Despite the rising availability of more mental health resources than ever before—like therapists, medications, apps, awareness campaigns—the rates of anxiety and depression in the United States continue to rise.1 Almost 20% of American adults have a diagnosed mental illness, and nearly a third of us struggle with some type of anxiety disorder in our lifetime.
If access to resources and providers were the problem, the rates of anxiety would be dropping. But the problem isn’t a lack of care: it’s a flawed framework. Over the past several decades, people have been trained to see themselves as patients, wait…
Despite the rising availability of more mental health resources than ever before—like therapists, medications, apps, awareness campaigns—the rates of anxiety and depression in the United States continue to rise.1 Almost 20% of American adults have a diagnosed mental illness, and nearly a third of us struggle with some type of anxiety disorder in our lifetime.
If access to resources and providers were the problem, the rates of anxiety would be dropping. But the problem isn’t a lack of care: it’s a flawed framework. Over the past several decades, people have been trained to see themselves as patients, waiting for relief to arrive from the outside. And while this mindset may reduce shame, it also unintentionally reduces agency. People see anxiety as something that happens to them, rather than something their brains have learned to do.
As a neurosurgeon who has spent more than 25 years making structural changes in patients’ brains to improve or save lives, I believe we are approaching anxiety the wrong way.
Neuroscience tells us that the brain is not a static organ simply reacting to life. It is a dynamic system that changes based on what we repeatedly think, attend to, and practice. This process, neuroplasticity, is not controversial. It is established science, validated by hundreds of 21st-century functional imaging studies.2
And although we rarely teach anxious people how to use neuroplasticity to their advantage, science reveals a sobering truth: either we learn to operate our nervous system, or it will operate us. This is why making the “patient-to-doctor switch” is a powerful tool for those struggling with anxiety. You can take ownership of your own healing when you stop seeing yourself solely as a patient waiting to be fixed and start recognizing your role as an active participant in shaping your own brain.
In other words, you can learn how to practice "self-brain surgery." Despite how this phrase sounds, self-brain surgery is neither a metaphor nor a positive-thinking mantra. It is a literal description of how meaningful change happens in the brain.
Self-brain surgery is the prescription only you can write to dispense hope to yourself.
Let’s return to the topic of neuroplasticity. Your brain contains built-in mechanisms designed to be shaped by experience, attention, and repetition. And every thought you repeatedly engage strengthens certain neural circuits and weakens others. Every habit of attention trains your brain to predict what matters, what is dangerous, and what is safe. Over time, these predictions become automatic, and what once required effort begins to feel like “who you are.”
This is how anxious thoughts become automatic. And this is also where self-brain surgery comes in. In the operating room, I don’t change outcomes by wishing a tumor away. I change outcomes by understanding the anatomy and intervening precisely at the point where change is possible.
The same principle applies here. Self-brain surgery is the deliberate, informed use of those built-in processes to change the structure and function of the brain itself. No scalpels, no manifesting, and no magic required. Just the purposeful application of attention, intention, and repetition to retrain the brain away from fear-based loops and toward healthier patterns of response.
Once you realize you have some agency and control over your responses to anxious thoughts, you gain confidence that your brain has simply been awaiting better instructions. Anxiety is not a moral failure or a character flaw. It is a learned neural pattern. And learned patterns can be unlearned—not through willpower alone, but through practice that engages the brain’s own mechanisms for change.
This doesn’t mean therapy or medication are unnecessary. For many people, they are essential. But they work best when paired with a framework that restores agency rather than replacing it. When individuals understand that their daily patterns of thought and attention are actively shaping their brains, treatment stops being done to them and becomes something they participate in.
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I’ve seen self-brain surgery change outcomes in others and in my own life. I’ve also seen what happens when people are never taught that they have any role to play beyond compliance. Hopelessness grows, dependency deepens, and anxiety tightens its grip. Because anxiety thrives where agency disappears.
The most hopeful message neuroscience offers is that we are designed with the capacity to change. While we may not be able to control what happens to us, we can learn to influence how our brain responds, adapts, and heals.
In a world overflowing with resources but starving for results, the shift from patient to doctor, from helplessness to participation, may be the prescription we’ve been missing all along.