:13.720 --> 0:15:16.360 my lab has done several clinical studies where we got 0:15:16.400 --> 0:15:20.680 a fifty seven percent reduction in clinically validate anxiety scores 0:15:20.800 --> 0:15:24.080 in anxious physicians using an app. You know, we did 0:15:24.080 --> 0:15:26.600 a study with generalized anxiety disorder. We got the sixty 0:15:26.640 --> 0:15:30.120 seven percent reduction, and there we could actually calculate that 0:15:30.240 --> 0:15:33.200 number needed to treat the thing I mentioned earlier ray 0:15:33.240 --> 0:15:36.360 for this. So in medications it's five. With this study 0:15:36.400 --> 0:15:41.320 it was one point six, So so it only takes 0:15:41.440 --> 0:15:48.160 one point six people doing this kind of a mindful 0:15:48.200 --> 0:15:51.240 thought behavioral work around anxiety to see your results. Is 0:15:51.240 --> 0:15:53.880 that what you mean? That's great. When I first found 0:15:53.920 --> 0:15:56.240 out twenty years ago, when I went to therapy for panic, 0:15:56.320 --> 0:15:58.880 and it was explained to me that it's just my 0:15:58.920 --> 0:16:01.680 adrenaline kind of seaking out and it's this leftover thing 0:16:01.800 --> 0:16:04.320 from you know, my brain is trying to protect me. 0:16:04.480 --> 0:16:06.360 That that was of great comfort. But I know for 0:16:06.480 --> 0:16:08.920 some people that it can seem like, oh great, well 0:16:08.960 --> 0:16:12.280 now it can't be fixed. But like a lot of things, 0:16:12.400 --> 0:16:18.040 we we can actually change our mind literally literally we can. 0:16:18.160 --> 0:16:21.600 And I think one thing that I see they get 0:16:21.680 --> 0:16:26.000 some conflated or mixed mushed together, is people conflating the 0:16:26.040 --> 0:16:30.160 survival piece with the actual anxiety piece. So if you 0:16:30.200 --> 0:16:32.400 think of the Cayman brain, it was really set up 0:16:32.440 --> 0:16:35.680 to develop habits, you know, where it's it's about learning 0:16:35.720 --> 0:16:38.920 where to remember food is and also how to avoid danger. 0:16:39.600 --> 0:16:42.160 On top of that's been layered the neo cortex, literally 0:16:42.200 --> 0:16:44.560 the new brain, which helps us survive in a different way, 0:16:44.600 --> 0:16:48.280 which is through thinking and planning. And that survival comes 0:16:48.400 --> 0:16:52.920 based on getting information, like accurate information in the present moment, 0:16:53.240 --> 0:16:56.360 so we can our brains can basically simulate based on 0:16:56.440 --> 0:17:02.280 past experience using information that we have. So here it's about, 0:17:02.600 --> 0:17:05.680 you know, if we don't have accurate information, that's when 0:17:05.720 --> 0:17:08.639 our brains starts spinning out of control into anxiety. And 0:17:08.680 --> 0:17:10.800 I think I want folks to be very you know, 0:17:10.880 --> 0:17:15.000 to understand that because it's not just our adrenaline. Certainly, 0:17:15.040 --> 0:17:17.880 when we get freaked out, our adrenaline pumps, but it's 0:17:17.920 --> 0:17:21.800 not that you know, that fear reaction that happens really quickly, 0:17:21.800 --> 0:17:24.960 actually faster than we can even think. That's a survival 0:17:25.000 --> 0:17:28.040 mechanism that helps us learn to avoid danger. That's different 0:17:28.240 --> 0:17:31.720 than anxiety. Does that make sense? That makes total sense? 0:17:31.760 --> 0:17:34.159 And yeah, I'm glad you separated that for me too, 0:17:34.200 --> 0:17:36.520 because I think i've like you said, anxiety is a 0:17:36.560 --> 0:17:40.960 shape shifter, and uh, I think sometimes I have conflated 0:17:40.960 --> 0:17:45.800 that fear instinct with with anxiety. Yes, so we all 0:17:45.920 --> 0:17:49.600 have times when we're anxious and when we when we worry, 0:17:49.640 --> 0:17:53.159 for example, that can actually feedback and you know, basically 0:17:53.240 --> 0:17:56.520 kicking our adrenaline that makes us more anxious. So I 0:17:56.560 --> 0:17:58.600 have a lot of patients in my clinic who when 0:17:58.640 --> 0:18:02.280 they go to bed, there head hits the pillow and 0:18:02.280 --> 0:18:04.640 the brain starts thinking. And it's like the brain says, okay, 0:18:04.680 --> 0:18:06.440 it's my turn. Now you get a chance to talk. 0:18:06.440 --> 0:18:09.160 And now it's we start regretting the things we've done 0:18:09.240 --> 0:18:11.640 during the day, or we start worrying about the future. 0:18:12.240 --> 0:18:15.080 And then and then they look at the clock and 0:18:15.160 --> 0:18:17.119 they think, I gotta get sleep because I got this 0:18:17.200 --> 0:18:20.600 thing to do tomorrow, and which, of course, Jack's their adrenaline. 0:18:20.960 --> 0:18:23.840 It makes it much harder for them to sleep. Yeah. Right, 0:18:23.920 --> 0:18:27.480 so now they've just created this kind of thought pattern 0:18:27.720 --> 0:18:35.320 of now the anxiety is about the sleep. Yeah, we'll 0:18:35.359 --> 0:18:49.800 be right back. What what's the story on chemical imbalances? 0:18:49.840 --> 0:18:52.200 I mean, is it just sort of a a thing 0:18:52.240 --> 0:18:55.399 that people saying, it's not really something we're born with? 0:18:55.520 --> 0:18:58.040 Or can we change our chemistry in our brain? Well, 0:18:58.080 --> 0:19:00.640 we can certainly change our chemistry in our brain. Thoughts 0:19:00.680 --> 0:19:04.800 will literally have chemical have chemical cascades that lead to 0:19:05.760 --> 0:19:08.520 chemical reactions. So in that sense, we are basically just 0:19:08.560 --> 0:19:12.159 a jumble of chemistry. If you look at the chemical 0:19:12.280 --> 0:19:16.360 and balanced thing, I think it's a simple and quick explanation. 0:19:16.600 --> 0:19:19.040 Oh take this pill because it's a chemical imbalance and 0:19:19.040 --> 0:19:21.359 it's going to help with the chemic. For some people, 0:19:22.200 --> 0:19:26.399 they have genetic polymorphisms, meaning that they're they're they're the 0:19:26.480 --> 0:19:29.880 proteins that are expressed on certain cells look slightly differently 0:19:30.000 --> 0:19:35.760 than other people, which can affect how certain neurotransmitters, you know, 0:19:35.920 --> 0:19:39.280 function in their brain. And for some people, you know, 0:19:39.320 --> 0:19:43.160 things like selective serotonine reactic inhibitors, which are the first 0:19:43.200 --> 0:19:46.120 line treatment like the prozacs, the soul lofts, the paxels 0:19:46.160 --> 0:19:49.440 of the world. That's how you know, for some people 0:19:49.480 --> 0:19:52.760 those can be helpful. Yeah, this is where this number 0:19:52.800 --> 0:19:54.919 needed to treat comes in. It should be noted that 0:19:55.040 --> 0:19:59.520 historically these were developed as antidepressants and people just started 0:19:59.600 --> 0:20:02.560 using um testing them out with anxiety and found, oh, 0:20:02.600 --> 0:20:05.800 they're better than placebo, so we'll prescribe those as well. 0:20:06.480 --> 0:20:11.080 So you know, they affect serrantonin reuptake, that's where their 0:20:11.160 --> 0:20:15.000 name comes from. But it doesn't necessarily mean, especially for 0:20:15.040 --> 0:20:18.520 the majority of the population, some chemical imbalance in their brain. 0:20:18.720 --> 0:20:21.760 It means, this is the best we've got, and here's 0:20:21.760 --> 0:20:26.320 our explanation. So try the pill. And because they're generally benign, 0:20:26.720 --> 0:20:29.280 you know, they don't have generally don't have sign effects 0:20:29.320 --> 0:20:31.679 for most people, and you know, they're it's hard to 0:20:31.720 --> 0:20:35.480 overdose on them. For a psychiatrist or even a general 0:20:36.119 --> 0:20:39.320 practitioner like a primary care provider, to to prescribe these 0:20:39.320 --> 0:20:41.880 things and not worry about it too much. And there's 0:20:41.920 --> 0:20:44.840 also you know the added benefit of having a placebo effect. 0:20:44.840 --> 0:20:47.960 Oh I am taking a pill to help my brain. 0:20:48.200 --> 0:20:51.240 And you know that's not to discount the placebo effect 0:20:51.240 --> 0:20:55.400 for some medications. That's the majority of effect that's happening 0:20:55.440 --> 0:20:58.080 in and from you know, from my clinical perspective, it's 0:20:58.119 --> 0:20:59.960 like whatever, you know, if this is helping and it's 0:21:00.000 --> 0:21:03.359 not harming, game on. So in terms of the type 0:21:03.359 --> 0:21:06.280 of therapist someone should see, right if if they're experiencing, 0:21:06.400 --> 0:21:10.760 let's say, daily anxiety attacks, um, whether it's thoughts, you know, 0:21:10.880 --> 0:21:15.200 thoughts spiraling or sweaty palms or whatnot, or they're avoiding 0:21:15.200 --> 0:21:17.959 certain things driving on the freeway there, you know, certain 0:21:18.320 --> 0:21:20.720 places give them panic attacks, you know, all the whole 0:21:20.800 --> 0:21:24.480 shi bang. And they're looking in a directory and they're 0:21:24.520 --> 0:21:27.560 looking to find a therapist. Is there something they should 0:21:27.560 --> 0:21:30.400 be looking for, because I know that for me when 0:21:30.440 --> 0:21:33.640 I was having daily panic attacks, you know, my therapist 0:21:33.640 --> 0:21:35.840 wanted to go back into childhood, which is great, but 0:21:35.920 --> 0:21:38.040 it wasn't going to help me have some tools to 0:21:37.840 --> 0:21:40.639 go to bring to the office the next day. And 0:21:41.240 --> 0:21:44.840 I believe in my recovery as an anxious person that 0:21:45.480 --> 0:21:48.919 I need the tools now because I need to just 0:21:48.960 --> 0:21:51.200 be able to function and then once I'm better, sure, 0:21:51.320 --> 0:21:53.639 let's go back to childhood. Let's talk about this. I 0:21:53.760 --> 0:21:57.840 get it, um, but what what do you tell what 0:21:57.880 --> 0:22:00.040 would you tell someone to look for? So, as a 0:22:00.040 --> 0:22:03.680 hard carrying psychiatrist who is trained about the whole childhood 0:22:03.720 --> 0:22:06.439 thing and all that, it wasn't until I became a 0:22:06.520 --> 0:22:10.199 neuroscientist that I started to realize, you know, neuroscience may 0:22:10.240 --> 0:22:13.200 play a bigger role here in helping people with anxiety 0:22:13.359 --> 0:22:17.879 than going back to our childhood and that childhood piece 0:22:17.960 --> 0:22:22.600 maybe somewhat of a holdover from you know, whether it's 0:22:22.600 --> 0:22:25.600 Freudian days or whatever. You know, in a way that 0:22:25.680 --> 0:22:27.919 we're just trained, Oh, this is what we should be doing. 0:22:28.520 --> 0:22:32.920 But if you look at it, especially looking at how 0:22:33.320 --> 0:22:36.439 anxiety is driven. So this is something I did not 0:22:36.600 --> 0:22:40.640