Your Sweet Embraceable Amygdala

My hand had slowly been going numb for the entire second half of a basketball game in Uganda that I wasn’t coaching. Sitting courtside with my right arm around my wife, Louise, I’d been making a fist with my left hand tracking the troubling progress but saying nothing about it. While driving home, I could see my fingers grabbing the ball of the gear stick, but I couldn’t feel them. I squeezed the wheel with my right hand, and it was going numb too. I’d lived in Uganda long enough to be completely comfortable behind a steering wheel on the right side of a car and driving on the left side of the road, but I was quickly becoming increasingly uncomfortable with all the numbness. Stopped at a light, I pinched my left arm with my heavy right fingers. Without looking at Louise in the passenger seat, I finally told her, “My hands are numb. My arm’s going numb. My left one.”

“Weird,” she said, distracted, as we rolled into heavy traffic.

“I’m serious.”

“I believe you. I was thinking,” she said. “I worked with a girl back home who felt like that once. She went to the doctor and found out she had a nerve disease. Her spine was deteriorating.”

I saw my brain slip through the bottom of my skull and plop into my gut on top of a pile of vertebrae. I felt an earthquake in my head. Everything went sideways. I pulled off the road onto the shoulder avoiding pedestrians, livestock, and bicycles, the edges of our left tires inches from a concrete ditch. “You’ve gotta drive me to the hospital.”

“Seriously?”

I didn’t answer. I climbed out and around the vehicle, barely avoiding the ditch, while Louise, eight months pregnant with our first child, realized how serious I was and climbed across the front seat to replace me at the wheel.

Twenty panicked minutes later, I was on my back on a metal triage bed with a Ugandan nurse attempting to stick EKG contacts to my skin through my chest hair. Louise stood smiling down at me in one of the two dresses she could still wear — the blue one — holding my hand that was no longer numb. A few minutes later, a Ugandan doctor joined us and asked, “You are the American who coaches basketball?” I nodded. “I don’t see any problem, but you should visit our cardiologist soon for reassurance.” I didn’t respond. “Please,” he said. “Do not worry. Get some rest. You are working too hard, I think.” Louise smiled at him.

I’m sure the doctor and nurse who stood with us, along with the chorus of medical professionals we spoke with over the next few years from nearly a dozen countries on three continents, were aware of the amygdala and its function, but they didn’t know how helpful it would have been to share that information with me. What medical professionals call “anxiety disorder” (when they diagnose one in five^[1] of us with it) can be treated without patients knowing and understanding their amygdala. However, in my experience, anxiety disorder cannot be managed, survived, and “put to use”^[2] without knowing, understanding, dignifying, and even appreciating the amygdala.

Your amygdala (uh–mig-duh-luh) is a tiny twin-engined system spectacularly equipped to do the one job most people would agree is the most important job of any body part: SAVE YOUR LIFE. Tucked safely away in your skull near the level of your ears, two unpredictable, off-the-grid, almond-sized organs hide like ninjas comfortably stationed behind heavy curtains on either side of the holiest of holy spaces in your mental temple. They each clutch an inaccessible black box full of countless memories related to all of your experiences — emotions, needs, priorities, desires, passions, and the who, what, where, when, and how connected to them all. Without your conscious input, the black box fills with whatever looks, smells, feels, and sounds to you like a threat and files it appropriately for the almond ninjas who stand, constantly rehearsing all possible protocols, poised to initiate immediate simultaneous action without permission or warning to accomplish their one essential job.

Imagine you come home late from work to a dark, empty house, put your phone and keys down to flip on a light, and the bulb is dead. You kick the door closed, step into the kitchen, drop bags on the counter, and flip the kitchen light on. Somehow, lions are in your house — three of them. They stare at you while one steps between you and the door. You don’t think. You can’t think. Your amygdala has already recognized the threat, taken control of your brain, and flooded your entire body with adrenaline. All of you (muscles, veins, pupils, pores, everything) is responding to a threat, and you are about to fight or flee. You can’t form words in thought or speech because survival doesn’t require language. You can only know one thing: you will die in several seconds without a miracle. If you are able to access words, they are something like prayers: “Help!” or “I’m dying.” Your amygdala knows exactly what you need and are capable of, and it forces you to do what is best for you. If you don’t survive, it’s not your fault or your amygdala’s.

If you do survive, you’ll be thrilled, but there will be no high fives. As soon as the threat passes, your normal cognitive ability returns, your biorhythms settle, and the ninjas settle back behind their curtains, ready for the next crisis. As you catch your breath and find words, you might ask yourself, “What just happened?” or say, “My body just took over.” You might feel disturbed and unbalanced for several minutes or hours afterwards, but you won’t think about that — you’ll celebrate the miracle.

But what if you experience all of that without the lions — without an immediate threat to your life? That’s a different problem. That’s a panic attack.

Like your heart, lungs, and other organs with involuntary functions, your amygdala acts involuntarily. It may kick off an internal squall of lifesaving adrenaline any second, while you’re at your desk, on your couch, on a train, or lounging on a blanket at the park. If the storm hits and there are no lions, you have a two-tiered problem that’s invisible from the outside but might as well be a lion fight on the inside. First, your amygdala has taken over, and all you can know is, without a miracle, you will die in several seconds. Second, the power of the adrenaline must somehow be used. This results in a terrifying circus of freakish abnormalities that can last several minutes — your heart rate doubles in speed and intensity; your head throbs; you can’t breathe; and/or you experience vertigo and flashes of sharp pain anywhere you have nerves as well as numbness, trembling, buzzing, all manner of gastrointestinal and bladder disruption, hot flashes, chills, irregular twitching in muscles across your body, voice loss, sight loss, and a disturbingly long list of other anomalies you cannot stop, which also mimic symptoms of life-threatening medical conditions familiar to the great and powerful algorithm (DO NOT GOOGLE ANY OF THEM). All of this is especially terrifying for you and those around you when the only words you can express are, “Help” or “I’m dying.”

If you’ve experienced this, you know that life is nearly unbearable as long as the attack lasts. Your loved ones know that life also becomes extremely uncomfortable for them. Knowing that the amygdala is the generator of these attacks makes it possible for us to think of it as your worst enemy. Can’t we just take it out like a tonsil? That’s a reasonable feeling and question, but NO. It’s OK to call the experience a panic attack, to acknowledge the difficulty and discomfort, and to work on avoiding it in the future, but it’s not OK to call it a false alarm or malfunction. What feels like your worst enemy is actually your best fearfully and wonderfully made friend.

Not only should we not remove the amygdala, but we should also learn to listen to it. Most of us are aware of the obvious threats to our lives — guns, fires, hurricanes, tornadoes, hungry lions, extreme heights — but the less obvious personalized threats become tricky. The way you think, feel, and care about healthy things like career, home, family, loved ones, and the future can become dangerously unbalanced. All of these and more can become what St. Augustine would call “disordered loves,” yet we often praise them as virtues: loyalty, ambition, passion, purpose, drive. You may even be rewarded with recognition or promotions for your unbalanced cares and regard the awards as markers of success. Don’t worry. If you attach your reason for living to realities beyond your control and outcomes measured by others, and you fear deeply enough or often enough that those realities will be lost, destroyed, or taken from you, your amygdala is paying attention and will do the only thing it can do for you: take over your body for several miserable minutes to let you know something is dangerously wrong.

If this happens to you once, it is unfortunate. If it happens more than once, you should talk to a trusted medical doctor, and a trusted therapist.

When I developed a panic anxiety disorder eighteen years ago in my early thirties, I was an expat educator at a new Ugandan university, teaching, coaching basketball, and running a new athletic department. I was also a new husband in a cross-cultural marriage, about to become a new father, and preparing to welcome my aging parents who were moving to Uganda to settle into their last two years of professional life before retirement. The dead hands, brain drop, and vertigo shot I experienced on the way home from a casual basketball game was the first of dozens of panic attacks that terrorized me for over a year and continued as I also lost my voice for several months and was sent on a crisis sabbatical to Ireland, my wife’s home. In Belfast, I met a 92-year-old priest/therapist who helped me begin to understand what was happening and suggested specific physical and spiritual adjustments, most notably the spiritual discipline of The Jesus Prayer^[3]. Two days later, my voice returned completely. We returned to Uganda, hopeful, but the panic attacks continued, and we packed everything and left again with no plans to return.

This was the beginning of a healing process that is still underway. For seventeen years I’ve been working a regimen of prayer, meditation, breathing, exercise, therapy, and medication, all of which contribute to an increased awareness of the agonizing complexity and soothing simplicity of the ways of God. Behind the intricately designed cosmos is the maker of heaven and earth, who crafted every one of our cells in his image for his glory and also made our amygdalae, capable of protecting some of us from fierce and hungry lions and others from unrealistic and unrelenting anthropological expectations.

For years, I was afraid I’d never get back to my old self. Seven years into recovery, I found a detailed description of the amygdala in a book^[4] from my therapist’s office. Understanding the benevolent physiology behind panic attacks helped me appreciate the process, realize it is possible to make some conscious recommendations to my ninjas about what goes into the black box, and discover that a low dose of daily medication helps temper my amygdala enough to keep it from initiating full-on protocols as frequently as before. For a dark season, the panic attacks dominated me two to three times per week. Now they hit one to two times per year. They are just as terrible in the moment but subside quickly. Most importantly, I no longer wish to get back to my old self. With the help of my amygdala, I’ve been able to establish healthy habits that are now becoming intuitive. The more distance I put between my new self and my old self, the more I recognize myself being “renewed in knowledge after the image of its creator.”^[5]

If you are the one in five experiencing regular panic attacks, breathe as slowly as possible while saying The Jesus Prayer and trust the promise of Revelation 21:5, “I am making all things new.” You are not at the end of anything. Ask for professional help. Ask the helpers to work with your ninja amygdala and its alarms so you can learn to make adjustments to how you care. Day by day, survival by survival, with the grace and mercy of God and a host of heavenly and human angels, the fear will subside, the time between alarms will expand, and your life will become more stable — abundantly stable.

^[1] https://newsinhealth.nih.gov/sites/newsinhealth/files/2016/March/NIHNiHMar2016.pdf

^[2] Balthasar, Hans Urs von. The Christian and Anxiety. Ignatius Press, 2000.

^[3] “Lord Jesus Christ, have mercy on me, a miserable sinner.” As quoted in J.D. Salinger’s Franny and Zooey; slightly different versions of the prayer are employed in Luke 18 and many ancient and contemporary texts.

^[4] Pittman, Catherine M. and Elizabeth M Karle. Rewire Your Anxious Brain: How to Use the Neuroscience of Fear to End Anxiety, Panic, & Worry. New Harbinger Publications, Inc., 2015.

^[5] Colossians 3:10