Understanding the Anxiety and Depression Types—Type 1: Pure Anxiety

12 Common Symptoms of Type 1: Pure Anxiety

Anxiety and depression are not single or simple disorders. The nervousness you feel may be very different than the panic or dread someone else experiences. But in traditional psychiatry and medicine, healthcare providers often lump people with these conditions into a single box with a cookie-cutter approach to treatment. But giving everyone who feels anxious or depressed the same treatment will never work.

Based on the brain SPECT imaging work at Amen Clinics, which has the world’s largest database of functional brain scans related to behavior (over 160,000 scans from 155 countries), as well as clinical experience with tens of thousands of patients over more than 30 years of practice, it has become evident that there are multiple types of anxiety and depression. Specifically, the neuropsychiatrists at Amen Clinics have identified 7 types of anxiety and depression.

This blog series will explore each type, including the common symptoms, brain SPECT findings, and effective interventions.


Type 1: Pure Anxiety often results from overactivity in the basal ganglia, setting one’s “idle speed” on overdrive. Sufferers feel stirred up, anxious, or nervous. If you have Type 1: Pure Anxiety, you may feel uncomfortable in your own skin. Some Amen Clinics patients report feeling as though they could “climb the walls” or that they are “crawling out of their own skin.” You may be plagued by feelings of panic, fear, and self-doubt. It’s common to suffer from physical feelings of anxiety as well, such as muscle tension, nail-biting, headaches, abdominal pain, heart palpitations, shortness of breath, and sore muscles.

Amen Clinics has identified 7 types of anxiety and depression. Type 1: Pure Anxiety often results from overactivity in the basal ganglia. Click To Tweet

It’s as if you have an overload of tension and emotion. The symptoms may be a consistently disruptive presence in your life, or they may come in unexpected waves. Irrational fears and phobias may also be a burden. If you’re like most people with this type, you may have a tendency to avoid anything that makes you anxious or uncomfortable, such as places or people that might trigger panic attacks or interpersonal conflict.

People with Type 1: Pure Anxiety tend to predict the worst and look to the future with fear. You may be excessively shy or startle easily, or you may freeze in emotionally charged situations.


  • Frequent feelings of nervousness or anxiety
  • Panic attacks
  • Avoidance of people or places due to a fear of having anxiety or panic attacks
  • Symptoms of heightened muscle tension (headaches, sore muscles, hand tremor)
  • Periods of heart-pounding, nausea, or dizziness
  • A tendency to predict the worst
  • Multiple persistent fears or phobias (such as dying or doing something crazy)
  • Conflict avoidance
  • Excessive fear of being judged or scrutinized by others
  • Being easily startled or a tendency to freeze in anxiety-provoking or intense situations
  • Shyness, timidity, and getting easily embarrassed
  • Biting fingernails or picking skin


On SPECT scans, Pure Anxiety is associated with increased activity in the basal ganglia, seen on both concentration and resting studies. The basal ganglia are a set of large structures toward the center of the brain that surround the limbic system. They are involved with integrating feelings, thoughts, and movement, along with helping to shift and smooth motor behavior. Research suggests the basal ganglia are involved in forming habits.

At Amen Clinics, we’ve noticed they are also involved with setting the body’s anxiety level. In addition, the basal ganglia help to modulate motivation and are involved with feelings of pleasure and ecstasy (which is why drugs like cocaine and methamphetamines work in this part of the brain).

The integration of feelings, thoughts, and movement in the basal ganglia causes you to jump when you get excited, tremble when you’re nervous, freeze when you’re scared, or get tongue-tied when the boss is chewing you out. The basal ganglia allow for a smooth integration of emotions, thoughts, and physical movement, and when there is too much input, they tend to lock up.  When the basal ganglia are overactive (as we have seen in the case of people with anxiety tendencies or disorders), people are more likely to be overwhelmed by stressful situations and have a tendency to freeze or become immobile (in thoughts or actions).

Interestingly, some of the most highly motivated individuals we’ve scanned, such as entrepreneurs and corporate CEOs, have significantly increased activity in this part of the brain. We theorize that some people can use this increased activity in the form of motivation to become “movers” in society.



In too many instances, people with anxiety turn to anti-anxiety medication as the first and only thing they do to calm their nerves. Unfortunately, prescription drugs for anxiety, such as benzodiazepines (“benzos”), come with troublesome side effects. For example, benzos are associated with decreased overall brain activity, and they’re habit-forming. In addition, research in the Journal of Clinical Neurology shows that taking them for long periods of time raises the risk of dementia by over 50%.

Medications aren’t the only answer. In fact, there are many natural alternatives to anti-anxiety pills, including:

  • Diaphragmatic breathing—deep belly breathing whenever you’re feeling stressed or nervous
  • Hand warming—learn to warm your hands using mental imagery
  • Heart rate variability (HRV) training—enhance your HRV to lower anxiety
  • Supplements—GABA, l-theanine, and magnesium soothe anxiousness
  • Calming diet—eat more anti-anxiety foods
  • ANT Therapy —learn to challenge the automatic negative thoughts (ANTs) that make you anxious
  • Meditation and hypnosis—these practices calm stress and anxiety
  • EMDR Therapy—EMDR (eye movement desensitization and reprocessing) helps overcome anxiety related to trauma
  • Learning how to deal with conflict—handling issues rather than running from them helps keep anxiety in check
  • Neurofeedback—this biofeedback technique can lead to greater relaxation

Anxiety, panic attacks, depression, and other mental health issues can’t wait. During these uncertain times, your mental well-being is more important than ever, and waiting until life gets back to “normal” is likely to make your symptoms worsen over time.

At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk.


  1. What a great article, especially used as a supplemental tool after reading your book, “Change Your Brain, Change Your Life.” As a person with an overactive basal ganglia, your book helped me ease the anxiety a friend had regarding her tremors. I know how embarrassing those are; dealing with the comments people make about our “shaking” just adds to our anxiety. This article adds to that knowledge and I can say EMDR works WONDERS for anxiety (as do the other tools you mention). Unfortunately, it’s not as commonplace as I believe it should be—thank you for mentioning it here!

    I’ve bookmarked this article to share with friends and refer back to as needed. You’re a saint!

    Comment by Alicia Randolph-Lucchesi — November 13, 2020 @ 3:13 AM

  2. Am interested in the different scans for “manic depression w/anxiety” hearing music, conversations – general talk only. many years of depression, chronic clinical.

    Comment by GERRI STEVENS — November 13, 2020 @ 3:19 AM

  3. My daughter was born with a the hiccups, a strong startle reflex, unable to self sooth, needed to be in arms as a new born and as time went on -in full motion of bouncing or swinging in our arms to transition to sleep. I used the description, she had an over active nervous system and she struggle with transitions because she couldn’t metabolism stimulation. Fast forward 17 years and endless nights of insomnia ( it runs in one side of the family so was not surprising) her new theripist suggested she had the symptoms of an over active basil ganglia. Before this woman began working with my daughter she did a full intake and spoke with me about the pregnancy, birth and my impressions and experience. This theripist had a college friend who’s son went to Amen Clinic. We called immediately and found my mothers instinct “of not being able to metabolize stimulation” was correct! After years of taking criticism from other parents for not letting my daughter “cry it out” and living with the pain of watching my small and then not so small daughters struggles , there was an answer and with it a devoted group to find and tweak as needed a regime of protocol and supplements. As a teenager and now 22 year old young adult there is a learning curve and necessary willingness that allows for more or less relief. Like when time is made to use yoga regularly etc. I love Amen clinic!
    My older daughter and I have also undergone Spec scanning without a dire need but just to become informed of some of the brain patterns that get in our way – we all have them! My gratitude for the work of Dr. Amen and the teams is immense ! Thank You!

    Comment by Carrie — November 13, 2020 @ 6:08 AM

  4. Yes and yes! I suffered from 9 of the listed symptoms for anxiety for many, many years. After chemical and talk therapy, EMDR and a number of wellness related activities like meditation, mindfulness, eating clean food, learning Tai Chi, yoga, and diaphragmatic breathing, I have gotten rid of ALL symptoms. I now teach Tai Chi and have never been happier to share this path to wellness.

    Comment by Jan Clark — November 13, 2020 @ 6:54 AM

  5. What are the best GABA, l-theanine, and magnesium to take and how much of each. I am sure I have pure anxiety

    Comment by Char Grady — November 13, 2020 @ 7:26 AM

  6. I have suffered and panic since I was in my late twenties early thirties I think even into my childhood! At almost seventy I would love to be free of struggling- But I understand these scans are expensive – are they covered by insurance?

    Comment by Allacen Rathbun — November 13, 2020 @ 9:21 AM

  7. Great article thanks so much!!!

    Comment by Lynne Beresford — November 13, 2020 @ 12:55 PM

  8. When will you be posting information about the other types of anxiety? Your article is very helpful and comprehensive.
    thank you

    Comment by elecia hart — November 13, 2020 @ 1:57 PM

  9. i would venture there are more than 7 types of these issues w depression or anxiety? with your approach to brain health, how are there “types” at all? each patient needs a personalized protocol, this is why amen is the successful option for the patients i have referred? as each brain is unique, each brains reaction or overload will evolve or present uniquely from another humans? as well as blending with bodily sensation differently? as in a pain tolerance scale example, these sensations could also run from 1-10, varying the situations even more? why type them at all?

    Comment by km quinn — November 14, 2020 @ 3:59 AM

  10. Cannot wait for the next article in this series. I never used to have anxiety. I am wondering if it can be hereditary or if it can be triggered by a traumatic event or if it is in the system building up until it’s triggered. Is is learned/modeled or innate? My mother suffers from what I believed to be this type of anxiety And I am noticing some of these creeping into my own life. It’s making me very nervous. I don’t wanna be an anxious person. It is affecting the overall quality of my life.

    Comment by Amy Bluedorn — November 14, 2020 @ 5:11 AM

  11. How does one getva Spec scan? Where ?

    Comment by HEATHER WHITE — November 14, 2020 @ 5:46 AM

  12. I have an adult son with autism and adhd and an anxiety disorder. Can’t afford a scan. Can you suggest any help for him.

    Comment by Drissia Wright — November 14, 2020 @ 6:06 AM

  13. I have been writing to you before and reading about the anxiety I have most of them. I wish I could go to the Amen center because I know I need help and the one I am receiving right now is not working at all. My resources are limited to pay for a studies and treatment. Right now I am going to an acupuncturist because I knew for the hours of my worst symptoms acupuncture can but she doesn’t study the brain and I can understand that. If you can send a name of a book so maybe I can help myself

    Comment by Sirena Garrido — November 14, 2020 @ 7:40 AM

  14. Looking forward to reading more about the different types of Anxiety. I have all the symptoms of Type 1. However as Covid has drained all my reserves, I can not afford supplement’s. And health insurance is not an option. If I can’t eat, well I can’t pay for insurance. This only adds to my depression and anxiety 🙃 thanks for the information.

    Comment by Curtis J Horning — November 14, 2020 @ 9:41 AM

  15. Are you going to continue explaining all of these? I battle clinical depression. Doctor says it was passed down from my mother.
    Thank you.

    Comment by Cora Tatum — November 15, 2020 @ 3:35 PM

  16. Having experienced two of the worse traumas, my 3.5 year old daughter died years ago of the flu, then in 2015, my wife of 25 years died tragically of aneurysm, I’m slipped into many of these symptoms, including PTSD and now any loud sounds causes bad anxiety. Also live in doubt now that life wont hurt again. Reading your book now hoping for solutions, married to a strong woman helping me along the way, doing all I can, but wonder how much I can do WITHOUT taking any medications

    Comment by Anthony — November 16, 2020 @ 6:28 AM

  17. Please send info on treatment medications for anxiety/depression.

    Comment by Carol berger — November 27, 2020 @ 7:19 AM

  18. Thank you for pointing out that conflict avoidance and shyness can be signs of pure anxiety. I am worried that my son might be dealing with some kind of social anxiety because he hasn’t been attending any of his school clubs. I want my son to be happy, so it might be a good idea for me to find a counselor he can talk to.

    Comment by Thomas Clarence — June 7, 2022 @ 11:52 AM

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