By Felicia Song, BS and Sharon Brock, MS, MEd

Our nervous system is wired to perceive and assess risk and quickly decide if we are safe. When we perceive something as a threat—whether it’s an animal in the wild, an angry co-worker, or an intense emotion from within—our body activates the fight-or-flight stress response.

To understand the neurobiology of stress, it is essential to consider the brain structures involved in maintaining our survival in the face of threats. The amygdala, an almond-shaped region located in the center of the brain, initiates the fight-or-flight response. When the amygdala perceives a threat, the sympathetic nervous system is activated and the hypothalamus signals the adrenal glands to release cortisol. The stress hormone cortisol increases our energy, while adrenaline raises our heart rate and blood flow to optimize physical performance, allowing us to fight against or run from the threat.

Another major player regarding the perception of threat is the vagus nerve. It is the the body’s longest cranial nerve—it is attached to the pubic bone and travels up through the torso, connecting to the base of the brain. When our brain perceives a threat, a message is sent down the vagus nerve to protect the vital organs in our abdomen, which is why we often curl up in a ball when we feel scared. Since the vagus nerve is a two-way street, when we stand tall and open up our lower abdomen, a message is sent up to the brain that there is no threat present, which calms the fight-or-flight response.

The Difference Between Stress and Anxiety

Stress usually stems from a specific external cause (e.g., a work deadline), while anxiety can be chronic and arise without any apparent trigger. According to the American Psychological Association, anxiety is often sustained by ongoing internal worry and negative thought patterns.

Neuropsychologist Shaliza Shorey, PsyD, who works at the Palo Alto Veterans Affairs Medical Center, explains that anxiety can affect more than just mood–it can impair the prefrontal cortex, the brain’s executive control center located just behind the forehead. Chronic anxiety can compromise one’s ability to focus, remember, and solve problems.

“Even though anxiety is rooted in our neurobiology, it is also highly responsive to cognitive therapies, so there is hope,” says Dr. Shorey. “Understanding how to engage with the nervous system and retrain unhelpful thought patterns can help restore a sense of calm and control.”

Reducing Anxiety for Improved Cognitive Function

Below are practical, research-supported strategies that form a comprehensive toolkit for reducing anxiety and enhancing emotional regulation.

1. Cognitive Behavioral Therapy

When working with patients with anxiety, many therapists use cognitive behavioral therapy (CBT), which helps them recognize and change anxiety-inducing thought patterns. At the heart of CBT is a technique called cognitive restructuring, which involves identifying distorted or exaggerated thoughts and reframing them into more balanced, realistic interpretations.

Cognitive restructuring is a powerful technique because our interpretation of events—more than the events themselves—shapes our emotional response. If an individual thinks “I’m going to fail” before giving a presentation, their body will respond as if that outcome is guaranteed, and the stress response will become activated. Instead, a reframed thought, such as “I’m prepared and doing my best” helps regulate both the emotional and physiological responses. With practice, this awareness strengthens the prefrontal cortex, allowing reasoning to override fear-driven signals from the amygdala and reduce emotional reactivity.

“With my patients, I have them step back and observe their thoughts and ask themselves, ‘Is this thought factual or fear-based? Is it helpful or harmful?” says Dr. Shorey. “Over time, these cognitive restructuring practices help rewire the brain by creating new neural pathways that support clarity, confidence, and calm, ultimately diminishing the intensity and frequency of anxiety.”

2. Deep Breathing and Safety Signals

We all know that taking deep, slow breaths can calm us down. The science behind this phenomenon is that when we slow the breath to five or six per minute, the vagus nerve in the lower abdomen sends a message to the brain that “we are safe.” This signal switches our autonomic nervous system from the sympathetic (aka, the fight-or-flight response) to the parasympathetic nervous system (aka, the rest-and-digest response). Via the vagus nerve, deep breaths bring our experience into a relaxed state of mind and  body.

Deep breathing can be especially effective when combined with resonant breathing—a practice that synchronizes breath and heart rhythms to create physiological coherence.

We can further reinforce safety in the nervous system by combining deep, slow breaths with a “safety signal.” Safety signals are sensory cues that help evoke a sense of calm and well-being at the personal level. Examples of safety signals include listening to one’s favorite song, smelling one’s favorite essential oil, cuddling with a pet or stuffed animal, or looking at images that illustrate a safe place. One study showed that safety signals can effectively reduce fear responses even in individuals with high anxiety.

3. Mindfulness

Mindfulness is the practice of being fully present in the moment without judgment. When practiced regularly, mindfulness meditation helps interrupt cycles of rumination and worry, which are hallmarks of anxiety.

Since the practice of mindfulness involves observing one’s thoughts and emotions, it calms the amygdala and engages the prefrontal cortex, thereby increasing emotional resilience. Over time, this practice helps establish a calmer baseline nervous system and enhances cognitive control, attention, and mood.

“Mindfulness doesn’t require hours of practice—just a few minutes of focused breathing or observation each day can begin to shift the brain’s stress response,” says Dr. Shorey.

4. Neurofeedback

When working with patients at the Veterans Affairs Medical Center, Dr. Shorey sometimes utilizes neurofeedback techniques to reduce anxiety. Neurofeedback is a type of biofeedback that allows individuals to observe and regulate their brainwave activity in real-time. Using electroencephalogram (EEG) technology, electrodes placed around a patient’s scalp detect brain wave patterns, such as beta waves (linked to anxiety) or theta waves (linked to relaxation). This data provides in-the-moment feedback that supports patients to shift into a more balanced brain state.

Dr. Shorey’s research in neurofeedback shows that it can be an effective complement to CBT and mindfulness-based strategies to reduce anxiety and improve cognitive abilities. Through consistent sessions, her patients have trained their brains to maintain focus, reduce anxiety, and establish healthy neural patterns. Some studies suggest neurofeedback may even induce long-term neuroplastic changes in the brain, improving both emotional regulation and cognitive function.

Long-Term Benefits of Regular Stress Management

Integrating these techniques into daily life can offer lasting emotional, physical, and brain-health benefits, such as:

• Reduced blood pressure and heart rate
• Improved immune function
• Decreased risk of chronic conditions like cardiovascular disease and metabolic disorders
• Enhanced sleep quality (which impacts brain health)
• Improved working memory and concentration
• Greater emotional resilience and overall life satisfaction

The cumulative effect is not only a calmer mind but also a healthier brain and body. As the stress response becomes less dominant, the brain and body’s self-repair systems are restored.

“For those with anxiety, I want to emphasize that we do have influence over our nervous system. We can reclaim agency over our mental and emotional landscapes,” says Dr. Shorey. “With intention, repetition, and compassion for ourselves, we can transform how our body and mind respond to stress—moving from reactivity to resilience, from fear to clarity.”