Wednesday, October 23, 2002 - Page updated at 12:00 AM

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Your body may tell you to be afraid, even when there's nothing to fear

Seattle Times staff reporter

Fear can be an enormously useful emotion. For millions of years, it kept our ancestors steps ahead of predators. Today, it keeps people from walking in front of speeding trucks.

But in some people, researchers and doctors say, the body's fear response turns on too often and at inappropriate times, causing both psychological and, perhaps, physical harm.

These days scientific study of fear and anxiety and their health consequences is on the rise, prompted by what some believe to be an increase in the problem.

Not everyone agrees. After all, some say, our ancestors had pretty big stressors — the ever-lurking possibility of starvation, for one thing.

But it doesn't take much of a leap to imagine, as some experts do, that our modern world — random sniper fire, 24/7 media saturation, traffic congestion, terrorism — has created more hyper-anxious and fearful people.

Stress has been defined as the brain's response to changes in the status quo — think of the famous scale that purports to measure the "stress quotient" of events such as the death of a spouse and loss of a job. By that definition, modern life, with its accelerating rate of change, may be more stressful than other eras.

Dr. Peter Roy-Byrne, chief of psychiatry at Harborview Medical Center, who believes this is true, notes a study that shows that the rate of anxiety and depression is higher now than in the 1930s.

And modern humans also have the capacity to see the bigger picture — and thus to feel angst from more directions simultaneously.

As Robert Sapolsky, professor of neuroendocrinology at Stanford University says: "We have the capacity to shift from being fearful about what's happening right here, right now, to much bigger issues over time and space. We turn on the (anxiety) response thinking, 'Am I going to make mortgage payments for 25 years?'

"It can range from the very concrete — 'Oh no, that person is going to mug me' — to the very abstract — 'Oh no, they're going to call on me in class tomorrow.' "

Fear and anxiety are related, if not identical. Fear is caused by a specific cue — a grizzly bear sniffing your tent at 2 a.m. — that involves the "flight or fight" response. Anxiety is more vague, as when you worry about a danger that might occur in the future.

One thing is clear: anxiety disorders — misfirings of the nervous system, ranging from phobias to post-traumatic stress disorder — are today the most common mental disorder in the U.S., according to the National Mental Health Association. More than 19 million — or 13 percent of the population — are affected.

Who's most vulnerable?

Why do some people's "alarm systems" go off faster and louder than others? Mostly because of genetics and temperament.

"People on the least 'reactive' side seek out things — like climbing a rock wall or jumping out of an airplane — that people on the other side avoid," said Dr. Arthur Peskind, a Seattle psychologist.

Other factors:

Women suffer from anxiety disorders more than men. Among the reasons, says Bobbie Geiger, a Seattle social worker who treats anxiety disorders, are biological differences and a higher rate of childhood sexual abuse.

Media overload about scary situations can condition people to be more fearful, according to some studies.

The mind/body connection

Although it's clear that excess anxiety or fear can wreak havoc on the mind, scientists are still unraveling their effect on physical health.

• "Chicken-and-egg": Questions persist about the relationship between poorer health and anxiety. There are associations between the two: People with anxiety disorders have more physical disorders, says Seattle psychiatrist Herbert Orenstein, who has treated anxiety disorders for more than 25 years, and medical patients tend to have higher rates of anxiety and depression. But, he says, there's no research showing that anxiety causes physical illness.

Ulcers, diabetes, hypertension, sudden-death syndrome: Such ailments have been associated with anxiety, but experts say anxiety is only one of many causes; it may make an existing condition worse or appear earlier than otherwise. (While ulcers are now known to be caused by bacteria, some scientists believe that stress could contribute to their development by weakening the immune system.)

Besides influencing the immune system, anxiety and fear are suspected of affecting the endocrine system (which governs hormones), but scientists haven't discovered how this occurs, said Harborview's Roy-Byrne. He referred to studies of medical students demonstrating that those with the highest stress levels are more likely to get colds.

Link with alcoholism: According to Orenstein, the one illness that has a proven connection to anxiety disorder is alcoholism: A high percentage of people with anxiety disorders self-medicate with booze.


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