Here's Why the Source of Your Anxiety Is Also Your Way Out
Discover how your brain's greatest liability—its ability to manufacture anxiety from thin air—is also your ticket to freedom.
People often come to therapy to understand and alleviate their stress and anxiety. Unfortunately, many of us have the wrong perspective on anxiety and its true effect on mental health. Allow me to share insights that could transform your perspective on this fundamental aspect of the human experience.
The two faces of stress: friend or foe?
Picture this: It’s early morning, and you’re sitting in your office with a racing heart and sweaty palms. Your mind is buzzing with anticipation. Are you about to deliver the presentation of your career, or are you stuck in another soul-crushing meeting with your micromanaging boss?
Physiologically, your body can’t tell the difference. The same stress response that makes you feel alive before a thrilling roller coaster ride is the same one that slowly eats away at your health during chronic workplace toxicity. The difference? It’s all about valence—essentially, whether we perceive the experience as positive or negative.
Think of stress as a volume knob on a stereo. Short-term stress amplifies beneficial effects: sharper focus, enhanced performance, increased resilience. However, if you leave the volume maxed out for days or months—like in daily traffic jams or toxic relationships—you’ll blow the speakers. That’s chronic stress, where all the health problems live.
The secret lies in the amygdala, the brain’s alarm system. When it becomes active, excitement turns into terror. When it stays quiet, stress becomes stimulation. It’s the difference between paying to watch a scary movie and lying awake at night worrying about going bankrupt.
The most misunderstood molecule in your body
Now, let’s talk about testosterone, the “bad boy” of steroid hormones. Everything you think you know about this hormone is probably wrong—and understanding it reveals something crucial about how we misinterpret our own biology.
When you think of testosterone, the first image that comes to mind is the “alpha male” archetype. “Testosterone makes you aggressive,” right? Wrong. Testosterone is more like a volume amplifier for whatever you already are. It doesn’t create aggression; it amplifies existing tendencies. It’s the difference between adding heavy metal to your mental playlist and turning up the volume on whatever pop song is already playing.
My favorite testosterone fact: Give people testosterone in a setting where status comes from generosity and trustworthiness, and they become more generous and trustworthy. The hormone doesn’t turn you into a caveman; it makes you better at whatever your culture values for achieving status.
This challenges everything we assume about gender and behavior. Women produce testosterone too—about 5-10% of male levels—and it functions identically in their brains and bodies. The aggressive bidder throwing money around at a charity auction? Whether male or female, testosterone is doing the same thing as with the aggressive guy at the gym—helping them compete for status. The only difference is the playing field.
Biological advantage or double-edged sword?
One unique aspect of being human is our overdeveloped, densely connected prefrontal cortex (PFC). It acts as the CEO of your brain, overseeing planning, decision-making, impulse control, and social behavior. It’s central to our capacity for complex culture, symbolic thought, and self-regulation.
This thinking machinery allows us to experience stress over things that don’t even exist yet. You can feel inadequate while watching a movie character or get your heart racing over a hypothetical scenario you’ll probably never face.
This is both our superpower and our kryptonite. We can stress ourselves out over things that would normally require a charging rhinoceros. But we can also think ourselves out of them.
The confidence trap
This is where testosterone reveals something fundamental about anxiety management. While it makes you more confident, which sounds great, it also makes you more confident in your bad decisions. Testosterone breeds dangerous overconfidence, leading you to believe that complex problems have simple solutions.
In my practice, I constantly see this pattern. Once people start improving, they can become so emboldened that they become careless and make impulsive decisions they later regret. The same mechanism is at work when someone decides their anxiety is “fixed” after two good weeks and stops doing the things that helped them.
Want proof that testosterone with poor prefrontal cortex supervision is a disaster? Look no further than YouTube. Young adults film themselves hanging from skyscrapers for views not just because of testosterone, but also because their prefrontal cortices won’t fully develop until their late twenties. This brain structure—involved in planning, impulse control, emotional regulation, and long-term decision-making—is supposed to be the grownup in the room, asking, “Is this actually a good idea?” But when it’s still under construction, testosterone gets to drive the car unsupervised. The result? A generation of people who are confidently convinced that dangling from a crane for likes is a rational decision.
This matters because it illustrates a fundamental principle: Our biology doesn’t care about accuracy. It cares about action. Testosterone pushes you to act decisively. Your amygdala pushes you to react protectively. Neither system is designed to help you think clearly; they’re designed to help you survive. That’s where your prefrontal cortex comes in.
Your anxiety factory and your salvation
The prefrontal cortex is also where anxiety originates. This is both terrifying and liberating.
Unlike other animals, which need an actual threat to trigger their stress response, humans can manufacture anxiety from thin air. Your prefrontal cortex can conjure elaborate scenarios of failure, rejection, or disaster that haven’t happened—and may never happen. It’s like having a Hollywood special effects studio in your head that’s constantly producing horror movies starring you.
This narrative machinery is anxiety’s birthplace. It’s the gap between what is and what your mind imagines could be. Your amygdala can’t tell the difference between a real tiger and one conjured by your prefrontal cortex. So while you’re lying in bed at 2 a.m., your body prepares to fight or flee from... nothing.
The dark side: when thinking becomes suffering
Your prefrontal cortex is an overachiever that never learned to take a break. It’s constantly running “what if” scenarios, playing out conversations that might happen, and rehearsing failures that probably won’t occur. I call this “time travel anxiety”—your brain’s ability to make you worry about the past (which you can’t change) and the future (which doesn’t exist yet).
You can experience genuine distress about scenarios that exist only in your imagination or feel socially rejected by people who don’t even know you exist, just by scrolling through Instagram.
The prefrontal cortex also loves to play “compare and despair.” It takes everyone else’s highlight reels and compares them to your behind-the-scenes footage. It creates infinite hierarchies for you to worry about—not just your job performance, but your parenting skills, fitness level, home décor, and vacation photos. The modern world provides this part of your brain with unlimited material.
The bright side: your ticket to freedom
The twist: The same prefrontal cortex that creates anxiety is also your way out of it. This part of your brain enables you to take a step back and observe your thoughts. With practice, you can learn to recognize when you’re catastrophizing or misinterpreting situations.
Your prefrontal cortex can reframe experiences. It can take a racing heart and reinterpret it as excitement instead of anxiety. It can stop you in the middle of a worry spiral and ask, “Is this helpful? Is this even true?” This part of you can choose your response rather than being hijacked by automatic reactions.
Cognitive Behavioral Therapy (CBT) works by teaching your prefrontal cortex to better manage your emotional responses. Rather than producing anxiety, it learns to evaluate and redirect anxious thoughts strategically.
Remember testosterone’s confidence trap? Your PFC is what allows you to question that surge of certainty, to pause before acting on impulse, to distinguish between confidence and wisdom. It’s the part of you that can recognize when you’re being pushed toward action by biology rather than judgment.
The integration challenge
The trick is learning to work with your emotional brain, not against it. When the emotional brain and the prefrontal cortex are at war, you become paralyzed by analysis or overwhelmed by emotions you can’t think your way out of. When they’re collaborating, you gain wisdom—the ability to feel your emotions without being controlled by them and to think clearly without getting lost in mental loops.
I consider cognitive integration the holy grail of mental health. You’re in charge, whether you realize it or not. The goal isn’t to eliminate anxiety but to pause, and train your prefrontal cortex to recognize anxiety as information, not truth; as a signal to pay attention, not a command to panic.
The problem is that we now have an infinite number of hierarchies to worry about. Social media means you’re not just competing with your coworkers anymore; you’re unconsciously comparing yourself to the carefully curated highlight reels of millions of strangers. Your Stone Age brain is trying to process modern-day status competitions it was never designed for, while your prefrontal cortex generates detailed scenarios about all the ways you might be failing at life.
The secret to stress management
There is no one-size-fits-all solution or miracle recipe. The mindfulness meditation practice that makes your friend feel zen might make you want to scream after ten seconds. The exercise routine that energizes your colleague might feel like punishment to you.
The magic lies in four elements: control, predictability, outlets for frustration, and social support. However, you can’t artificially manufacture these elements. Telling a homeless person to “take control of their life” isn’t just useless—it’s harmful.
Instead, focus on the things you can control. For example, you might not be able to control your commute, but you can control the podcasts you listen to. You can’t predict your boss’s mood, but you can plan your morning routine. You can also work to overcome your blind spots by getting help from a coach or therapist to learn better ways to manage stress. Having small pockets of control and predictability can significantly reduce your stress levels.
The bottom line
Your brain is ancient software running on modern hardware, trying to navigate a world it was never designed for. The stress response that once helped your ancestors avoid predators now triggers over email notifications and social media comparisons.
Understanding this gives you power. When you recognize that your racing heart could be excitement rather than anxiety, you can begin to reframe your experiences. When you understand that confidence without wisdom is dangerous, you can learn to pause before acting on impulses. When you see that your prefrontal cortex is both manufacturing your worry and capable of managing it, you gain agency.
The goal isn’t to eliminate stress but to dance with it more skillfully. Some stress is stimulation in disguise. Anxiety can point toward a useful strategy. Some confidence is worth questioning. Sometimes the best thing you can do is choose which game you’re playing rather than letting society choose for you.
Your brain is remarkably adaptable. With the right knowledge and practice, you can learn to work with your stress response rather than be overwhelmed by it. That’s not magic—that’s neuroscience meeting self-awareness, and it’s available to anyone willing to do the work.