Welcome to Your Brain (22 page)

stress, which is known to damage the hippocampus. It turns out, though, that when

researchers looked at identical twin pairs, in which only one twin had combat experience, a

small hippocampus in the twin who stayed home from the war was a good predictor of

whether the other twin would get PTSD in combat. This finding suggests that certain people

are predisposed to get PTSD, perhaps because their brains are hyperresponsive to stress.

Mild anxiety shouldn’t require professional treatment. If you want to try the self-help approach,

start by thinking about how to reduce stress in your life. You can do this in two main ways: reduce

your exposure to stressful situations or learn better skills for coping with them. Which of these

approaches is most useful will depend on what’s causing your stress. One good way of living more

comfortably with stress is to exercise regularly, preferably at least thirty minutes every day. Exercise

improves mood and, as we learned in
Chapter 14
, has the added benefit of helping to preserve brain

function and reduce the risk of dementia as you age, so there’s really no downside. Meditation may

also reduce stress responses. Some people find yoga particularly helpful, as it combines exercise

with mental calming. You should also try to reduce your caffeine intake and get enough sleep. Resist

the temptation to medicate anxiety with tranquilizers or alcohol, which will only make the problems

worse in the long run; many people with anxiety also suffer from substance-abuse disorders. If these

techniques don’t reduce your anxiety or if your anxiety causes serious problems in your life, you may

need to see a professional therapist.

Two types of psychotherapy, which are often used together, have proven to be effective for

anxiety disorders in clinical studies. Both approaches are short-term interventions that concentrate on

teaching patients to control situations that make them anxious, and both require active participation

from patients. Behavioral therapy is based on extinction learning, which you may recall from Chapter

13. Repeated exposure to a feared object or situation without negative consequences results in

extinction, a process that teaches the animal or the patient not to fear the stimulus. Behavioral therapy

focuses on helping people to stop avoiding anxiety-provoking situations, so they can learn that these

situations are not really dangerous (see
Practical tip: How to treat a phobia
). Cognitive therapy

focuses on helping people to learn how their thought patterns contribute to their discomfort and to

substitute more productive ways of thinking about the problem, by distinguishing between realistic

and unrealistic thoughts, for instance. Before you see a therapist, you should make sure you know

what type of therapy he or she practices and whether it works for the problem that you want to have

treated.

Practical tip: How to treat a phobia

A phobia is an intense fear of something that is not really that dangerous. People may

develop irrational fears of anything from spiders to heights to social interactions. Phobias

commonly start in childhood or adolescence, suggesting that they may be learned, but most

patients don’t remember a specific incident that triggered their fear. The tendency to

acquire phobias seems to be partly due to genetic factors.

The good news is that phobias are among the most treatable of psychiatric disorders.

Short-term behavioral therapy that focuses on desensitizing the patient’s fear is very

effective. Sometimes this approach is supplemented with drugs to temporarily reduce the

fear and make it easier to face, or with cognitive behavioral therapy to encourage the

patient to rethink her attitude toward the fear-inducing stimulus.

The therapist slowly exposes the patient to the feared situation in small steps,

consulting often with the patient to be sure that the anxiety stays within a tolerable range.

For instance, for a phobia of heights, the patient might first look at a picture taken from the

second floor. Then the patient might imagine standing on a balcony and eventually an even

higher place. As the anxiety fades, the patient would be exposed to real anxiety-producing

situations in a controlled way to demonstrate that they are not really dangerous. This

approach, in the hands of a trained therapist, has a good track record of bringing phobias

under control.

Doctors are testing some exciting variants to these approaches for treating anxiety disorders,

though these new treatments are not yet widely available. Because the demand for behavioral therapy

exceeds the number of trained therapists, some researchers are working on computer systems that

allow people to control their own exposure to anxiety-producing situations. Another approach is to

expose patients to a simulated version of the situation. Doctors have used virtual reality therapy to

treat phobias, panic disorder, and PTSD. Preliminary evidence suggests that it may be as effective as

direct exposure to the fear-triggering stimulus. In one particularly exciting new approach, doctors

asked patients to take a drug called d-cycloserine before virtual reality behavioral therapy sessions.

This drug activates NMDA receptors, which are important for learning. By improving learning, the

drug increases the rate of fear-extinction learning during behavioral therapy. Patients in this study

showed reductions in anxiety after as little as two sessions, and the improvement lasted for three

months. This group is now testing the same approach for treating PTSD in veterans of the Iraq war,

who have an 18 to 30 percent risk of the disorder. If these treatments live up to their promise in

further testing, it might be possible to greatly decrease the number of people who struggle with

excessive anxiety.

Of course, we can’t expect to eliminate anxiety altogether by using any of these techniques. If that

happened, we would never get anything done. There’s definitely an optimal level of anxiety—not so

low that you lie on the couch all day, but not so high that you huddle under the bed—and unfortunately

the best level for survival isn’t necessarily the one that makes us feel most comfortable. But if anxiety

is interfering with your life, we strongly encourage you to do something about it. Don’t let a problem

with anxiety take control of your life.

Chapter 18

Happiness and How We Find It

Timothy Leary would have been disappointed to learn that some of the happiest people in the U.S. are

married, churchgoing Republicans who make more money than their neighbors. He might have been

more pleased, however, to know that happy people also have a lot of sex and socialize frequently.

People’s happiness tends to be determined by comparison to other people. Average income in the

U.S. has risen steadily over the past fifty years, but the percentage of people who consider themselves

very happy has stayed about the same, presumably because the standard for comparison has risen

along with the average income. Thus, the important determinant of happiness is not absolute wealth

but relative wealth—as long as you make enough that your basic needs are secure (about $30,000 per

year). This means that most of us would feel happier to make $50,000 a year in a job where the local

average salary is $40,000 than to make $60,000 where the average salary is $70,000. The things we

could buy with the extra $10,000 each year wouldn’t come close to compensating us for the happiness

that we would derive from being paid better than our coworkers.

As one researcher says, “The key to happiness is low expectations.” When you’re making a major

purchase, it’s worthwhile to remember that ultimately you won’t be comparing your new acquisition

to the other possibilities in the store, but instead to what you already own—or what your friends own.

Indeed, people tend to be less satisfied with their decisions when they have to choose among many

options than when only a few options are available, suggesting that making more comparisons may

reduce happiness by causing us to regret the options that we were unable to choose.

Even major life events have less lasting influence on happiness than you might guess. For

example, blind people are no less happy than people who can see. Married people are, on average,

happier than unmarried people (see
Did you know? How scientists measure happiness
), but having

children has no overall effect on happiness. It seems that after a strong transient response to most

good or bad events, people’s happiness tends to return toward their individual “set point,” which is

mildly positive on average. This is called adaptation, and it’s the reason that some people keep

buying stuff they don’t need: if having something new makes you happy, you have to keep renewing

the feeling by buying more stuff because the effect never lasts.

Did you know? Happiness around the world

In the U.S., happiness differences between individuals don’t depend strongly on

demographic factors like income, but things change when we compare across countries.

The explanation may be that because of the relative amount of wealth and stability in this

country, happiness differences among Americans based on economic and political

circumstances are not significant. On the other hand, the nations of Africa and the former

Soviet Union contain some of the unhappiest people in the world, presumably due to

widespread poverty, poor health, and political upheaval. Researchers from the Economist

Intelligence Unit reported that 82 percent of the differences in average happiness between

countries can be predicted from nine objective characteristics. Starting from the most

important, these characteristics were health (life expectancy at birth), wealth (gross

domestic product per person), political stability, divorce rate, community life, climate

(warmer is better), unemployment rate, political freedom, and gender equality (the more

even the ratio of male to female income, the happier the people).

Cultural factors also seem to affect happiness. For example, people in Denmark

consistently report substantially higher levels of happiness than people in Finland, although

the countries are similar on most demographic variables. A Danish research group

provided a tongue-in-cheek explanation for this difference: on the same survey, Danes

report having lower expectations for the upcoming year than Finns.

Did you know? How scientists measure happiness

If the idea of studying happiness sounds too touchy-feely for you to take seriously,

you’re not alone. There are some real limitations to this sort of research, but it’s more

reliable than you might think. The usual method for collecting data in such studies is pretty

simple: researchers call up and ask people how happy they are. (“How satisfied are you

with your life as a whole these days? Are you very satisfied, pretty satisfied, not very

satisfied, or not at all satisfied?”) Then they ask about a bunch of other stuff like people’s

income, marital status, and hobbies. When they have this information from a significant

sample (typically thousands of people), they try to figure out what kinds of answers are

more likely to come from happy people than from unhappy people.

This approach to research is called correlational, and it does have one big drawback. If

you find out that two things routinely occur together, then it’s a pretty good bet (though not