Anxiety & Depression

While these two words are very family, it is not always clear what they mean. Here, I am referring to  mood disorders, or neuropsychiatric conditions, that reflect a disruption of brain chemistry, cognitive function and emotional experience, and may require medical treatment.

It is helpful to distinguish between a “mood disorder” and an “emotion,” a “mood state,” and an “emotional style” or temperament.  An emotion is a temporary experience that is usually triggered by an thought or an event. It reflects a sudden and complex change in our brain chemistry and in our physiology more generally. I think of an emotion as a wave that crashes over us, temporarily changing the way we think and feel about everything. 

A mood, or mood state, is more persistent than an emotion but similar in character. It can last a few hours or a few days, but generally resolves on its own. We can be in an anxious mood state, feeling generally anxious, a depressed mood state, feeling generally sad or hopeless or unmotivated, or an angry or irritable mood state. In an irritable mood state we are  really cranky. Things that may normally not bother us too much may seriously annoy us. We tend to over-react, snap, or explode. 

An irritable mood state often reflects physiologic distress, as in situations of immune activation (when we’re sick), unmet primary needs (when we’re hungry or tired) or under stress (work deadline, interpersonal conflict). We can be in a happy mood state too,  when something good is going on, or an excited mood state, when too much is going on. And we can be in a calm, open and neutral mood state.

Our mood style, or temperament, reflects emotional tendencies that are genetically determined, or “hard-wired,”  and apparent from a very young age. We are more or less sensitive to emotions in general, feeling them more or less intensely, and tend to experience some emotions more than others.  Some of us tend to worry, some of us tend to explode.  Some of us have big ups and downs, others are more even – keeled, with more muted reactions. This is set of characteristics, our emotionality, may be apparent to others – we “wear our heart on our sleeve,” or may be hard to read.  Some people feel emotions very deeply but do not express them outwardly.


Mood Disorders

When we experience negative mood states that are prolonged or severe and interfere with our functioning at work, at home, or in relationships, we call it a mood disorder – an anxiety disorder or a depressive disorder. There are different types of anxiety disorder – generalized, social, panic, and obsessive-compulsive disorders, and different depressive disorders – persistent depressive disorder, and major depressive disorder.  Core features of depression are feelings of hopelessness, lack of motivation and initiative,  and poor concentration. These reflect, in terms of our systems model, the lack of a positive charge.  Bipolar disorder is a condition characterized by periods of severely depressed mood state and irritable or elevated mood state (too excited, can’t sleep, thoughts are racing), which can be associated with irrational thoughts and beliefs. In children, sudden and intense fluctuations in mood, usually with irritability and angry outbursts, is called disruptive mood dysregulation disorder.


The Affective System

Our emotionality – our hard-wired tendencies to experience emotions and mood states, describes our Affective system, one of the five brain systems in the ThinkPrint model. Our Cognitive system is similarly hard-wired – we each have a unique set of preferences, tendencies, and abilities to think  and learn about different kinds of things that is genetically determined and then shaped – enhanced or obstructed – by our experiences in life. 

One of the most important things to understand about how our brains work is that emotion rules.  We fancy ourselves rational beings, but we can be rational only when we are not in the grip of an emotional wave. 

The Affective system is the boss system, because it drives the Executive system, which in turn controls the Sensory (input) system (paying attention and ignoring distractions) and the Motor (output) system (initiating and inhibiting responses) and supports the Cognitive system.  What we pay attention to, what we do, and how we think and learn and remember, all depend on emotion. We think we can be rational, but there really isn’t much going on in the brain without emotion, without the Affective system assigning a charge to things.

This is because the brain’s job is to ensure the survival of the body. The brain’s number one priority is to get our needs met and to prevent harm.  So the things we need have a big positive charge on them (we want them), to make us notice and respond to them, and the things that are dangerous have a big negative charge on them (we are afraid of them), also to make us notice and respond to them (quickly!)  These things have a bigger charge than everything else, the things that don’t meet our needs and can’t really hurt us, so they eclipse everything else.  They interfere with our attending to, and responding to, the other things that maybe we think we want to do.

This explains a large proportion of what drives us crazy about the people around us, and our own behavior. In fact, by observing what we’re doing or paying attention to, we can determine what has the strongest charge. Here’s an example. Have you ever wondered (maybe loudly) why your child won’t start working on the paper that was assigned two weeks ago until 11:00 the night before it’s due?  Well, it makes perfect sense, really. If I have an assignment and I’m not working on it, there is either too much negative charge (I hate doing it, I’m afraid I can’t do it, I’m afraid of missing a social event in order to do it). Or there is not enough positive charge on doing it (it’s stupid and boring).

Or, there’s not enough negative charge on not doing it. The reason we don’t start the paper until the night before it’s due is because it’s only then that the negative charge on not doing it becomes stronger than the negative charge on doing it. The negative charge on showing up without it and getting a failing grade becomes stronger than the positive charge on hanging out with my friends. What we do is always what has, for us at the moment, the strongest emotional charge.

Changing the emotional motivation is the only way to change attention and behavior. No learning or thinking or remembering goes on if we don’t feel safe or if our basic needs aren’t met. This is critically important for parents and teachers to understand.