PANIC/GRIEF

Jaak Panksepp initially called the sixth primary affect system the PANIC /GRIEF system to reflect what goes on deep in the subcortical brain. Like the other primary emotions, the GRIEF system consists of a widespread emotional network concentrated largely in ancient medial brain regions.

GRIEF may be the most powerful affective network of the human brain. It is one of the most important systems in generating depression, anxiety, and stress. When we have secure attachments to loving others, we are granted a lifelong gift. When attachment processes are impaired, the diverse manifestations of psychic pain can lead to chronic feelings of distress throughout life. This distress often encumbers how we can relate to others.

When infants and young children experience separation from their mother and poor attachment, they experience panic and anxiety. GRIEF comes later in the higher cortical thinking level of the brain. When older people are deprived of companionship they tend to feel lonely and sad rather than panicky like little children.

I distinctly remember the initial overwhelmingly, powerful trauma. Screaming for hours in isolation. Even as a tiny infant, I knew my mother should come. She must come. Thirty years later I asked my sister, six years older if she could recall when I was an infant. She said I cried and screamed for hours on end. She could not understand why no one paid any attention. No one else seemed to hear or be aware of my constant screaming.

It affects me now in my eighties. My wife would ask me if I could remember having a nightmare. She was suddenly woken by my screaming at the top of my lungs. Yet it was all beneath the level of cortical awareness, buried deep in the subcortical brain. She asked if she should wake me next time. I always said not to. I felt I would not be able to encounter the horror of the trauma raging deep beneath the surface of consciousness.

Bodily warmth, familiar maternal odors, soothing voices, even sugar-water quiets babies by secreting endogenous brain chemicals. The opioid release becomes conditioned, ie learning to love others who remind them of their mother, perhaps whose smell resembles their mother, or even music associated with mother.

But traumatized babies later in life have autonomic reactions to a remark or event, reactions that surface at lightning speed. Then these reactions are slow in recovering back to baseline. This is what makes it so difficult to get hold and take back control.

You feel the unpleasant autonomic changes. The stress surging through your body feels like it requires a reaction, often to lash out at someone. Road rage and other irrational acts are the result of this high-speed escalation.

If RAGE has been a major problem in your life, it helps to know the biological roots of this debilitating discomfort. Understanding the biological side of RAGE is the start of a plan for dealing with it. I had no idea of the biological underpinnings that drove my RAGE and I am blessed that I avoided prison.

Yet in all my years of therapy, RAGE has never been dealt with. And when I brought up the stress behind the rage with a psychiatrist, it would be dealt with as a symptom of OCD with additional medication. I had a dresser drawer filled with color-coded pills of all shapes and sizes. Then at fifty-six years old, I went cold turkey and burnt out of teaching.

Opiates for Poorly Bonded

A dearth of endogenous opioids and oxytocin may result in feelings of loneliness and depression. These feelings of loneliness and depression then block the production of endogenous chemicals.

Modest doses of opiates are effective antidepressants that take rapid effect, in contrast to the matter of weeks that current medications generally require to become fully effective. Such rapidly acting antidepressants are desperately needed. Unfortunately, the fact that opiates can be drugs of abuse when taken in large quantities has prompted researchers to overlook their great potential for psychiatric medicinal use.” Jaak Panksepp

Before the present era of psycho-pharmacology, the effective psychiatric medicines available to psychiatrists were opioids. Their patients were socially isolated and social isolation is similar to maternal separation. When babies bond with their mothers this stimulates endogenous opioids and makes them happy. When psychiatrists gave opioids to their unhappy patients, it made them happy as well. When bonding and social contact breaks down, so do opioids, leaving GRIEF in its place. Replace the opioids and feelings are good again. Both endogenous and pharmacological opioids make people happy.

Three endogenous -produced in our body – neuropeptide brain chemicals strongly reduce GRIEF.  Strongest are endogenous opioids. The pharmacological forms of opioids, morphine, and heroin, have the same effect. The two other neuropeptide brain chemicals are oxytocin and prolactin, both important in the CARE system. When brain opioids, oxytocin, or prolactin are elevated in distressed infants, they relax and exhibit signs of comfort usually displayed when enjoying the comfort of a nurturing mother.

Brain imaging studies confirm that depressed people who lack adequate social support have low levels of these social-affect endogenous molecules in their brains, making them more likely to abuse addictive drugs.

Well-Bonded Makes the Difference

Poorly bonded children lack social skills and don’t develop ways to cope with loneliness. They experience stress, GRIEF, and PANIC. The poorly attached and bonded live a vicious cycle of loneliness, GRIEF,  PANIC, and stress. Poorly bonded children don’t know the rules of PLAY.

As well-bonded children mature into adulthood, they learn social skills that keep them close to friends and relations. They develop skills and distractions that enable them to cope with inevitable periods of loneliness. They don’t experience extended periods of GRIEF that slows opioid secretion in their brains as with poorly attached or bonded children. 

Stress

Poorly bonded children often experience a lifetime of stress. Stress is all about the endocrine glands. Primary endocrine glands secrete hormones to regulate the secretions of the secondary endocrine glands. Secondary endocrine glands secrete hormones into the blood.

The hypothalamus and pituitary glands are primary endocrine glands in the brain near the brain stem.

The adrenal glands are primary endocrine glands sitting atop each kidney. 

These three primary endocrine glands form the HPA axis, the stress system. The three powerful primary endocrine glands of the HPA axis secrete hormones to regulate the secretions of the secondary endocrine glands through the entire body.

The pituitary gland is often referred to as the master gland because it governs the function of other glands throughout the body. I think of the pituitary as the “ big kahuna,” in control of your body and mind.

When the GRIEF system is aroused, the HPA axis releases neuropeptides. Neuropeptides are small protein-like molecules – peptides used by neurons to communicate with each other. These neuropeptides activate the stress system. 

The hypothalamus, a shapeless cluster of neurons level with the bridge of the nose, targets the pituitary, a pea-size gland beneath the hypothalamus, with the peptide corticotropin-releasing hormone (CRH).

CRH activates the pituitary gland. The pituitary gland then targets the adrenal cortex, atop the kidneys with the peptide adrenocorticotropic hormone (ACTH). The adrenal cortex sends the stress hormones cortisol and adrenaline back up to both the hypothalamus and anterior pituitary.

All this happens before it rises to a conscious level. This is effective when you come across a wild bear in a mountain forest. You take off running without having to think over your plan of escape – before you get mauled or eaten. This is not effective in your day-to-day life, though, if you are not prone to encounter fearful beasts, and especially if you are prone to RAGE and violent behavior. 

The three primary endocrine glands of the HPA can change a good day into a bad day in an instant. They secrete hormones that regulate the secretions of the secondary endocrine glands throughout the entire body. and mind.

When the hypothalamus activates the pituitary gland and the pituitary gland releases ACTH, activating the adrenal glands atop the kidneys to release the hormones adrenaline and cortisol, the sympathetic nervous system activates and pupils dilate, heart rate increases, and muscles tense. You may tremble as respiration quickens.

Endocrine System

Figure: Secondary endocrine glands throughout the body and mind

But cortisol is a steroid that is not usually around for very long. When the stress system is functioning well, cortisol winds down the stress response and returns to a calm parasympathetic state. Cortisol amazingly both energizes and calms down the stress response.

The autonomic reactions in your body to a remark or event come on at lightning speed, but then slow in recovery back to baseline. This makes it difficult for some of us to get a hold of ourselves and take back control. When cortisol and adrenaline activate the sympathetic nervous system, for us, road rage and other violence are some unfortunate reactions.

Some people, like those with OCD, take an excessively long time to come down from a stressful event. Once the stress is generated, the event plays over and over, gaining strength with replays. Even a small amount of stress builds into a monstrous reaction, making it disastrous to allow the system to run autopilot. By midlife, I knew I had to deal with stress constructively or RAGE would land me in prison.

For those with conditions stemming from early childhood abuse, trauma, and PTSD, the production of CRH and cortisol continues unabated, exerting a deleterious effect on the body and brain, creating chronic feelings of stress and conditions of depression or manic excitement. Prolonged high levels of CRH and cortisol released into the circulation causes hippocampal damage impairing cognitive functions like memory. I could never memorize and had to use all kinds of memory tricks to get through school. Memorizing an elementary spelling list would take forever to achieve a grade never higher than “C.”

Stress is ubiquitous – emotional, family, friends, enemies, financial, work, and personal factors. You spend much of your time at work and many workers are stressed by their manager, lack of recognition, being asked to take on more and more responsibility for insufficient remuneration, and difficult coworkers.

The stress hormone cortisol rises and peaks in the morning. As soon as I wake in the morning, I get right up and Ki Breathe as I stretch, brush my teeth, get dressed, and make breakfast. (At least that is what I shoot for.) When stress hits, I am (hopefully) reminded to begin to Ki Breathe if I have stopped. But, alas, too often I have not even started. But never too late.

Mind-body systems that heal communicate via the same messenger molecules that regulate the stress system. The HPA axis promotes optimal functioning of hormones of the endocrine system, healing mind and body. Messenger molecules (neurotransmitters and hormones) communicate information including state-dependent memory, learning, and behavior throughout the body directing the endocrine system to produce steroid hormones that reach into the nucleus of the cells of the body.

As opposed to stress, the positive healing of the HPA axis is set off by creative work, flow, and images of health and well-being. When the HPA axis functions smoothly, it modulates the biochemical processes within the cell and optimizes the functioning of the autonomic nervous system, endocrine, immune, and neuropeptide systems.

The autonomic nervous system, the endocrine, immune, and neuropeptide systems communicate via the messenger molecules encoded with state-dependent memory (in my case state-dependent means memory infused with early childhood abuse), learning, and behavior. Just an awareness of this interconnectedness helps facilitate healing through mindfulness and breathing.

Depression

Prolonged CRH and cortisol are followed by the depletion of chemicals known as biogenic amines that include norepinephrine, serotonin, and dopamine. Initially, CRH and cortisol powerfully arouse these biogenic amines. But when stress is prolonged chemicals at the synapses of nerves become exhausted. Neural growth factors are reduced and inflammatory processes within the brain are increased. When the brain’s biogenic amines are depleted, you sink into depression and GRIEF. It is therapeutic to be aware of this to understand why you remain depressed or gyrate from mania and stress into depression.

Comorbidity

One of the findings of a December 2019 study in “Psychiatric Research” is that most emotional disorder is not due to a single emotional system or a single chemical imbalance. 

How could it be? The endocrine system via the HPA touches every molecule of the mind and body.

Most people reflect the concept of comorbidity with several emotional and chemical unbalances. That is essentially what comorbidity means, that more than one psychiatric syndrome occurs at the same time. The paper concludes:

A pragmatic approach to psychiatric assessment, allowing for recognition of individual experience, may, therefore, be a more effective way of understanding distress than maintaining a commitment to a disingenuous categorical system.

DSM dictates commitment to this disingenuous categorical system as long as the drug companies and insurance companies keep profiting from such commitment. Sort of like trying to stop climate change. Economics dictates over reality.

An example of comorbidity is Post-Traumatic Stress Disorder (PTSD). PTSD is a complex condition involving several different emotional systems. In addition to chronically overactive manifestations of the FEAR and PANIC/GRIEF systems, PTSD is often accompanied by RAGE.

Another example of comorbidity is depression. Depression is a comorbid mix of psychological pain, anxiety, angry irritability, as well as diminished urges to seek and pursue life interests. A diagnostic description would need to address the many emotional systems involved.

Generalized categories such as depression are ambiguous, implying both generalized malaise and sickness. A more accurate comorbid description would need to address the emotional systems involved and the ways that their over or under-arousal contribute to the clinical symptoms.

Drug Therapy

Since clinical depression involves the depletion of biogenic amines, it would make sense to take medication that replaces biogenic amines. The most popular way to do this is by blocking their reuptake so they build up in the space between neurons. Prozac blocks the reuptake of serotonin. It took me months of trials to find this correct molecule. Zoloft, for example, covered my body in hives.

To teach school I took benzodiazepines BZs. In twenty minutes I went from manic anxiety to blissful calm. I could achieve this at a fairly low dosage. BZs enhance the effect of gamma-aminobutyric acid (GAGA) a neurotransmitter that inhibits the firing of neurons by reducing their rate of firing. Then one day I decided to quit by going cold turkey and crashed and burnt out of teaching.

Attention Therapies such as Ki Breathing Meditation and Insight Meditation should be on top of your to-do list. I present Attention therapies in this book and my previous book, and Cognitive Therapy in my first book, which I hope to translate from Japanese back into English. And I made a series of videos where I walk you through the Attention Therapies. You can access these commercial-free, on my blog at joeldames.com. or on Youtube.

It took Aikido and Ki Breathing Meditation training to kickstart my life. Along the way, I added Vipassana Insight Meditation and Open Focus Training. I went from damaged goods – psychotic violent monster –to somewhat loving husband and father gradually over years. Serotonin Reuptake Inhibitors came midway. Medication is huge; I rarely missed a dose. I marked it daily on a calendar. Prozac ended my violence. But in my eighties, my brain has finally learned to take charge without medication.

In the next chapter, I’ll cover PLAY, the last of Jaak Panksepp’s seven primary emotions. You probably don’t think of play as an emotion, but Panksepp says playfulness is the source of one of the most positive social-affective feelings our brains can generate and should be a common aspect of therapeutic inventions.

Self-help books that help:

Total Self-Renewal through Attention Therapies and Open Focus

The Open-Focus Brain: Harnessing the Power of Attention to Heal Mind and Body