Are You Stuck in the Anxiety-Distraction Feedback Loop?

Are You Stuck in the Anxiety-Distraction Feedback Loop?

by Jud Brewer - May 19, 2020

As a psychiatrist specializing in anxiety and habit management, I’ve seen a lot of change over the past two months, and very little for the better. One of my patients works at his family-owned liquor store (considered an “essential” business by the state of Rhode Island). During our newly minted telehealth visits, he told me that he has been working 70+ hours a week. His business has never been busier. Several other patients have been joining the growing ranks of Netflix binge-watchers as a way to distract themselves. Others still are concerned about the “quarantine 15,” or gaining weight because they turn to food for comfort.

Whether your vice is food, alcohol, social media, work, or television, when faced with increasing anxiety, why does your brain urge you toward distractions?

Let’s start with a bit of biology.

Anxiety is defined as “a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.” Understandably, that feeling has increased on a societal level right now. Biologically, your survival brain was set up to scan territory for both food and danger. When your ancestors found a new food source, their stomachs sent a cascade of signals to their brains that resulted in dopamine firing. They then formed a memory about where the food was located to help them understand how to find it in the future. The same is true for danger. When your ancestors explored new places, they had to be on high alert, scanning for movement so that they didn’t become a food source themselves. Uncertainty helped them, and therefore people, as a species, survive.

There is a caveat, however - and this is important to understanding the relationship between anxiety and distraction. Once a place becomes familiar to people, whether it is dangerous or not, that uncertainty decreases. This means that only after your ancestors revisited a territory again and again were they able to relax.

Shifting back to what this means for the present day, and for you: when you become more certain, your brain uses dopamine differently. Instead of firing when you eat food or spot danger, for example, dopamine fires in anticipation of those events. Dopamine is far from a “pleasure molecule” as it has been characterized by popular literature. Once a behavior is learned, it has been most consistently associated with cravings and urges to act.

From an evolutionary perspective, this makes sense. Once your ancestors knew where their food source was, they had to be prodded to go and get it.

In response to the pandemic, my patients are demonstrating exactly this same process. Whether addicted to a substance or a behavior, they have learned to associate a particular action with an outcome. Anyone who gets an urge to eat a snack, check their news feed, or go on social media when they’re bored or anxious can relate to this this feeling. That restless contraction in your stomach or chest. It lets you know that something is off. Your brain says “do something!” and the action, or the distraction, makes you feel better. To you, looking at cute puppies on YouTube (again) may seem like a strange choice when you still have a big project to do. But to your brain, it’s a no-brainer. Its survival 101.

Think of it like this: Distraction is the modern day equivalent of avoiding the dangerous or unknown in ancient times. Uncertainty makes you feel anxious. Anxiety urges you to do something. In theory, that urge is there to drive you to gather information. Yet, when no new information about the pandemic is available, checking the news doesn’t make you feel better. Your brain quickly learns that distraction is a pretty solid alternative.

The problem is that, often, distractions are not healthy or helpful. No one can binge on food, booze, or Netflix forever. In fact, it’s dangerous to do so. You brain will become habituated to these behaviors. You eventually will begin to need more and more of them to get the outcome you’re accustomed to.

Sadly, your survival brain is just trying to lend you a helping hand, yet can’t see that it is driving you toward habits, and even addictions, that could become hard to break. What to do?

Reading this article is a good first step. Only when you begin to understand how your mind works can you begin to work with it. If you’re stuck in an anxiety-distraction habit loop, you need to map out the trigger-behavior-reward process that creates and perpetuates your unwanted habits. This involves noticing the trigger (anxiety), the distraction behavior (eating, drinking, watching TV), and the reward (feeling better because you are distracted from the trigger). Once you identify your typical anxiety-distraction habit loops, map out when they show up. Is it in a certain context or at a particular time of day?

Next, begin to explore how rewarding these habit loops actually are. Your brain chooses between different behaviors based on their reward levels. Instead of trying to force yourself not to stress eat or check social media, focus on the mental and physical results of your actions. I have my patients ask a simple question: “What do I get from this?” It’s not an intellectual question, but something I have them use experientially. What does the brief relief feel like? How long does it last? Are there other effects that have boomerang consequences, like getting more anxious because you have not completed a task?

It is important to note that not all distraction is bad. It becomes a problem when the reward you seek stops being rewarding. You can explore what it’s like to eat a little versus a lot of chocolate when you’re nervous. You can explore what binging on five versus two episodes of your show du jour feels like. When you pay attention, you will likely discover a classic inverted U-shaped curve, where the pleasure of distraction plateaus and sends you sliding down, back into restlessness and worry, leading your mind to search for the next best thing.

This brings me to the last step of this process, which is to find the “Bigger Better Offer” (BBO). Because your brain chooses more rewarding behaviors, you need to identify behaviors that are more rewarding than your bad habits.

This doesn’t always mean picking an entirely new behavior. Sometimes it means stopping your current one when the balance shifts from it being helpful to harmful. Keep the phrase “how little is enough” in mind when indulging a distraction. Apply this to everything from food to TV by simply checking in with your body and mind after you’ve indulged to see if you’re satisfied. My lab has studied this by embedding a “craving tool” into a mindfulness training app (Eat Right Now) that helps people break the habit of stress or overeating. We have people pay attention as they eat, and then ask how content they feel after they’ve eaten. This way, they can link up how much (or what type of food) they’ve eaten with sensations in their bodies and minds. It helps them clearly see how unrewarding it is to overindulge, and how rewarding it is to stop when they’re full.

If your goal is to step out of your habit loop entirely, then you do need to explore BBOs that are different behaviors. For example, if you are anxious, you can use mindfulness practices to work with the anxiety itself, rather than needing to distract yourself from it. (Our lab found that mindfulness resulted in a 57% drop in anxiety scores in anxious physicians, and 63% reduction in people with Generalized Anxiety Disorder). Treating the anxiety at the source of your distraction is analogous to having some pain in your body and getting at the root cause instead of taking pain killers to temporarily numb yourself - which masks the symptoms of the problem, and can cause you to become dependent.

In the end, this process really boils down to knowing your own mind. Self-knowledge is always power, but it is particularly effective when it comes to working with our brains. When uncertainty abounds, step out of anxiety-distraction habit loops by bringing forward what you have evolved to do best: learn.

Jud Brewer MD PhD is an addiction psychiatrist and neuroscientist specializing in anxiety and habit change. He is an associate professor at Brown University’s School of Public Health and Medical School and the author of The Craving Mind: From Cigarettes to Smartphones to Love - Why We Get Hooked and How We Can Break Bad Habits. Dr. Brewer has posted 20+ short videos on how to develop resilience and work with Coronavirus-related mental health issues on his YouTube Channel.