About Dr. DeMarco
Dr. Anthony DeMarco is a board certified member of the American Board of Anesthesiology. He is a graduate of Kansas City University with a Doctor of Osteopathy degree, a holistic approach to patient care.
Dr. DeMarco completed his residency in 1993 at Hahnemann University Hospital in Philadelphia.
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Physiological Responses to Fear and Anxiety
There are dozens of psychological responses when we face a perceived threat. The more evident responses, however, are physiological. These physical manifestations can be harder to suppress, and, at times, can lead to health problems.
The most evident form of physiological response is that which is known as the “fight or flight” response. When we are faced with what we consider to be a dangerous situation, 
the first noticeable change is an increase in perspiration, as well as heart and respiratory rates. This physical reaction is due to the activation of a small, walnut sized structure in the fore-brain, called the amygdala. This structure, in turn, then stimulates the hypothalamus to produce CRH, or corticotropin-releasing hormone. This hormone, then, triggers the production of adrenocorticotropic hormone, known as ACTH, in the pituitary gland, a small, oval gland at the base of the brain. Finally, this signal travels to the adrenal gland, sitting just above the kidney, which produces cortisol, causing an increase in glucose production to provide additional fuel for the muscles and brain to deal with the stress. This complex series of direct communications between the hypothalamus, pituitary gland, and adrenal gland is known as the hypothalamic-pituitary-adrenal, or HPA, axis, a vital and major part of the neuroendocrine system that controls the reaction to stress, amonsgt other body processes. Clearly, the simple physical responses to fear are the product of a chain of biological events.
When one is confronted by a perceived threat, there are many more physical responses that are less evident, such as: pupil dilation; increased muscle tone; decreased blood flow to the skin, intestine and kidneys; and bowel and bladder emptying. Consider the last time that you watched a horror movie. When you were startled by a suspensful scene, the first thing that you probably noticed was your heart and resiratory rates quickening. After that, you would probably have begun sweating. Your skin became paler as the blood flow was redirected to your muscles, which increased in tone and strength to facilitate the “fight or flight” response. Even in a situation that is a false alarm, so to speak, your body would still respond to the stimulus. This is because the amygdala responds before the conscious mind can make any determination. While the degree of these reactions can vary, the response is still the same.
When the stressor that triggers these fearful responses is inescapable, such as an impending medical procedure, the fear often leads to anxiety. Anxiety is a period of prolonged fear, or worry, and is usually accompanied by heart palpitations, fatigue, nausea, chest pain, shortness of breath, stomach aches, or headaches. Think back to your high school years. Many of us experienced a great deal of anxiety at this time, most often during our final exams. As most students do, you were probably concerned about how you would do. You studied for hours, trying to remember everything that you went over throughout the semester. Even after the test was taken, you worried about the score that you would receive, and wondered if you could have studied harder.
Often, manifestations called panic attacks can develop. These episodes carry many of the same symptoms as heart attacks, and are often misinterpreted as such. Anxiety can last for as long as the stressor is evident, and it has been linked, through various studies, to a myriad of health issues, such as arthritis, migraines, allergies, and thyroid disease.
Most commonly, continuous anxiety has been linked to gastrointestinal problems, such as peptic ulcers. While a mechanism tying these disorders together has yet to be discovered, studies have shown a remarkable correlation of people who have experienced both generalized anxiety disorder, or GAD, and stomach ulcers. Chronic anxiety has also been linked to cardiovascular disease. Once again, specific links have yet to be identified, but it is believed that the link is due, in part, to prolonged stress on the heart from physical responses, such as increase in both heart rate and blood pressure.
Anxiety can cause both physical and mental scars, and can easily complicate one’s life. Given this, it is important to regulate fear and anxiety. . The key is not to eliminate fear, but to effectively manage it so it doesn’t spiral out of control.
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22 Responses to “Physiological Responses to Fear and Anxiety”
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