[{"command":"openDialog","selector":"#drupal-modal","settings":null,"data":"\u003Cdiv id=\u0022republish_modal_form\u0022\u003E\u003Cform class=\u0022modal-form-example-modal-form ecl-form\u0022 data-drupal-selector=\u0022modal-form-example-modal-form\u0022 action=\u0022\/en\/article\/modal\/7263\u0022 method=\u0022post\u0022 id=\u0022modal-form-example-modal-form\u0022 accept-charset=\u0022UTF-8\u0022\u003E\u003Cp\u003EHorizon articles can be republished for free under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence.\u003C\/p\u003E\n \u003Cp\u003EYou must give appropriate credit. We ask you to do this by:\u003Cbr \/\u003E\n 1) Using the original journalist\u0027s byline\u003Cbr \/\u003E\n 2) Linking back to our original story\u003Cbr \/\u003E\n 3) Using the following text in the footer: This article was originally published in \u003Ca href=\u0027#\u0027\u003EHorizon, the EU Research and Innovation magazine\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003ESee our full republication guidelines \u003Ca href=\u0027\/horizon-magazine\/republish-our-stories\u0027\u003Ehere\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003EHTML for this article, including the attribution and page view counter, is below:\u003C\/p\u003E\u003Cdiv class=\u0022js-form-item form-item js-form-type-textarea form-item-body-content js-form-item-body-content ecl-form-group ecl-form-group--text-area form-no-label ecl-u-mv-m\u0022\u003E\n \n\u003Cdiv\u003E\n \u003Ctextarea data-drupal-selector=\u0022edit-body-content\u0022 aria-describedby=\u0022edit-body-content--description\u0022 id=\u0022edit-body-content\u0022 name=\u0022body_content\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea ecl-text-area\u0022\u003E\u003Ch2\u003EWhat anxiety does to our breathing \u003C\/h2\u003E\u003Cp\u003EAnxiety disorders are the most common mental health problem in Europe, affecting \u003Ca href=\u0022https:\/\/www.oecd-ilibrary.org\/docserver\/health_glance_eur-2018-4-en.pdf?expires=1591375847\u0026amp;id=id\u0026amp;accname=guest\u0026amp;checksum=16D75DB6DF431D34DBA114EE960ACC5C\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003Eabout 25 million people across the region\u003C\/a\u003E.\u003C\/p\u003E\u003Cp\u003EWhereas anxiety is a normal reaction to difficult times, enabling us to take precautions, people with disorders can have high levels of dread that come out of nowhere and affect their daily life.\u003C\/p\u003E\u003Cp\u003E\u2018Having an anxiety disorder is when anxiety levels are both elevated and are causing problems,\u2019 said Dr Olivia Faull, a neuroscientist at the University of Zurich in Switzerland. \u2018It can stop (people) from doing things that they would like to do or things that they need to do like going out to the shops or visiting friends.\u2019\u003C\/p\u003E\u003Cp\u003EAlthough existing treatments can help, they aren\u2019t ideal for everyone. Drugs such as serotonin reuptake inhibitors can alleviate symptoms but may also be accompanied by negative side effects. Exercise is recommended since \u003Ca href=\u0022https:\/\/www.health.harvard.edu\/blog\/can-exercise-help-treat-anxiety-2019102418096\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003Eit can activate the frontal part of the brain which helps control our reactions to real or imagined threats. \u003C\/a\u003E\u0026nbsp;But it\u2019s not appropriate for people with certain types of anxiety. \u2018It might be far too much for someone who has severe social anxiety,\u2019 said Dr Faull. \u2018They don\u0027t want to go to an exercise class or have a personal trainer.\u2019\u003C\/p\u003E\u003Cp\u003ENew treatments for anxiety are therefore needed and could be developed using a new approach. Dr Faull and other researchers are now investigating the link between anxiety and our ability to perceive what\u2019s going on inside our body, called interoception.\u003C\/p\u003E\u003Cp\u003E\u2018It\u2019s a novel research domain and we don\u0027t know much about it yet,\u2019 said Dr Omer Van den Bergh, a health psychology researcher at the University of Leuven in Belgium.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003ESignals\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EInteroception involves sensing signals from internal organs, such as changes in heart rate or how hard you\u2019re breathing. When running, for example, most people are aware that their heart is beating faster and that it\u2019s more difficult to breathe. Feelings of hunger also stem from gauging sensations in the gut.\u003C\/p\u003E\u003Cp\u003EResearch, however, suggests that people with high anxiety levels may not accurately perceive what\u2019s going on inside their body. Early work on this found \u003Ca href=\u0022https:\/\/europepmc.org\/article\/med\/3829747\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003Eanxiety disorder sufferers to be less sensitive to changes in their breathing\u003C\/a\u003E compared to healthy individuals. \u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5062102\/\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003EA recent study\u003C\/a\u003E found that there seem to be differences in how anxious individuals perceive different bodily signals. Heart signals were typically gauged more accurately compared to breathing.\u003C\/p\u003E\u003Cp\u003EDysfunctional interoception is thought to be both a cause and effect of anxiety. For example, an anxious person may not notice changes in breathing until they become extreme and they suddenly feel lightheaded. The physical symptoms then add to their initial worry and make them even more anxious. \u2018If you aren\u0027t able to dissociate the symptoms and your thoughts as to what\u0027s making you anxious, they can just feed off each other,\u2019 said Dr Faull.\u003C\/p\u003E\u003Cp\u003ESome anxiety sufferers may also misinterpret interoceptive signals from their body. Dr Van den Bergh and his colleagues are particularly interested in how health anxiety and somatic symptom disorders, which involve physical symptoms that can\u2019t be medically explained, affect a person\u2019s perception of their internal state.\u003C\/p\u003E\u003Cp\u003ESomeone may be constantly scared that they have a brain tumour, for example. If they become stressed and their breathing and heart rate change, they may wrongly interpret the physical symptoms. \u2018They might receive evidence for a brain tumour even if there is very little discriminative input from the body,\u2019 said Dr Van den Bergh.\u003C\/p\u003E\u003Cp\u003EMistaking a benign symptom for a sign of disease has advantages. If you\u2019re feeling breathless during exercise, for example, your brain has to decide if it\u2019s simply a normal side effect or if you are ill. Assuming you are ill may be a false alarm but it ensures that you don\u2019t miss a threat that could kill you.\u003C\/p\u003E\u003Cp\u003E\u2018Better safe than sorry is a very important survival mechanism,\u2019 said Dr Van den Bergh. \u2018Some people are more tuned than others to apply this strategy depending on how you grew up and adverse experiences in childhood, for example.\u2019\u003C\/p\u003E\u003Cp\u003E\u003Cblockquote class=\u0022tw-text-center tw-text-blue tw-font-bold tw-text-2xl lg:tw-w-1\/2 tw-border-2 tw-border-blue tw-p-12 tw-my-8 lg:tw-m-12 lg:tw--ml-16 tw-float-left\u0022\u003E\n \u003Cspan class=\u0022tw-text-5xl tw-rotate-180\u0022\u003E\u201c\u003C\/span\u003E\n \u003Cp class=\u0022tw-font-serif tw-italic\u0022\u003E\u2018If you are chronically concerned about having somatic symptoms, you put your brain in a state of readiness to perceive the things you are afraid of.\u2019\u0026amp;nbsp;\u003C\/p\u003E\n \u003Cfooter\u003E\n \u003Ccite class=\u0022tw-not-italic tw-font-normal tw-text-sm tw-text-black\u0022\u003EDr Omer Van den Bergh, University of Leuven, Belgium\u003C\/cite\u003E\n \u003C\/footer\u003E\n\u003C\/blockquote\u003E\n\u003C\/p\u003E\u003Cp\u003EDr Van den Bergh and his colleagues hypothesise that anxious people and particularly those with somatic disorders are guided by their fears rather than actual symptoms. They \u003Ca href=\u0022https:\/\/journals.sagepub.com\/doi\/abs\/10.1177\/0956797613519110\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003Edeveloped a paradigm\u003C\/a\u003E to test their theory which was used in \u003Ca href=\u0022https:\/\/cordis.europa.eu\/project\/id\/653750\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003Ea project called CIP\u003C\/a\u003E\u0026nbsp;(see box)\u003C\/p\u003E\u003Cp\u003E\u2018If you are chronically concerned about having somatic symptoms, you put your brain in a state of readiness to perceive the things you are afraid of,\u2019 said Dr Van den Bergh.\u003C\/p\u003E\u003Cp\u003EA better understanding of how interoception differs in anxious people could lead to new treatments. Dr Van den Bergh thinks that anxious people could be trained in interoceptive differentiation while adopting an attitude to \u2018let information come\u2019 rather than anxiously anticipate a threat. \u2018We believe that this might be a new route,\u2019 he said.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EBreathing\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EBreathing tests themselves could also give more insight into how sensitive anxiety sufferers are to respiratory signals. Dr Faull and her colleagues are investigating how anxiety changes the brain\u2019s perception of interoceptive information from breathing as part of the \u003Ca href=\u0022https:\/\/cordis.europa.eu\/project\/id\/793580\u0022\u003EILBAB project\u003C\/a\u003E. As a first step, they are examining healthy volunteers who experience either mild or moderate anxiety to establish if there are any differences. In a follow-up project, Dr Faull wants to tackle clinical anxiety.\u003C\/p\u003E\u003Cp\u003EIn one experiment, thirty people from each anxiety level group were asked to inhale though a tube and report whether they thought a resistance had been added and if so by how much. They were also asked how confident they were about their answer. \u2018It\u0027s like your ability to judge how well you did in an exam before you got the results back,\u2019 said Dr Faull.\u003C\/p\u003E\u003Cp\u003EPreliminary results suggest that people with higher levels of anxiety are slightly less sensitive to changes in breathing, which was expected from previous work using different techniques. Their early findings also suggest that higher anxiety impairs awareness of interoception or what Dr Faull refers to as insight.\u003C\/p\u003E\u003Cp\u003EA \u003Ca href=\u0022https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0006322318300295\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003Edifferent study\u003C\/a\u003E, however, has shown that anxiety has no effect on insight, but it involved a visual task, which requires taking in signals from one\u2019s environment rather than inside the body. Dr Faull thinks this makes sense given an anxious person could be capable of helping a friend navigate a crisis, but may not be logical about a personal problem.\u003C\/p\u003E\u003Cp\u003E\u2018When it turns to themselves, and the signals are from themself, then that insight is impaired,\u2019 she said.\u003C\/p\u003E\u003Cp\u003EThe team\u2019s ultimate goal is to come up with targeted treatments involving breathing exercises for a range of psychiatric disorders including clinical anxiety and depression based on their findings. But if patients have a better understanding of the link between anxiety and perception of breathing it could help too.\u003C\/p\u003E\u003Cp\u003EOnce they have more concrete results, Dr Faull and her colleagues plan to talk to the public about them as it could help patients to better manage their anxiety. Recognising how anxiety changes insight could be particularly helpful.\u003C\/p\u003E\u003Cp\u003E\u2018When (someone) is in a very big state of anxiety, they need to remember that their insight is probably quite compromised,\u2019 said Dr Faull. \u2018That\u0027s why it maybe feels so overwhelming.\u2019\u003C\/p\u003E\u003Cp\u003E\u003Cem\u003EThe research in this article was funded by the EU. If you liked this article, please consider sharing it on social media.\u003C\/em\u003E\u003Cdiv class=\u0022moreinfoblock\u0022\u003E\n \u003Ch3\u003ERating the effort of breathing\u003C\/h3\u003E\n \u003Cp\u003EIn a series of tests to study anxiety and breathing, researchers manipulated participants\u2019 breath by making them inhale from a breathing system where resistance is applied, changing the effort it takes to breathe. In one experiment with healthy individuals, the resistances were presented randomly and participants rated them based on several factors such as intensity and unpleasantness. In another task, the same resistances were categorised into two groups, A or B, based on their intensity. The lowest four resistances formed category A while the highest four were part of category B. The participants were told the category of a stimulus when it was presented and asked to rate it again.\u003C\/p\u003E\u003Cp\u003EThe team found that there were differences in how the stimuli were perceived when presented without and with a category. Participants would find stimuli from the same category to be more similar than when they were presented uncategorised. Differences between stimuli from different categories became more pronounced.\u003C\/p\u003E\u003Cp\u003EThe idea behind the tests was that using categories, such as low and high intensity, creates expectations and can prime a person to anticipate a certain type of breathing stimulus. This priming effect is similar to how the fears of an anxious person can influence their interoception. The effect of categorisation is expected to be more extreme in anxious people since they place more importance on their expectations.\u003C\/p\u003E\u003Cp\u003EHowever, \u003Ca href=\u0022https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2015.00732\/full\u0022\u003Eone study\u003C\/a\u003E\u0026nbsp;revealed that the relationship isn\u2019t that simple. The team found that anxious individuals only misinterpreted stimuli that were at the boundary of two categories and therefore more ambiguous. Only a stimulus that is unclear may therefore be perceived as a threat. It shows that interoceptive abilities in anxious people are flexible and depend on the stimulus, says Dr Van den Bergh.\u003C\/p\u003E\n\u003C\/div\u003E\n\u003C\/p\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n \u003Cdiv id=\u0022edit-body-content--description\u0022 class=\u0022ecl-help-block description\u0022\u003E\n Please copy the above code and embed it onto your website to republish.\n \u003C\/div\u003E\n \u003C\/div\u003E\n\u003Cinput autocomplete=\u0022off\u0022 data-drupal-selector=\u0022form-8nteljcfkvv5caa8t2y6zf-1ubiflfgtkyjvd5bgvbm\u0022 type=\u0022hidden\u0022 name=\u0022form_build_id\u0022 value=\u0022form-8nTeljCfKvv5cAa8t2Y6Zf_1UBIfLFGtKyJVD5bgVbM\u0022 \/\u003E\n\u003Cinput data-drupal-selector=\u0022edit-modal-form-example-modal-form\u0022 type=\u0022hidden\u0022 name=\u0022form_id\u0022 value=\u0022modal_form_example_modal_form\u0022 \/\u003E\n\u003C\/form\u003E\n\u003C\/div\u003E","dialogOptions":{"width":"800","modal":true,"title":"Republish this content"}}]