ANXIETY DISORDERS SYMPTOMS AND TREATMENT

What is Anxiety Disorder? How anxiety arises ?

Anxiety is related to stress from enviroment and person sensitivity. External or environmental stress can be a tiring and overwhelmed situation in the interaction between people and the environment, and individual sensitivity & differences in perception of stressors are related to heredity and learning experience. However, external pressure does not necessarily cause anxiety in an individual. If a person's vulnerability is high, even a small amount of pressure can cause a great anxiety in the individual.

There is probably no person in the world who does not experience Anxiety Disorder. Anxiety is a normal human emotion, it arises as a reaction to potential danger. Anxiety has always helped us survive. In the course of evolution, as a rule, more anxious individuals survive, because they better analyze the danger, and therefore the chance that they will survive increases. In subsequent generations, genes associated with anxiety are passed on. There is a theory that widespread anxiety disorders are the result of such selection.

Many phobias and anxiety disorders are based on the instinct of self-preservation. For example, a social phobia or a fear of public speaking: try to come into a strange tribe and start telling them something - there is a high chance that they will eat you. From here comes inborn anxiety when dealing with strangers. The fear of heights is also rational, because you can fall and break. Now we are surprised by the fear of spiders or dogs, but spiders can bite mortally, and dogs in the past were less friendly and could even eat. Phobias that prevent a person from living in the modern world are evolutionarily embedded wisdom.

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According to the Russian systematics, anxiety disorders belong to the group of neurotic disorders (neurosis), i.e. to psychogenic caused disease states characterized by partiality and egodistonism of various clinical manifestations, awareness of the disease, and the absence of changes in personality self-awareness.

According to ICD-10, anxiety disorders are divided into anxiety-phobic disorders, the so-called other anxiety disorders, including panic disorder, generalized anxiety disorder, as well as mixed anxiety depressive disorder, obsessive-compulsive disorders, and reactions to severe stress and adaptation disorders, which include post-traumatic stress disorder. Most of them are considered in the relevant sections (see the rubrics Fears, Post-Traumatic Stress Disorder, Panic Disorder, Obsessive-Compulsive Disorder), so this article will focus on only two disorders - generalized anxiety and mixed anxiety depressive disorder. Anxiety Disorder Symptoms and Treatment.

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The main feature of generalized anxiety disorder is anxiety, which is generalized and persistent, is not limited to any specific environmental circumstances and does not even occur with obvious preference in these circumstances (i.e., it is “unfixed "). For diagnosis, the primary symptoms of anxiety must be present in the patient for at least several weeks. Most often in this capacity are:

1. Fears (anxiety about future failures, a feeling of excitement, difficulty in concentrating, etc.).

2. Motor tension (fussiness, tension headaches, trembling, inability to relax).

 

3. Vegetative hyperactivity (sweating, tachycardia or tachypnea, epigastric discomfort, dizziness, dry mouth, etc.).

Mixed anxiety and depressive disorder is used in cases where the patient has symptoms of anxiety and depression, but neither of them individually are clearly dominant or pronounced enough to determine the diagnosis.

As it is easy to notice, the diagnostic criteria for these conditions are less clear than, for example, panic disorder and are rather constructed on the basis of exclusion. Symptoms of generalized anxiety disorder bear the features of diffuse, generalized and diffuse anxiety of medium or low intensity, which is characterized by vague anxiety, constant over time. This is its main difference from panic disorder, in which paroxysms of anxious affect of excessive intensity arise.

This variant of the anxiety state is called “floating alarm”; vague anxiety in this case is expressed in a state of internal tension, premonitions of misfortune and threat, which are often provoked by real minor conflicts and frustrating situations. However, in the patient’s personal coordinate system, such situations grow to enormous problems and seem unsolvable. Often, anxiety is accompanied by increased aggressiveness. Constant internal stress leads to disruptions in the activity of the autonomic-endocrine system, which is in constant excitement and ready to fight and flight, which, in turn (according to the vicious circle principle), increases the state of internal stress. The same applies to the musculoskeletal system - muscle tension gradually increases and tendon reflexes increase, which underlies the feeling of fatigue and myalgia.

According to most researchers, generalized anxiety disorder does not represent a single diagnostic category, but rather reflects a particular anxiety phenomenon that occurs with different diagnoses. So, in some of its phenomenological manifestations, it is close to the anxiety of expectation characteristic of panic disorder. At the same time, unlike the latter, generalized anxiety reactions are characterized by a lesser participation of vegetative manifestations, an earlier and more gradual onset of the disease, and a more favorable prognosis. At the same time, the alarming symptoms are tonic, and not clonic, as in a panic, in nature. It should also be borne in mind that some patients with panic disorder may develop further generalized anxiety disorder and vice versa. Anxiety Disorder Symptoms and Treatment.

In general, the comorbidity of generalized anxiety with other anxiety disorders is high: with panic attacks (56%), obsessive-compulsive disorder (35%) and social phobia (32-42%). Comorbidity with depression, according to various authors, reaches 23-87%.
From the point of view of domestic psychiatry, the diagnosis of generalized anxiety disorder does not make sense at all, since such states, due to the nonspecific nature of the manifestations, can occur within the framework of neurosis, psychogenic reactions, decompensation of character accentuations and anxiety-suspicious psychopathies, etc.

Awareness of Anxiety Disorders. 

Anxiety disorder is a disease with excessive anxiety, worry, fear, and avoidance as the main symptoms, causing great pain and impairing social and occupational functions. It can be mainly divided into the following diseases:

Panic Disorder: A unique and unpredictable reaction of extreme anxiety, with a fear of near-death.

Obsessive-compulsive disorder: Repeating unwanted thoughts or behaviors.

Generalized Anxiety Disorder: Excessive generalized anxiety or worry.

Dementia: Persistent worry that you may get a physical illness.

Symptoms of Anxiety Disorder. 

Physiological reactions: body heat, palpitations, chest tightness, hyperventilation, gastrointestinal discomfort, dizziness, dry mouth, muscle tension, pain, tiredness, inability to concentrate, confusion, etc.

Cognitive Responses: I can't do it, I feel stupid, people pay attention to me, I might faint, I have a heart attack, I can't breathe, I don't want to go out, I'm going crazy, etc.

Emotional reactions: fear, excitement, panic, excessive worry, restlessness, feeling the world is ruined, sadness, loss of control, guilt, anger, depression, etc.

The impact of illness on school, family and work. Anxiety Disorder Symptoms and Treatment.

Academics are stressful for individuals and cause anxiety, which in turn can have a negative impact on academics. Individuals with anxiety neurosis will not be able to concentrate, stay still and concentrate on reading, and their memory will also be affected. Many patients will suffer from insomnia, resulting in very tiredness and dizziness during the day. Of course, the effect of reading will be reduced. Not a lot.

For some patients with anxiety neurosis, some family problems (such as economic problems, children's education problems) are likely to bring them great psychological pressure, emotional unrest, tension, excessive anxiety, and various various physical symptoms. In the early stage of the patient's illness, most of the family members will be very concerned and patiently accompany the patient to seek medical treatment. Once the patient cannot find the pathogenic factor for a long time, it may lead to impatient family members, and the family members may start to alienate and ignore them. At this time, the family atmosphere will fall into a low ebb, the family relationship will be out of balance, and new pressure will be generated in the family. 

Work itself is a kind of pressure. The boss's requirements, performance needs, and self-expectations are all stressors at work, and they are all enough to cause anxiety. Anxiety neurosis patients often feel that organs in various parts of the body are not right or painful at work, ranging from headaches, dizziness, to general weakness, numbness in the limbs, etc. In severe cases, they cannot concentrate on work at all, but in real life, often They are not allowed to leave work, and as a result not only work stress exacerbates symptoms of anxiety, but the disease itself in turn creates a new stress.

Anxiety Treatment. Anxiety Disorder Symptoms and Treatment.

The principle of treatment is to make trade-offs according to the main problem of the patient. Under the detailed diagnosis of the doctor, it is decided to solve the troubles caused by the anxiety disorder with the treatment method suitable for the patient. The main treatment modalities are:

Medical reatement:

The two main types are anxiolytics and antidepressants. The medicine must be taken according to the doctor's instructions, and do not adjust the dose or stop the medicine by yourself. With the development of medical technology, the side effects of a new generation of drugs have been gradually reduced, but there are still some side effects after taking the drug. Stop or reduce the medication by yourself due to the discomfort caused, because this may not achieve the effect of the treatment. If the side effects make you very sad, you can discuss with your doctor and make appropriate adjustments.

For the treatment of generalized anxiety disorder (GAD), both tranquilizers (mainly the benzodiazepine series) and antidepressants can be used. Of particular importance in the treatment of GAD belongs to alprozolam (xanax, cassadan), which combines the properties of a tranquilizer and antidepressant. The effective dose of the drug is 1.5-2 mg / day. A good result is given by sedative antidepressants in small or medium doses - doxepin, amitriptyline, as well as mianserin and trazodone. Serotonergic antidepressants (except fluoxetine) are also used successfully; unlike benzodiazepine tranquilizers, they can be used for long-term maintenance therapy.

Strategies for psychotherapy are almost no different from those used to treat other anxiety disorders. The most commonly used behavioral therapy, consisting in the patient's consistent contact with the stimuli avoided by him and consciously slowing down the pathological reaction that arises in this case, is rational, based on the patient’s logical conviction. 

Psychotherapy:

Slow down the confusion of thinking and behavior caused by anxiety, and express the fear of being afraid of certain things.

Group therapy:

Get support and advice to improve psychological distress and restore motivation.

Behavioral Therapy:

Treat anxiety disorders with simple, actionable techniques.

Muscle relaxation training:

Improve anxiety and symptoms of hyperventilation.

Conclusion (Help yourself)

• Receive appropriate diagnosis and treatment, and discuss plans for anxiety disorders with medical staff.
• Maintain a positive attitude to absorb the experiences of others.
• Participate in activities that make you feel comfortable, relax your pace of life, talk to relatives and friends, and adjust your emotions.
• Get help by participating in relevant support groups.
• Learn about treatment and other recovery options for anxiety disorders.
• Maintain a regular daily routine and cultivate leisure activities.

What is Anxiety Disorder