Psychology and Psychiatry

Anxiety disorder

Anxiety disorder - This is a certain psychopathic condition characterized by specific symptoms. Every subject periodically experiences anxiety due to various situations, problems, dangerous or difficult working conditions, etc. The emergence of anxiety can be considered a kind of signal that informs an individual about changes in his body, body or in the external environment. Hence, the feeling of anxiety acts as an adaptive factor, provided that it is not expressed excessively.

Among the most frequently encountered anxiety states today are generalized and adaptive. Generalized disorder is characterized by pronounced persistent anxiety, which is aimed at various life situations. Adaptive disorder is characterized by pronounced anxiety or other emotional manifestations that arise in combination with difficulties in adapting to a particular stressful event.

Causes of Anxiety Disorder

The causes of the formation of disturbing pathologies today are not fully understood. Mental and somatic conditions are important for the development of anxiety disorders. In some subjects, these states may appear without clear triggering mechanisms. Anxiety can be a response to external stress stimuli. Also, individual somatic diseases are themselves a cause of anxiety. Such diseases include heart failure, bronchial asthma, hyperthyroidism, etc. For example, organic anxiety disorder can occur due to cardiocerebral and cardiac disorders, hypoglycemia, vascular pathology of the brain, endocrine disorders, and brain injuries.

For physical reasons include taking drugs or narcotic drugs. May cause anxiety cancellation of taking sedatives, alcohol, certain psychoactive drugs.

Today, scientists highlight psychological theories and biological concepts that explain the causes of anxiety disorders.

From the point of view of the psychoanalytic theory, anxiety is a signal of the formation of an unacceptable, forbidden need, or a message of an aggressive or intimate nature that motivates the individual to unconsciously prevent their expression.

Symptoms of anxiety in such cases are considered as incomplete restraint or crowding out an unacceptable need.

Behavioral concepts consider anxiety, and in particular, various phobias initially arise as a conditioned reflex response to frightening or painful stimuli. Subsequently, disturbing reactions may occur without sending. Cognitive psychology, which appeared later, focuses on twisted and incorrect mental images that precede the development of anxiety symptoms.

From the standpoint of biological concepts, anxiety disorders are the result of biological abnormalities, with a sharp increase in the production of neurotransmitters.

Many individuals who have an anxious panic disorder have also experienced extreme sensitivity to a small increase in the concentration of carbon dioxide in the air. In accordance with the domestic systematics, anxiety disorders are attributed to the group of functional disorders, in other words, to psychogenically determined painful conditions, which are characterized by awareness of the disease and the lack of transformations in personal self-consciousness.

Anxiety personality disorder can also develop due to the hereditary characteristics of the subject's temperament. Often these states of different types are related to the behavior of a hereditary nature and include the following features: fearfulness, isolation, shyness, uncommunicity, if the individual is in an unknown situation.

Anxiety Disorder Symptoms

The signs and symptoms of this condition may vary significantly depending on the individual characteristics of the subject. Some suffer from violent anxiety attacks that appear suddenly, and others from obsessive anxious thoughts that arise, for example, after the release of news. Some individuals may struggle with various obsessive fears or uncontrollable thoughts, others live in constant tension that does not disturb them at all. However, despite the diverse manifestations, all this together will be an anxiety disorder. The main symptom, which is considered the constant presence of fear or anxiety in situations in which most people feel safe.

All the symptoms of a pathological condition can be divided into manifestations of an emotional and physical nature.

The manifestations of an emotional nature, in addition to irrational, immense fear and anxiety, also include a sense of danger, a violation of concentration, an assumption of the worst, emotional tension, increased irritability, a feeling of emptiness.

Anxiety is more than a simple sensation. It can be considered as a factor in the readiness of the physical body of the individual to escape or fight. It contains a wide range of physical symptoms. Due to the many physical symptoms of anxiety, subjects suffering from anxiety often take their symptoms as a disease of the body.

Symptoms of anxiety disorder of a physical nature include accelerated heartbeat, dyspeptic disorders, intense sweating, increased urination, dizziness, shortness of breath, tremor of limbs, muscle tension, fatigue, chronic fatigue, headaches, sleep disturbance.

The relationship between anxiety personality disorder and depression was also noted. Since many individuals suffering from anxiety disorder have a history of depression. Depressive states and anxiety are closely interconnected psycho-emotional vulnerability. That is why they quite often accompany each other. Depression can aggravate anxiety and vice versa.

Anxiety personality disorders are generalized, organic, depressive, panic, mixed type, so that the symptoms may differ. For example, organic anxiety disorder is characterized by clinical manifestations of qualitatively identical symptoms of anxiety-phobic disorder, but to diagnose an organic anxiety syndrome, it is necessary to have an etiological factor that causes anxiety as a secondary manifestation.

Generalized Anxiety Disorder

A mental disorder characterized by general persistent anxiety that is not associated with specific events, objects, or situations is called generalized anxiety personality disorder.

Persons suffering from disorders of this type are characterized by anxiety, which is characterized by resistance (duration not less than 6 months), generalization (ie, anxiety manifests itself in marked tension, anxiety, feeling of future troubles in everyday events, the presence of various fears and misgivings) , not fixed (i.e., an alarm is not limited to any specific events or conditions).

Today, there are three groups of symptoms of this type of disorder: anxiety and fear, motor tension and hyperactivity. Fears and anxiety are usually rather difficult to control, and their duration is longer than that of people who do not suffer from generalized anxiety disorder. Anxiety does not focus on specific problems, such as the likelihood of a panic attack, getting into a difficult situation, etc. Motor tension can be expressed in muscle tension, headache, extremity tremor, inability to relax. Hyperactivity of the nervous system is expressed in increased sweating, accelerated heartbeat, dry mouth and discomfort in the epigastric region, dizziness.

Among the typical symptoms of a generalized anxiety personality disorder, irritability and increased sensitivity to noise can also be distinguished. Other symptoms of motility include the presence of aching muscle pain and muscle stiffness, especially the muscles of the shoulder area. In turn, autonomic symptoms can be grouped by functional systems: gastrointestinal (dry mouth, difficulty swallowing, epigastric discomfort, increased gas generation), respiratory (difficulty breathing, chest contraction), cardiovascular (discomfort in the heart) , heart palpitations, pulsation of the cervical vessels), urogenital (frequent urination, in men, disappearance of erection, decreased libido, in women, menstrual disorders), nervous system (like fainting, blurred vision, dizziness and paresthesia).

Anxiety is also characterized by sleep disturbance. People with this disorder may experience difficulty in falling asleep and feel anxious on waking. In such patients, sleep is characterized by intermittentness and the presence of unpleasant dreams. Patients with generalized anxiety disorder often have nightmares. They often wake up feeling tired.

An individual with such a disorder often has a specific appearance. His face and posture look tense, his eyebrows are frowned, he is restless, and there is often a tremor in the body. The skin of such a patient is pale. Patients are prone to crying, which reflects depressed mood. Among the other symptoms of this disorder should be identified fatigue, depressive and obsessive symptoms, depersonalization. These symptoms are minor. In cases where these symptoms are leading, a generalized anxiety personality disorder cannot be diagnosed. Periodic hyperventilation was observed in some patients.

Anxiety Depressive Disorder

Anxiety-depressive disorder can be called a disease of modernity, which significantly reduces the quality of life of an individual.

Anxiety-depressive disorder should be attributed to the group of neurotic disorders (neuroses). Neuroses are psychogenically determined states characterized by a significant variety of symptomatic manifestations, the absence of transformations of personal self-awareness and awareness of the disease.

During life, the risk of anxiety-depressive state is about 20%. At the same time, only one third of the patients turn to specialists.

The main symptom that determines the presence of anxiety-depressive disorder is a steady feeling of vague anxiety, the objective reasons for which does not exist. Anxiety can be called the unchanging feeling of imminent danger, catastrophe, an accident that threatens close people or the individual himself. It is important to understand that in anxiety-depressive syndrome, the individual feels not the fear of a certain threat that actually exists. He only feels a vague sense of danger. This disease is dangerous because the constant feeling of anxiety stimulates the production of adrenaline, which contributes to the increase of the emotional state.

Symptoms of this disorder are divided into clinical manifestations and autonomic symptoms. Clinical manifestations include sustained decrease in mood, increased anxiety, constant anxiety, sharp fluctuations in the emotional state, persistent sleep disorder, obsessive fears of a different nature, asthenia, weakness, constant tension, anxiety, fatigue; decrease in concentration of attention, working capacity, speed of thinking, mastering a new material.

Vegetative symptoms include fast or intense heartbeat, tremor, feeling of suffocation, increased sweating, hot flushes, moisture in the palms, pain in the solar plexus area, chills, disorders of the chair, frequent urination, pain in the abdomen, muscle tension.

Many people experience similar discomfort in stressful situations, but in order to diagnose anxiety-depressive syndrome, a patient must have several symptoms in the aggregate, which are observed for several weeks or months.

There are risk groups that are more likely to be disturbed. Thus, for example, women are much more likely to have male half of the population susceptible to anxiety and depressive disorders. Since the beautiful half of humanity is characterized by more pronounced emotionality, compared to men. Therefore, women need to learn to relax and relieve accumulated tension. Among the factors contributing to the emergence of neurosis in women, we can distinguish hormonal changes in the body due to the phases of the menstrual cycle, pregnancy or the postpartum state, menopause.

People who do not have a permanent job are much more likely to experience anxiety-depressive states than working individuals. The feeling of financial insolvency, the constant search for a job and the persecution of failures at interviews lead to a sense of hopelessness. Drugs and alcohol are also factors contributing to the development of anxiety-depressive states. Alcohol or drug addiction destroys the identity of the individual and leads to the occurrence of mental disorders. Constantly accompanying depression forces one to seek happiness, satisfaction in a new portion of alcohol or a dose of a narcotic drug, which only aggravates depression. Unfavorable heredity is often a risk factor for anxiety and depressive disorders.

Anxiety disorders in children whose parents suffer from mental disorders are observed more often than in children with healthy parents.

Older age can also be a cause for neurotic disorders. Individuals at that age lose their social significance, their children have already grown up and have ceased to depend on them, many friends have died, they are experiencing a deprivation in communication.

A low level of education leads to anxiety disorders.

Severe somatic diseases form the most severe group of patients with anxiety and depressive disorders. Indeed, many people often suffer from incurable diseases that can cause severe pain and discomfort.

Anxiety and Phobic Disorders

A group of disorders arising from a combination of psychological factors of influence and external causes is called anxiety-phobic disorders. They arise as a result of exposure to stressful irritants, family troubles, loss of loved ones, frustrations of hope, problems associated with work, impending punishment for a previously committed offense, danger to life and health. An irritant is a single superstrong exposure (acute mental trauma), or a multiple weak action (chronic mental trauma). Traumatic brain injuries, various kinds of infections, intoxication, diseases of internal organs and diseases of the endocrine glands, prolonged sleep deprivation, permanent overwork, disturbance in the diet, prolonged emotional stress are factors that contribute to the emergence of psychogenic diseases.

The main manifestations of phobic neurotic disorders include agoraphobia, panic attacks and hypochondriacal phobias.

Panic attacks can be expressed in the form of an overwhelming sensation of fear and a sense of approaching death. They are accompanied by vegetative symptoms, such as an accelerated heartbeat, a feeling of lack of air, sweating, nausea, dizziness. Panic attacks can last from a couple of minutes to an hour. Often, patients during such attacks are afraid of losing control over their behavior or are afraid of losing their mind. In general, panic attacks appear spontaneously, but at times their occurrence can be provoked by drastic changes in weather conditions, stress, lack of sleep, physical overstrain, excessive sexual activity, and alcohol abuse. Также некоторые соматические заболевания могут спровоцировать появление первых панических атак. К таким заболеваниям можно отнести: гастрит, остеохондроз, панкреатит, некоторые заболевания сердечнососудистой системы, заболевания щитовидной железы.

Psychotherapy of anxiety personality disorders is aimed at eliminating anxiety and correcting inappropriate behavior. Also during the course of therapy, patients are taught the basics of relaxation. Individual or group psychotherapy may be used to treat individuals suffering from anxiety disorders. If phobias prevail in the history of the disease, then patients need psycho-emotional maintenance therapy to improve the psychological state of these patients. And to eliminate phobias allows behavioral psychotherapy and the use of hypnosis. It can also be used in the treatment of obsessive fears and rational psychotherapy, in which the patient is explained the essence of their disease, develops an adequate understanding by the patient of the symptoms of the disease.

Mixed anxiety and depressive disorder

In accordance with the international classification of diseases, anxiety states are divided into anxiety-phobic disorders and other anxiety disorders, which include a mixed anxiety-depressive disorder, generalized and anxious panic disorder, obsessive-compulsive disorders and reactions to serious stress, adaptation disorders, including self posttraumatic stress disorder.

Diagnosis of the mixed anxiety-depressive syndrome is possible in cases where the patient has approximately the same severity symptoms of anxiety and depression. In other words, along with anxiety and its vegetative symptoms, there is also a decrease in mood, a loss of previous interests, a decrease in mental activity, motor retardation, and the disappearance of self-confidence. However, in this case, the patient's condition cannot be directly attributed to any stressful event and stressful situations.

The criteria for mixed anxiety-depressive syndrome include temporary or persistent dysphoric mood, which is observed with 4 or more symptoms for at least a month. Among such symptoms, there are: difficulty concentrating or slowed thinking, sleep disturbances, fatigue or fatigue, tearfulness, irritability, anxiety, hopelessness, heightened alertness, underestimated self-esteem, or a sense of worthlessness. Also the listed symptoms should cause violations in the professional sphere, social or other important areas of the subject’s vital activity or provoke clinically significant distress. All the above symptoms are not caused by taking any drugs.

Treatment of anxiety disorders

Psychotherapy for anxiety disorders and drug treatment with anti-anxiety drugs are the main methods of treatment. The use of cognitive-behavioral therapy in the treatment of anxiety allows us to identify and eliminate the negative patterns of thinking and illogical views that fuel anxiety. Five to twenty daily sessions are usually used to cure increased anxiety.

Desensitization and confrontation are also used for therapy. During the course of treatment, the patient confronts his own fears in a non-hazardous environment, which is controlled by a therapist. Through repeated immersion, in the imagination or reality, in a situation that provokes the emergence of fear, the patient acquires a greater sense of control. Directly face your fear, gradually reducing anxiety.

Hypnosis is a reliable and fast mechanism used in the treatment of anxiety disorders. When the individual is in deep physical and mental relaxation, the therapist applies various therapeutic techniques to help the patient face his own fears and overcome them.

An additional procedure in the treatment of this pathology is physical rehabilitation, which is based on exercises taken from yoga. Studies have shown the effectiveness of reducing anxiety after performing a thirty-minute special set of exercises from three to five times a week.

In the treatment of anxiety disorders, various drugs are used, including antidepressants, beta-blockers and tranquilizers. Any drug treatment shows its effectiveness only in combination with psychotherapy sessions.

Betta-adrenergic blockers are used to relieve vegetative symptoms. Tranquilizers reduce the severity of anxiety, fear, help relieve muscle tension, normalize sleep. The lack of tranquilizers is the ability to cause addiction, due to which there is a dependence in the patient, the consequence of this dependence will be withdrawal syndrome. That is why they should be appointed only for serious reasons and non-durable course.

Antidepressants are medications that normalize pathologically changed depressive mood and contribute to the reduction of somatovegetative, cognitive, and motor manifestations caused by depression. In addition, many antidepressants also have an anti-anxiety effect.

Anxiety disorders in children are also treated with the help of cognitive-behavioral therapy, drugs, or their combination. There is a widespread opinion among psychiatrists that behavioral therapy has the greatest effect for treating children. Her methods are based on modeling frightening situations that cause obsessive thoughts, and taking a set of measures that prevent unwanted reactions. The use of drugs has a shorter and less positive effect.

Most anxiety disorders do not require prescription of drugs. Usually, an individual with an anxiety disorder needs only a conversation with the therapist and his persuasion. The conversation should not be long in time. The patient should feel that he fully takes the attention of the therapist, that he is understood and sympathized with him. The therapist must provide the patient with a clear explanation of any somatic symptoms that are associated with anxiety. It is necessary to help the individual overcome or come to terms with any social problem related to the disease. So uncertainty can only increase anxiety, and a clear treatment plan helps reduce it.