Moderate anxiety is familiar to everyone. What could be more natural than excitement before an important life event, worrying about loved ones, worrying about your health and well-being? However, there are situations when a feeling of inexplicable anxiety completely takes over a person, begins to control his thoughts and actions, turning life into a constant expectation of danger.

How can you tell healthy anxiety from serious conditions like personality disorder, anxiety depression, panic attack, or social anxiety disorder? What problems can be solved independently, and when professional treatment is required?

Where is the line between normal anxiety and painful anxiety?

Before you panic and worry about your mental health, you should understand how serious your anxious feelings are. Healthy anxiety can protect a person from potentially dangerous situations or, conversely, motivate him to perform actions leading to a favorable outcome of the event. Anxiety is always forward-looking and consists of several emotions: guilt, sadness, and fear. Poor preparation for an exam or careless completion of a thesis give natural reasons to worry before passing. If you have been bitten by a dog in the past, it is normal to be afraid of a repeat of the situation. How does pathological anxiety manifest itself? A person experiences constant tension that interferes with normal work and family life, while he does not realize the reasons for such excitement, and he cannot independently resist these feelings. A person is afraid that something negative will happen, and he expects catastrophic consequences and dangers from everywhere. This is how anxiety-depressive syndrome usually manifests itself. If a person tries to avoid ordinary everyday situations and things that make him nervous, this may be an anxiety disorder. Panic attacks are associated with recurring attacks of sudden rapid heart rate against the background of acute anxiety, which can roll over a person for no particular reason.

Why do anxiety disorders occur?

Prerequisites for the development of increased anxiety may be the biological characteristics of the body, in particular, increased production of certain neurotransmitters or a genetic predisposition. Many researchers are inclined to the psychogenic nature of the occurrence of anxiety disorders: initially, a feeling of anxiety arises as a conditioned reflex to a frightening stimulus, after which increased anxiety may appear on its own. Social anxiety disorder is often the result of traumatic experiences. If a sensitive teenager has been rejected by peers, experienced humiliation from their side, or received other psychological trauma, he may develop social phobia in the future. People with a melancholic temperament due to heredity, as well as those who in childhood were criticized and rejected by their parents, are more likely than others to develop an anxiety disorder. Agitated depression is usually diagnosed in older people. Severe somatic illnesses and disorders in the endocrine system can also provoke an anxiety-depressive disorder in a person. The occurrence of mental illness with increased anxiety is often influenced by a combination of genetic, social and psychological causes.

Typical signs of pathological anxiety

According to ICD-10, diseases with increased anxiety belong to the class of neurotic, stress-related and somatic disorders. The key symptom is the presence of a high level of anxiety and unreasonable fear in the absence of an adequate reason for this condition. It is often combined with such symptoms of the emotional sphere as a feeling of emptiness, a pessimistic attitude, increased nervous tension and irritability, difficulty concentrating, and expectation of danger. Each patient also has characteristic somatic symptoms of an anxiety disorder:

• sleep disturbance, lethargy, high fatigue;
• squeezing headaches, muscle tension, dizziness;
• trembling in the arms and legs, agitated depression is also accompanied by motor and speech anxiety;
• feeling of difficulty breathing, shortness of breath, profuse sweating;
• stomach pain, diarrhea, increased urination;
• rapid pulse, palpitations, pressure in the chest.

The nature of the course of different forms of anxiety disorders

Depending on the severity of anxiety in relation to other symptoms, the presence of other concomitant mental illnesses and characteristic symptoms, different types of anxiety disorders can be distinguished:

• The generalized form of the disorder is characterized by the presence of persistent anxiety without reference to specific situations or objects. It proceeds in waves with periodic exacerbation of key symptoms: autonomic hyperactivity, motor tension, fear. Often associated with chronic stressful environmental influences.
• The disorder with panic attacks proceeds paroxysmal, accompanied by outbreaks of unmotivated fear and excruciating anxiety with characteristic somatic symptoms.
• Avoidant personality disorder is characterized by a person's desire to withdraw from social contacts and his increased sensitivity to criticism from others.
• In phobic anxiety disorder, irrational fear is the predominant or only symptom. If a person is dominated by a fear of social actions and attention from other people, then they are diagnosed with social anxiety disorder.
• Anxiety and depression often co-occur, in which case the diagnosis depends on which disorder's symptoms are predominant.

Increased anxiety in depression

Often there are situations when anxiety is a symptom of a depressive disorder. Anxiety depression is more common in the female half of the population. The risk group also includes people living in unfavorable socio-economic conditions and pensioners. Older people are prone to strong feelings because of their social uselessness, a sharp decline in the quality of life, and a lack of communication. As a result, they often develop involutionary agitated depression, which is manifested by excessive fussiness, impaired speech, stereotyped movements, and hand tremors. A person constantly talks about an impending misfortune, repeats the same phrases without a break, cannot sit still, rushes about. Agitated depression occurs due to the decrease in the ability of the nervous system to cope with negative situations with age. Traumatic brain injuries, as well as inflammation and tumors in the left temporal lobe of the brain, often lead to anxiety depression in the patient. At the same time, a person constantly changes the position of the body, sighs, looks around with fear, sleeps poorly, worries that something bad will happen to him. Treatment of such disorders is carried out by a psychotherapist using antidepressants.

avoidant personality disorder

With this type of disorder, a person tends to isolate himself from others, avoids social contacts, reacts sharply to criticism addressed to him, and often feels inferior. A person who has an anxious personality disorder considers himself unattractive to others in terms of communication, tries to avoid interaction with society, as he is afraid of humiliation, ridicule, and is afraid of causing hostility. Avoidance disorder usually appears in late adolescence. Such people are characterized by excessive shyness, very low self-esteem, awkwardness in social situations. Their main problem is that they need social contacts, but try to avoid them, for fear of being rejected. Such people start relationships with others only if they are completely sure that they will not be rejected, they are too worried about their own shortcomings. Anxious personality disorder often occurs in those who have experienced constant rejection from parents and peers. The accumulated negative experience is so painful that loneliness seems to be the best solution.

Social phobia or fear of social action

If a person experiences an unreasonable fear to the point of trembling in the knees before speaking in public, is afraid of random glances in his direction, is not able to do anything when they are looking at him, most likely, such a person develops social anxiety disorder. People with social phobia make excessive demands on themselves, always trying to make a positive impression on others. They are obsessed with their appearance and behavior in society, and deep down they experience true horror and panic from what assessment they will be awarded by others. Constant scrolling in the head of possible scenarios causes severe anxiety and stress. Such a person rarely looks the interlocutor in the eye. Social anxiety disorder is accompanied by physiological manifestations: arrhythmia, tremor of the limbs, shortness of breath, nausea, tears, profuse sweating. Often occurs simultaneously with depression, panic attacks and other mental disorders.

What to do if you suspect an anxiety disorder?

If you notice signs of an anxiety disorder in yourself or someone close to you, you should definitely consult with a practicing psychologist or psychotherapist. A more serious illness may be hiding behind an increased sense of anxiety, only a doctor can accurately diagnose and prescribe the appropriate treatment. Of course, anxious feelings are not always a sign of pathology, but if the level of daily anxiety negatively affects your work, family relationships and lifestyle in general, then a consultation with a specialist is very important. Treatment of anxiety disorders is usually carried out using psychotherapy methods, only in especially severe cases, medical support is required. It is possible to reduce the level of anxiety in everyday life on your own. Good exercise, walks in the fresh air, regular healthy sleep and a balanced diet help. Do not overload yourself with responsibilities, overwork and work seven days a week. It is better to completely give up alcohol and cigarettes, or at least reduce their consumption. Try to restore emotional balance, avoid stressful situations, find a person in your close circle who you can trust with your experiences.

anxiety disorder- symptoms and treatment

What is an anxiety disorder? We will analyze the causes of occurrence, diagnosis and treatment methods in the article of Dr. Seregin D.A., a psychotherapist with an experience of 11 years.

Definition of illness. Causes of the disease

Anxiety disorders(TR) are a group of mental disorders characterized by extremely strong feelings of anxiety and fear. Anxiety is a worry about future events, and fear is a reaction to what is happening at the present moment in time. These feelings can cause physical symptoms such as palpitations and unsteadiness.

Anxiety disorders include:

Anxiety disorders are caused by a combination of genetic and environmental factors. Risk factors include a history of child abuse, a family history of mental disorders, and poverty. Anxiety disorders often co-occur with other psychiatric disorders, especially major anxiety disorders, personality disorders, and substance use disorders.

Without treatment, anxiety disorders in most cases persist. Disease management may include lifestyle changes, counseling (cognitive behavioral therapy), and medications. In particular, medications such as antidepressants, benzodiazepines, and beta-blockers can improve a patient's condition.

About 12% of people suffer from an anxiety disorder, and 5-30% of people have anxiety disorders only at some point in their lives. The condition is twice as common in women as in men and usually begins before age 25. The most common are phobic disorders and social anxiety disorder. They mostly affect people between the ages of 15 and 35 and become less common after age 55.

Causes of the disease

Abuse of narcotic drugs and psychoactive substances (Substances)

Anxiety and depression can be caused by alcohol abuse. Even moderate, sustained drinking can increase anxiety levels in some people. Dependence on caffeine, alcohol, and benzodiazepines may worsen or cause anxiety and panic attacks. Anxiety usually occurs during the acute alcohol withdrawal phase (complete withdrawal or reduction of the dose of alcohol after prolonged use) and can persist for up to two years as part of the post-acute withdrawal syndrome in about a quarter of people recovering from alcoholism.

There is evidence that chronic exposure to organic solvents in the work environment may be associated with anxiety disorders. During painting, varnishing and other work during which a person is significantly exposed to organic solvents, the development of an anxiety disorder may occur.

Caffeine intake can cause or exacerbate TR, including panic disorder. In some foreign classifications, an anxiety disorder caused by caffeine is considered a disorder caused by a substance / drug. However, this subtype should not be classified as an addictive substance disorder.

Cannabis (cannabis) use is associated with anxiety disorders, but this relationship still needs a strong evidence base.

Endocrine diseases

Sometimes an anxiety disorder can occur as a side effect of an underlying endocrine disorder that causes an overactive nervous system. These diseases include pheochromocytoma (hormonally active tumor of the medulla) and hyperthyroidism (hyperthyroidism).

Stress

Anxiety disorders can occur in response to life stresses such as a financial crisis or chronic physical illness. Anxiety among adolescents and young adults is a common disorder due to the stresses of social interaction and lifestyle. Anxiety is also common among elderly sufferers. On the other hand, anxiety disorder is sometimes misdiagnosed among older people: doctors misinterpret physical symptoms (such as palpitations due to cardiac arrhythmia) as signs of anxiety.

chronic anxiety

Low anxiety levels are good. In fact, the hormonal response to anxiety is beneficial as it helps people respond to dangers. Evolutionary medicine believes that such an adaptation allows a person to become aware of the presence of a potential threat and act accordingly to provide the greatest opportunity for protection. Studies have shown that people with low levels of anxiety have a higher risk of death than people with moderate levels of anxiety. This is because the lack of fear can lead to injury or death. In addition, patients with anxiety and depression were found to have a lower proportion of morbidity than those with depression.

The functional significance of symptoms associated with anxiety includes greater vigilance, faster preparation for action, and a reduction in the likelihood of the absence of threats. In the wild, for example, vulnerable people (pregnant or sick) have a lower threshold for an alarm response, which makes them more alert. This indicates a long evolutionary history of the anxiety response.

evolutionary mismatch

It has been suggested in the scientific community that high levels of anxiety are a reaction to how the social environment has changed since the Paleolithic era. For example, in the Stone Age there was more skin-to-skin contact and more communication with children by their mothers, behaviors that reduced anxiety. In addition, nowadays one has to often contact with strangers, compared to interaction exclusively between close-knit tribes. The researchers argue that a lack of ongoing social interaction, especially during formative years, is a driving cause of high rates of anxiety.

Many of the responses likely emerged as a result of evolutionary mismatch - the emergence of traits necessary to adapt to a changing environment. And although the feeling of anxiety is there to help in life-threatening situations, sometimes just hearing bad news can cause a strong reaction in highly sensitive people, in particular in Western cultures.

If you experience similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of an Anxiety Disorder

All anxiety disorders share some common symptoms:

• panic, fear and anxiety;
• sleep disturbance;
• inability to remain calm and still;
• chills, sweating, tingling of the hands or feet;
• dyspnea;
• cardiopalmus;
• dry mouth;
• nausea;
• tense muscles;
• dizziness.

The pathogenesis of anxiety disorder

Biological

Low levels of gamma-aminobutyric acid (GABA), as well as neurotransmitters that reduce activity in the central nervous system, contribute to anxiety. Therefore, some types of tranquilizers based on the property of GABA have a positive effect on people suffering from anxiety disorders.

Amygdala

tonsil ( amygdala) is central to the processing of fear and anxiety, and its function may be impaired in anxiety disorders.

Sensory information enters the amygdala through the nuclei of the basolateral complex, which consists of the lateral, basal, and accessory basal nuclei. The basolateral complex processes sensory-related fear memories and communicates the importance of their threat to memory and sensory processing in other parts of the brain, such as the medial prefrontal cortex and the sensory cortex.

Another important area is the nearby amygdala central nucleus, which controls species-specific fear responses through connections to regions of the brainstem, hypothalamus, and cerebellum. In people with generalized anxiety disorder, these connections appear functionally less distinct, with a large amount of gray matter present in the central nucleus. The amygdala reduces connectivity to the cingulate and insular regions of the brain, which are responsible for stimulus perception and are associated with the parietal and prefrontal cortices that underlie executive functions.

Clinical studies have shown a correlation between anxiety disorders and difficulty maintaining balance. A possible mechanism is a disturbance in the parabrachial region of the brain structure that, among other functions, coordinates signals from the amygdala with information regarding balance.

Classification and stages of development of an anxiety disorder

Generalized TR is a common disorder characterized by long-term anxiety that is not focused on any one object or situation. People suffering from generalized TR experience non-specific persistent fear and are overly concerned about daily activities.

Generalized TR "is characterized by chronic excessive anxiety accompanied by the following symptoms (for such a diagnosis, at least three of the following must be present): restlessness, fatigue, problems with concentration, irritability, muscle tension, and sleep disturbance."

Generalized TR is the most common anxiety disorder among the elderly. Anxiety may be a symptom of another medical condition or may occur in connection with substance abuse problems, which should be taken into account by the physician in the diagnosis. The person may have trouble making daily decisions and remembering commitments due to lack of concentration/preoccupation. Outwardly, the patient looks tense, sweating of the hands, feet and armpits is increased. The person may be tearful, indicating depression. Before making a diagnosis of an anxiety disorder, a doctor must rule out drug anxiety and other medical causes.

In children, this type of anxiety disorder can be associated with headaches, anxiety, abdominal pain, and palpitations. It usually begins at the age of 8-9 years.

• Phobic disorders

The single largest category of anxiety disorders are phobias, which include all instances where fear and anxiety are triggered by a specific stimulus or situation. Between 5% and 12% of the population worldwide suffer from phobic disorders. Patients tend to foresee the horrifying consequences of encountering the object of their fear, which can be anything from an animal to a public place. Common phobias: air travel, blood, water, driving, tunnels. When people are exposed to a phobia, they may experience shaking, shortness of breath, or a rapid heartbeat. People understand that their fear is out of proportion to the actual danger, but still they cannot overcome it.

• panic disorder

In panic disorder, a person experiences brief episodes of intense fear and anxiety, often marked by trembling, confusion, dizziness, nausea, and/or difficulty breathing. These panic attacks, defined as fear or discomfort that come on suddenly and peak in less than ten minutes, can last for hours. Attacks can be triggered by stress, irrational thoughts, general fear, or fear of the unknown. However, sometimes the trigger is unclear and therefore attacks can occur without warning. To prevent an attack, the trigger must be avoided. However, not all attacks can be prevented.

In addition to recurring unexpected panic attacks, a diagnosis of panic disorder requires that these attacks have chronic consequences: either worry about the potential consequences of the attacks, a persistent fear of future attacks, or significant changes in behavior associated with the attacks. Often, the normal changes in heartbeat noticed by patients make them think that something is wrong with their heart, and they may have another recurring panic attack.

Agoraphobia is the fear of crowded places and open spaces. It is closely related to panic disorder and is often caused by fear of a panic attack. Manifested by the need to find a door or other escape route in a constant field of view. In addition to the fears themselves, the term agoraphobia is often used to refer to avoidance behaviors that often develop in patients with panic disorder. For example, after a panic attack while driving, a person suffering from agoraphobia may develop anxiety about driving and therefore avoid driving. This avoidance behavior can often have serious consequences and increase fear.

Social SR (also known as social phobia) describes intense fear and avoidance of negative social controls, feelings of embarrassment, humiliation, or social interaction. This fear may occur in specific social situations (such as during public speaking) or generally in most (or all) social interactions. Social anxiety often presents with specific physical symptoms, including blushing, sweating, and difficulty speaking. As with all phobic disorders, those people who suffer from social anxiety will often try to avoid the source of the anxiety. In the case of social anxiety, this is especially problematic, and in severe cases, it can lead to complete social isolation.

• Post Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) was previously classified as an anxiety disorder (now, according to the foreign classification of mental disorders, PTSD has moved to traumatic and stressor-related disorders). It is the result of a traumatic experience. PTSD can be the result of an extreme situation such as a struggle, a natural disaster, rape, hostage situations, child abuse, bullying, or even a major car accident. Anxiety disorder can also result from long-term (chronic) exposure to severe stress (eg, soldiers who endure individual battles but cannot cope with continuous combat). People may experience sleep disturbances. There are a number of treatments that form the basis of an anxiety care plan for those suffering from PTSD. Such treatments include cognitive behavioral therapy, psychotherapy, and support from family and friends.

The study of PTSD began with Vietnam veterans as well as victims of natural disasters. These studies have shown that the degree of exposure to a natural disaster is the best predictor of PTSD.

• Emotional disorders with onset specific to childhood

This type of TR involves feeling an excessive and inappropriate level of anxiety about being separated from another person or place. Anxiety disorder affects approximately 4% of children and 7% of adults, but, as a rule, they experienced difficult psychological situations in childhood. In some cases, even a brief separation can cause panic. Treating a child in the early stages of the disorder can prevent further problems. Therapy includes teaching parents and families how to deal with this type of AD. Often parents increase anxiety because they don't know how to properly work with a child. In addition to parental preparation and family therapy, medications such as SSRIs can be used to treat anxiety.

• situational anxiety

Situational anxiety arises in connection with new situations or changing events. It can also be caused by various events that cause a person some discomfort. This type of TR is quite common. Most often in specific situations, a person will experience panic attacks or high anxiety. A situation that makes one person anxious may not affect another person at all. For example, some people become restless in crowds or tight spaces, so being in a crowded vehicle or store can cause them extreme anxiety and possibly a panic attack. Others may experience anxiety when major life changes occur, etc.

• obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD), like post-traumatic stress disorder, was previously classified as an anxiety disorder according to the Foreign Classification of Mental Disorders. OCD is a condition in which a person has obsessions (anxious, persistent, and intrusive thoughts or images) and/or compulsions (compulsions to perform certain actions or rituals repeatedly) that are not caused by drugs or physical influences. This condition arouses anxiety or social dysfunction. Compulsive rituals are personal, individual rules that should be followed in order to alleviate anxiety. OCD affects approximately 1-2% of adults (more women than men) and less than 3% of children and adolescents.

The person with OCD knows that the symptoms are unreasonable and therefore struggles with both thoughts and behaviors. Symptoms may be related to external events that cause fear (imagining a house on fire at the thought that the person forgot to turn off the iron) or anxiety about misbehavior.

Behavioral, cognitive, genetic and neurobiological factors may be involved in the onset of OCD. Risk factors include family history, loneliness (although this may result from a disorder), higher socioeconomic class, or lack of paid employment. About 20% of people with OCD will overcome the disorder, and its symptoms will at least improve over time in most people (another 50%).

Selective mutism is a disorder in which a person who is able to talk does not speak in certain situations or in contact with specific people. Selective mutism usually coexists with shyness and social anxiety. People with selective mutism remain silent even when the consequences of their silence include shame, social ostracism (exile), or even punishment. Selective mutism affects about 0.8% of people at some point in their lives.

Complications of an anxiety disorder

Socio-psychological complications

Without proper treatment, anxiety disorders can lead to low self-esteem, isolation, insomnia, cognitive decline, and a general feeling of exhaustion and hopelessness. Due to lack of energy and overwhelming emotional issues, people with chronic anxiety are often unable to keep up with the demands of their daily lives. Job loss, financial problems, and the end of relationships are possible consequences that can exacerbate the general sense of hopelessness and provocation. Unsurprisingly, anxiety is a major risk factor for development. Further research has shown that anxiety combined with depression increases the risk of suicidal thoughts and attempts.

Addiction to drugs, alcohol, or nicotine is quite common among people who struggle with anxiety for a long period of time. Like depression, addictive behaviors (the desire to escape from the real world) can be a risk factor and complication of anxiety disorders.

Physical Complications

Anxiety often causes organ complications such as irritable bowel syndrome, heartburn, diarrhea or constipation. Weight fluctuations, loss of interest in sex life, sleep problems, headaches, muscle tension and chronic pain are other common physical problems associated with anxiety.

Stress and anxiety also reduce the activity of the immune system and the number of white blood cells. In addition, researchers have found that stress plays a major role in the development of allergies and autoimmune diseases. Because these illnesses themselves can cause significant stress and anxiety, both mental and physical conditions can reinforce each other in a viscous cycle.

At the cellular level, stress hormones increase oxidative stress in cells and lead to the accumulation of free radicals that cause cell damage. Free radicals can damage all components of a cell, including telomeres, which are specific DNA sequences at the end of chromosomes. Telomeres are designed to protect chromosomes from degradation and prevent them from fusing with each other. Scientists have found that the cells of people suffering from chronic stress have significantly shortened telomeres, which means that these people are at increased risk of accelerated aging, cancer, autoimmune and heart disease.

Anxiety can have serious and long-term consequences for a person's mental and physical health. If a person experiences chronic feelings of anxiety, restlessness, or insecurity, then they need to take these symptoms seriously and see a doctor. Anxiety is one of the most common health problems. However, there are many effective treatment options that can help overcome this emotional challenge and restore strength.

Diagnosing an Anxiety Disorder

Anxiety disorders are often severe chronic conditions that can occur at an early age or start suddenly after a trigger event. They are capable of flaring up during times of high levels of stress and are often accompanied by physiological symptoms such as headache, sweating, muscle spasms, tachycardia, palpitations and hypertension, which in some cases lead to fatigue.

In everyday discourse, the words "anxiety" and "fear" are often used interchangeably. In clinical usage, they have different meanings: "anxiety" is defined as an unpleasant emotional state, the cause of which is either not easily identified, or is perceived as uncontrollable or inevitable; "fear", in turn, is an emotional and physiological response to a recognized external threat. The term "anxiety disorder" includes fears (phobias) as well as anxieties.

Diagnosis of anxiety disorders is difficult because objective biomarkers do not exist, and is based on symptoms that should typically be present for at least six months or longer than would be expected in a particular situation and reduce social functioning. To detect anxiety symptoms, questionnaires such as the Beck Anxiety Scale, the Tsung Self-Assessed Anxiety Scale, and the Taylor Anxiety Scale are used. Other questionnaires combine the measurement of anxiety and depression - the Hamilton Anxiety Rating Scale, the Hospital Anxiety and Depression Scale (HADS), and the Patient Health Assessment (PHQ).

Anxiety disorders often occur alongside other psychiatric disorders, in particular depression, which can affect as many as 60% of people with anxiety disorders. The fact that there is significant overlap between symptoms of anxiety and depression, and that the same triggers can trigger symptoms in either condition, may help explain this high rate of comorbidity.

Research has also shown that anxiety disorders are more likely among those with a family history of anxiety disorders, especially certain specific types.

Sexual dysfunction often accompanies anxiety disorders, although it is difficult to determine whether the anxiety is due to sexual dysfunction, or whether they arise from a common cause. Mostly in people prone to anxiety disorders, or occurs. Sexual dysfunction is especially common among people with panic disorder (people who may fear that a panic attack will occur during sexual arousal).

Differential Diagnosis

The diagnosis of an anxiety disorder requires that an underlying medical cause be ruled out first. Conditions that may look like an anxiety disorder include:

It is also important to remember that some medications and substances can lead to anxiety or make it worse. These include alcohol, tobacco, cannabis, sedatives (including prescription benzodiazepines), opioids, stimulants (such as caffeine, cocaine, and amphetamines), hallucinogens, and inhalants.

Anxiety disorder treatment

Treatment options include lifestyle changes, therapies, and medications. Currently, there is no evidence of which particular treatment method is most effective. Therefore, the choice of treatment method depends on the patient. In most cases, people with anxiety disorders first resort to therapeutic methods.

Lifestyle changes

Lifestyle changes include exercising, improving sleep, reducing caffeine intake, and stopping smoking. Smoking cessation has a greater benefit in treating anxiety than medication.

Therapeutic methods

Cognitive behavioral therapy is effective for anxiety disorders and is the first line of treatment. It equally has a positive effect both in a direct therapy session with a patient (in person) and in remote therapy (via the Internet).

Family therapy is a form of treatment in which the child meets with a therapist along with primary caregivers and siblings. Each family member can visit the doctor individually, but family therapy is usually a form of group therapy. Art and play therapy is also used. Art therapy is most often used when a child is unwilling or unable to communicate verbally (the latter may be caused by an injury or disability that causes the child to lose the ability to communicate). Participation in artistic activities allows the child to express what he or she would not otherwise be able to convey to others. During play therapy, the child is allowed to play as he pleases, as long as the therapist is watching him. The therapist may from time to time make a question, comment, or suggestion. These methods are effective if the child's family plays a role in his treatment.

The use of drugs

Medical treatment includes the use of SSRIs (with selective serotonin reuptake inhibitors). This method is the first line of choice for treatment of generalized TR. If this type of drug is effective, then a course of treatment lasting about a year is recommended. Self-cessation of medication leads in most cases to the risk of relapse.

Elderly people should use this drug with caution as it is more likely to have side effects due to coexisting chronic conditions.

Forecast. Prevention

Recently, attention to the prevention of anxiety disorders has increased markedly. There is preliminary evidence supporting the effective use of cognitive behavioral therapy and mindfulness therapy.

The prognosis varies depending on the severity of each case and the treatment for each patient individually.

If children with AD go untreated, they face further risks such as poor school performance, avoidance of important social events, and drug abuse. Children with AD may develop other disorders such as depression, eating disorders, and attention deficit disorders.

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anxiety disorder is a neurotic state. It is characterized by constant anxiety of patients about life circumstances, their appearance or relationships with other people.

Due to internal discomfort and unpleasant thoughts, patients often withdraw into themselves, limit their social circle and do not develop their abilities.

The description of this pathological condition has been found in the works of famous psychiatrists since the beginning of the 20th century, scientists have noted that increased anxiety is often combined with other mental disorders and long-term somatic diseases.

Nowadays, empirical and practical knowledge about the disease has been accumulated, methods are known and tested on how to treat the disorder (drug and psychotherapeutic techniques).

The specialists in whose competence is the diagnosis and treatment of neurosis include psychiatrists and medical psychologists.

The line between the norm And pathology Feelings of anxiety are very subtle, since such anxiety is a natural defense mechanism that occurs in response to external circumstances. Therefore, self-discovery in oneself or treatment of the disease is unacceptable, this can lead to aggravation and complication of the neurotic state.

If you suspect an anxiety disorder, it is important to seek professional help from a healthcare provider.

ICD-10 code

In scientific circles, this neurosis has its own definition, classification and medical code. (F41) .

Anxiety personality disorder is included in the category of neurotic disorders, along with fears and phobias, suspiciousness and post-traumatic states.

One of the defining signs of pathological anxiety for scientists is the disproportionality of the defensive reaction to the provoking factor, i.e. even an ordinary event in life can cause a violent negative reaction in sick people, an emotional breakdown and somatic complaints.

Pathology is quite common in the world, according to statistics, its signs are found in one out of four examined people, and according to the World Health Organization, the disease has been detected more than 2% the population of the earth.

Causes

The etiology (origin) of the disease is not fully understood, experts suggest that it is provoked by the following factors:

• chronic heart or hormonal diseases, persistent circulatory disorders;
• taking psychoactive substances or their abrupt withdrawal, chronic alcoholism or drug addiction;
• head injuries and their consequences;
• prolonged stressful situations;
• melancholic temperament or anxious character accentuation;
• mental trauma in early childhood or in adults in extreme situations (war, being on the verge of life and death, leaving loved ones or depriving them of support);
• high susceptibility to dangers, their exaggeration;
• neurotic conditions (neurasthenia, depression, hysteria) or mental illness (schizophrenia, paranoia, mania).

In various psychological schools, the appearance of increased anxiety is considered from the point of view of the main approach to human mental activity:

1. Psychoanalysis . In this theory, the occurrence of an anxiety disorder occurs due to the displacement and distortion of unrealized human needs. Due to social and internal prohibitions, people constantly turn on the mechanism of suppressing their desires, to which the psyche reacts with inadequate neurotic reactions and anxiety disorders.

2. Behaviorism . In this scientific direction, high anxiety is considered as the result of a break in the connection between an external stimulus and the reaction of the psyche to it, i.e. anxiety arises out of nowhere.

3. cognitive concept defines an anxiety disorder as a reaction to mental images distorted in the mind, safe stimuli are transformed by patients into threatening ones.

Diagnostics

To identify the disease are used:

• survey during an individual consultation (collection of information about the emotional reactions of patients, their lifestyle, motivation and interests);
• psychodiagnostic examination, specialized questionnaires are usually used (Spielberg-Khanin Scale, etc.) and a projective test (Market's drawing, Rorschach spots, etc.), revealing signs of increased anxiety and related disorders;
• monitoring the life of patients, their social contacts and relationships with others.

Kinds

1. Anxiety-depressive the disorder is characterized by feelings of constant anxiety without real sources of danger. It is manifested by pathological changes in the personality of patients and their physical health.

2. anxiety-phobic the condition is caused by a constant sense of danger arising from dwelling on past traumatic events in a person's life or fictional fears of the future.

3. Social the disorder is manifested by diligent avoidance of any contact with others, even their simple observation of the actions of patients causes them emotional discomfort, criticism is extremely painful for such patients.

4. Adaptive phobia proceeds with the fear of getting into new conditions of life.

5. organic anxiety is a consequence of a somatic disease, therefore, in addition to anxiety, patients have other signs of damage to the body (persistent headaches with loss of orientation in space, memory loss or severe malfunctions of the heart, pancreas, liver, etc.).

6. mixed the disorder is characterized by signs of anxiety and a lowered background of mood at the same time.

Symptoms

The signs of mental and autonomic disorders common to all forms of anxiety disorder are:

Each type of disease can have its own distinctive features. So generalized anxiety disorder, the symptoms of which are caused by total anxiety in almost any life circumstances, manifests itself in difficulty concentrating on any activity at home or at work, inability to relax and constant motor tension, pain in the stomach and digestive disorders, heart disorders.

BUT anxiety-depressive Panic attack disorder occurs with anxiety attacks on the background of depression and is characterized by:

• lack of interest in life and loved ones;
• lack of positive emotions;
• a sudden feeling of fear;
• vegetative pathology: increased heart rate, a feeling of pressure in the sternum and proximity to fainting, lack of air, excessive sweating.

Treatment

Therapeutic assistance in the treatment of the disease is:

• in the normalization of the regime of work and rest of patients (rational nutrition, prevention of physical and emotional stress, maintaining a healthy lifestyle);
• in taking medications as prescribed by a doctor: tranquilizers and antidepressants (Xanax, Eglonil);
• psychotherapy courses (cognitive, behavioral, rational, psychoanalytic, etc.).

Most often, the treatment of increased anxiety takes place in a complex way, but if the doctor confirms its psychogenic origin, it is recommended to provide assistance in case of illness during individual and group sessions with patients.

Carrying out the treatment without based on psychotherapy sessions, specialists use:

• gradual confrontation of patients with provocative stimuli by the type of addiction to them;
• changing their attitude to frightening factors through logical persuasion;
• detection and awareness of psychotraumatic situations, strengthening thoughts about prescription and the loss of their significance in real life;
• learning relaxation techniques for emotional and muscle relaxation.

A positive result of therapy is a stable change in the behavior of patients, their adequate reactions to stressful events, memories or planning their future.

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Everyone experiences intense anxiety or anxiety from time to time. Such feelings arise due to the influence of negative factors. These include dangerous situations, various problems and life difficulties. But if persistent anxiety is not associated with certain situations or objects, then this may indicate the development of such a psychopathic condition as an anxiety disorder.

This disorder can develop in people of all ages, regardless of their gender, social and marital status. Anxiety is characterized by a set of specific symptoms that greatly complicate a person's life. However, with timely access to specialists, you can completely get rid of an anxiety disorder. In some cases, a simple conversation between the patient and a psychotherapist is sufficient for healing, but sometimes treatment requires more serious measures.

How does anxiety disorder manifest?

The manifestations of this pathology can vary greatly in different patients. The clinical picture depends, first of all, on the characteristics of the personality and character of the person. But the most important symptom that makes it possible to judge the presence of pathological anxiety is the prolonged presence of anxiety and fear in situations that most people do not cause fear.

All the symptoms that occur with anxiety disorder, experts divide into two main categories:

1. Emotional symptoms. In addition to unreasonable and inexplicable anxiety, a sick person experiences difficulty concentrating, increased nervousness and emotional tension, and a feeling of complete emptiness. In this state, the patient cannot sit still, it seems to him that something terrible is about to happen, and he is looking for signs confirming the onset of danger. The thought flow moves at a high speed, and a person is not able to control this process.
2. Physical symptoms include a rapid heartbeat and profuse sweating, dizziness, shortness of breath, and tremors in the limbs. A person constantly has a headache, he cannot sleep normally, feels increased fatigue, muscle tension. There is also a failure of the digestive and excretory systems, diarrhea and frequent urge to urinate.

Since anxiety is the body's response to a certain threat, it can have a wide range of manifestations. In this way, the body demonstrates its readiness to flee or fight.

However, people suffering from an anxiety disorder cannot always adequately assess their condition. The various physical manifestations of this mental pathology are often perceived by patients as symptoms of some disease of the body.

Types of Anxiety Disorders

Experts distinguish several types of anxiety disorders, which differ in their symptoms and course. The treatment for anxiety in each of these cases will be different:

• generalized anxiety disorder. In this state, a person experiences increased anxiety, not due to any situation or object. Symptoms are quite stable, they observe for 6 months or more. In addition to anxiety, a person experiences motor tension, and also becomes hyperactive and prone to tearfulness. A sick person can also be identified by appearance - it is quite specific. The face and posture of the individual are quite tense, the person is very restless, his eyebrows are furrowed, and the trembling in the body is visible from the side, the skin is very pale;
• Panic disorder is characterized by constant panic attacks. They arise unexpectedly, for no apparent reason, and a person is not able to control them. The patient may also experience fear of the panic attack itself. In this case, he will try to avoid situations that can cause a panic attack;
• obsessive-compulsive disorder is associated with the occurrence of intrusive thoughts, bringing anxiety and discomfort. A person can constantly worry that he forgot to do something important, and this can affect his safety. The patient's behavior becomes strange and inadequate. He can spend hours washing his hands or washing clothes to get rid of pathogenic microbes, hide dangerous objects in inaccessible places, etc .;
• A phobia is a persistent and highly exaggerated fear. Objects or situations that are completely safe or that pose a minimal danger can cause such fear. There are a large number of varieties of this disorder, they are distinguished based on the characteristics of the objects of fear. A person suffering from a phobia tries in every possible way to avoid contact with an object that causes horror in him, but this leads to increased anxiety and aggravates the situation;
• social anxiety disorder manifests itself in the fear of being negatively evaluated by other people. People who suffer from social phobia are extremely shy and timid. They are afraid to speak in front of a large number of people, avoid public places or do not go out at all;
• Post-traumatic stress disorder (PTSD) occurs as a result of a trauma or life-threatening situation. In this case, anxiety arises constantly and almost never subsides. The person is haunted by intrusive memories and nightmares of the traumatic event.

An anxiety-depressive disorder related to neuroses can be called a disease of our time. If the patient equally manifests symptoms of anxiety disorder and depression, then we can talk about the development of a mixed form of pathology.

Anxiety disorder is a disease in which a person is aware of their problems. With this pathology, personality transformation does not occur.

Causes

To date, there is no clear understanding of how anxiety disorders arise. This pathology can develop under the influence of various mental and somatic factors.

Anxiety can occur in response to external stimuli, with various somatic diseases, brain injuries and endocrine disorders. Anxiety can be caused by taking certain medications, narcotic and psychotropic drugs.

There are several theories that explain the causes of anxiety pathologies:

1. From the point of view of psychoanalysis, pathological anxiety indicates that a person has a forbidden or unacceptable need. At the subconscious level, there is a prevention of acts that have an aggressive or intimate coloring, which leads to the development of anxiety disorders. Anxiety in this case displaces or restrains this unacceptable need.
2. Behavioral theory describes anxiety as a reflex response to more painful or frightening stimuli. Anxiety may continue to occur in the absence of these factors.
3. Cognitive psychology focuses on the mental images that precede the onset and escalation of anxiety symptoms. As a rule, the thoughts of a sick person are twisted, irrational.
4. Biological theory believes that pathological anxiety is the result of a malfunction of metabolic processes in the brain. It has been noted that a sharp increase in the production of neurotransmitters leads to an increase in the level of anxiety.

In addition, a pattern was found between a person's tendency to develop anxiety pathologies and sensitivity to an increase in the concentration of carbon dioxide in the air. People with anxiety disorders react even to slight fluctuations in this indicator.

The risk of developing pathological anxiety largely depends on the characteristics of the character and temperament of a person.

Treatment

Just as in the correction of other types of psychological disorders, the treatment of anxiety is primarily carried out by psychotherapeutic methods. Medications are used extremely rarely, usually the patient feels a noticeable relief after the first conversation with a psychotherapist. But the use of beta-blockers allows you to remove vegetative symptoms, tranquilizers can eliminate manifestations of anxiety and muscle tension, normalize sleep. If the patient has been diagnosed with a mixed disorder, antidepressants may be taken. Treatment with all these drugs should be under the supervision of a doctor and only on his recommendation.

Among the psychotherapeutic methods, the most successful in the treatment of various anxiety disorders is cognitive behavioral therapy. Its main idea is the doctrine that a person's thoughts influence the psychological state, behavior and physical health. In the course of working with the patient, the psychotherapist identifies irrational thoughts, points to them and corrects the patient's consciousness. The therapy is built in such a way that the person himself comes to the right conclusions under the guidance of a doctor.

After completing a course of psychotherapy, the patient not only copes with his fears, but also learns to confront them in the future. It will take 5 to 20 sessions to achieve sustainable results. In this case, the patient is given homework, during which it is possible to speed up the treatment.

An equally effective method for correcting anxiety disorders is hypnosis and suggestion. It is not uncommon for psychotherapists to combine behavioral and hypnosuggestive therapies. When a patient is in a hypnotic trance, the therapist can reinforce new patterns of thought and behavior. Thus, in the course of treatment, the impact is on an unconscious level.

How to deal with anxiety on your own

While all psychological and mental disorders are best dealt with by qualified doctors, there are methods that can be used at home. If you feel an anxiety attack coming on, try the following:

1. Try to relax and feel your body. List the signs of your anxiety, do not run away from this feeling, but accept it.
2. Do some breathing exercises - they will help you calm down quickly. Take a few deep breaths, the exhalations should be as relaxed as possible. Breathing is better with holding your breath in a row. Several cycles of such exercises normalize the condition.
3. Learn to enter into a resourceful state. By this term, experts mean a sense of one's own strength. You should feel that you have enough internal resources to solve the problems that confront you at the moment. Try to remember the last time you experienced this feeling. Go back to that moment mentally or reproduce the situation in life. Each person has their own source of strength and joy. It can be meetings with loved ones, doing what you love or doing sports, talking with animals, walking in the woods, visiting a bathhouse and much more. Be sure to make time for activities that give you pleasure. This will reduce the feeling of anxiety.
4. Try to visualize your body and identify where the anxiety is. Take a pencil in your hand, and then mentally draw a line from your anxiety to it. Then draw your feeling. No need to control or analyze what is happening, just let the hand move on its own. The drawing must be torn or burned. This exercise allows you to relieve tension at a particular moment.
5. Be sure to review your work schedule. It is necessary to allocate time for proper rest and sleep. Particular attention should be paid to the diet.
6. Try to protect yourself from negative information. Avoid watching TV shows and movies with dark negative overtones.
7. It is necessary to realize and accept the fact that a person cannot fully control everything that happens around. You need to learn to trust the people around you. If anxiety is caused by situations that you cannot influence, then you need to change your attitude towards it.
8. Break the habit of always expecting the worst. As soon as negative thoughts start to appear in your head, you need to tell yourself: “Stop!”. But you do not need to protect yourself from these thoughts, but you need to rethink them. It is necessary to separate reality and frightening fantasies.

Often anxiety has a secondary benefit, but it is not realized by the person. As a rule, similar states occur in people who have not realized themselves in life. It is more convenient for them to be in a state of anxiety. In their opinion, in this way they will be able to prevent negative events. But in reality, they are only protecting themselves from feeling guilty about what might happen. After all, you can always say: “I said that it would be like this and was worried about it, so it’s not my fault in what happened.”

But being in a state of anxiety and taking real steps to prevent a tragic situation are two different things. To identify the secondary benefit of your anxiety, you need to honestly answer yourself that negative things can happen or positive things will not happen if anxiety disappears. After that, you can understand what anxiety gives you, whether it is possible to get rid of something bad or prevent negative events with its help.

By following these tips, you can deal with anxiety on your own. But this requires sufficient willpower and a desire to change your life for the better. Getting rid of serious forms of anxiety disorders without visiting a specialist is quite difficult. Therefore, you should not postpone a visit to a psychotherapist if you notice signs of this or another psychological disorder.