June 11, 2022

Your Anxiety in Surgery (What Happens Under Anesthesia?)

Dr. Kaveh explains what happens to your anxiety under anesthesia. Using this understanding, you can better understand why you become anxious, and how you can overcome that anxiety.

Anxiety is common before surgery. And anxiety even affects your brain under anesthesia. Surgery anxiety, or even anesthesia anxiety, can reduce the success of surgery, and your professional and personal success.

First, we need to understand anxiety and your brain. Fortunately, for most of us, it’s actually quite straightforward.

Anxiety in Simple Terms

Anxiety can simply be defined as the difference between what you want to do and what you think you can do. For example, if you want a job promotion, but you are uncertain if you can talk to your boss, you can have anxiety. The anxiety comes from your uncertainty to talk to your boss and subsequent loss of control over getting what you want (the promotion).

Your Brain’s Motivation is Easy to Understand

Your brain functions on two properties: laziness and control. This is why “get rich quick schemes” are so popular. After all, the brain wants control over its revenue streams, and will try to find the easiest way to do so.

This is also why anxiety and worry come so naturally. And why panic attacks can follow.

Our brain is motivated to solve our problems quickly - even if it comes at a cost

When we don’t have control of our situations, and we have uncertainty, our brain is motivated to take back control. Our brain spins and spins to try to find solutions. Unfortunately, this "spinning" comes easily to our brain, even if it doesn't actually solve the problem. This spinning out of control can lead to a panic attack.

Anxiety in your Brain: 2 Steps to Fix?

Hopefully you can see that treating anxiety can be as simple as:

  1. Making a lazy brain less anxious with less worrisome "lazy habits"
  2. Redefining the values our brain cares to control

Now let’s talk about your anxiety under anesthesia!

An anxious woman looks nervous and worried before surgery. This anxiety can cause complications in surgery, according to Dr. Kaveh
Anxiety before surgery is real and can have real consequences

Anxiety under Anesthesia: The Awake Brain

Both your brain’s laziness and its sense of control are disrupted under anesthesia (and also with disruptive life experiences, meditation, psychedelics, and more).

The awake brain will do whatever it takes to feel like it has control, even if it spins you into a spiral of anxiety (like problem solving to get that promotion).

Laziness is a little harder to understand. I’m not saying you're lazy. I’m saying your brain’s lowest energy state can be to perseverate and ruminate over problems. That's why it's so easy to start spinning through unhelpful thoughts as you "try" to solve your problem.

If there's too much uncertainty in the problem, your brain will simply spin and spin in an anxiety cycle. That changes under anesthesia.

Anxiety under Anesthesia: The Asleep Brain

When you’re under anesthesia, depending on the dose, your brain doesn’t fall into problem solving spirals. Why not?

Firstly, our relationship with our values changes under anesthesia. In fact, one of our most important values, like breathing, goes out the door if the dose of anesthesia is high enough. Even at lower doses, our values, like that promotion, simply aren’t important enough for us to try to control.

Next, because our brains don’t need the same level of perceived control, we can achieve our lowest energy state without perseverating and ruminating. In fact, our brains don’t need to spin at all under anesthesia.

This is a powerful opportunity for growth. At light doses of anesthesia, some of my patients can reevaluate what values they are trying to control. When they wake up, they can take their experience with them to change what their brain tries to control.

Anxiety in Your Asleep?

Have you ever had racing thoughts at night? Your body may be exhausted, but your brain is still trying to attain the lowest energy state. This may be because it’s worrying or perseverating in the pursuit of control. This can lead to insomnia, worse anxiety, and more diseases.

Anxiety While Meditating?

Meditation can similarly restructure our values that we try to control. Furthermore, with enough practice, our brains lowest energy state can become a meditative state. This addresses anxiety by both changing the values that we’re trying to control and our brains lowest energy state.

This is just one example of overcoming anxiety without anesthesia, medications, or psychedelics.

Next Time You’re in a Low Mood...

Our brains are susceptible to anxiety in a handful of situations. These include being:

  • Hungry
  • Bored
  • Lonely
  • Frustrated
  • Annoyed

You can get ahead of your worrying in these situations! You can ask yourself what’s going on in your brain before the worrying cycle gets out of control. And this can often be done without any medications or anesthesia, with the exception of severe conditions.

Just ask yourself "what am I trying to control?"

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