pathological anxiety. Avoidant personality disorder. Increased anxiety in depression

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. FROM panic attacks associated with recurring attacks of sudden palpitations 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 was rejected by peers, experienced humiliation from their side, or received another psychological trauma, in the future he may develop social phobia. People with a melancholy 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 diseases and disturbances in the work of the endocrine system can also provoke anxiety in a person. depressive disorder. 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. Often associated with these symptoms emotional sphere, as a feeling of emptiness, a pessimistic attitude, increased nervous tension and irritability, difficulty concentrating, expectation of danger. Each patient also has characteristic somatic symptoms. 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, one can distinguish different types course of anxiety disorders:

• 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 key symptoms: vegetative hyperactivity, motor tension, apprehension. 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, the predominant or the only symptom is an irrational fear. 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, stereotypical 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 a decrease in abilities with age nervous system deal with negative situations. 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 pain that being alone seems like 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 consultation with a specialist is very important. Treatment of anxiety disorders is usually carried out using psychotherapy methods, only in special cases. severe cases medical support is required. It is possible to reduce the level of anxiety in everyday life on your own. Good physical exercise, walking on fresh air regular healthy sleep and balanced diet. 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 is a feeling that every person has experienced at least once in their life. If there is some important event in our life, the outcome of which we are not sure, then there is a great opportunity to experience this state.

Anxiety is twice as common in women as in men.

FROM scientific point The term can be deciphered as follows:

Anxiety is a universal human phenomenon that arises in response to an uncertain or threatening situation, a lack of information and manifests itself in the form of experiencing internal anxiety, expectation of a catastrophe, misfortune, impending troubles.

In general, anxiety can arise at any time. It can appear both in normal situations, contribute to the adaptation of a person to new conditions, and act as a pathological symptom.

Normally, anxiety is preventive in nature, because it signals a person about possible danger prompts him to take action. Feeling anxious? Something urgently needs to be done: to defend or run away.

Pathological anxiety is a generalized reaction of the body that occurs with various mental pathologies, which in its duration and intensity does not correlate with real threat.

Help or hinder?

Anxiety cannot be unequivocally attributed to positive or negative emotions. It all depends on whether you can control this factor.

For example, if there is some important event ahead of you, an exam, and the anxiety you feel helps you mobilize your strength, take a more responsible approach to preparing, making a decision, then this emotional component can be assessed as useful.

On the other hand, if you are at odds with your worries, do not know how to control them, direct them in the right direction, then anxiety can take a dominant position in our minds. As a result, there will be no time or energy left to prepare for the decisive event. Yes, and the probability of success will be negligible. If we consider the anxiety state from this angle, then there will definitely be little pleasant in it.

Only those who know how to control the anxiety that arises can become successful.

Manifestations

Recognizing anxiety is not difficult if you know its manifestations.

Allocate vegetative, psychological and behavioral symptoms of anxiety.

The most common vegetative signs alarms:

• cardiopalmus;
• shortness of breath or a feeling of suffocation;
• increased sweating;
• flushes of heat;
• feeling of constriction, tingling, pain in the heart;
• trembling in the body;
• dry mouth;
• frequent urination;
• nausea, frequent stools, abdominal pain;
• difficulty swallowing (like a "lump" in the throat);
• dizziness and others.

Classic psychological manifestations of anxiety:

1. experiencing a sense of danger;
2. feeling of helplessness, combined with self-doubt;
3. deterioration in concentration;
4. guilt complex;
5. irritability;
6. impatience and others.

Behavioral symptoms of anxiety - restlessness, desire to run somewhere, do something incomprehensible, stiffness, unsteadiness, tension, fatigue.

Classification

I have already mentioned that intense anxiety can occur in various situations, both normal and pathological. Based on this, distinguish different types anxiety.

The main types of normal anxiety:

1. Mobilization anxiety is an episodic phenomenon. Her task is to help a person gather strength, prepare for a difficult situation. Most often found in active individuals.
2. Situational anxiety occurs only in stressful situations, and when the effect of stress ends, the anxiety state itself disappears.
3. Social anxiety is observed in situations accompanied by contact with the management, during public speaking when the person is in the public eye. Such people are too dependent on the opinions of others, they are afraid of an unflattering assessment of their actions, statements. Social anxiety is a borderline condition. If its manifestations are excessively expressed, a whole “bouquet” of alarming symptoms will be observed, social phobia may occur.
4. Personal anxiety is also referred to as anxiety. This is a personality trait that equates to a low anxiety threshold. Increased anxiety is characteristic of anancaste, anxious and dependent individuals.

pathological anxiety

Diseases that are most often accompanied by excessive anxiety:

• affective disorders - often depressive symptoms are combined with anxiety, the latter, in turn, aggravates the course of the underlying disease;
• , phobic anxiety disorders (eg, social phobia, agoraphobia), post-traumatic stress disorder (PTSD), etc.;
• schizophrenia spectrum disorders - schizophrenia, schizotypal and;
• somatoform disorders and others.

Pathological anxiety can be neurotic, psychotic, or pharmacogenic.

Pharmacogenic anxiety occurs due to exposure to any medicinal substances or as a result of their cancellation.

Most often occurs when:

• use narcotic substances- hallucinogens, cocaine, caffeine, hemp (cannabis);
  as a consequence of the withdrawal syndrome in persons taking long-term benzodiazepine tranquilizers;
• when using high doses of thyroid drugs;
• with the abrupt cancellation of certain antidepressants - paroxetine, venlafaxine;
• due to withdrawal syndrome on the background of long-term use of alcohol, cocaine, nicotine.

neurotic anxiety

Neurotic anxiety arises in the structure of neurosis, described in more detail here. It is a chronic condition, accompanied not only by severe anxiety, but also by fear, panic attacks. The symptoms present significantly interfere with normal functioning.

A person is aware of his condition, but he cannot resist the disorder on his own, he needs treatment. Most often, neurotic anxiety occurs within the framework of panic or obsessive-compulsive disorders,.

Separately, within the framework of neurotic anxiety, the following conditions are distinguished:

1. Physiological anxiety sometimes occurs as a result of childbirth, surgery, severe somatic pathology. This condition is characterized by both anxiety and asthenic manifestations.
2. Somatic anxiety is a secondary condition, accompanied by a fear of becoming seriously ill, incurable disease accompanied by various symptoms. However, numerous studies failed to detect any serious pathology. As a result, a hypochondriacal or somatoform disorder, cardioneurosis, and chronic pain conditions may develop.
3. Vital anxiety arises when it is impossible to realize vital necessary functions, they are also called vital - thirst, hunger.

Due to the impact of a strong, life-threatening stress factor, an anxiety state can be transformed into.

psychotic anxiety

With psychotic anxiety, in addition to the disturbing component, there is actually psychotic symptoms - hallucinations, delusions, psychomotor agitation.

Anxiety is a common component of psychotic states. Unreasonable anxiety may precede the onset of schizophrenia, be combined with paranoid or hallucinatory symptoms.

The presence of anxiety can further exacerbate the psychotic state of the patient, increases the risk of committing suicide.

Diagnostics

Diagnosis of anxiety is carried out by questioning the patient, clarifying complaints, assessing his mental status, monitoring the mental and somatic state of the patient.

It is necessary to deal with the situation that provoked the appearance of anxiety in order to assess how it corresponds to the existing symptoms.

To diagnose anxiety, special questionnaires have been developed, the most famous of which are:

Treatment

Treatment of anxiety should be carried out in two directions - medication and psychotherapy.

Considering how long-term anxiety is dangerous for mental state man, even a special group of anti-anxiety drugs has been developed - anxiolytics (tranquilizers) - gidazepam, phenazepam, diazepam, mexidol.

In addition to tranquilizers, some antidepressants (for example, paroxetine), nootropics (bifren), antipsychotics (sonapax, quetiapine, risperidone) have a moderate anti-anxiety effect.

In order to stop anxiety, you need A complex approach to a mental state, appointment drug therapy corresponding to the underlying pathology of the patient. So, with schizophrenia and similar diseases, the use of neuroleptics is necessary, with most anxiety and depressive states treatment with antidepressants with anti-anxiety effects is indicated.

Features of therapy

Which drug is right for you - only a psychiatrist can determine this, taking into account the symptoms you have, the severity of your mental and somatic condition, and many other factors. Both anti-anxiety drugs and antidepressants are the most dangerous of drugs in inexperienced hands. I am not writing this to discourage you from taking medication. No and no again. And just for that so that you remember that only a doctor should prescribe them, select a treatment regimen.

Another point I want to dwell on is the duration of treatment. Be sure to discuss this issue with your psychiatrist. The fact is that some anti-anxiety drugs from the benzodiazepine group can only be taken in short courses. Otherwise, there is a significant risk of developing addiction, dependence.

Antidepressants have another feature - the effect of these drugs, unlike benzodiazepines, can be felt not immediately, but only after a few weeks. But you can take them for a long time, without fear of the development of pathological addiction.

If in the background drug treatment you got some adverse reactions, do not rush to refuse treatment on your own. Perhaps you just need to adjust the dosage of the drug, for example, reduce it for a while. Be sure to discuss this issue with your doctor and follow his recommendations.

Not only with caution you need to approach the start of taking drugs. It is also necessary to complete the course of treatment or reduce the daily dose smoothly in order to avoid the regression of the symptoms of the disorder, the occurrence of a withdrawal syndrome. Any adjustments in treatment must be agreed with a specialist.

Empirically proved that the best effect gives a combination drug therapy with psychotherapy than each of the methods separately.

Psychotherapeutic treatment can be carried out with the help of various techniques. Most often resort to relaxation training, cognitive psychotherapy, behavioral psychotherapy.

How to learn to control anxiety?

By whether a person knows how to direct anxiety for the good, one can say whether he is successful or not. After all, one who, in any situation, knows how to control the emerging anxiety, will certainly become successful.

By the way, there is nothing supernatural in the ability to control your feelings, both in trifling and serious situations. I recommend that you read, dedicated to simple and at the same time affordable methods of dealing with anxiety, suitable for any situation.

Classification and diagnosis

Literature

Conclusion

Some current trends in development and problems in the field of psychological intervention in depressive disorders have already been discussed; Let's end with a few more. special attention today the adaptation of cognitive-behavioral and interpersonal therapeutic methods for the treatment of depression in childhood and adolescence(Reynolds & Johnston, 1994); there has also been an increase in attempts to exploit the therapeutic potential of these methods for the treatment of chronic and treatment-resistant depressed patients (Mason, Markowitz & Klerman, 1993; Zimmer, 1995). Recently, there has been a significant increase in attention to the prevention of relapse in patients with depression, so attempts to continue psychological intervention for some time after the elimination of depressive symptoms are now coming to the fore (Frank, Johnson & Kupfer, 1992, Herrle & Rühner, 1994). Some researchers believe that cognitive-behavioral strategies should be used for primary prevention - to prevent the development of a depressive disorder in people at an increased risk of them (Munoz & Ying, 1993).

The problems facing fundamental therapeutic research are no less complex and multifaceted than the problems to be solved. clinical practice. For example, how can one explain the fact that the effects of both different psychological methods Therapy for depression and drug treatment are by and large the same? And how to explain the fact that the advantage of the combined psychological-medical therapeutic approach turned out to be clearly less than it should have been? It is now generally accepted (in the sense of the “final common pathway” concept (Whybrow, Akiskal & McKinney, 1984) that depressive disorders are the result of a development that may be mediated by psychological, psychosocial, and physiological conditions; therefore, the above data seem to support the “common therapeutic final path.” However, we still do not have enough knowledge about which paths lead to this final path, which specific and/or common factors impacts underlie the effects achieved. The results of the relevant detailed empirical analyzes are still quite heterogeneous (Rehm, 1995; Blöschl, 1996). Thus, both in the interests of theoretical knowledge and in the interests of broad practice, it is necessary to continue and stimulate research work in this direction.

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Chapter 37

Roselinde Lieb and Hans-Ulrich Wittchen

The most important condition classification of anxiety disorders is, on the one hand, the finest possible differentiation anxiety as a primary emotion with its affective, physical and cognitive components, anxiety as personality traits and differential diagnosis various forms pathological anxiety, and on the other hand, drawing a line between pathological anxiety and other types of mental disorders. The main signs of pathological anxiety are the following: 1) anxious reaction and avoidance behavior are experienced by people suffering from this disease as unreasonable, inadequately strong and occurring too often, 2) they begin to avoid situations that cause anxiety and lose control over anxiety, 3) anxious reactions occur sequentially and last longer than usual; and 4) lead to impaired quality of life. Pathological anxiety is the leading symptom of anxiety disorders. However, it can also occur with other psychiatric disorders (such as depression) as well as somatic diseases(for example, endocrine disorders). Anxiety is especially common in severe acute affective disorders (depressions and bipolar disorders), psychotic illnesses (eg, schizophrenia) and progressive stages of substance dependence (eg, withdrawal symptoms). Therefore, carefully conducted differential diagnosis has great importance in the diagnosis of anxiety disorder.

Distinguishing normal anxiety and anxiety from various forms of pathological anxiety in last years It has become much easier to carry out due to the introduction of clear diagnostic criteria and algorithms for making a diagnosis. For these purposes, two classification systems are currently used, now well coordinated with each other and convenient for solving both research and practical problems - WHO ICD-10 (World Health Organization, 1992), supplemented by unambiguously formulated diagnostic criteria for research (World Health Organization, 1993), and the fourth version DSM American Psychiatric Association ( DSM IV; American Psychiatric Association, 1994, 1996), containing significantly more differentiated signs of disorders than in the ICD. Tab. 37.1.1 gives an idea of ​​the classification structure of these systems in relation to anxiety disorders and some of the differences between them. Because DSM IV describes the picture of the disorder in much more detail than the ICD-10, then in our subsequent presentation we will rely mainly on the categories DSM IV.The corresponding F-codes from ICD-10 are given in brackets.

Table 37.1.1. Classification of anxiety disorders according to ICD-10 and DSM IV

»

Feeling advanced level anxiety , by far, are most common in large cities. This borderline mental state is accompanied by a sensation or distinct sensations

anxiety , when a person clearly feels this state, or it can manifest itself in the form of a not clearly defined state, when a psychiatrist, psychotherapist (psychotherapist), has to find out this fact through special examination techniques.

Anxiety is the affect of expectation of some unpleasant event, the experience of tension and fear, apprehension.

Prolonged anxiety is pathological condition, characterized by a sense of danger and accompanied by somatic symptoms, which is associated with hyperactivity of the autonomic nervous system.

Differential Diagnosis

Increased anxiety should be differentiated from fear, which occurs in response to a specific threat and is a biologically justified reaction of the higher nervous system.

Anxiety is one of the most common psychopathological conditions in medical practice.

Anxiety in this case is called an exaggerated reaction that does not correspond to the degree of threat. In addition, anxiety develops when the source of danger is not clear or known. Most often, anxiety arises in response to some conditioned stimulus, the connection of which with the danger itself is forced out of consciousness or forgotten by the patient.

It should be noted the breadth of the range of manifestations of anxiety - from mild neurotic disorders (borderline level of mental disorders) and generalized anxiety disorder, to pronounced psychotic states of endogenous origin. Anxiety refers to the sphere of human experiences, hard to bear emotions and is expressed in a feeling of torment. Not infrequently, when a person finds the object of his anxiety or “invents” this object, then he develops fear, which, unlike anxiety, appears in response to a specific reason. Fear should be qualified as a pathological condition only if it is experienced in connection with objects and situations that do not normally cause it.

Symptoms of increased anxiety

• Trembling, twitching, body shaking, back pain, headache, dizziness, hot flashes, dilated pupils, fainting.
• Muscle tension, shortness of breath, rapid breathing, increased fatigue, dysfunction of the autonomic nervous system (often called vegetative-vascular dystonia, VVD, redness, pallor.
• Tachycardia, palpitations, sweating, cold hands, diarrhea, dry mouth, frequent urination, numbness, tingling, tingling, difficulty swallowing.
• Gastrointestinal disorders, diarrhea, constipation, vomiting, gastritis, peptic ulcer, dyskinesia, heartburn, bloating, irritable bowel syndrome.

Psychological symptoms of increased anxiety

• Feeling of danger, decreased concentration.
• Hypervigilance, sleep disturbance, decreased libido, "lump in the throat."
• Sensation of nausea (“sick with fear”), heaviness in the stomach.

Anxiety is a psychological concept that expresses an affective state, which is characterized by a feeling of insecurity and general anxiety. Often compared, and sometimes used as a synonym for the concept of neurotic fear. In a state of anxiety, there are no physiological or somatic manifestations, such as, for example, suffocation, sweating, increased heart rate, numbness, etc. The state of increased level of anxiety in most cases is taken for light form neurosis, in which it is anxiety that dominates the patient's life. As a rule, this form of neurosis is treated with psychotherapeutic methods, without the use of drugs. Usually, the treatment of such psychological conditions does not exceed ten sessions of psychotherapy.

In young children, anxiety appears in the following cases: fear of the dark, animals, loneliness, strangers, etc. In older children, anxiety is associated with a sense of fear of punishment, fear of failure, illness, or contact with loved ones. Such states, as a rule, are defined as anxious personality disorders and respond well to psychotherapeutic correction.

In addition to borderline mental disorders, anxiety can also accompany deeper mental disorders associated with endogenous brain pathologies and manifest itself as an anxiety-paranoid syndrome.

Anxiety paranoid syndrome

- Combination of the affect of anxiety, accompanied by agitation and confusion, with delusions of relationship or persecution, verbal illusions and hallucinations. Most often manifested in schizophrenia and organic psychoses.

Diagnosis of increased anxiety

When diagnosing anxiety states as a borderline mental state, pay attention to such basic criteria as:

• Excessive anxiety and restlessness in connection with various events or activities, observed for more than 4 months.
• Impossibility or difficulty in trying to cope with anxiety on your own, through the efforts of your own will.
• Anxiety is accompanied by at least three of the following symptoms (in children, only one symptom is sufficient):
• Restlessness, fussiness or impatience.
• Fast fatiguability.
• Disorder of concentration or memory.
• Irritability.
• Muscular tension.
• Sleep disturbance (difficulty falling asleep, nocturnal awakenings, early awakenings, sleep disturbances, sleep that does not bring a feeling of freshness).

The psychotherapist needs to accurately establish the subject of an increased level of anxiety or anxiety, since there are certain criteria that are important in determining the type of anxiety.

The presence of an increased level of anxiety causes significant disturbances in social, labor or other areas of activity, which reduces the quality of human life.

Increased anxiety is not directly related to the presence of exposure to a psychoactive substance (drugs, drugs, alcohol) and is not associated with other organic disorders, severe developmental disorders and endogenous mental illness.

Group of anxiety disorders

The group of mental disorders, in which anxiety is caused exclusively or predominantly by certain situations or objects, is currently not dangerous. Treating high levels of anxiety is always successful. The patient's concern may be centered on individual symptoms such as, for example, palpitations, feeling faint, pain in the stomach or abdomen, headaches, and often associated with secondary fears of death, loss of self-control, or insanity. Anxiety is not relieved by the knowledge that other people do not consider this situation so dangerous or threatening. The mere idea of ​​entering a phobic situation usually triggers anticipatory anxiety in advance.

Anxiety often coexists with depression. Moreover, anxiety almost invariably increases during a transient depressive episode. Some depressions are accompanied by phobic anxiety, and

low mood often accompanies some phobias, especially agoraphobia.

Increased level of anxiety

The presence of an increased level of anxiety, when increased, often causes panic states, which are often referred to by people as panic attacks. The main symptom of panic attacks are repeated attacks of severe anxiety (panic) that are not limited to a specific situation or circumstance and therefore are not predictable. For panic attacks dominant symptoms vary greatly in different people, as well as with others, but unexpected palpitations, chest pains, sensations of suffocation, dizziness and a feeling of unreality (depersonalization or derealization) are common. Secondary fears of death, loss of self-control or insanity are almost inevitable. Usually, panic attacks last only minutes, although sometimes these states can persist for longer. The frequency and course of panic attacks have many variations in manifestation. Most often, people, with the manifestations of a panic attack, experience a sharply increasing fear, turning into a panic state. At this point, vegetative symptoms begin to increase, which lead to a further increase in anxiety. As a rule, most people at the same time try to leave their place of residence as soon as possible, to change the situation, the environment. Later, in order to prevent manifestations panic attack, people try to avoid places or situations that were at the time of the manifestation of a panic attack. A panic attack leads to a feeling of constant fear of a subsequent panic attack.

To establish pathological anxiety (paroxysmal anxiety, panic attacks), the following conditions are necessary under which severe attacks occur autonomic anxiety and which arose during the month:

• under circumstances not related to an objective threat;
• panic attacks should not be limited to known or predictable situations;
• between panic attacks, the state should be relatively free of anxiety symptoms, but anticipatory anxiety is common.

Treatment for increased anxiety

Treatment for anxiety is primarily determined by true reasons formation of a complex of manifested symptoms. The reasons for the formation of these symptoms should be determined in the course of differential diagnosis.

As a rule, when forming a treatment plan, it is necessary to start with the rapid removal of the leading symptoms, which is most difficult for the patient to tolerate.

During the treatment of increased anxiety, the doctor, during the entire period of therapy, should carefully monitor the patient's condition and, if necessary, take corrective measures, which may include both correction in neurometabolic therapy and in the psychotherapeutic plan.

Conclusion

An important point in the treatment of anxiety is that directly to everyone healing process only a doctor supervised, any amateur activity of psychologists is not allowed. It is strictly forbidden self-treatment increased level of anxiety by psychologists or other people without a higher medical education. Violation of this rule always leads to very serious complications and obstacles to the full treatment of disorders with manifestations of an increased level of anxiety.

Any state of anxiety can be treated.

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WHAT is pathological ANXIETY. Causes and symptoms.

First of all, there are mental and somatic (bodily) symptoms of ANXIETY.

SYMPTOMS can manifest themselves in the most different combinations and vary in severity.
Most often, the feeling of ANXIETY is experienced by overly worried people who are characterized by nervousness, irritability, or a periodic state of "on edge". It is possible and vice versa, a person is inhibited, tense and impatient, cannot concentrate and concentrate, there is emptiness in the “head”. Feelings of anxiety can cause states close to fainting.

Not only mental, but physical state. Constant and pointless concern is accompanied by dizziness, palpitations, increased blood pressure, difficulty breathing or chest tightness, excessive sweating or, conversely, chills, dry mouth. General weakness, fatigue and overwork, insomnia joins everything. But how! The body is in constant tension, the person forgot when he relaxed, the brain constantly thinks something or does not think at all. IT'S HARD TO KEEP.

There are a number of other SIGNS of pathology, which depend on general condition and susceptibility of the organism. However, a GENERAL SIGN OF pathological or abnormal ANXIETY is an increased sense of anxiety, anxiety for no apparent and real reason.

Moreover, this condition is noted for a LONG time, several months, or even years. It happens that for life a person cannot cope with this problem, and even more so on his own. The whole established way of life is violated.

Anxious people differ in their behavior. They are CHARACTERISTIC of such traits as fussiness and restlessness, awkwardness, tightness, lethargy or nervousness, timidity and shyness, fearfulness, vulnerability. It could be other behaviors as well. Anxiety is typical for a person who is constantly worried about something, does not give rest, interferes with a normal life.

WHAT can most often cause a FEELING OF ANXIETY?

Unpleasant memories associated with a certain event in life.

Illness of oneself or loved ones, with a disappointing prognosis.

Unstable, unstable position in the family, or at work, in public life.

distrust or suspicion.

Worry about the future of relatives, friends, children, friends, financial situation, lack of confidence in the implementation of plans.

The presence of a threat or lack of security.

Individual genetic and biological characteristics of the organism.

In any case, it is NECESSARY to look for the reasons and get out of this state.