Anxiety is a common condition characteried by excessive, persistent and unrealistic fear or worry and can have a range of extremely mild to debilitating and chronic symptoms. Anxiety disorders are the most common mental illness in the U.S., affecting more than 18% of the population. Despite the fact a majority of anxiety goes untreated, anxiety often has symptoms like physical illness, so people with anxiety disorders are up to five times more likely to go to the doctor than those without anxiety.

Anxiety has a powerful impact on social and intimate relationships as well as your relationship to your own body and internal experience. Negative looping–“pervasive thought patterns that amplify the negative emotional and physical impacts of an anxiety-provoking incident“–can be relentless, stealing your mental focus and draining energy. Anxiety is unpleasant and impacts your physiology, cognition and moment-by-moment experience, giving rise to a neurochemical avalanche of catecholamine (stress hormones) and hormonal shifts. “Stomach knots” are not uncommon.

People who suffer most from anxiety are found to have:

• Increased activity in the amygdala, a primitive, emotional center of the brain that regulates fear responses
• Decreased activity in the medial prefrontal cortex, the more advanced “thinking” part of the brain indicated in social behavior and emotional regulation
• Changed functioning of the hippocampus, one of the primary neural mechanisms responsible for memory

During episodes of anxiety the brain’s ability to regulate emotional intensity becomes impaired, while the brain’s instincts for protective vigilance and self-preservation ramps up. While this cascade of events can certainly aid us during threats to survival, it rarely serves us in the modern world.

The immune system is in constant interaction with our emotional neural circuitry. The important links between the mind and the immune system have lead science to explore the implications of chronic anxiety, in particular, as playing a critical role in an array of physiological symptoms including cancer, heart disease, diabetes, multiple sclerosis, irritable bowel syndrome, and arthritis. The costs of hidden anxiety in the body are extreme and continue to be explored by researchers (though anxiety already costs almost a third of the country’s $150 billion mental health bill).

The emotional centers of the brain are physiologically connected to the nervous system, the hormonal apparatus, and the behavioral response systems, being joined together by chemical messengers. When the brain’s neurotransmitters are consistently taxed by overriding chemicals associated with anxiety, the implications to various systems and functions of the body are greatly impacted.

When acute anxiety is triggered, not only is the function of immune cells diminished, increases in cortisol release will occur, leading to hyper-vigilance, muscular exertion, spurts of endurance, and enhanced memory activation related to prevailing emotions. When anxiety is chronic, however, cortisol levels ultimately decline but can lead to atrophy and neuronal death of the hippocampus and its function in the brain. Some researchers believe that chronic anxiety can be a contributing factor toward dementia and Alzheimer’s later in life.

The good news is anxiety is highly treatable. Keys to success in managing anxiety include mindfulness, skills to navigate and mitigate the body’s reaction to anxiety, and reframing of current life experiences. Because anxiety can be relentless, learning to track related sensations and thought content is a necessary first step to managing and ultimately transforming anxiety. Once you learn to identify the path that anxiety takes in your unique body and mind, you can build the emotional, relational and behavioral support necessary to practice new responses that may ultimately “rewire” your anxiety response patterns.