Ian Weinberg in Publishers & Bloggers, Healthcare, English Developer and facilitator of neuro-coaching program; Neurosurgeon in practice • NeuroSurge: - neuro-coaching; Neurosurgical practice Oct 3, 2016 · 1 min read · 2.1K

The Lethal Cocktail of Fear with an Existential Crisis

The Lethal Cocktail of Fear with an Existential Crisis

There is the long story and the short story. Out of respect for the lay-readership I’m going with the short version. (The reference at the end is a link to the long version for the so-inclined.)

The paradigm has shifted – your thoughts and feelings impact comprehensively on your immune system and other fundamental physiological functions. Your immune system in turn engages with your neurochemistry and profoundly influences your thoughts and feelings.

And so we recognize that fear and/or anger is associated with raised levels of adrenaline and noradrenaline which is useful if we’re being chased by a lion and we need to jump over a six foot wall! But if we’re not being chased by a lion, that persistently raised adrenaline-noradrenaline mix is going to increase the levels of our inflammatory mediators (pro-inflammatory cytokines) resulting in chronic inflammation. This is somewhat worrisome when one reviews the literature and notes that chronic inflammation is the precursor of cardiovascular disease (heart attacks, strokes and the like), neurodegenerative conditions such as Altzheimer’s disease, Parkinson’s disease (as well as Lewy Body Dementia), Motor Neuron Disease and cancer.

Unfortunately the raised adrenaline-noradrenaline mix also suppresses our reasoning ability (pre-frontal cortex) as well as the stuff that mediates our reward centre (dopamine). That’s a bit of a bind since we need to reason our way out of this fight/flight victim zone, needing in addition the reward gratification to sustain the effort. One final little thorn in the side is that the reward centre and the fear-anger centre work in opposition to each other. So when the reward centre is compromised in terms of function, the fear-anger centre (amygdala) rages unchecked, producing copious amounts of the adrenaline-noradrenaline brew! And so the cycle is perpetuated.

But then comes the second whammy! Those multiple existential crises, or periods of hopeless-helplessness that we all experience at some points in life are associated with decreasing dopamine and serotonin levels which once again give rise to raised levels of inflammatory mediators. This is not a good thing because not only does it predispose to the ills mentioned above, but also because the inflammatory mediators diminish the availability of dopamine and serotonin resulting in ..... you guessed it, an aggravation of the mind state of hopless-helplessness! The lowered dopamine of course allows the fear-anger centre to rage unchecked with its own consequences.

Now when you’re in the thick of it, you can’t see the wood for the trees! You’re lost in neurochemical subjectivity. So what to do? Some suggestions:

1. Chill, breathe deeply and confirm that you are still alive and functional

2. Remind yourself of your blessings, achievements, talents and gratifying moments

3. Engage in a gratifying activity and then add ‘purposeful’ to the mix (pushes up dopamine)

4. Add regular exercise to the mix (pushes up dopamine and serotonin)

5. Connect with another person or people – talk, have coffee, hug, have sex. It all pushes up oxytocin levels which increase dopamine, decrease inflammatory mediators and calm the amygdala (lowers the adrenaline-noradrenaline brew)

If that doesn’t restore the balance, you may need to consult the professionals – psychiatrists (generally for a chemical fix unless you’re fortunate enough to come across one that will actually counsel you!), therapists – to get a handle on who you are, where you’ve come from and where you’re probably headed (change will be your prerogative), life-coaching – to strategize an action plan to take you to a better place.

If all else fails, eat chocolate!



Leckey Harrison 3/10/2016 · #24

#17 It certainly points out the differences between the containers we all are, in terms of capacity and fragility. One of those hiding boogey men though is cortisol, which is no friend to the hippocampus and is a precursor to growth of the amygdala. I like your phrase, "cytokine shower." It doesn't help that we're constantly activated, never fighting/flighting, and not releasing. I'm grateful the body has an answer to that problem.

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Gerald Hecht 3/10/2016 · #23

#21 @Ian Weinberg yes. This also is poetic/economical

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Gerald Hecht 3/10/2016 · #22

And as Spinoza would remind us; this is a (two sided) coin https://www.bebee.com/producer/@gerald-hecht/another-type-of-paradigm-shift

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Ian Weinberg 3/10/2016 · #21

Correction: The hippocampal atrophy was reversed with timely cognitive intervention. The cortical atrophy in response to raised cortisol levels is observed in Cushing's disease and is reversed once the cortisol levels return to the normal range.

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Gerald Hecht 3/10/2016 · #20

#17 @Ian Weinberg It can be a dangerous game...one must take to heart the "nosce te ipsum thingie" before playing...

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Ian Weinberg 3/10/2016 · #19

As regards the effectiveness of speech-based cognitive intervention, I agree that the unique subjectivity of each individual will determine not only what is filtered but what unique emotional tags exist that will trigger (and be triggered) by specific chemical configurations. I dealt with this concept to a degree in a previous buzz – see https://www.bebee.com/producer/@ian-weinberg/challenging-limiting-beliefs-20993 It should be noted however that Broca’s speech area is expressive and if compromised, should not affect comprehension and recall (Wernicke’s area). In any event I have no literature indicating that adrenaline (or cortisol) affects Broca’s or Wernicke's areas. Raised adrenaline and noradrenaline specifically compromise pre-frontal cortical activity (Arnsten). High cortisol levels do indeed compromise hippocampal function and thus declarative memory and in the chronic state lead to hippocampal atrophy as well as cortical atrophy (both reversible with timely cognitive intervention).

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Gerald Hecht 3/10/2016 · #18

#16 @Leckey Harrison lol! I don't know how we came to be; but I'd really like to see the original blueprints

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Ian Weinberg 3/10/2016 · #17

@Deb Helfrich @Gerald Hecht @Leckey Harrison Based on nature-nurture determinants and the narrative which evolved thereafter though the life path, we have indeed found comfort zones in different spaces of the autonomic fluctuation range. However I’ve emphasized here the final common pathway which triggers inappropriate pro-inflammatory cytokine secretion and resultant morbidity. This final common pathway should be seen as an integrated combination of several components and their fluctuating configurations. So for example there are those that when challenged in conflict, experience an adrenaline high but since they enjoy conflict, also develop a dopamine gratification component. They walk away without a cytokine shower. Conversely there is the fearful individual with a compromised self-esteem who, when challenged in conflict experiences a marked rise in adrenaline (fear) together with a severe insult to self-esteem which devolves into hopeless-helpless (low dopamine) and a consequent predisposition to a cytokine shower. And so on and so forth. There is a final common chemical pathway with fluctuating components which deftly play the cytokines, but nevertheless each component has validated ‘end-organ’ effects.

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