Anxiety Disorders and Their Treatment

Anxiety disorder – common features

There are many types of anxiety. Each of them manifests a little differently, however, one can distinguish several commonly occurring elements:

• a sense of worry and anxiety most of the time,
• difficulty in calming down,
• feeling overwhelmed or terrified by sudden feelings of panic/anxiety,
• experiencing recurring thoughts that cause fear,
• experiencing unpleasant states (memories, nightmares) after a traumatic event,
• there may be discomforts associated with the cardiovascular system, breathing, and the digestive system – specific examples of somatic symptoms are given for particular disorders,
• it is also worth knowing that anxiety may accompany some somatic diseases (eg Alzheimer’s disease, thyroid disorders, Parkinson’s disease, hypoglycemia). Therefore, for the diagnosis of anxiety disorders, it is necessary to first exclude the causes of anxiety resulting from somatic diseases.

 What are the causes of excessive anxiety?

Excessive anxiety is usually a combination of various factors:

• mental disorders occurring in the family of origin:

  they may be a predisposition to an anxiety disorder, but it does not mean that if someone in the family struggled with psychological problems, they will automatically affect us as well,

• stressful events:

  change of work, housing, pregnancy and the birth of a child, experience of a traumatic event, the death of a loved one, experiencing verbal, sexual, physical or emotional violence,

• physical problems:

  the most common somatic diseases triggering anxiety are hormonal problems, diabetes, asthma, heart disease,

• psychoactive substances:

  substances such as alcohol, marijuana, amphetamine, sedatives can trigger anxiety, especially when the effects of taking a given substance subside. Also, people with existing anxiety, striving to reduce it, sometimes take more and more of these substances, which in the short-term can be effective, but in the long-term increases and strengthens the feeling of fear in the mechanism of the vicious circle,

• personality factors:

  researchers believe that certain personality traits such as perfectionism, increased the need for control, or low self-esteem can predispose to anxiety.

Types of anxiety disorders (neuroses)

Below we briefly present the main types of anxiety disorders (neuroses). It is worth noting that often people experience more than one type of these disorders.

1) Social phobia

People with social phobia feel a strong fear in the face of exposure to the so-called social situations in which there is the possibility of being assessed by others. Such people are afraid of potential criticism, embarrassment or humiliation, even in ordinary situations such as speaking, eating in a public place, initiating a conversation.

These fears are usually accompanied by an increased vegetative response: sweating, redness, palpitations, tension, and faster breathing.

A person with a social phobia is usually convinced that these symptoms are grossly visible to the environment and additionally contribute to the “social embarrassment”. Fear of the occurrence of these vegetative symptoms causes their intensification in social situations (in the mechanism of a vicious circle).

Social phobia is distinguished from shyness above all by the occurrence of paralyzing anxiety that prevents or seriously hinders participation in all social situations. Feeling of anxiety and somatic symptoms may increase even at the very thought of exposure to public display. This usually leads to avoiding such situations and variously advanced social isolation. More – in the article Social phobia.

2) Phobias are specific

Specific phobias are a disorder manifested by a strong and inexplicable fear of specific objects or situations. People who experience them usually realize the irrationality of their fears and exaggerated feelings of fear, yet they avoid all contact with stimuli that cause phobias.

Phobia is accompanied by various physiological symptoms, including palpitations, fast breathing, sweating, fainting. According to diagnostic criteria, simple phobias can be divided into:

• animal phobias – eg fear of snakes, spiders, rats,
• Phobias related to the natural environment – eg fear of the storm, flowers, water, snow,
• fobie type krew /injection/injury – e.g. fear of pain, dirt, germs,
• situational phobias – eg fear of heights, claustrophobia, fear of theft, fear of a dentist,
• other phobias – eg fear of God, the smell, smells, number 13, sharp objects.

Many people experience fear in a confrontation with some stimuli, but in reality, phobias affect no more than 10% of the population.

3)       Generalized Anxiety Disorder (GAD)

This team is characterized by an unrealistic and exaggerated fear of a potential disaster or catastrophe, which is accompanied by almost constant worrying.

It is characterized by the presence of specific symptoms such as muscle tone, irritability, sleep disorders. GAD is a chronic and significantly impeding the daily functioning of the disorder.

To diagnose it, symptoms must occur most of the time for at least six months. The subject of worrying is often financial matters, the health condition of family members, and the exclusion of one reason for anxiety causes the appearance of another. More: in the article Generalized anxiety disorder.

4)      Panic fear with agoraphobia or without agoraphobia

A person with this disorder experiences sudden panic attacks (about 5-20 minutes), intense and overwhelming episodes of intense anxiety that he experiences as “unmanageable”.

Usually accompanied by a number of physiological symptoms (shortness of breath, sweating, body shaking, shallow breathing, dizziness, numbness, nausea, abdominal pain, fear of death, paresthesia). Panic attacks are sudden, unrelated to any situational factor.

A person experiencing panic fear is often afraid of occurring subsequent attacks, so he avoids places where escape could be difficult (often cinema, supermarket, public transport) – in such cases, panic disorder with agoraphobia is diagnosed.

Agoraphobia can also occur without panic attacks. In this case, the person avoids being in public places for fear of suffering somatic complaints – heart attack, fainting. More: in the articlePanic disorder.

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5) Obsessive-compulsive disorder (OCD)

The basic feature of OCD is the repeated occurrence of obsessions and compulsions that are severe and time-consuming (> 1 hour per day).

Obsessions are unwanted, intrusive, unacceptable and repetitive thoughts, images and impulses that are difficult to control and cause great stress, even if the person experiencing these thoughts is aware of their irrationality.

Their content focuses on worrying, disgusting, meaningless content like dirt, pollution, germs, unacceptable sexual behavior, fear of hurting someone, need for order and symmetry.

Compulsions usually appear in response to obsessions. These are stiff, repetitive rituals that a person feels compelled to perform. They are to serve the reduction of tension caused by intrusive thoughts, to protect against anxiety. The most common compulsions include: hand washing, checking, arranging and mental activities – repeating certain phrases, counting, and prayer.

Obsessive thoughts are very troublesome for the patient. They concern matters that are afraid of them, and compulsive activities are to prevent them from becoming real.

Such a person tries to perform the activities perfectly, but almost never is completely satisfied with their performance, so he feels compelled to repeat them, which causes that these activities absorb a lot of time, especially in the intensified form of the disorder. More: in article Obsessive-compulsive disorder.

6) Acute stress syndrome (ASD) and post-traumatic stress disorder (PTSD)

Acute stress syndrome (ASD) can occur after experiencing a traumatic situation. The main criterion for differentiating these two disorders is the occurrence of dissociative symptoms in the case of ASD.

This group includes feelings of numbness, depersonalization, derealization, a sense of bewilderment, isolation from people, strange behaviors, problems with memory.

These symptoms follow a shocking event and last from several days to a month. If the symptoms persist for more than a month, PTSD will be the right diagnosis.

Post-traumatic stress disorder (PTSD) may occur as a result of experiencing a traumatic event (war, assault, communication accident, ecological disaster, physical or psychological abuse).

Symptoms may include constant tension and difficulty in relaxing, nightmarish dreams, recurring memories of a traumatic event and strenuous attempts to avoid everything associated with it / associated.

A person affected by this disorder has a problem with remembering the course of traumatic events, problems with insomnia, concentration, feeling positive emotions, quickly gets angry and irritated, it is easy to scare. More: in the article Post-traumatic stress disorder.

 Treatment of anxiety disorders

The way in which anxiety disorders are treated depends, among other things, on how anxiety is experienced by the patient and what a person has expectations.

Mild symptoms can be silenced, for example, by changing the lifestyle (regular exercise, relaxation, meditation). If the symptoms are more serious and last for a relatively long time, adversely affecting the quality of human life – it is advisable to seek professional psychological and/or psychiatric help.

Psychological methods

Psychological therapies can not only help return to balance but also prevent the recurrence of anxiety. They are the most effective strategy for treating anxiety disorders.

One of the most effective forms of psychological therapy in anxiety disorders is cognitive-behavioral therapy (CBT). During such therapy, the patient learns to see the patterns of his thinking and behavior that predispose him to fear.

If these patterns are recognized, the patient can consciously and intentionally change them to those that reduce anxiety and strengthen the ability to deal with it. During CBT therapy, the patient is working on changing the way of thinking into a more realistic and problem-focused problem.

It is often very helpful to gradually face the situation that causes fear. More: in the article Cognitive-behavioral psychotherapy.

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pharmacotherapy

Studies show that psychological therapies are best suited for dealing with anxiety, but in the case of severe symptoms, pharmacotherapy may be very helpful. This applies to people who are very anxious and difficult to function and those who for various reasons can not take psychotherapy.

• Antidepressants with an anxiolytic effect:

  many types of antidepressants can help deal with anxiety. This is because anxiety and depression often occur together, and have very similar neuroreceptor pathways.

• Researchers indicate that people suffering from anxiety disorders have specific neurochemical changes associated with the transmission of serotonin, noradrenaline, and dopamine. Antidepressants have been designed to compensate for this transmission between cells in the brain. The decision to start treatment with antidepressants should be made jointly with the psychiatrist, after careful assessment and reflection. These drugs are not addictive and if they are properly selected – they facilitate and improve the functioning of the patient. They are also often well tolerated. They can be used long-term. Discontinuation of treatment should be gradual,

• Drugs from the benzodiazepine group:

  Unlike antidepressants, benzodiazepines are only intended for short-term use (2-4 weeks) as part of a wider treatment plan, and not as the first or only treatment option. They can help reduce tension without causing drowsiness. Due to the addictive potential, benzodiazepines are only suitable for short-term, auxiliary treatment.

How to deal with anxiety?

The following advice can not replace professional help, but it can be useful. When you experience anxiety:

• postpone serious changes to life later: it is difficult to face them without increased fear, so if possible, make serious decisions on how to move or change jobs when you feel better,
• solve conflicts in relationships: problems in relationships can contribute to anxiety, therefore develop the ability to open communication and solve problems when they start to build up,
• maintain a healthy lifestyle: healthy eating, regular physical exercise and getting a good night’s sleep can help you deal with anxiety,
• relax: find time for activities that make you enjoy reading, running, meditating, listening to music. There are also many relaxation techniques that can be learned, to do this buy a guide or sign up for the right course,
• reduce the consumption of alcohol and stimulants: they can cause long-term problems and hinder recovery. It is also a good idea to avoid stimulating substances, in particular, excess caffeine and similar substances contained in, for example, energy drinks.

 When a loved one experiences anxiety:

Family and friends can play an important role in dealing with the anxiety experienced by their relatives. If you notice symptoms of anxiety disorder in a loved one – let her know about it, ensure your willingness to help, readiness to listen carefully without judging. first to exclude

Try to encourage her to seek professional support, offer help in finding the right specialist. Encourage healthy habits (sufficient sleep, regular meals, exercise), entertainment, and relaxing activities. Stay in touch with this person, suggest it to other family members/friends, but do not press too much.

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