"Goodbye Love 4" guests are anxious, this study tells you how the brain works

Produced by: Science Popularization China

Author: Denovo

Producer: China Science Expo

The recently popular "Goodbye Love 4" focuses on the difficulties and conflicts in real marriages, triggering extensive discussions among viewers about emotional relationships and individual psychology. The program truly presents the anxiety that middle-aged people generally face, including emotional conflicts, financial pressures, and physical fatigue. From the interactions of several couples, we not only see how anxiety affects individual thinking and behavior, but also gain insight into its profound impact on intimate relationships. This also makes us have to think deeply: In today's society, where does anxiety come from? Is it the pressure of the external environment, or the imbalance deep in the heart? Faced with the challenges of life, how can we find a way to coexist peacefully with stress?

What is the mechanism of anxiety?

Recently, the controversial guest Mai Lin often showed strong emotional fluctuations in the show: she cried because the portrait was not good-looking, and stopped because the dance was not graceful enough... People can't help but wonder, is her behavior due to fear of negative evaluation from the outside world, or because of the deep anxiety caused by the rejection of her self-image? Faced with such questions, we need to understand that although fear and anxiety are often confused, they have completely different connotations.

Fear is a direct response to a clear and specific threat in the present, which lasts for a short time and is usually accompanied by strong immediacy; while anxiety is more manifested as worry and uneasiness about future uncertainty, lacks a clear threat object, and often lasts for a long time, and may even become chronic. The emotional state of anxiety is often vague, difficult to describe specifically, and is accompanied by certain psychological pain.

Vague, unspecific threats are typical of anxiety, which manifests itself in sensitivity to dance moves, frugality in household spending, and sensitivity in marital relationships, all of which are long-standing problems.

Mai Lin was unable to express her worries specifically, and it was difficult for her to clearly communicate the source of these emotions with Li Xingliang. She could only release her anxiety by accusing or suggesting that she might have suffered from a common anxiety disorder, generalized anxiety disorder. In Goodbye, My Love 4, marital conflicts and emotional entanglements were important factors that triggered her generalized anxiety disorder.

The psychological factors of anxiety include cognitive bias, personal experience, genetic factors, personality traits, etc., which together shape the way individuals cope with stress and uncertainty, thus forming the complex psychological root of anxiety. Mylene's anxiety is closely related to her personal experience. As a "full-time wife", she gradually gave up her ideals and life, and slowly developed self-doubt and dissatisfaction. This emotion made her unable to truly feel happy even if she had love around her, and she gradually developed anxiety and eventually developed a desire for control.

Although many people tend to simply attribute it to the current predicament or their own psychological problems, research in recent years has shown that anxiety is not just a psychological phenomenon, but a complex emotional response caused by the combined effect of multiple physiological and psychological factors.

fMRI images of GAD brains show some differences from normal brains

(Image source: Document 3)

Scientists have found through imaging studies that the amygdala-prefrontal cortex circuit in the brain may be dysfunctional when in an anxious state. The amygdala is the core area in the brain that processes threat information. After the threat signal is transmitted from the sensory receptor to the thalamus, it will directly receive the information before the cerebral cortex, thereby quickly triggering an emotional response. The prefrontal cortex works in synergy with the amygdala and other emotional centers such as the ventral striatum and insula to relieve fear or anxiety by regulating emotional responses.

However, in an anxious state, the amygdala may become abnormally active, causing the individual to be overly sensitive to threats. At the same time, due to structural changes and inactivation, the prefrontal cortex weakens its ability to inhibit the amygdala, and its emotion regulation function decreases accordingly. This imbalance in neural circuits further exacerbates anxiety, forming a vicious circle. On February 12, 2024, Li Xiaoming's team at Zhejiang University discovered a neural pathway independent of the amygdala, which suggests that in addition to the traditionally believed amygdala, there may be other independent neural mechanisms in the brain that are involved in the regulation of fear and anxiety.

Amygdala-prefrontal circuit

(Image source: Document 2)

How does anxiety affect the body?

When people feel anxious, they often experience physical reactions such as sweating, dizziness, palpitations, chest tightness, and shortness of breath. These physiological changes are closely related to the activation of the hypothalamus-pituitary-adrenal (HPA) axis.

When we perceive a threat, the amygdala in the brain is triggered, which then transmits a signal to the hypothalamus, which quickly releases corticotropin-releasing hormone (CRH), which stimulates the pituitary gland to secrete adrenocorticotropic hormone (ACTH).

ACTH is transmitted to the adrenal glands through the blood, prompting them to secrete the stress hormone cortisol. Cortisol further activates the sympathetic nervous system, triggering the release of a large amount of adrenaline and norepinephrine, leading to physiological reactions such as increased heart rate, rapid breathing, and muscle tension. The essence of these changes is to enhance the body's ability to respond to threats, allowing us to face potential dangers more quickly.

Hypothalamic-pituitary-adrenal (HPA) axis

(Image source: Document 5)

However, when this reaction is excessive or long-lasting, it can interfere with the normal homeostasis of multiple physiological systems (such as the cardiovascular, respiratory, digestive and nervous systems), and may also cause a series of physical discomfort and health problems, which is called "somatization."

Taking the cardiovascular and digestive systems as an example, Michael Marmot of University College London in the UK studied a large number of long-term stress data in work scenarios and found that the long-term increase in cortisol and other hormones caused by long-term stress and anxiety will have a significant impact on the health of the cardiovascular system and increase the risk of coronary heart disease, hypertension and other cardiovascular diseases. Douglas A Drossman of the University of North Carolina in the United States found that anxiety and stress can significantly increase the incidence of functional gastrointestinal diseases (such as irritable bowel syndrome) by changing the function of the HPA axis and intestinal activity.

It is worth noting that long-term activation of the HPA axis inhibits neuroplasticity, thereby impairing the function of the hippocampus responsible for memory and emotion regulation, thereby significantly increasing the risk of depression. At the same time, under anxious conditions, dysfunction of neurotransmitters such as serotonin (5-HT), dopamine, and norepinephrine may also lead to low mood and depressive symptoms. In addition, anxious individuals are in a state of excessive worry for a long time, tend to magnify negative results, and gradually form negative thinking patterns. This cognitive burden will evolve into typical thinking characteristics of depression, such as helplessness and despair. Therefore, many patients with anxiety disorders also meet the diagnostic criteria for depression.

Similarly, some patients with anxiety disorders also show social disorders, such as excessive avoidance of social occasions or excessive sensitivity to interpersonal evaluations, further exacerbating the vicious cycle of anxiety and depression. In response to this problem, in 2022, Li Xiaoming's team at Zhejiang University provided new insights. They revealed the neural circuits and molecular mechanisms behind the above behaviors induced by anxiety, and found that different serotonin (5-HT) neural pathways leading to the amygdala regulated different behavioral characteristics of anxiety. This discovery not only broadens the understanding of the mechanism of anxiety, but also brings new hope for breaking the vicious cycle of anxiety-depression-social disorder.

Different 5-HT neural pathways regulate different behavioral working modes of anxiety

(Image source: Document 7)

How to identify and diagnose anxiety?

According to the World Health Organization, about 4% of the world's population suffers from anxiety disorders, making it one of the most common mental disorders. Anxiety disorders not only seriously affect the patient's quality of life, but may also further induce other health problems. Therefore, it is particularly important to face anxiety and deal with it scientifically. So, how can we determine whether we have generalized anxiety disorder?

The typical characteristics of generalized anxiety disorder are persistent excessive worry and tension, and the symptoms last for at least 3 months, which have a significant impact on daily life and function. Patients often have obvious somatization symptoms, such as frontal or occipital headaches, dizziness; insomnia, dreaminess, difficulty relaxing, frequent tension; easy to be frightened; often accompanied by sweating, rapid heartbeat, dry mouth; throat obstruction or chest discomfort.

Global disability-adjusted life years (DALYs) by mental disorder, sex and age, with anxiety disorders in light red

(Image source: Global Burden of Disease Study 2019)

In order to determine whether we have generalized anxiety disorder, we can observe ourselves to evaluate whether we have the above-mentioned emotional, physical or behavioral symptoms, and determine whether these symptoms have a negative impact on our lives. If we are unable to make a clear judgment, we can use the Self-Rating Anxiety Scale (SAS) or the Generalized Anxiety Disorder Scale (GAD-7) to understand our anxiety level through quantitative scoring. If we are unable to make a judgment or the result is high, it is recommended to consult a mental health professional as soon as possible to make a clear diagnosis and develop a personalized intervention plan.

Even if we are diagnosed with anxiety disorder, we only need to accept it calmly and respond positively, avoiding exaggerating or "demonizing" anxiety . In fact, the human body already has an internal mechanism to relieve anxiety. On November 19, 2024, researchers from the Salk Institute and other institutions in the United States found that when we actively slow down our breathing, a specific neural circuit in the brain can effectively reduce anxiety and negative emotions. On January 31, 2024, Professor Zhu Jingning's team at Nanjing University found that during challenging exercises, the hypothalamus-cerebellum-amygdala circuit will be more strongly activated, improving anxiety... Therefore, we can relieve anxiety through moderate meditation, regular work and rest, moderate exercise, and seeking support from family and friends.

Conclusion

The progress of modern science has given us more possibilities. From revealing the role of neural circuits to the popularization of quantitative assessment tools, anxiety is no longer an emotional enemy that is difficult to fight. Through active coping and scientific intervention, I believe that the guests in "Lover 4" and we in life can find ways to coexist peacefully with stress, regain control of our emotional state, and move towards a healthier future through continuous learning and adjustment.

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