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Is Chronic Anxiety a Learning Disorder? (scientificamerican.com)
225 points by laurex on Oct 13, 2018 | hide | past | favorite | 72 comments



Fascinating that Behrens reward game showed that humans were able to mentally model volatility at the level of an "ideal learner". But in the variation of the game where there was punishment instead of reward, non-anxious people still performed as "ideal learners" whereas anxious people's predictions became totally out of whack. In other words, the overly anxious mind temporarily lost its capacity to correctly formulate heuristics, which can lead to all kinds of mental chaos.

Personally, I remember that I was once in a job interview where I had to code on a whiteboard. I was so overwhelmed with anxiety that I was temporary incapable of completing simple coding tasks. In the face of extreme anxiety, I literally become stupid.


>In the face of extreme anxiety, I literally become stupid.

You don't need to experience "extreme anxiety", or even have a diagnosis, to experience this effect. Most people that are just learning how to drive a car will at some point experience how acute stress causes you to fail even the most basic tasks, things you would never predict that you would fail doing before you actually do. When I was learning how to drive, I repeatedly forgot checking the rear view mirror before switching lanes (even though I knew this was extremely important), because I was so focused on manual gear shifting. I would switch to the wrong gear or forget turning the turn indicator off, because my stressed mind would filter out the noise of the indicator blinking.

Some even believe that the "experience of driving" in itself is detrimental, and that "each exposure elicits an acute stress response, and that repeated exposures may act as a chronic stressor".[1]

[1]: https://journals.plos.org/plosone/article?id=10.1371/journal...


I failed my first driving test for similar reasons! In fact, driving is the elephant in the room when it comes to common stressful activities. Even if you follow the rules, not everyone else will and you always need to be ready. In addition, the stakes are high... Lifetime odds of dying in a car crash are 1/102 (source: https://injuryfacts.nsc.org/all-injuries/preventable-death-o...)


This is the exact reason I failed my driving test 7 times before finally passing (pass rate in UK is ~60%). It's hard to describe to people that it's not that you're necessarily bad at the task, just the anxiety causes you to react in a bad way.


> each exposure elicits an acute stress response

I experienced this quite viscerally in my last job, where I had roughly a 40 minute commute in heavy traffic each way. On the surface, it sounds like nothing, but I feared for my safety every time and it worsened with each passing month.

There were several reasons I left the job, but this was at least 30% of it and I can tell you it significantly improved my mental health. For a while I had anxiety every time I had to drive, and it started well before I ever got in the car. A couple years later, I was able to handle several very long road trips and even did a stint as a rideshare driver with almost no issues-- the anxiety is pretty much gone now, it was nearly all due to that commute.


I worry that a lot of mental health issues are essentially situational and that we (as a society) put all sorts of barricades in place that make it difficult for people to shift their overall situations (the thing that will likely most benefit them).


I can remember interviewing at Google on a whiteboard, with an employee who was: disinterested, overly specific, and antagonistic. Left that building wondering which was less healthy: my anxiety or their culture.


Was that the culture or part of the test?


If that’s part of the test, then it’s definitely the culture.


It wasn't entirely clear to me if it was part of their culture to be overly dismissive of the applicants perspective and expectations in working somewhere or to intentionally test your reaction to contrived behavior..

But assuming behavior was contrived tests, why would you want to work for an employer that is tuning on who to hire by making sure they can abuse them in certain ways?

There's probably no sense in trying to fathom anything about why a company seems ugly when you can just move on.


Hah. First experienced this as a kid when helping out at my mom's jewellery shop for the first time. Someone bought something and I had to calculate how much cash to give them. I don't know why I wasn't using a cash register, can't recall. Anyway, I'm really good at math, yeah? One of the best in my grade, yeah? Then why couldn't I calculate how much money I needed to give the guy? I did this kind of subtraction problem in my head all the time. But I froze. I felt so stupid at the time. :) STOP STARING AT ME, I'LL GIVE YOUR MONEY, JUST WAIT A SECOND!!!! :) Funny thing is that he probably wasn't judging me at all, it was all just in my head.


It's the reason for procrastination as well. Well, it's one reason, there are some more but anxiety is a common one. It's definitely my reason. I'm so afraid of failing I can't start working on a task until I'm more afraid of disappointing people completely instead of just partly.

In my case it's also amplified by ADD and rejection sensitive dysphoria. It doesn't matter how much I achieve (e.g. I have, converted from German to US grades, a 3.7 GPA), or what I do, it won't go away. So I just live with it.


In the face of extreme anxiety, I literally become stupid.

In a stressful situation your brain disengages the frontal cortex and falls back to an instinctual mode of operation. This mode is generally unaware of the modern world. In my own field of expertise sometimes divers with plenty of gas in their cylinder will tear their regulator out of their mouth. What’s happening? They are having difficulty breathing normally, panicked and the hind brain has said “there’s something in my mouth, take it out!”. Similarly pilots who fly aircraft into the ground, they have panicked and the hind brain has said “get to low ground ASAP”.

And after the fact everyone wonders “what we’re they thinking?” But the answer is, they weren’t thinking at all, they couldn’t.


This happened to me at Amazon the first time I visited HQ.

The interviewer was standing about six feet away intently watching for every mark I made, which made me freeze up and start rambling about stars shining, or something equally nonsensical.


Could that have been the dreaded 'stress interview'?


Had similar experiences when trying to code in front of a boy I liked... I was a bumbling idiot. Similar thing driving with a guy I liked in the car - regular near crashes including spending some time in the wrong lane (admittedly in an ambiguous situation Tesla might have fucked up, too).

He must have been surprised by my sudden jump in intelligence when he got a girlfriend...


Yes -- I basically outright refuse to do any coding when someone is watching.


Oh man, i had two similar interview experiences where i struggled even to type.


Sounds like learning to play poker could be a cure.

There's this TED talk by a "poker champion" Liv Boeree where she says that calculating probabilities is the main thing that she learned in poker and applies in everyday life. I also saw an article on that, with many poker players answering the question what they learned from the game, and the ability to estimate probabilities comes up every single time.

A quote from Liv: "So now I also try to speak in numbers as well. So if someone asks me, "Hey, Liv, do you think you're going to come along to that thing tonight?" instead of just saying to them, "Yeah, probably," I actually give them my best estimate -- say, 60 percent. Because -- I know that sounds a little odd -- but the thing is, I ran a poll on Twitter of what people understand the word "probably" to mean, and this was the spread of answers. Enormous! So apparently, it's absolutely useless at actually conveying any real information."

Liv Boeree' TED talk: https://www.ted.com/talks/liv_boeree_3_lessons_on_decision_m...


I have observed that playing chess competitively helped me a lot with my anxiety. A game of chess is self contained, you can analyze afterwards what went wrong, the implications are limited and you learn that focusing on the task and setting aside your worries helps improve your game. Moreover, that happens in a protected environment, with well defined rules and no interruptions, which facilitates the learning process.


Anecdotally I had something different. As a kid I was always a sore loser, and sulked after every loss in the game. In retrospect I'm not sure why I took winning so seriously.


The CIA did a study on such "words of estimative probability" back in the 60's

https://www.cia.gov/library/center-for-the-study-of-intellig...


Journal article here: Anxious individuals have difficulty learning the causal statistics of aversive environments @ http://dx.doi.org/10.1038/nn.3961


For me it was magnesium deficiency.


Same here, I have had severe anxiety and depression for quite some time. I was prescribed a few SSRI's bet, but my doctor was a dick and pretty much state I need to just get out and do more, get my mind off shit.

So on trying to improve my mental health I started taking nootropics. Some of them people SWARE BY, yet I never experienced any noticeable effect. But by chance I ordered a batch of Magnesium L-Threonate and it was absolutely exhilarating. I can honestly say I've been dosing for about 6 months now and it's completely turned my around. I don't suggest anyone experiment with supplements and/or medications without professional assistance. Because this was more like one of those one shot wonders, where you just chance it till you find whatever works.


I have had a similar experience. Magnesium lowered my anxiety and made me feel 10 years younger. My sleep is better too. And it's so cheap, yet none of the doctors mentioned it. I only discovered it by chance, when I bought a tube of effervescent pills to sweeten water while travelling (didn't trust the taste of water where I was going). So many schooled doctors, and yet none of them made such a simple suggestion!

Another wonder mineral is Calcium. It relieves my back pain. I have learned when I need Mg or Ca by the way I feel, so now I am OK without abusing them. I just pop one when needed.


Are muscle cramps the source of your back pain?


I up my consumption of calcium rich foods and B vitamins for low back pain. In my case, it seems to be immune distress. The pelvic bones are the largest well of bone marrow in the body.


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Just an FYI to other people: please note, this is a green handle using a capital I in place of the L in my name. I didn't leave the above remark.


The old Sans Serif font trick! Haven't seen that since the AOL days.


Magnesium annihilated my anxiety too. I had severe anxiety and insomnia. I used magnesium supplement for about 6 months. All gone, now I have no mental problems and stopped using magnesium supplements. Just eating healthy, and it seems fine enough. Not sure how I developed that serious magnesium deficiency for years...


I suggest you use Cronometer.com for a few weeks or days and see if you actually reach the RDA of 400mg a day. My guess is you don't from food alone unless you eat a lot of pumpkin seeds and nuts that are magnesium rich every single day. Most people are deficient in magnesium.


Interesting website, thanks for sharing.


I suggest you check out Cronometer


Can you tell me the advantage of L-Threonate? Choosing magnesium (and dosage) opens up a world of options and examine.com doesn't help a huge amount...


Here's a pretty decent explanation from NootropicsDepot: http://nootropicsdepot.com/articles/magnesium-glycinate-vs-l...


I haven’t read the article but as someone who has suffered from generalized anxiety (primarily manifested through hypochondria) for a vast portion of my life, I can conclude most definitely yes.

It’s hard to pay attention when your mind is telling you that you need to go to the hospital for some random reason at all times.

For the most part I’ve learned to keep it in check. But it took 30 years so it greatly affected my learning years, I believe. I also always make sure to carry around Xanax just in case.


Is meditation (the simple notion) effective for you ?


It has not been. Regular exercise is probably the most helpful.

During an attack, very controlled deep breathing and taking my shirt off to walk around in circles.


Exercise is neat indeed, and IMO it has similar mechanisms regarding meditation but since meditation is invisible and quite fuzzy.. exercise is easier to use.

If I may, keep the meditation thing in mind, it really changed how I approached my own anxiety and how I could restore a balanced state of mind. Maybe one day it will click for you, I hope.


We already know that too many choices is a bad thing. For some apparently, taken to an extreme, it becomes anxiety. Toss in neuroplasticity and for a subset that becomes chronic.

Evolution is an infinite process. There's no reason to believe humans are no longer evolving. Survival is relative to current conditions. Some of us are, naturally, just not wired for the "amenities" of modern life.


I have a tough time making choices now, I think because of anxiety and obsession. I just bought a snow blower (of all things) and the process wss torturous. Do I get the 24" that is easier to maneuver and is cheaper? Or the 26" that is more powerful? This one brand has history of breaking shear pins. This other brand clogs easily. Before you know it I've spent a few hours watching youtube reviews and it's 60 degrees outside. I finally pulled the trigger on one and then afterwards found out the model has a history of carburetor problems (and then go down the rabbit hole of how to clean and prevent issues.) I hate what the information age has done to my brain!


I recommend the book "Your Brain at Work" by David Rock. He does a great job at explaining what goes on in your head on a given day, for a given decision.

https://www.amazon.com/Your-Brain-Work-Strategies-Distractio...


Cool, added to my cart. Thanks!


I for one look forward to abusing the new and exciting prescription drugs designed to treat this.


I had a girlfriend who when faced with the choice of Chain-Coffee v Small-Shop-Coffee she’d at first choose the Chain-Coffee but as days passed she’d choose the SmallShop-Coffee more and more.

When I asked her why she chose the one with clearly no particular expertise in coffee making(they were also right next to one another) she’d tell me that she wanted to support the independent small player and not the big corporate chain.

I always wondered how efficient those theories, like the learning theory are, with complex intelligent beings like us. Sometimes we can even ignore all conventional models and just do smt because of philosophical belief. Which in turn developed by other unknown factors..

(When she was alone at University or Downtown she’d mostly hang out to the local big Chain-Coffee, but when faced with an easy choice of two different types of coffee shop one right next to each other she’d after some time make mostly the “philosophical” choice)


When someone changes a decision like that after multiple experiences with the outcome, they are overriding a natural human bias for consistency. That likely indicates a strong reason. Maybe the coffee or atmosphere was actually consistently better?

The article example is pretty dumb honestly. Chains are a mental shortcut for making decisions, but truthfully, there is much more variation between two Starbucks than they would like to admit.


chains are predictable. less risky: your expectations are stable and accurate.


My experience with coffee chains is the chains are predictably mediocre or bad, and the small shops are less predictable but on average generally much better than the chains (with the occasional place that's a lot worse than the chains, but this is rare from my experience).


could be, but for risk averse people (most people) the variance matters.


Expectations are more stable, but that doesn't mean the underlying product is at all stable and consistent.


I've a friend, a high end foodie. he proposes to use the big Mac as the international standard/reference point for burger quality. that would t be possible unless the big Mac basically tasted the same at pretty much every mc Ds


This is a very strange point of reference for a foodie, as McDonald's burgers are not even remotely close to anything tasty.


And if those expectations are predictably and accurately poor?


it's just math. you have your typical concave risk averse utility function, and you measure the difference in expected utilities between a low variance option and a high variance option, feed into softmax hoila


A very long article saying little


It definitely could be at least two times shorter, but it does explain a lot of my anxious behaviours. A lot of people here think the same, so I wouldn't say that it says "little".


Quite maybe, but that doesn’t make it easy to treat.


There is an irony there. Or maybe it's a trap. We speak of naming things as akin to understanding them. And we have grown quite used to being able to control things we understand.

Yet, I am fairly confident we can name more things than we can control. So, I don't know why that is such a common misunderstanding. One I often have.


Don’t go too far down the rabbit hole.

I’ve had a large number of conversations over the years with people over the decision whether or not to pursue a diagnosis for a mental disorder. Naming something doesn’t give you a ticket to understand something, but it does give you something to find in the card catalog or Google. If you have both eyes open, you can answer “Do I have an anxiety disorder?” or “Do I have bipolar disorder?” and understand some of the consequences, both negative and positive, of labeling yourself that way. It’s not a truly binary choice, but when you apply these labels to yourself it both exposes you to the effects of stigma and makes treatment and support available, depending on circumstances. I say “choice” because for many, the diagnosis is a choice… a capable adult who is not a danger to themself has a lot of latitude here.

If you think that “we” speak of naming things as akin to understanding them, then there are very, very few people I know who are in this group “we”.

A name is just a substitute for the infinite complexity of the universe. We can’t understand the universe, so we have to name things, create models, and understand the models as a proxy.


I am willing to bet I can find several text books that include phrases about the power of naming things. Pretty sure SICP does. And this is ignoring how common the trope is in fantasy.


"naming is the origin of all particular things" - Tao Te Ching.

That quote, first page, stopped me in my tracks for a long time. I often recall it when I'm tempted by the naming (categorization, abstracting, ...) of some X imagining I understand more about it than I actually do. Similar to as you note, I think.


Oriental philosophy has had a lot to say about names and their vacuity, but at the same time constructed its own extremely elaborate abstractions and conceptual systems. They don't give due credit to abstract and conceptual thinking though. It's not like we can understand the world any other way, we have to use names and abstractions, but apparently that comes in conflict with spiritual practice. I think the practice of stopping abstract thinking during meditation is a way to escape from reality into a self induced stated of peace, but it does nothing to help you solve practical problems, for which you would still have to engage in name based conceptual thinking.


The point of dropping the abstractions during meditation is not to deny the usefulness of them. It's to prevent getting caught up in abstractions to the point of extreme delusion. In this way, it improves the executive function of the mind which can have practical benefits. I view meditation as a way of giving the brain some "fresh air" and keeping abstractions in check.


One view of of thoughts is that there are 2 types of them: one type focused around analysis and problem solving, and a second type focused around the stories the "self" invents and gets absorbed in. This analysis also correlates with different brain activation patterns.

Many people's minds spend most of the time in the second type of thoughts("self"), and it can be very helpful to have less of those, both for peace and other psychological benefits, and for having more mental power and clarity for useful thoughts.

But in the context of ancient India, China, where eastern philosophies came from, people don't need that much thought most of the time, but spiritual qualities can be very useful in small interdependent peasent communities.


I find the phrase "oriental philosophy" to be problematic in addition to being quite vague.

Additionally, your statement that this "oriental philosophy"(?) doesn't give "due credit" to abstractions, which seems like a very wide dismissal of an undefined subset of philosophical groups.

Then you go on to dismiss meditation as a practice as well, as an "escape from reality". I am assuming that you would agree that since abstractions and definitions are important, the term "reality" isn't well-defined within your statement.

I am curious as to what you mean in general, because it seems like you're trying to tear down some sort of philosophy that we aren't privy to without offering any meaningful alternative counterpoint.


>I find the phrase "oriental philosophy" to be problematic in addition to being quite vague. oriental philosophy

And I find your tone to be unnecessarily confrontational. People have been writing about consistent differences between Eastern and Western philosophies for at least a hundred years. Hell, there's an entire Wikipedia page dedicated to Eastern philosophy[1]. I'm curious as to what exactly you find "problematic" about GP's post.

1.https://en.m.wikipedia.org/wiki/Eastern_philosophy


Seems insanely far fetched to expect that similar techniques used to treat heart disease would work for the psychological, social, and biological factors that make up anxiety / depression. This type of reductionism isn't even that effective with the mechanics of the heart (as we see from the constant debate of what to eat to keep this "simple pump" healthy), yet these doctors expect to reduce the entirety of one's experience to something so simple? Modern psychiatry to me is beyond perplexing and truly at or below the level of doctors using leeches to clean blood. This type of reductionism and the heavy reliance on drugs that goes along with it truly is akin to those doctors using leeches. The irony is, those doctors probably spent more time talking to their patients and while they were obviously ineffective at treating heart disease, they were likely much more effective at treating psychological problems than modern psychiatrists because they were at least willing to converse with their patients.


Front line treatment for a range of anxiety disorders is a talking therapy from a therapeutic st or psychologist. It's only when that fails that doctors become involved with medication.

We should not trivialise anxiety disorders: they cause death and harm and they can lead to years of life lost to disability. They can be very debilitating.


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We detached this subthread from https://news.ycombinator.com/item?id=18206442 and marked it off-topic.


If this is a serious comment (I can't tell) accusing people of shillage is explicitly against HN rules. https://news.ycombinator.com/item?id=11211627


I think they are looking in the wrong place. This is related to intestinal health and microbiome. So it is closely related to diet. But, I also suspect it is habitual. Some creatures in the body get "drunk" by the chemicals released when the body is in the state of anxiety. One such chemical may be histamine. This is the reason I believe why such trivial things as choosing train seats can cause anxiety. These internal creature can "paint" a perfectly normal process as catastrophic to get their feed. These are guesses from observation of what happens in myself. But I'm sure anxiety is caused by issues in the gut.




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