1 00:00:00,305 --> 00:00:00,894 anxiety disorder 2 00:00:01,345 --> 00:00:02,994 the brain's disaster rehearsal 3 00:00:03,504 --> 00:00:04,253 three in the morning 4 00:00:04,585 --> 00:00:05,434 you wake up 5 00:00:05,785 --> 00:00:07,434 not startled awake by a nightmare 6 00:00:07,464 --> 00:00:09,314 but woken by a single thought 7 00:00:09,664 --> 00:00:11,214 will tomorrow's presentation go wrong 8 00:00:11,904 --> 00:00:13,833 that test result last month was a little high 9 00:00:13,904 --> 00:00:14,933 could it be some serious illness 10 00:00:15,625 --> 00:00:17,393 the kid's grades have been slipping lately 11 00:00:17,464 --> 00:00:18,893 will they fail to get into a good school 12 00:00:19,585 --> 00:00:22,393 then these thoughts start flooding your mind like a barrage 13 00:00:22,504 --> 00:00:23,623 one after another 14 00:00:23,625 --> 00:00:24,333 faster and faster 15 00:00:24,585 --> 00:00:25,594 denser and denser 16 00:00:25,824 --> 00:00:26,974 you tell yourself to calm down 17 00:00:27,225 --> 00:00:28,393 but your body won't listen 18 00:00:28,745 --> 00:00:29,574 your heart races 19 00:00:29,945 --> 00:00:30,914 your palms sweat 20 00:00:30,984 --> 00:00:32,753 your chest feels like a stone is pressing on it 21 00:00:32,984 --> 00:00:33,933 you toss and turn 22 00:00:34,225 --> 00:00:35,234 until dawn 23 00:00:35,730 --> 00:00:37,379 this isn't occasional nervousness 24 00:00:37,730 --> 00:00:40,139 this is an inner war playing out every single day 25 00:00:40,730 --> 00:00:43,938 more than three hundred and fifty million people worldwide are fighting this battle 26 00:00:44,529 --> 00:00:47,059 according to World Health Organization data from twenty twenty one 27 00:00:47,249 --> 00:00:50,129 anxiety disorder is the most common mental disorder on earth 28 00:00:50,130 --> 00:00:51,099 bar none 29 00:00:51,410 --> 00:00:52,739 more common than depression 30 00:00:53,170 --> 00:00:57,578 and only one in four patients receives any form of treatment 31 00:00:58,397 --> 00:00:58,707 hello 32 00:00:58,957 --> 00:00:59,427 everyone 33 00:00:59,598 --> 00:01:00,646 I'm Wang Lijie 34 00:01:00,957 --> 00:01:03,607 I once did an episode about depression 35 00:01:03,757 --> 00:01:06,067 called I once thought about ending it all 36 00:01:06,797 --> 00:01:09,267 that episode was about the brain's energy being drained away 37 00:01:09,758 --> 00:01:13,847 serotonin crashing dopamine shutting down cognition narrowing into a tunnel 38 00:01:13,958 --> 00:01:16,886 a person trapped in darkness unable to see a way out 39 00:01:17,237 --> 00:01:19,146 then there was another episode on panic attacks 40 00:01:19,597 --> 00:01:22,166 about the brain suddenly sounding a nuclear alarm 41 00:01:22,318 --> 00:01:25,606 the whole body entering life or death mode within minutes 42 00:01:26,341 --> 00:01:27,411 the anxiety disorder we're talking about today 43 00:01:27,701 --> 00:01:29,191 is different from both of those 44 00:01:29,622 --> 00:01:31,700 depression is like your power plant shutting down 45 00:01:31,701 --> 00:01:33,150 the whole person sinking into darkness 46 00:01:33,462 --> 00:01:35,551 a panic attack is like a sudden explosion 47 00:01:35,622 --> 00:01:37,031 it hits hard and passes fast 48 00:01:37,462 --> 00:01:38,131 but anxiety disorder 49 00:01:38,421 --> 00:01:39,210 it's not a blackout 50 00:01:39,501 --> 00:01:40,551 and it's not an explosion 51 00:01:40,981 --> 00:01:44,271 it's an alarm in your brain that can never be turned off 52 00:01:44,501 --> 00:01:46,831 buzzing away twenty four hours a day 53 00:01:46,981 --> 00:01:47,971 not too loud not too soft 54 00:01:48,182 --> 00:01:49,510 not enough to break you down 55 00:01:49,581 --> 00:01:52,070 but just loud enough to keep you from ever finding peace 56 00:01:52,964 --> 00:01:55,253 this is the most insidious thing about anxiety disorder 57 00:01:55,483 --> 00:01:58,492 it doesn't knock you down all at once the way a panic attack does 58 00:01:58,723 --> 00:02:02,372 it drains you slowly steadily and without pause 59 00:02:02,563 --> 00:02:03,992 like a faucet that isn't fully closed 60 00:02:04,244 --> 00:02:05,533 dripping drop by drop 61 00:02:05,923 --> 00:02:07,693 every day you feel something is off 62 00:02:07,884 --> 00:02:09,932 but you can't quite say what's wrong 63 00:02:10,163 --> 00:02:11,032 you still function 64 00:02:11,283 --> 00:02:12,242 you can still go to work 65 00:02:12,244 --> 00:02:13,252 you can still socialize 66 00:02:13,364 --> 00:02:16,132 but the background noise inside you never stops 67 00:02:16,712 --> 00:02:18,200 now let me show you 68 00:02:18,271 --> 00:02:19,991 this alarm that can't be turned off 69 00:02:19,991 --> 00:02:21,320 what's really going on with it 70 00:02:21,791 --> 00:02:24,081 deep in your brain there's an amygdala 71 00:02:24,391 --> 00:02:26,281 this thing is about the size of an almond 72 00:02:26,352 --> 00:02:28,001 tucked inside the medial temporal lobe 73 00:02:28,032 --> 00:02:30,681 it's the oldest threat detection system humans have 74 00:02:30,991 --> 00:02:31,991 hundreds of millions of years ago 75 00:02:31,991 --> 00:02:34,841 when our ancestors were still small mammals 76 00:02:34,951 --> 00:02:36,841 this system was already in place 77 00:02:36,951 --> 00:02:40,001 its job is extremely simple scan the environment 78 00:02:40,032 --> 00:02:41,070 detect danger 79 00:02:41,071 --> 00:02:42,121 sound the alarm 80 00:02:43,285 --> 00:02:43,795 the key thing is 81 00:02:44,206 --> 00:02:46,575 it's so fast it bypasses your consciousness 82 00:02:46,806 --> 00:02:48,684 in two thousand eight the Monk team 83 00:02:48,686 --> 00:02:52,094 published a study in the Archives of General Psychiatry that found 84 00:02:52,285 --> 00:02:56,235 even when a threatening face flashes by for just seventeen milliseconds 85 00:02:56,565 --> 00:02:58,314 too fast for you to even make it out 86 00:02:58,806 --> 00:03:02,094 the amygdala of an anxiety patient still lights up instantly 87 00:03:02,366 --> 00:03:03,795 what does seventeen milliseconds even mean 88 00:03:04,246 --> 00:03:07,055 a single blink takes you three to four hundred milliseconds 89 00:03:07,285 --> 00:03:08,175 in other words 90 00:03:08,246 --> 00:03:10,615 a face you haven't even had time to make out 91 00:03:10,725 --> 00:03:14,495 your amygdala has already completed a threat assessment for you 92 00:03:15,285 --> 00:03:18,075 and this study found something even more crucial 93 00:03:18,445 --> 00:03:20,575 faced with this kind of fleeting threat 94 00:03:20,725 --> 00:03:24,254 the amygdala of an anxiety patient reacts far more strongly than in ordinary people 95 00:03:24,597 --> 00:03:28,836 in a normal person the prefrontal cortex hits the brakes after the amygdala fires 96 00:03:28,836 --> 00:03:30,246 pressing the signal back down 97 00:03:30,556 --> 00:03:32,846 but in an anxiety patient this braking system 98 00:03:32,877 --> 00:03:34,045 is clearly weaker 99 00:03:34,477 --> 00:03:36,205 the amygdala slams the gas 100 00:03:36,396 --> 00:03:38,285 the prefrontal cortex only taps the brakes lightly 101 00:03:38,676 --> 00:03:40,485 you can picture it as a car 102 00:03:40,956 --> 00:03:41,785 in a normal brain 103 00:03:42,157 --> 00:03:44,205 the gas and the brakes work well together 104 00:03:44,437 --> 00:03:45,466 speed up when there's danger 105 00:03:45,877 --> 00:03:47,366 slow down once the danger's gone 106 00:03:47,636 --> 00:03:49,485 but in an anxiety patient's car 107 00:03:49,597 --> 00:03:51,366 the gas pedal is stuck 108 00:03:51,396 --> 00:03:53,246 and the brake pads are worn thin 109 00:03:53,396 --> 00:03:54,885 so it just keeps accelerating 110 00:03:54,997 --> 00:03:56,646 even when there's nothing on the road 111 00:03:57,181 --> 00:03:59,110 in twenty twenty one the Kenwood team 112 00:03:59,141 --> 00:04:02,189 published a review in Neuropsychopharmacology 113 00:04:02,220 --> 00:04:04,070 that explained this mechanism even more clearly 114 00:04:04,165 --> 00:04:04,964 they said 115 00:04:05,021 --> 00:04:08,550 the prefrontal cortex of primates expanded greatly over evolution 116 00:04:08,701 --> 00:04:12,110 originally to add a layer of rational control over the anxiety response 117 00:04:12,261 --> 00:04:15,070 but if certain pathways in the prefrontal cortex go wrong 118 00:04:15,261 --> 00:04:17,790 it not only fails to suppress the amygdala's output 119 00:04:17,861 --> 00:04:19,530 it actually produces a negative bias 120 00:04:19,901 --> 00:04:22,949 meaning you become more likely to notice threat signals 121 00:04:22,980 --> 00:04:25,340 harder to pull out of an anxious state 122 00:04:25,340 --> 00:04:28,829 and start avoiding every situation that might trigger discomfort 123 00:04:29,021 --> 00:04:32,110 this is the core neural circuit of anxiety disorder 124 00:04:32,860 --> 00:04:34,009 it's not that something's wrong with your personality 125 00:04:34,340 --> 00:04:35,579 it's not that you're too sensitive 126 00:04:35,581 --> 00:04:36,910 it's not that you overthink 127 00:04:37,180 --> 00:04:39,619 it's that between the gas and the brakes in your brain 128 00:04:39,621 --> 00:04:41,389 there's a hardware level imbalance 129 00:04:41,791 --> 00:04:43,080 but the story isn't over yet 130 00:04:43,311 --> 00:04:45,401 just having an overactive amygdala 131 00:04:45,431 --> 00:04:47,200 isn't enough to create an anxiety disorder 132 00:04:47,392 --> 00:04:49,750 what really turns anxiety into a chronic condition 133 00:04:49,752 --> 00:04:52,520 is another system your stress hormone axis 134 00:04:52,752 --> 00:04:56,161 in medicine it's called the hypothalamic pituitary adrenal axis 135 00:04:56,311 --> 00:04:59,041 you can think of it as the body's emergency mobilization system 136 00:04:59,231 --> 00:05:00,101 under normal circumstances 137 00:05:00,351 --> 00:05:01,721 when you meet a real danger 138 00:05:01,752 --> 00:05:02,741 this system kicks in 139 00:05:02,991 --> 00:05:04,120 releasing cortisol 140 00:05:04,152 --> 00:05:08,080 helping you focus mobilize energy and prepare to fight or flee 141 00:05:08,231 --> 00:05:09,020 once the danger passes 142 00:05:09,231 --> 00:05:10,140 cortisol comes back down 143 00:05:10,392 --> 00:05:11,361 the system resets 144 00:05:11,680 --> 00:05:15,249 but in an anxiety patient the stress hormone axis doesn't reset properly 145 00:05:15,839 --> 00:05:18,769 in twenty nineteen the Fiksdal team's research found 146 00:05:18,920 --> 00:05:20,889 the more severe a person's anxiety symptoms 147 00:05:20,959 --> 00:05:24,129 the flatter their cortisol recovery curve after a stress test 148 00:05:24,403 --> 00:05:24,869 what does that mean 149 00:05:25,519 --> 00:05:28,598 it means other people's alarm shuts off quickly after it goes off 150 00:05:28,600 --> 00:05:31,369 yours keeps buzzing there long after it's gone off 151 00:05:31,480 --> 00:05:34,689 slowly and reluctantly dragging its feet before it quiets down 152 00:05:35,508 --> 00:05:40,157 and the twenty fourteen Dieleman team's research on childhood anxiety is even more startling 153 00:05:40,427 --> 00:05:41,056 they found 154 00:05:41,388 --> 00:05:43,037 children with chronic anxiety 155 00:05:43,068 --> 00:05:45,797 actually have lower baseline cortisol levels 156 00:05:46,388 --> 00:05:47,667 this seems contradictory 157 00:05:47,667 --> 00:05:49,537 but it actually points to exactly one thing 158 00:05:50,107 --> 00:05:53,436 the system has been chronically drained to near exhaustion 159 00:05:53,667 --> 00:05:54,917 it's like a fire brigade 160 00:05:54,987 --> 00:05:58,196 if it's called out by false alarms twenty times a day 161 00:05:58,388 --> 00:05:59,097 over time 162 00:05:59,347 --> 00:06:00,756 the firefighters burn out 163 00:06:00,787 --> 00:06:03,316 and when there's a real fire they can't respond 164 00:06:03,861 --> 00:06:07,030 this is the fundamental difference between anxiety disorder and occasional nervousness 165 00:06:07,462 --> 00:06:09,551 occasional nervousness is a normal alarm 166 00:06:09,782 --> 00:06:12,671 anxiety disorder is the alarm system itself breaking down 167 00:06:12,741 --> 00:06:13,991 either it won't stop ringing 168 00:06:14,142 --> 00:06:16,751 or it rings until it can't ring anymore 169 00:06:17,022 --> 00:06:17,210 alright 170 00:06:17,741 --> 00:06:19,590 now we come to the most crucial part 171 00:06:19,941 --> 00:06:21,700 this faulty alarm system 172 00:06:21,701 --> 00:06:22,850 what exactly is it warning about 173 00:06:23,766 --> 00:06:24,314 the answer is 174 00:06:24,646 --> 00:06:25,334 the future 175 00:06:25,846 --> 00:06:28,855 this is the most essential difference between anxiety and depression 176 00:06:29,286 --> 00:06:32,314 the core of depression is despair over the past and the present 177 00:06:32,766 --> 00:06:34,884 what has already happened crushes you 178 00:06:34,886 --> 00:06:36,214 you can't see a way out 179 00:06:36,365 --> 00:06:40,764 but the core of anxiety is fear of the future things that haven't happened yet 180 00:06:40,766 --> 00:06:43,454 your brain has already started rehearsing disaster 181 00:06:43,775 --> 00:06:47,895 modern neuroscience has a brilliant framework to explain this 182 00:06:47,895 --> 00:06:49,385 it's called predictive coding 183 00:06:49,616 --> 00:06:52,505 your brain is essentially a prediction machine 184 00:06:52,816 --> 00:06:55,345 it doesn't passively receive information from the outside world 185 00:06:55,376 --> 00:06:58,825 it actively generates predictions about the world a second from now 186 00:06:59,056 --> 00:07:01,984 then compares the actual input against those predictions 187 00:07:02,215 --> 00:07:02,924 if they match 188 00:07:03,215 --> 00:07:04,304 nothing happens 189 00:07:04,575 --> 00:07:05,614 if they don't match 190 00:07:05,616 --> 00:07:08,505 the brain produces a signal called prediction error 191 00:07:08,535 --> 00:07:09,945 to correct the model 192 00:07:10,057 --> 00:07:13,667 in twenty twenty five the Ballal team proposed an integrated model 193 00:07:13,818 --> 00:07:14,946 it's really elegant 194 00:07:15,141 --> 00:07:15,941 they said 195 00:07:15,977 --> 00:07:19,146 the problem in anxiety patients lies in precision weighting 196 00:07:19,458 --> 00:07:20,686 what is precision weighting 197 00:07:21,258 --> 00:07:24,227 it's the level of trust the brain assigns to different signals 198 00:07:24,658 --> 00:07:29,456 a normal brain adjusts flexibly according to context in a safe environment 199 00:07:29,458 --> 00:07:31,367 it lowers its sensitivity to threat signals 200 00:07:31,898 --> 00:07:33,167 in a dangerous environment 201 00:07:33,417 --> 00:07:34,706 it raises the sensitivity 202 00:07:35,378 --> 00:07:37,146 but the brain of an anxiety patient 203 00:07:37,177 --> 00:07:41,586 sets the weight on uncertain signals from inside the body far too high 204 00:07:42,018 --> 00:07:43,086 the heartbeat speeds up a little 205 00:07:43,417 --> 00:07:45,266 read as the warning sign of a heart attack 206 00:07:45,778 --> 00:07:46,847 the stomach feels a bit off 207 00:07:47,177 --> 00:07:48,867 read as a sign of cancer 208 00:07:49,338 --> 00:07:50,727 the breathing gets slightly rapid 209 00:07:51,057 --> 00:07:52,706 read as being about to suffocate 210 00:07:53,251 --> 00:07:55,020 their computer simulations show 211 00:07:55,170 --> 00:07:57,259 once this weighting bias forms 212 00:07:57,331 --> 00:07:58,860 the system reinforces itself 213 00:07:58,891 --> 00:07:59,759 getting more and more rigid 214 00:08:00,050 --> 00:08:02,259 harder and harder to return to a normal state 215 00:08:02,610 --> 00:08:04,660 anxiety creates more physical discomfort 216 00:08:04,691 --> 00:08:07,819 physical discomfort gets read under high weighting as a bigger threat 217 00:08:07,891 --> 00:08:10,179 a bigger threat creates more anxiety 218 00:08:10,490 --> 00:08:12,619 this is a self locking loop 219 00:08:12,811 --> 00:08:14,009 so now you understand 220 00:08:14,011 --> 00:08:16,499 anxiety patients aren't worrying over nothing 221 00:08:16,771 --> 00:08:19,840 their brains really are seeing evidence that the sky is falling 222 00:08:20,331 --> 00:08:23,379 it's just that this evidence is manufactured by the brain itself 223 00:08:23,869 --> 00:08:27,278 it's like a security checkpoint turned up to its highest sensitivity 224 00:08:27,629 --> 00:08:28,458 a normal checkpoint 225 00:08:28,670 --> 00:08:30,278 knives guns and explosives can't get through 226 00:08:30,350 --> 00:08:31,838 a keychain gets waved through 227 00:08:32,069 --> 00:08:33,838 but an anxiety patient's checkpoint 228 00:08:33,869 --> 00:08:36,958 a single paper clip can trigger a full airport evacuation 229 00:08:37,270 --> 00:08:38,348 and what's worse 230 00:08:38,349 --> 00:08:41,189 every evacuation makes the system think see 231 00:08:41,189 --> 00:08:42,098 there really was a threat 232 00:08:42,429 --> 00:08:44,878 then it turns the sensitivity up another notch 233 00:08:45,606 --> 00:08:46,816 so you might ask 234 00:08:46,846 --> 00:08:48,975 if this system breaks down so easily 235 00:08:49,206 --> 00:08:50,875 why didn't evolution weed it out 236 00:08:51,566 --> 00:08:52,115 the answer is 237 00:08:52,407 --> 00:08:53,575 it's not a malfunction 238 00:08:53,926 --> 00:08:55,495 it's an outdated feature 239 00:08:55,846 --> 00:08:57,735 on the African savanna a hundred thousand years ago 240 00:08:57,806 --> 00:08:59,615 your ancestors needed this system 241 00:08:59,846 --> 00:09:01,495 an odd rustle in the bushes 242 00:09:01,566 --> 00:09:03,686 the amygdala responds in zero point zero one seven seconds 243 00:09:03,686 --> 00:09:05,855 making you leap up at once ready to run for your life 244 00:09:06,127 --> 00:09:06,715 in that era 245 00:09:07,047 --> 00:09:08,896 the anxious types lived longer 246 00:09:09,167 --> 00:09:12,166 nine times out of ten a rustle in the grass is just the wind 247 00:09:12,167 --> 00:09:14,215 but the tenth time it's a leopard 248 00:09:14,287 --> 00:09:16,205 the cost of those nine false alarms is low 249 00:09:16,206 --> 00:09:17,536 just a few extra steps 250 00:09:17,726 --> 00:09:20,215 but the cost of missing the tenth is death 251 00:09:21,047 --> 00:09:25,615 so evolution chose a strategy of better a false alarm than one missed 252 00:09:25,750 --> 00:09:26,300 the problem is 253 00:09:26,671 --> 00:09:28,759 you no longer live on the savanna 254 00:09:29,031 --> 00:09:31,239 you live in a world with no leopards 255 00:09:31,630 --> 00:09:35,200 but your amygdala still runs on the savanna's parameters 256 00:09:35,510 --> 00:09:38,239 it treats an email from your boss as a leopard 257 00:09:38,311 --> 00:09:42,279 it treats silence at a social gathering as a sign of being cast out of the tribe 258 00:09:42,510 --> 00:09:46,960 it treats one arrow on a medical report as the footsteps of approaching death 259 00:09:47,431 --> 00:09:49,759 your hardware is a hundred thousand years old 260 00:09:49,791 --> 00:09:52,320 but your environment is the twenty first century 261 00:09:52,551 --> 00:09:54,999 the mismatch between hardware and environment 262 00:09:55,071 --> 00:09:59,479 is the underlying reason anxiety disorder erupts on a massive scale in modern society 263 00:10:00,733 --> 00:10:01,323 at this point 264 00:10:01,574 --> 00:10:03,343 I want to turn our perspective back to the East 265 00:10:03,694 --> 00:10:06,483 Buddhism has a very precise concept called restlessness 266 00:10:07,094 --> 00:10:08,823 restlessness is one of the five hindrances 267 00:10:08,974 --> 00:10:11,402 the five hindrances are the five main obstacles on the path of practice 268 00:10:11,854 --> 00:10:15,422 sensory desire ill will sloth restlessness and doubt 269 00:10:15,773 --> 00:10:19,503 restlessness means a mind that is unsettled scattered and agitated 270 00:10:20,363 --> 00:10:22,041 if you look closely at the definition of restlessness 271 00:10:22,042 --> 00:10:26,452 you'll find it maps almost perfectly onto the anxiety disorder modern neuroscience describes 272 00:10:26,723 --> 00:10:28,362 restlessness isn't a great storm 273 00:10:28,363 --> 00:10:30,762 it's the constant little ripples on the water's surface 274 00:10:30,762 --> 00:10:32,171 never able to settle 275 00:10:32,522 --> 00:10:35,852 the Buddha observed this state twenty five hundred years ago 276 00:10:35,882 --> 00:10:40,571 and ranked it alongside greed anger and sloth as an obstacle of equal magnitude 277 00:10:41,302 --> 00:10:42,010 what does this tell us 278 00:10:42,501 --> 00:10:44,990 it tells us anxiety isn't an invention of modern people 279 00:10:45,261 --> 00:10:48,311 it's a built in trap in the structure of the human mind 280 00:10:48,822 --> 00:10:50,030 it's just that in ancient times 281 00:10:50,101 --> 00:10:53,290 people had more ways to burn off their excess vigilance energy 282 00:10:53,861 --> 00:10:56,571 physical labor rising with the sun and resting at sunset 283 00:10:57,022 --> 00:10:58,671 close knit community bonds 284 00:10:59,101 --> 00:11:00,990 but modern people sit in offices 285 00:11:01,022 --> 00:11:02,390 the body barely moves 286 00:11:02,501 --> 00:11:03,931 the brain runs around the clock 287 00:11:04,381 --> 00:11:06,030 social relationships are fragmented 288 00:11:06,422 --> 00:11:08,250 every floodgate that could help you release the pressure 289 00:11:08,542 --> 00:11:09,711 is blocked up 290 00:11:10,599 --> 00:11:11,109 so what do we do 291 00:11:11,680 --> 00:11:15,368 I'm not going to repeat the help seeking advice from the last depression episode 292 00:11:15,479 --> 00:11:18,329 today I'll just add one point unique to anxiety disorder 293 00:11:18,479 --> 00:11:21,049 and it's the one I find most practically valuable 294 00:11:21,320 --> 00:11:24,368 the essence of anxiety is an inability to tolerate uncertainty 295 00:11:25,238 --> 00:11:28,906 in clinical psychology this concept is called intolerance of uncertainty 296 00:11:29,757 --> 00:11:32,087 in twenty twenty two the Zemestani team 297 00:11:32,117 --> 00:11:35,406 studied nearly seven hundred children and adolescents and found 298 00:11:35,598 --> 00:11:39,676 intolerance of uncertainty is the thing that cuts across every anxiety subtype 299 00:11:39,678 --> 00:11:41,127 the core risk factor 300 00:11:41,438 --> 00:11:46,166 whether it's generalized anxiety social anxiety separation anxiety or panic disorder 301 00:11:46,318 --> 00:11:48,387 the same thing is driving all of them underneath 302 00:11:48,877 --> 00:11:50,627 you can't stand not knowing how things will turn out 303 00:11:51,318 --> 00:11:52,327 to put it the other way 304 00:11:52,397 --> 00:11:55,526 if you can raise your tolerance for uncertainty 305 00:11:55,637 --> 00:11:58,327 every type of anxiety drops in step 306 00:11:58,746 --> 00:12:01,235 this lines up strikingly with what the Buddha taught 307 00:12:01,427 --> 00:12:01,936 the Buddha said 308 00:12:02,307 --> 00:12:03,916 the root of suffering is attachment 309 00:12:03,946 --> 00:12:07,755 and the core of attachment is wanting to control what cannot be controlled 310 00:12:08,187 --> 00:12:10,066 you cling to a certain future 311 00:12:10,066 --> 00:12:11,875 but the future is never certain 312 00:12:12,027 --> 00:12:12,975 the harder you try to grasp it 313 00:12:13,187 --> 00:12:14,906 the more it slips through your fingers 314 00:12:14,907 --> 00:12:16,115 and the more anxious you become 315 00:12:16,605 --> 00:12:17,404 so 316 00:12:17,461 --> 00:12:20,869 every effective anxiety intervention whether it's cognitive behavioral therapy 317 00:12:20,901 --> 00:12:22,259 or mindfulness training 318 00:12:22,260 --> 00:12:25,489 or exposure therapy they're all essentially doing the same thing 319 00:12:26,020 --> 00:12:28,310 training you to coexist with uncertainty 320 00:12:28,701 --> 00:12:30,050 not to eliminate uncertainty 321 00:12:30,461 --> 00:12:31,629 because that's impossible 322 00:12:32,061 --> 00:12:33,950 but to change your relationship with it 323 00:12:34,220 --> 00:12:38,230 from I must know the outcome to I can not know the outcome 324 00:12:38,260 --> 00:12:39,649 and still live just fine 325 00:12:40,301 --> 00:12:40,970 this shift 326 00:12:41,301 --> 00:12:43,310 can't be achieved by thinking alone 327 00:12:43,421 --> 00:12:44,669 it takes practice 328 00:12:44,860 --> 00:12:46,669 just as a muscle needs training 329 00:12:46,781 --> 00:12:49,850 your capacity to bear uncertainty also needs to be built time after time 330 00:12:49,860 --> 00:12:53,210 experienced endured and discovered in real situations 331 00:12:53,210 --> 00:12:55,169 uncertainty didn't kill me after all 332 00:12:56,134 --> 00:12:57,063 you know what 333 00:12:57,215 --> 00:12:59,604 what does Buddhism call the steadiness cultivated in practice 334 00:13:00,134 --> 00:13:00,883 it's called forbearance 335 00:13:01,575 --> 00:13:02,864 not the enduring kind of forbearance 336 00:13:02,935 --> 00:13:05,504 it's resting in discomfort without running away 337 00:13:05,935 --> 00:13:06,803 the opposite of forbearance 338 00:13:07,175 --> 00:13:08,584 is precisely restlessness 339 00:13:08,935 --> 00:13:10,783 you think you're fighting anxiety 340 00:13:10,894 --> 00:13:12,864 but really you're practicing forbearance 341 00:13:13,175 --> 00:13:16,944 every time you choose to stay in that discomfort one second longer 342 00:13:16,975 --> 00:13:19,883 instead of instantly grabbing your phone or hitting a search engine 343 00:13:20,215 --> 00:13:23,043 or repeatedly asking the people around you am I okay 344 00:13:23,575 --> 00:13:26,944 you're recalibrating that faulty security scanner 345 00:13:27,544 --> 00:13:29,232 finally I want to say one thing 346 00:13:29,664 --> 00:13:33,653 the sentence anxiety patients hear most is you think too much 347 00:13:34,184 --> 00:13:35,333 this is well meaning 348 00:13:35,544 --> 00:13:36,673 but it's wrong 349 00:13:37,103 --> 00:13:38,533 anxiety disorder isn't overthinking 350 00:13:39,144 --> 00:13:42,592 it's a parameter error in the brain's threat detection circuit 351 00:13:42,703 --> 00:13:44,752 the precision weighting has shifted 352 00:13:44,943 --> 00:13:47,673 the reset mechanism of the stress hormone axis has grown sluggish 353 00:13:47,904 --> 00:13:50,053 these are all things that can be scientifically measured 354 00:13:50,264 --> 00:13:52,512 changes with a neurobiological basis 355 00:13:53,043 --> 00:13:55,833 you wouldn't tell a nearsighted person just look more carefully and you'll be fine 356 00:13:56,364 --> 00:13:58,932 nearsightedness is a problem in the eye's refractive system 357 00:13:59,043 --> 00:14:01,172 it needs glasses or surgery 358 00:14:01,523 --> 00:14:02,522 by the same logic 359 00:14:02,523 --> 00:14:05,572 anxiety disorder is a problem in the brain's threat assessment system 360 00:14:05,724 --> 00:14:06,973 it needs professional intervention 361 00:14:07,243 --> 00:14:10,483 if you're going through persistent anxiety that affects your life 362 00:14:10,484 --> 00:14:12,733 please see a psychiatrist or a mental health professional 363 00:14:13,003 --> 00:14:14,003 this isn't weakness 364 00:14:14,003 --> 00:14:16,093 it's the smartest decision you could make 365 00:14:16,608 --> 00:14:20,048 in that earlier depression episode I said a line that isn't you 366 00:14:20,049 --> 00:14:20,857 that's the illness 367 00:14:21,169 --> 00:14:22,438 today I'll say it again 368 00:14:22,728 --> 00:14:23,818 in a different version 369 00:14:24,129 --> 00:14:25,038 you're not weak 370 00:14:25,289 --> 00:14:26,497 you're not being dramatic 371 00:14:26,608 --> 00:14:27,977 you're not overthinking 372 00:14:28,328 --> 00:14:31,497 your brain is fitted with a warning system from a hundred thousand years ago 373 00:14:31,728 --> 00:14:35,377 and now it's frantically sounding alarms in a world with no leopards 374 00:14:35,728 --> 00:14:37,017 this isn't your fault 375 00:14:37,368 --> 00:14:39,938 but you can learn to recalibrate it 376 00:14:40,916 --> 00:14:43,465 do you think anxiety is the baseline color of our generation 377 00:14:44,036 --> 00:14:46,685 if you've had experience living alongside anxiety 378 00:14:46,716 --> 00:14:48,556 whether good or bad 379 00:14:48,556 --> 00:14:49,886 tell me in the comments 380 00:14:50,076 --> 00:14:50,825 I'm Wang Lijie 381 00:14:51,117 --> 00:14:52,416 see you next time