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What
is anxiety?
Anxiety is an unpleasant state of
fear that manifests externally through various symptoms and signs, and can be a
normal or exaggerated response to certain stressful world we live in, but can
also be a pathological response and produced by abnormal variety of medical and
/ or psychiatric.
Although usually speaks of anxiety
and distress as equivalent terms, are not really the same, so that the first is
related more to the psychological inner feeling of discomfort and distress with
bodily outward manifestations that accompany anxiety.
How
does it manifest anxiety and what causes it?
Anxiety can occur chronically, as
a personality trait present for most of the individual's life ("GAD")
or as cut-intensive episodes. These episodes that cause feelings of impending
doom ("thanatophobia"), or fear of going crazy ("manifobia")
are the "panic attacks", "panic" or "panic attacks"
and are the "panic disorder or panic. "
The difference, therefore, between
the "generalized anxiety disorder" and "anxiety or panic" is
based on that in the first patient continually unwell, whereas panic disorder, the
subject is perfectly fine between crises. In addition, many people who suffer panic
attacks often develop a fear or dread a repetition progressive, appearing then
called "anticipatory anxiety".
As for the causes, we speak of
primary and secondary anxiety.
In primary anxiety found no cause
that justifies the table, while the secondary is always due to another disorder
(drug and alcohol, amphetamines and cocaine, hyperthyroidism, etc.
What
are the characteristics of "generalized anxiety disorder?
These patients are characterized
by a constant state of hypervigilance and hyperactivity of the nervous system
as well as a state of constant motor voltage.
The picture is more frequent in
women than in men.
It is related to chronic stress
situations.
According to WHO, to say that a
patient has a "generalized anxiety disorder", you must have the
following symptoms most of the day for 2-3 consecutive weeks:
Muscle tension manifested by headache,
inability to relax, restlessness and difficulty sleeping.
Autonomic nervous system
hyperactivity manifested by sweating, palpitations, upset stomach, shortness of
breath and dry mouth.
Apprehension, worry, and
difficulty with attention and concentration.
What
are the characteristics of "panic disorder?
Introduction of one or more panic
attacks have been unexpected, namely that have not been displayed immediately
before or during exposure to a situation that almost always causes anxiety, and
have not been triggered by situations in which the individual has been the
focus of attention of others.
At least the presence of four
crises over a four week period, or one or more attacks followed by persistent
fear of another attack present for at least a month.
At least four of the following
symptoms for any of the crisis:
Shortness of breath or choking
sensation.
Dizziness, unsteadiness or loss of
consciousness.
Palpitations or increased heart
rate.
Trembling or shaking.
Sweating.
Suffocation.
Nausea or abdominal discomfort.
Feeling of not recognizing our own
body or "derealization".
Numbness of hands.
Chills.
Chest pain.
Fear of dying.
Fear of going crazy or losing
control.
In some of these crises, at least
four of the above symptoms have emerged rapidly and increased in intensity
during the 10 minutes of the onset of the first symptom.
Unable to establish the existence
of other pathology or organic factor explaining the picture.
Panic attacks usually last between
5 and 30 minutes, rarely more.
The disorder is more common in
women and usually begins between 20 and 30 years.
Some patients develop secondary
dependencies to alcohol or anxiolytic drugs.
It is often associated with
agoraphobia (fear of being in places or situations where escape is difficult
and many people concentrate.
It is currently one of the most
frequent reasons for consultation in emergency departments, and frequent cause
of admission.
What
other processes can confuse anxiety attack?
With medical disorders that
sometimes occur with sympathetic nervous system hyperactivity: myocardial
infarction, stroke, epilepsy, pain, hypoglycemia, toxic tables, etc..
Anxiety or fear as a psychological
reaction to physical discomfort or significant life circumstances in the person's
life (as possible from an incurable disease).
Abuse of drugs and toxic
substances (caffeine, cocaine, cannabis) or pictures of them abstinence (primarily
alcohol and opiates like heroin).
Crisis of anxiety as a symptom of
a major psychiatric illness: psychotic disorders or mood disorders in subjects
who have been abused.
What
to do when a "generalized anxiety disorder?
First go to the general
practitioner to rule out physical problems that are causing this disorder. This
will scan the patient and carried out blood tests and an electrocardiogram. It
may also be useful the determination of thyroid hormones and glucose levels.
In cases where there are no other
causes, patient calm concerns explaining the picture and saying "There's
nothing wrong."
It is necessary to keep a healthy
lifestyle while avoiding alcohol and coffee.
Use techniques or relaxation and
yoga courses can be very useful, especially in patients with high voltage motor.
In case of persistent box must
control the symptoms with medication: anxiolytic substances such as
benzodiazepines, low dose, with regular and temporary suspensions depending on
the patient's improvement.
What
to do about a "crisis of anxiety or distress?
In the emergency room should be
provided with the patient lying down relaxing on the couch, inviting you to
close your eyes, breathe deeply and slowly, and trying not to think about
anything.
While blood tests will be done to
rule out other possible causes.
If we are witnessing a crisis with
hyperventilation (the subject breathes a very fast), it may be helpful to place
a plastic bag or glove over your nose and mouth to breathe in an atmosphere
rich in CO2. This operation will occur all over the head uncovered and provided
with plastic bag to observe and see the patient's face (may vomit or acquire a
bluish hue that can indicate a more serious).
Anxiolytic medication is useful
for cutting the crisis. Benzodiazepines are commonly used orally at low doses, Diazepam
or Clorazepam type.
The patient was informed that
suffers a panic attack and that his life is not in danger.
Once the emergency situation, patients
will be referred to control your GP to decide, according to evolution, to refer
to a psychiatrist. If repeated crises will require a background treatment with
antidepressants.
What are phobias
and what are its characteristics?
They are a group of disorders in
which anxiety appears only in certain well-defined situations, for example take
the lift, public speaking, traveling by subway, etc. In young children are very
common as a derivation of his childhood fears, rarely needing treatment. The
defining characteristics of irrational fear that occurs in phobias are:
Is disproportionate to the
situation that creates it.
It can not be explained rationally.
The patient himself is no explanation for their behavior.
The subject tends to avoid the
phobic situation.
This situation have approximately 0.5
to 2% of the population, and 65% female. Predisposing factors are the existence
of separation anxiety during childhood and the sudden loss of a loved one. Most
phobias appear in childhood resolve spontaneously. However, occur or persist
into adulthood typically require for submission antidepressants and behavioral
therapy.
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Types of anxiety disorders
