Anxiety disorders are the most common mental disorders, with a lifetime prevalence of 28.8% (Kessler RC, 2005). Which means that almost 1 in 3 people will experience some form of anxiety disorder during their lifetime.
Definition of anxiety?
A series of unpleasant, intense and worrying physical symptoms, accompanied or not by a subjective state of anxiety, worry or panic. Anxious episodes can occur in relation to a specific situation/object or not. They are by definition disproportionately more intense than the situation that triggered them.
Main anxiety disorders
- Panic disorders
They are marked by moments when anxiety reaches very high intensities in very little time (about 15 minutes). These episodes are called panic attacks. Panic disorders are also characterized by an intense and exaggerated fear of the second, following panic attack. Panic disorders also involve avoiding exposure to stimuli that are considered to cause panic attacks and, of course, extreme efforts to avoid its recurrence, even if this seriously affects the sufferer’s quality of life (the person becomes unable to stay alone, does not leave the house – agoraphobia)
- Generalized Anxiety Disorders
Generalized anxiety is defined by excessive, uncontrollable fear and worry, present most of the time for at least 6 months. It is accompanied by restlessness (“like on pins and needles”), fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances.
- Specific phobias
Marked, persistent, and excessive/irrational fears, can even lead to panic attacks. It is triggered by the presence or possibility of exposure to a specific object/situation (airplane, height, animals, injections, etc.). The possibility of exposure to the feared stimulus is avoided even if this avoidance seriously affects the quality of life. For example, they refuse to travel because they have a phobia of flying; they risk their health because they avoid doctors and medical tests, etc.
- Social Phobia/Social Anxiety
Marked, persistent, and excessive/irrational fear, which can even lead to panic attacks. Social anxiety is triggered by the presence or possibility of exposure to a social or performance situation in which evaluation is possible.
For example fear of public speaking, fear of taking oral exams, fear of talking to strangers, etc.
The person avoids all situations and is frightened or blocked by the prospect of any social exposure for fear of negative evaluation. Shyness is another name for social phobia. In severe cases, the person becomes defined by this behavior and becomes an avoidant personality disorder.
This disorder is marked by obsessions and/or compulsions. Obsessions are thoughts, images, and impulses that appear in the mind repeatedly, persistently, without being able to control or suppress them. E.g. the thought of not getting sick, not dying, being cheated on, etc. Compulsions are mental acts like counting, praying, and repeating; or behavioral acts: hand washing; tidying up; checking. They are designed, in an irrational, unjustified, or exaggerated way, to control or suppress obsessions. These obsessions or compulsions cause marked distress. It occupies at least 1 hour every day and affects a person’s normal life.
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The most common symptoms of anxiety are:
- Symptoms suggesting cardiological problems: palpitations, chest pain in the heart area, increased heart rate, chest pain, numbness, tingling in the limbs, intense fear that you may have a heart/heart attack, blood pressure.
- Symptoms suggesting respiratory problems: feeling of a lump in the throat; feeling short of breath or choking; feelings of dizziness; “light-headedness” or fainting; intense fear that you may die (through lack of air, heart attack, etc.).
- Symptoms suggesting digestive problems: pain in the abdomen, diarrhea, constipation, nausea, “knot in the stomach”; shivering, cold or hot sweats, tightness.
- Mental symptoms: derealization or depersonalization (the feeling of looking at yourself from the outside), of detachment from the body, of the outside appearing strange or altered; intense fear that you may lose control, fear of going mad; restlessness, worry, or irritability, always feeling “on pins and needles”, on alert; chronic fatigue, trouble concentrating, feeling “empty-minded” or sleep disturbances.
The great imitator
Anxiety is also referred to as the “Great IMITATOR”. This is because it can mimic other types of health conditions. For those with chronic anxiety, the range of symptoms it can cause is great. It can go from simple to unusual to rare.
Anxiety changes the way we think. Anxiety alters our perception and awareness. You may notice physical sensations that a person without anxiety would never notice.
Anxiety can intensify physical pain. For example, a person who does not have anxiety may have untreatable knee pain. When you suffer from anxiety you will feel knee pain as a strong pain. That’s because the mind has been changed, becoming very sensitive to how the body feels. Anxiety can also create symptoms that don’t exist.
The first signs of anxiety
Very often, if you are an anxious person, you will only notice several physical symptoms. In particular, you will notice the disturbing and painful ones. Sometimes it happens without being aware of the situation that creates the fear. With the appearance of these symptoms, additional suffering occurs.
To avoid these symptoms, many people end up not being able to leave the house unaccompanied, or go to places with many people (agoraphobia); they can no longer stay alone in their homes (monophobia) or they end up avoiding several things, and places in various areas of activity that generate anxiety.
To the surprise of many patients, there are no physical symptoms that cannot occur in the context of anxiety or on a “psychological basis”, from tremors and palpitations to fainting, diarrhea, or paralysis. That is why it is important not to conclude beforehand that certain symptoms are psychologically determined. It is wise to seek medical advice in internal medicine, cardiology, neurology, or other specialties. Waiting too long by looking into a physical illness can delay the diagnosis of an anxiety disorder.
It involves help for the psyche and not for the body.
What is the connection between anxiety and the body?
States of worry trigger the secretion of stress hormones (adrenaline, cortisol), which make the body enter ‘fight or flight mode’. This normal physiological event happens whether the danger is real (a ferocious animal is coming towards you) or unlikely (I’m going to faint in the street and no one will help me). In other words, the secretion of stress hormones occurs when we feel worried or have worried thoughts. Secretion is indifferent to how real the danger is.
Symptoms of anxiety are symptoms of stress, natural reactions produced by hormones in all organisms. They involve increasing the heart rate, tightening the muscles, and pushing blood to the heart and brain, all to prepare the body for the “fight” against the anticipated danger. The body is not sick, but just “bombarded” with repeated doses of adrenaline, which make “getting ready for battle” a permanent and exhausting state.
To the surprise of many patients, there are no physical symptoms that cannot occur in the context of anxiety or on a “psychological background”, from tremors and palpitations to fainting, diarrhea, or paralysis.
What causes anxiety?
Anxiety is not induced or caused by one cause but by several. There are always several different factors involved, in some combination. We can discuss personality factors, difficult life experiences, and physical health. Indeed, one can be dominant, but it is never just one.
Family history of mental illness
Some people who suffer from anxiety may have a genetic predisposition to anxiety. These conditions are usually common within the family. However, having a parent or a close relative who has anxiety does not automatically mean that you will also have this disorder.
Studies show that people with certain personality traits are more likely to become anxious. Children who often begin to have anxiety in childhood, adolescence, or even as an adult are: perfectionists; easily upset; shy; inhibited; lacking self-confidence, or wanting to control everything.
Current stressful events
Anxiety states can occur following one or more stressful life events. Among the most common triggers of anxiety are:
- Stress from work or changing jobs.
- Post-traumatic stress.
- Changes in personal life.
- The appearance of a newborn.
- Family or relationship problems.
- Major emotional shocks following a traumatic event.
- Verbal, sexual, or physical abuse. Including trauma.
Physical health problems
Chronic physical illnesses can contribute to the onset of panic attacks or impact on the treatment of anxiety. The most common chronic diagnoses associated with anxiety are present in the case of Diabetes, Asthma, Hypertension, or heart disease.
Some physical illnesses can mimic anxiety states, such as an overactive thyroid. It may help to see a doctor and check if there is a medical cause for your anxiety.
Other emotional disorders
While some people only have anxiety, others may have more complex problems, where anxiety is accompanied by other emotional problems. Anxiety is in most cases accompanied by depression. It is essential to check exactly what the source of the problems is because for the treatment to be effective, it is necessary to solve them at the same time.
Consumption of substances
Some of those who experience anxiety resort to substance use to cope. In some cases, they end up losing their independence, in addition to anxiety states, which of course do not disappear due to this behavior. Worse still, anxiety can be aggravated by substance use while the effects wear off. So it is important when treating anxiety and you have this problem, to treat it simultaneously.
Anxiety is a signal (unpleasant, sometimes unbearable, but useful) that something in our mental life is not healthy/balanced/adapted.
It is a sign that somewhere there is suffering, mostly old, that has changed:
- the way we think, evaluate, and react to life events
- how we see ourselves
- how we perceive others
- the interpersonal relationships through which we relate to life (responses to existential problems: “Why do we live?”, “What is the purpose of life?”, “What is my purpose in life?”, “What happens after death?”, etc.)
A simple way to understand the internal dynamics of anxiety symptoms is the “Inner Child” theory.
The inner child is a part of our psyche that has stored all our childhood experiences and is a concept that exists in various philosophical trends and most current psychotherapies. If we represent our Inner Child as our emotional brain, as our old, instinctive way of reacting, we can understand anxiety as the “crying” of this old part of us.
We can then have a very good way to know how to react to symptoms of anxiety: just like a crying baby. If we get upset that he’s crying, we may take him to the doctor because he’s “sick”. If we yell at him and criticize him for crying instead of trying to find out why he is crying, he will not stop crying but will cry even louder. Likewise, the symptoms will be exacerbated if we get angry about having anxiety instead of trying to find out what it means.
A simple way to understand the internal dynamics of anxiety symptoms is the “Inner Child” theory.
The inner child is a part of our psyche that has stored all our childhood experiences, and is a concept that exists in various philosophical trends and in most current psychotherapies. If we represent our Inner Child as our emotional brain, as our old, instinctive way of reacting, we can understand anxiety as the “crying” of this old part of us.
We can then have a very good way to know how to react to symptoms of anxiety: just like a crying baby. If we get upset that he’s crying, we may take him to the doctor because he’s “sick”. If we yell at him and criticize him for crying instead of trying to find out why he is crying, he will not stop crying but will cry even louder. Likewise, if we get angry about having anxiety instead of trying to find out what it means, the symptoms will be exacerbated.
How common is anxiety?
Anxiety disorders are the most common mental disorders. Almost 1 in 3 people will experience some form of anxiety disorder in their lifetime.
Mental and neurological diseases are very common in Europe. According to the latest survey, 165 million people, representing almost 38% of the population, suffer from an emotional disorder such as anxiety, depression, insomnia, or dementia.
Only a third of them chose to treat their condition through psychotherapy or medication. Thus letting this cause be a predominant one in society. The economic and social impact is huge, as these people lose their appetite for life. But also the relationships they had and their ability to work.
“Emotional disorders have become the biggest health issue for 21st century Europe” according to Reuters.
At the same time, some of the largest pharmaceutical companies are reducing their investments in this area. This leaves it to politicians, governments, and NGOs to find funding for research in this area.
Impact on the life
Because emotional disorders often begin in youth, they have a negative impact throughout life. Only early specialized treatment will prevent the risk of severe cases from increasing.
So these conditions are very common. Surely many of the people you know face the same problem. Although it negatively affects our lives, not all of us are aware of it, and even fewer of us do anything about it. The phenomenon can only get worse with time and will not go away, as we assume.
If you think you are in a similar situation, where you have enough of what you need, but you are not fully happy, it would be good to do a little test and get rid of these doubts. After all, it will be one less worry.
FIND OUT NOW IF YOU HAVE AN ANXIETY DISORDER BY FILLING THE TEST BELOW.
It only takes 3 minutes and you’ll know clearly what to do!
Treatment of ANXIETY
Fortunately, there are very effective ways to treat anxiety disorders!
In general, they consist of either psychotherapy (individual or group), medication, or both, depending on the case. In specialized clinics, all types of interventions are linked to dedicated programs, as is the case of the “Beyond Fear” program in our clinic.
The treatment of anxiety disorders is generally done on an outpatient basis. In certain serious situations, such as the concurrent occurrence of other symptoms (suicidal ideation, severe depression, substance use, or severe agoraphobia), treatment of anxiety disorders may require hospitalization.
Psychotherapy and medication are equally effective, according to studies over the last 30 years. Therefore, for the treatment to be correct and according to the latest guidelines, both alternatives should be offered as a first recommendation.
Anxiety is treated with antidepressants even if the anxiety is not depression!
Individual or group psychotherapy for anxiety
Psychotherapy is recommended in association with pharmacological treatment, but also for patients who prefer treatment without medication