Anxiety itself is common to most of us. Feelings of anxiety and restlessness in psychology are a normal state and are considered as an adaptation mechanism that helps us overcome various stressful situations. But as soon as anxiety acquires irrational forms of a pathological nature, it begins to be classified as a neurotic disease. However, anxiety is by far the most common problem, with about 40% of the population experiencing it to one degree or another.
So, anxiety disorder, as a diagnosis, is a neurotic syndrome, accompanied by a permanent feeling of anxiety in the patient regarding everything that surrounds him, and significantly reducing the quality and richness of his life. Often manifests itself in combination with other psychopathic diseases.
Previously, anxiety disorders were called neuroses, and it was believed that they were caused exclusively by childhood psychotrauma. Modern psychiatry does not share this belief and considers psychotrauma only an accompanying trigger mechanism.
How to distinguish causeless anxiety from a justified feeling of anxiety, which helps a person to look at situations sensibly, avoid real dangers and overcome difficulties?
Specific signs of an anxiety disorder
How to understand that this is neurosis?
Unlike the norm, pathological anxiety is characterized by the following symptoms:
- there is no real threat causing alarm;
- the person’s reaction is not adequate to the situation;
- accompanied by a total feeling of helplessness, fear of death, a feeling of catastrophe, and a permanent physically debilitating expectation of trouble;
- anxiety is actively repressed at the conscious level;
- significantly disrupts a person’s quality of life;
- long and intense;
- manifests itself in the form of specific psychopathological symptoms.
Causes of Anxiety Disorder
The etiology of the disease is not fully understood, but at the moment the scientific community is considering the following reasons:
- chronic diseases;
- taking medications, drug or alcohol addiction;
- brain injuries;
- prolonged stress;
- melancholic constitutional portrait of the personality;
- psychotrauma in childhood or adulthood (post-traumatic syndrome);
- Concomitant neurotic conditions (neurasthenia, depression, hysteria) or psychopathies (schizophrenia, paranoia, mania).
To look at the mechanism of triggering and developing anxiety a little deeper, let's look at the main predispositions that provoke the onset of the disease.
Pathogenesis of anxiety disorder
Organic component of anxiety
Most often it has an organic pathagonesis, expressed in hormonal disorders caused by a malfunction of the thyroid gland; problems with the cardiovascular system, brain tumors. Thus, by analogy with panic attacks, diagnosis is carried out by a complete examination and exclusion of the somatic component. Somatics and organics are considered as the root causes of this type of neurosis.
Genetic determinant
The child may inherit a reaction to a stimulus, which causes the transfer of anxious biology from the parents.
Intrauterine pathology
Due to a disrupted biological base during the prenatal period, the child could be born with increased anxiety. Such trauma in itself is rarely a clear trigger, but the social situation in the family and parenting style can provoke the development of an anxiety disorder if the initial prerequisites are present.
Social component
Lifestyle also greatly influences the development of this type of neurosis and the transition of accentuation into real neurosis. A sedentary lifestyle, excessive exposure to news, taking drugs of a certain cluster, a toxic environment - all these factors are also of great provocative significance.
As for the etiology of psychological development, today there are three main theories:
- Psychoanalytic
The appearance of destruction occurs due to frustration, or in other words due to the repression of unfulfilled desires and needs. Often the psyche reacts to censorship and multiple social prohibitions in a neurotic way. - Behavioristic
Here, the emergence of pathology is the result of a gap between the external situation and the mental reaction to it, thus anxiety arises for no reason. - Cognitive
Considers anxiety disorder as a distorted perception of reality by the individual’s consciousness.
Why does the disorder occur?
Doctors cannot give an exact answer to the question posed - they do not know the reliable mechanisms of occurrence of the described pathological process. But, some scientists argue that it has a cognitive origin, that is, obsessive experiences appear due to a distortion of a person’s stereotypical thinking.
According to A. Beck, an American psychotherapist, professor at the University of Pennsylvania and creator of cognitive psychotherapy, anxiety is a normal reaction to upcoming changes and danger, but there are individuals whose assessment of the development of the situation is distorted due to low self-esteem. It is because of self-doubt that they subconsciously believe that they will not be able to cope with a dangerous situation, as a result of which this pathology develops.
Symptoms of Anxiety Disorders
It is known that any psychopathic disorder is accompanied by a complex of symptoms, both psycho-emotional and somatic (vegetative) in nature.
The following symptoms are common to all types of anxiety disorders:
- intense tension and panic anxiety;
- sudden, causeless mood swings;
- sleep disorders of various types;
- increased conflict;
- deconcentration, slowness.
At the physiological level, the following may be observed:
Tremor of the limbs, sweating, tachycardia, headaches, nausea, pain in various parts of the body, osteochondrosis.
First symptoms and signs
An uncontrollable feeling of anxiety that lasts for at least six months without objective reasons is the main symptom of an anxiety disorder. Anxiety can be so strong that the patient’s life changes dramatically. A person will not be able to leave the house, work, or communicate with loved ones. Anxiety may subside for a few hours, days or weeks, but any minor reason will cause it to return again.
Physiologically, the following symptoms may appear:
- constant feeling of fatigue;
- disturbed sleep;
- persistent fear;
- inability to concentrate on any task or relax;
- trembling in hands;
- nervousness;
- rapid heartbeat in the absence of heart problems;
- dizziness;
- excessive sweating;
- headache and muscle pain.
Types of Anxiety Disorders
There are a huge number of varieties of this type of disease. The cluster of anxiety states includes obsessive-compulsive and panic attacks, phobic neuroses (Agarophobia, social phobia), post-traumatic stress disorder, hypochondriacal, personality disorder and many others.
Based on the duration of the affective episode, anxiety states are also divided into long-term and short-term . This aspect takes into account the period of time during which a person is unable to adequately respond to what is happening. Let's look at the most common forms:
Generalized anxiety disorder
It is a classic variation of neurosis and represents a type of chaotic anxiety, that is, without any logical direction. It is formed spontaneously and in response to everything, or more precisely, to events that attract the patient’s attention. The sick mind in this case is itself concentrated on finding and solving problems that actually do not exist (work, health, future, relationships). Such a person lives, in principle, with the question “What if?”, and overcoming one far-fetched problem, he comes up with the next one. Anxiety is localized primarily in thoughts (“mental chewing gum”), which is also characteristic of obsessive-compulsive disorder. Mostly the symptoms appear at night and prevent you from falling asleep deeply and for a long time.
At the everyday level, a person avoids everything new: for example, he walks the same road, flies to the same hotel (if he decides to fly in general). It seems to the patient that anxiety provides him with security, allowing him to be on alert, and he cannot be “caught by surprise.” Positive information and good events are leveled out and devalued by an anxious person. They are not happy with gifts and compliments.
Anxiety-hypochondriacal disorder
The main focus and experiences of the patient lie in the plane of his health. A person has constant anxiety regarding signals from his body, which he interprets as deadly. Hypochondria is also accompanied by a tendency to absorb specific and essentially unnecessary information. Most often, this type is combined with conversion and depressive pathologies.
Mixed and anxiety-depressive disorder
This type got its name due to a combination of symptoms defined as the “triad of depressive syndrome,” which includes: low mood, low motor activity and inhibition of mental processes combined with a high level of anxiety. Moreover, in a mixed form, increased anxiety in a patient may prevail over depression, or may correspond. The Hospital Anxiety and Depression Scale is used to assess the prevailing syndrome. The main psycho-emotional symptom, in addition to anxiety, is a lack of interest in life and loved ones, accompanied by vegetative pathology.
Paroxysmal anxiety (anxiety-vegetative) disorder
Paroxysmal, in fact, is another name for anxiety-panic disorder, or in simple words panic attacks, which we discussed in detail earlier. A panic attack is an acute attack of fear accompanied by mental and physiological symptoms.
Typically manifests itself with the following symptoms:
At the physiological level: increased blood pressure, shortness of breath, increased temperature, convulsions, palpitations, hyperhidrosis, tremors of the limbs, nausea and dizziness, insomnia. At the mental level, a person experiences a terrifying feeling of deconcentration and depersonalization (as if everything that is happening is unreal).
The intensity of a panic attack ranges from mild (anxiety and tension in the body) to severe (fear of imminent death). In general, it lasts from 15 to 30 minutes and can occur from 3 times a day to 1 time a month.
Anxiety-asthenic disorder
Another name for it is “anancastic” state of anxiety. Figuratively speaking, psychopathy manifests itself in a patient in the absence of order. As soon as the usual order of things is disrupted, or something new appears in the patient’s life, he falls into a feeling of uncontrollable anxiety. Those suffering from anancastic neurosis have a persistent desire to show perfectionism. In addition to the general characteristic symptoms, it is worth noting increased fatigue in the aspect of asthenic anxiety.
Organic anxiety disorder
Most often it appears against the background of somatic diseases, in connection with this, in patients, in addition to anxiety, dysfunctions of the body of various pathogenesis are observed in parallel (migraines, amnesia, deconcentration, disturbances in the functioning of the heart, thyroid or pancreas, liver).
Phobic disorders
This cluster is quite diverse and includes various types of phobias.
A phobia is an exaggerated, often unreasonable fear of some phenomenon, situation, object, which is often not so dangerous. The most common are social phobia (fear of any contact with people) and agoraphobia (fear of crowded places and open spaces). Phobias also include fear of snakes, spiders, airplane flights, heights, independent travel, and long-distance travel.
Where to treat
Getting rid of this deviation can occur in several scenarios, including outpatient and inpatient. The choice of one method or another depends on the severity of the disease and the preferences of the patient and his relatives.
Ambulatory treatment
In the first case, the patient will periodically visit a psychiatrist’s office to undergo cognitive-behavioral and metacognitive psychotherapy over several months - usually 2-3 conversations per week are prescribed. This method is effective when GAD is diagnosed at an early stage and the person does not have concomitant neuropsychiatric abnormalities.
Inpatient treatment for GAD
This type is preferable in cases of severe astinezia and the presence of clear clinical manifestations of the established diagnosis. It is indicated when it is impossible to select drug therapy on an outpatient basis due to the resistance of the condition and poor tolerability of drugs. In addition, rapid hospitalization to a clinic is necessary in case of a pronounced decrease in working capacity due to severe and obsessive anxiety, frequent panic attacks, as well as when isolation from life’s traumatic circumstances is necessary.
Outpatient program
According to clinical recommendations for the diagnosis and treatment of this disease, compiled by the Union of the Russian Society of Psychiatrists, an outpatient program for correcting this diagnosis includes:
– personality psychoanalysis sessions,
– a course of medications selected individually for each patient,
– various rehabilitation courses in a group,
- individual sessions.
Only after going through all the stages do patients enter the remission stage, and with proper treatment, the recurrence rate of this pathology is no more than 20%.
How to treat anxiety
Treatment of this disease, as well as other neurotic conditions, is based on three approaches:
Social
It implies a correct lifestyle and adherence to established regulations. Maintaining a daily routine, balanced nutrition, sports activities, activity, stress prevention.
Medication
In certain cases, the patient may be prescribed drug therapy, including drugs of a different spectrum: sedatives to tranquilizers and antidepressants. It is important to consider that medications are prescribed only if psychotherapeutic practice does not bring the desired result.
Psychotherapeutic
Includes many techniques: (cognitive, behavioral, rational, psychoanalytic) therapy.
As in the case of panic or any other type of disorder, psychotherapeutic techniques aimed at finding the cause of fear and changing the initial reflexes, as well as the patient’s value system, come to the fore.
How can these reflexes be changed?
First of all, clinical psychology recommends exposure and cognitive behavioral therapy methods. But what can a person do to help himself? Developing a new reflex and, accordingly, a new physiological reaction is the task of the patient himself. In this vein, the Visualization Method is good, which implies a certain separation of oneself from one’s inner child. Any new “seemingly dangerous” event, deliberately, through affirmations, should eventually begin to be perceived by a person as the happiest event that can happen. The technique of internal dialogue is independently applied - “It’s great that we will fly on an airplane,” the patient says to himself and convinces his inner child of this.
Scarlett technique
Or “I’ll think about it tomorrow.” The technique involves setting aside a certain amount of time for worry. For example, a person sets aside an “anxious hour” for himself from 15 to 16 and only at this time allows himself to worry from the bottom of his heart.
Speaking technique
As soon as an exciting moment arises, it is important to tell someone close to you about it in detail. Moreover, it is important to note that only “active listening” is required from the other person without advice or reassurance. As a last resort, you can even record the problem on a voice recorder; the main thing is to express yourself as much as possible regarding all the nuances that are troubling.
Body-oriented practices and aerobic exercise
Pilates, yoga, and spa treatments are known to have a relaxing and stabilizing effect. It is also worth paying attention to cardio and aerobic training, which should only be done in the first half of the day. Sports activities before bedtime can lead an anxious person, on the contrary, to overexcitation.
Treatment methods for disorders
The described type of neurosis can be successfully corrected after diagnostics using special tests, a detailed survey and some psychometric analyses. Most often, two methods are used to get rid of this condition:
– psychotherapy,
- use of medications.
Psychotherapy
Today, the most progressive and effective therapeutic methods are cognitive-behavioral and metacognitive psychotherapy. These techniques primarily pay attention to a person’s thoughts, which force him to see the whole world primarily in a threatening and negative light.
Also, both approaches help develop new skills for solving and overcoming your problems, which reinforce fear. During the classes, the patient learns to record his thoughts, separate real and imaginary threats, concentrate attention, manage his emotions, rationally perceive the world around him and steadfastly endure all the uncertainties and worries that cause significant factors.
Another psychological approach that shows good effectiveness is the relaxation technique. In this case, the psychologist teaches the patient, during the next attack of anxiety, to imagine calming situations that cause both psychological and muscular relaxation, which brings relief and calm.
Drug therapy
In addition to psychoanalysis, some are prescribed additional medications. The primary pharmacological line is the prescription of antidepressants and benzodiazepines. The drugs have anti-anxiety, sedative and muscle relaxant effects, which eliminate anxiety, sleep disorders and reduce depression. Most often, doctors prescribe paroxetine, escitalopram, sertraline, diazepam, lorazepam and phenazepam. Some of these drugs can be taken for long courses of up to one year, which is discussed with the treating doctor.
However, many of the above tablets also have side effects, so they should only be prescribed by the attending physician, based on the results of tests and screenings.
In addition to the two generally accepted methods, there are alternative ones. Among them, the biofeedback method, breathing and sports gymnastics, as well as various types of rehabilitation and relaxation are common.
How to get rid of anxiety and worry on your own
General techniques for reducing anxiety that a person can use independently.
First of all, you need to come to the realization that worrying does not mean thinking and does not mean deciding! That is why the patient’s main task is to move from the experiencing mode to the decision mode. And in order for a solution to come, it is enough to simply write down the problem and deal with it piece by piece.
Next, you should remember and remember well the advice of the Eastern sages, who suggest limiting yourself only to the framework of the current moment, that is, shifting the focus exclusively “to the here and now.” Directing attention to the plane of the moment, including anxiety in the body, is achieved through meditative and breathing practices. In general, Understanding the existentiality of being and accepting the idea of death is a general recommendation for people suffering from any neuroses.
