anxiety disorder test

anxiety disorder test

There are many situations that cause anxiety, but there are some, such as public speaking, have a job interview or examination, in which a large percentage of people with high levels of anxiety. Generally no one likes to be evaluated, the connotation of "judgment" involved any review, makes people who have to submit to it not usually be comfortable. All students feel anxiety when they have to take an exam, in fact this is one factor that motivates them to study. There are different levels of anxiety ranging from mild nervousness or restlessness nervousness up that can make us feel paralyzed.

It has been shown that students who experience high anxiety about examinations suffer from a significant decline in performance, tend to defer study or pay and get lower scores than if they were able to manage their anxiety, even getting ready properly ,

It is estimated that approximately 15% and 25% of students have high levels of test anxiety.

The causes of anxiety about exams can be related to external factors such as the type of examination forms of study, time management study, the number of reviewers, or personal factors that are related to the assessment and personal meaning students do on the state exam. So the same situation review, different students taking different valuations make a wide range of reactions, including anxiety would.

The anxiety about exams is manifested in four ways and in different degrees and forms. Are four areas affected:

Manifestations

Gastrointestinal symptoms.

Frequent urination.

Increased or decreased appetite.

General tension.

Tachycardia.

Sweating.

Tremor.

Contractures.

Tics.

Headaches.

Shortness of breath and chest tightness.

EMOTIONAL

Susceptibility.

Irritability.

Nervousness.

Anguish.

Aggressiveness.

Anger.

Fear of failure.

Fear paralyzed.

Apathy.

BEHAVIORAL

Restlessness.

Stuttering and / or difficulty speaking.

Nervous tone.

Insomnia and / or difficulty sleeping.

Increased consumption of snuff, drugs and / or alcohol.

Avoidance behaviors and / or flight.

Postponements.

COGNITIVE

Difficulty concentrating.

Feeling confused.

Phenomenon blank mind.

Distraction.

Concern for performance.

Concern about the negative consequences of failing.

Concern for the physical sensations.

Perfectionism.

A cognitive or mental anxiety begins to activate early when the student begins to worry about the exam. The types of concern that students often have high levels of anxiety are related to negative expectations about one's performance on the test ("If I stay with a blank mind, I disapprove"), the negative consequences of failing ("If you disapprove, do not get the job I want"), to concerns about the possible emergence of physical sensations ("If I decompose, I can not finish"), managing time ("I do not reach the time") and the judgment of others ("If I do not pass, they will think I'm useless").

Such concerns may occur before or during the examination, interfere with the resolution of the task and produces a lower yield than expected, as well, avoiding the study or examination, obtaining temporary relief.

A very common phenomenon is related to test anxiety is procrastination. Many students, postpone the exam or "leave for the next date" by the anxiety that generates them having to go through a test or to study. Procrastination is the tendency to postpone the study or examination caused by excessive anxiety, fear of failure, perfectionism ("If not all, I do not show"), anticipation and expectations catastrophic proportion. The person feels intense anxiety postponed by merely thinking about what to do, then resort to avoidance calming, obtaining temporary relief. But the delay has devastating consequences when the problem becomes chronic dropouts chances are career or academic failure, not because the person is not capable, but because this bad habit to believe that one is good for studying.

People who suffer from test anxiety may see their performance deteriorated, too, by the problems of storing and organizing information as problems in retrieving stored information.

There are students who use good study skills and that despite this, at the time of recall or retrieve that information suffer the "phenomenon of mind blank", caused by anxiety. The person focuses attention on internal aspects (such as negative thoughts) or physical sensations rather than the resolution of the task or the exam, reducing their test performance. On the other hand, the anxious student may have difficulty studying, storing information superficially, presenting problems to select the most important aspects of information, because ineffective study strategies. This causes perceived lack of preparation or insecurity that increases your anxiety when held.

In our clinical experience in treating people with anxiety problems, we note that 70% of people with an anxiety disorder, also suffer from moderate to severe anxiety before exams. In fact the situation in anxiogenic exam is for those suffering from an anxiety disorder and those who do not suffer. For a person with social phobia, a fear of being negatively evaluated by others or you notice your nervousness, can be difficult for the fact an exam, especially if oral and more than one evaluator. Indeed, 50% of patients with social phobia have chronic postponements of examinations. And many of them have abandoned and retaken several times the race. Other people with anxiety disorders such as OCD sufferers have great difficulty when filing multiple choice type tests, as well as studying, by increasing interference rituals, doubts and obsessions, which prevents them from the appropriate concentration.

There are people who tend to be perfectionists and worry excessively, as people suffering from Generalized Anxiety Disorder, and others who fear breaking when an exam, and those who suffer from panic disorder. In our clinical experience, we observed that 44% of patients who consult us have a tendency to avoid the examination situation, so we have developed treatment strategies using specific techniques for each type of student, training in the management of test anxiety with successful results.

The coping strategy is customized and testing arises according to the type of difficulty with the students.

The treatment of this problem consists in training the management of anxiety, which are used for relaxation techniques, techniques to achieve adequate control of worry and thought restructuring techniques are also used techniques for managing time and organization of the study material.

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Social concerns and attitudes usually feared

 CLINICAL

Childhood

The problems begin about three or four years by communication difficulties. There is a shyness with adults and other children. The child fled the confinement or contact instability. The anguish of separation from the mother are part of an ambivalent and sometimes hate. The father is not present and the child tries to avoid it. There may be significant and uncontrollable anxiety that manifests itself in night terrors various fears. Found inadequate educational attitudes and malicious.

Later, around school age appear like symptoms that are actually phobic fears related to archaic mechanisms. There is no intellectual impairment and learning outcomes are not disturbed. Aggression and jealousy are strongly present at this age and occur vis-à-vis the siblings or classmates. These children are unhappy with their grades in school, the attitude of parents and educators, they consider unfair to them. Insignificant facts are magnified and blown up.

In adolescence, the stiffness begins to manifest itself. These are young people complying with strict regulations, not admitting contradiction. Authoritarian and tyrannical vis-à-vis their peers, they profess strong opinions and irrefutable adopt political causes with fanaticism. The downward trend increases. Relationships with others, especially the opposite sex are difficult and conflicting. These young people demonstrate a moralism outrageous. They hide behind religious beliefs, rigid principles.

The paranoid style is manifested in adulthood and it becomes quite easy to spot, because the clinical features are marked.

Character

The subject is likely, he has a hard character, authoritarian, and sometimes delirium.

Some traits are characteristics: pride, distrust, susceptibility, stiffness, unrealistic and false judgment. The paranoid is proud and sometimes contemptuous of others, because he considers himself superior. Aggression is important indirectly expressed by a hint of contempt, or directly as about unpleasant insults. Distrust and suspicion are systematic. The subject is expected to diminish, or other exploit and always feared an attack from them. He questioned the honesty and loyalty of his family, he is almost always jealous.

The paranoid feel easily despised, he fears that he disrespect and sometimes imagine when this is not the case. Likely, it is intolerant remarks and criticisms. Disagreement, an unfavorable judgment of others, triggering anger and resentment. Prestige and social titles, filiations famous real or fictional attempt to compensate for this weakness. The paranoiac is rigid and self-criticism. Hard with himself and with others, he has unwavering opinions. The journalistic term "groupthink", is well suited to describe his way of thinking: it is the only one able to exist and everyone should join. At no time the subject can take a critical distance from him. For the paranoid, the world is obviously and immediately as he thinks.

Lines and relationships

The paranoid gives meanings to behaviors that do not, it casts doubt on others and idealizes a false judgment characteristic. This leads to inappropriate attitudes to the situation raise perpetual conflict. Despite a first glance remote tension in the relationship is fast.

The activity of the individual is normal and sometimes important. It may even have a social success as spectacular adaptation of paranoia is often excellent. It disappears only when it is invaded by delusional concerns. In the usual hierarchical relationships, it is hard to inferiors, respectful and obsequious to superiors, and competing aggressively with peers. It seeks to dominate and move up the hierarchy. The subject can seriously harm and without remorse to those he considers his enemies or rivals (for slander, premeditated vengeance).

Sexualized as a referent object, the other is seen as very different days. It is sometimes perceived as being very good and ideal, sometimes completely wrong. There is little regard for its own characteristics. There is also a desire for omnipotence which is to control, manipulate, use, object-referent. The relationship is burdened by jealousy.

Rationalism and delirium

Rationalism is powered by constant interpretations. It implements a dogma argued by an avalanche of arguments and reasoning assertive entirely at the service of the premise. The themes are ideological, political and social (social protest, racism, death penalty) or relate to the environment (neighborhood, spouse). Rationnalisantes these trends are sustainable. The facts are interpreted, writhe about to give a convincing demonstration.

Rationalism sometimes turns into a frenzy as the dogma becomes constant and unwavering. These delusions can soothe and resume spontaneously or become chronic. They occur in middle age, around 35 to 40 years. Delirium is a delirium sector, systematic, credible and convincing. It feeds interpretations (as fact, such a word, take an obvious meaning for the paranoid) and intuition (immediate sense idea that confirms delirium)

The delusional accumulates facts and evidence, and ruminates constantly nourishes sentiments of hatred against the plunderers. He devises plans to confuse revenge. Crossing the act related to delirium may take various forms: procedure assault to murder, separation from spouse. The passage to the act is the application of delusions and follows the feeling of growing hostility in the world, especially persecutors.

¤ Delusions of claim relate to neighbors, family, entrepreneurs, doctors, employers. This delusion can take the form of pessimism. After an accident, the paranoid claiming compensation, disability pension or annuity. Harasses social security experts responsible for the accident, lawyers, doctors. In the delirium of persecution the patient is convinced that a conspiracy was directed against him. Any word or act outside is interpreted according to the delirium that can lead to violent acts.

¤ Delusions of jealousy for the spouse or an acquaintance. Every look, word, or delay, is interpreted as evidence of infidelity. This is often the spouse who is desperate request. Erotomaniac delirium usually reaches a woman who feels loved by a third party (often a high social rank). The starting point can be a look, a word, etc. ... Then the delirium and organizes the patient builds a story in which she is courted.

¤ Other delusions have organized the theme of politics, religion, justice. Political extremism in recruiting willing paranoid.

For details on these delusions, see § "systematized delusions" in the article on psychotic decompensation in.

The evolution

Middle age brings little change for the paranoid. Traits are accentuated, become stiff and freeze. The trend is the same delusional. In old age, the decline of intellectual faculties gives free rein to delirium at the same time it makes it less convincing and less developed.

Theorizing

The central problem

Difficulties arose around the time of individuation. The object is split into two objects archaic omnipotent, good and bad and there is a prevalence of bad object. The relation to the other as object-referent is dominated by fear and hatred. The relation to the other is not stabilized by law and therefore persecutory fantasy is always ready to emerge and the projection is greatly facilitated.

Defensive reorganization occurs during the second structure. Defense mechanisms like control, retention, désafectisation, ritualization, powerful, erected a bulwark against anxiety archaic. Remote control and are used to counteract the lack of separation from the other. Because of overinvestment anal stage, the homosexual tendency is strong, but it is still suppressed.

Arrived at adulthood, is so fragile, aggressive impulses are important defense mechanisms of projection type predominate, there is a deficiency in the function réalitaire. The ego is weak, the superego and the ideal keep an archaic form. The libidinal fixations are not in the foreground, but the anal and homosexuality strongly tinged character.

Place of the subject in Scheduling human is not ignored, but it is uncertain which gives rise to a claim research and intense search for a site compensatory social (valuing prestigious positions) or even a genealogical research delirious descent.

Father and archaic superego

The paternal function and relationship to the law is distorted. There is a lack of integration in the sense of well-tempered assimilation rules. In its place there is an overvaluation of the paternal imago, poorly differentiated and omnipotent. The ideal and the superego are archaic related to this imago and invested by the deadly instincts. They are the custodians of an arbitrary order powerfully idealized producing totalitarian demands. This set forms a rigid binding instance archaic fed a parental imago very powerful and terrifying. It causes the "groupthink", which it is not possible to derogate for instance invades psychic functioning and I can not play any regulatory role. On the other hand waive subject to sanctions terrible and cause enormous stress.

Narcissistic disorder

Primary narcissism and relationship to the world organize themselves pathological. The existence, the sense of being, as is the independence from the mother, but in a defensive manner, as hateful aspects dominate the libidinal aspects. Relation to the world is organized in a hostile fashion. The child, not having a good protective idealized object, is organized defensively against other always suspected of being hostile. Empowerment is based on a decline and stabilization hate narcissistic remains uncertain. Primary narcissism is a defensive expensive furnishings.

Concerns and wacky themes can all be related to a narcissistic injury. - Harm: The subject feels that he is injured in an existential sense. It will seek to show harm in looking for all occasions, whether practical or moral. Jealousy is also in this vein: the subject thinks that her husband is cheating, but it is especially wrong. - The size unknown: The paranoid safe value and superiority think it is despised. In all cases is, he feels that his being and value are basically attacked ... which is just about psychopathology. He will try all his life bearing on the mode of delusional projection the original narcissistic wound.

Dominates the projection

Delirium is a decline in function réalitaire, but also the importance of projective mechanisms for adaptation to reality is far from being compromised. It is sometimes put at the service of delirium. The initial intuition is made by any concerns of the paranoid. The projective mechanism psychotic tendency specific topic is assigned to another project in general aggressive: he does not like me, he wants to hurt me. The contribution of delirium secondary benefits: Finally there is evidence of injury. The contradiction between certain damage but nonexistent subsides and more aggressive impulses are finally expressing themselves. Delusional themes refer to the narcissistic injury compensation and its megalomaniac.

Psychotic projection is a defensive mechanism archaic. She is steadfast and very specifically for an active tendency of the subject and immediately placed him outside in what is the reality for him. The psychotic plans which belongs to him and he can not recognize. Moreover, the mechanism generates absolute conviction. In jealousy is the homosexual tendency and projected that, in the persecution is the sadistic streak. We see that the function is not abolished réalitaire is how I use it to change: it is more the offsetting change in the fantasy, it is put to its service. Moreover, the judgment of attribution fail: the outcome of this trend can be recognized and attributed to himself, so it is assigned to what is outside oneself (to others or reality in general).

 CLINICAL FORMS APPENDICES

Sensitive form

Paranoia itself generates intermediate sensitive to the shape distanced we'll see then. The term comes from Kretschmer who described three types of paranoia: the paranoid combat, paranoid and paranoid sensory desire. Kretschmer invented this clinical form after connecting the character "sensitive" to paranoia. Sensitive form is characterized by a milder character, a female and sometimes delirium network. This is an opportunity to pay tribute to the author who first connected the character and all of the subject's life at critical moments (crazy). It is the precursor of the idea of ​​decompensation.

Sensitives are sensitive to the reactions of others, easily hurt, fleeing the contact. Fear leads to the establishment of a distance from others, perceived as hostile, which provides a protective search. The subject is on the alert, fearing not to be respected, to be attacked. Without feeling persecuted frankly, these topics have the impression that cares about them in a way that is excessive in their eyes and not caring. Generally dominates inhibition timidity relationship difficulties. The person has a sense of fragility and weakness. She fears not know how to answer, do not know how to fight. She sees herself as superior while having a sense of inferiority one self-deprecation. There is a mixture of pride and humility. Something painful enough to trigger delirium (a look unpleasant, a haughty attitude, a little prejudice).

On a theoretical level we can say that aggression is weaker and tends to turn against itself. Characterological defenses are less pronounced. Failure to meet the requirements of the ideal body archaic superego mixed and impose them on others results in a return of aggression against self and depressive tendency. On the other hand, these requirements exhausted by their binding. Sensitive paranoia can be considered as a transition with psychotic distanced form.

Paranoid type reactions

Sometimes you see these symptoms and traits appear transiently in other psychotic personalities or boundaries. This is called paranoid reaction. In cases of paranoid reactions, there are often circumstances triggering real (prejudice, rudeness, etc.).. They lead the certainty of having been prejudiced or misled. It follows will repair and revenge. The desire for revenge triggers different behaviors of claim whose commitment procedures to the authorities for redress. This way of reacting is favored by chronic poisoning cannabis poisoning and acute amphetamine or cocaine.

 WHAT TO DO

The applicants are not paranoid care on the psychic plane. There are not psychotherapy and if by chance it was the case, it would not be because of the indiction projective mechanisms that would hinder it. The psychiatrist usually meets paranoid during treatments somatic delusions or severe requiring hospitalization or circumstances after expertise crimes.

It must be very cautious and do not give rise to interpretations, which is sometimes impossible. The words to the paranoid must be very explicit and free of jokes or double meaning. It is useful to protect themselves using all possible legal and institutional guarantees: scrupulous procedures, safety rules. It may be helpful to be accompanied by another caregiver.

In forms delusional dangerous it is sometimes useful to use the police and the judiciary. It is a rare occasion that paranoids are psychiatric inpatients either HDT or by HO. Neuroleptic treatment can temporarily alleviate aggressive and reduce delirium. The paranoid is generally believed that hospitalization is abusive. In it, he tries to alert the public and the authorities, and after he tries to initiate a procedure vengeance.

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Main features, symptoms and / or cognitive demonstrations and physiological and kinetic

How does one distinguish normal anxiety and pathological anxiety?

Anxiety (normal or healthy) is defined as a natural and essential emotional reaction, a normal response to daily stress, where there is the presence of a certain apprehension of painful events. The threat seems more diffuse, vague or distant in the case of fear. Anxiety is generally used to direct attention to a danger or threat and can prepare the body to take action to bring about change.

It can also improve performance, motivate the individual to excel and serve as alarm signal when there is a danger and thereby ensure survival1. However, when this reaction persists for no apparent reason and it causes some problems in the functioning of the individual, anxiety is then termed pathological.

In addition, other criteria must be analyzed to distinguish normal anxiety of pathological anxiety such as intensity, frequency, pain, the moment of its appearance, sense of control (or not) on anxiety symptoms and the duration of those ci1.

How can manifest anxiety?

Anxiety can manifest itself in various ways. Indeed, it is possible to classify these events into four categories1:

affective symptoms (fear, anxiety, irritability, etc.).

physiological symptoms (dizziness, palpitations, shortness of breath, numbness, etc.).

cognitive symptoms (difficulty concentrating, fear of going crazy, losing control, having a heart attack, etc.).

behavioral symptoms (agitation, avoidance, edgy attitude, etc.)..

It appears important to note that these symptoms are usually not present at the same time or in each of the anxiety disorders. Indeed, a person may, for example, feel that only a few of these symptoms at once. In addition, some of them are more typical of a disorder in particular1.

How the mental health professionals they diagnose the presence of an anxiety disorder in an individual?

During clinical interviews and using different assessment tools (questionnaires, grids, etc.), mental health professionals are usually able to diagnose an individual struggling with an anxiety disorder. To this end, the majority of psychologists, psychiatrists and doctors are able to detect one or the other anxiety disorders as well as make a diagnosis.

How many people are struggling with an anxiety disorder in the population?

It seems that anxiety is the abnormal psychological problem most current1. Indeed, according to recent statistics, 10 to 15% of people consulting a GP large1 suffer from anxiety symptoms. Moreover, in the general population, 25% of people seem to have experienced intense anxiety at one time or another in their lives and about 7.5% of them are struggling with an anxiety disorder particular1.

A person with an anxiety disorder can she get out?

The scientific literature has demonstrated for anxiety disorders it was possible for an individual to reduce some of its symptoms and regain social functioning, personal and interpersonal satisfying and sometimes even without treatment with a professional. Professional help is important when a person with symptoms associated with an anxiety disorder sees its overall functioning affected and / or a significant pain associated with it.

At present, the treatment of choice for all anxiety disorders, appears to be the therapy of cognitive-behavioral approach. Moreover, it frequently happens that people with any anxiety disorder take medication. For further details on this, it is possible to see the following section: Pharmacotherapy.

For family

Certainly, anxiety disorders frequently have many negative impacts on the physical and psychological functioning, as well as the social, occupational and economic status of individuals who suffer (Gladis et al., 1999; Mendlowicz & Stein, 2000). Moreover, the negative effects of these disorders on the functioning of those who are affected are not without consequence for the family.

Relatives are frequently witnessed various behaviors difficult to understand from the individual as anxious avoidance (eg. Refuse an invitation to the restaurant), leakage (eg. Disaster out in a movie theater) rituals (eg. repeatedly check if the front door is locked), requests for reinsurance (eg. ask the same question several times), panic attacks (eg. afraid to die entering an airplane), etc..

Initially, relatives tend to adapt to the various manifestations of anxiety by changing some of the roles they assumed and adjusting according to the needs of the person with anxiety disorder. However, As the chronicise anxiety disorder, conflict and an atmosphere of tension can appear. Firstly relatives can become more intolerant of manifestations of anxiety and the need to have to adapt.

On the other hand, the individual is anxious can feel misunderstood and isolated or a vain attempt to limit the negative impact of the disorder on his entourage. In this context, the family usually try to help the anxious person to the best of their knowledge so that they regain functionality.

What to do if a loved one appears or is struggling with an anxiety disorder?

As a first step, it is desirable to encourage the individual anxious to therapy in this case a cognitive-behavioral therapy (CBT) since it is more effective than other forms of psychotherapy for the treatment of all anxiety disorders. In addition, it is possible for relatives to provide support and adequate help.

However, providing such support is particularly challenging given that the identification of supportive behaviors helping, that is to say, that meet the needs of individuals with an anxiety disorder are not clear. Indeed, some supportive behaviors may be perceived as meaningful by individuals with an anxiety disorder because they cause a rapid decrease in anxiety and physiological reactions associated.

However, many of these behaviors can be cons-productive because they contribute to the development or maintenance of the disorder by increasing avoidance and anxiety. For example, a patient with generalized anxiety disorder that is frequently advise a reassuringly close about his concerns will generally report a positive impression of this form of support while reinsurance reinforces intolerance to uncertainty, an important component of the disorder.

It is the same when a loved one changes its behavior depending on the condition (eg by performing a compulsive ritual in place of the other in order to avoid "stuck" with his doubts). The relative can also try to "secure" the individual anxiety by helping a tangible example by driving the car instead of an individual with panic disorder with agoraphobia is afraid to make a panic attack and fainted at the wheel.

What strategies can be appropriate caregivers and from someone close to a person struggling with an anxiety disorder?

To show empathy to the distress experienced

Consider the person as it is and help to identify other than by anxiety

Encourage them to seek professional help if necessary

Promote positive changes as gradually exposing themselves to phobic stimuli

Learn about the characteristics of the disorder, its development and appropriate treatment

Recognize and reinforce any progress, however small it may be

Evaluate progress according to the situation of the individual and not by an absolute standard (eg absence of symptoms)

Lower expectations during periods of stress

Be flexible and try to maintain a normal

Will give the right to the opportunity to feel helpless and frustrated

What strategies should be avoided by close to a person with an anxiety disorder?

Blame the individual or anxious themselves for the disorder

Criticize the anxious person in the way it manages its difficulties

Minimize the importance of psychological and physical discomfort

Require the anxious individual things he is afraid to

Encourage the person anxious to avoid or escape a situation

Organize their lives solely in terms of anxiety disorder

Take responsibility for the "cure" anxiety disorder

Abandon efforts to help the person anxious to get out

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Anxiety Disorders

Anxiety Disorders

What are they?

The following are six types; psychiatric disorders in which anxiety is one of the most important symptoms. Anxiety is a normal emotion in humans (and other animals) that fulfills an adaptive function, ie good for something, prepares for fight or flight when it perceives a threat. However, because the human being is more complex than animals, may experience anxiety about many more situations than they, and what at first were adaptive mechanisms, can lead to a serious obstacle to perform the activities of daily living . The six types are discussed below (Generalized Anxiety Disorder, Panic Disorder or Panic Attack, Social Phobia, Specific Phobias, Obsessive Compulsive Disorder and Post Traumatic Stress Disorder) are the best known and studied but many patients with panic disorder itself can not be included in these categories and which, however, are subsidiaries of medical help.

Types of Anxiety Disorders

Generalized anxiety disorder (GAD).

What is it?

The person with generalized anxiety is almost uneasy all day, and for much of his life (though it takes at least six months with symptoms to make the diagnosis). The patient with a TAG also has a tendency to worry excessively about almost anything or, following any minor detail, for example, after seeing a story on an accident or illness load worried, all day for the possibility that a colleague has an accident, or having a disease on which read something. Another hallmark of GAD is difficulty sleeping because the bed is circling the concerns that have hovered in the head all day. Other anxiety symptoms are muscle aches and headache (due to muscle tension), sensation of breathing difficulty (dyspnea), nausea, dizziness and sweating, (for vegetative nervous system hyperactivity or self, which is in charge of preparing the individual for fight or flight to danger through various reactions in different organs of the body), irritability, nervousness and difficulty concentrating and paying attention to what is being done.

Treatment

In the pharmacological treatment of GAD are often used benzodiazepines, some well known and consumed drugs worldwide. They are anti-anxiety drugs that relieve anxiety shortly (minutes) to take them, but its effect remains continuously only while enough of the drug circulating in the blood. As long as they remain active in the body (which is measured by the so-called half-life of the drug) is spoken; benzodiazepine, short half-life, medium and long, and based on this and other features decides the benzodiazepine most appropriate for each patient. Benzodiazepines are drugs useful and quite safe but also have side effects and disadvantages, the main disadvantage is that it can lead to dependence which forces, to close supervision and care, especially when interrupt (after a period of several weeks consumer can never be suddenly).

There are other alternatives to treatment with benzodiazepines. Buspirone is an effective drug for the treatment of some cases of anxiety that is not habit forming, cause sleepiness or benzodiazepines, but takes a few days to start working (this phenomenon is called latency of drug action ), and people who already have taken benzodiazepines for anxiety on occasion may not appreciate a sufficient effect. Also when there depressive symptoms (which, in fact, very often associated with anxiety symptoms) may be associated with some antidepressant therapy, mainly from the group of selective inhibitors of serotonin reuptake (SSRI) or serotonin and of noradrenaline (ISRNS).

Other possibilities of treatment of GAD are different psychotherapies, alone or in combination with medications, depending on the severity. As with depression, the main types of therapy are dynamically oriented and cognitive-behavioral. From a psychodynamic point of view, there have been different approaches to understanding the phenomenon of anxiety.; Basically, anxiety is understood as a product of the conflicts taking place in the unconscious of the individual therapy by analyzing these conflicts to make them aware, psychologically and resolve, thus stop producing anxiety. The cognitive-behavioral approach aims to retrain the individual eager to learn how to control anxiety, to recognize how to build and modify the ways of thinking that lead to their appearance. Uses for it as relaxation techniques, stress management and feedback or "biofeedback" (a technique in which through various instruments that measure physical changes such as muscle tension etc., The patient learns to recognize the onset of anxiety and control , watching normalize measured changes) and cognitive therapy.

Crisis of anxiety or panic attacks

What is it?

In this type of anxiety disorder is episodic (ie, is not constant as in the TAG), and the person who has suffered anxious moments short (typically less than one hour) very intense and no apparent trigger. The experience is the same as you have before a sudden and serious threat, such as an assault face fierce etc. As in the rest of disorders which have been exposed, panic reaction is, in principle, an adaptive response in the animals, ie through one learns, for example, not to be one when a tiger face has suffered panic at the sight. The problem in the case of the man who suffers, panic disorder is that crises occur seemingly nothing to threaten directly the subject. Experiencing a panic isolated on a sudden stressful situation does not involve intense, panic disorder, and it is relatively normal. But when crises recurring in nature are usually relatively normal. But when crises recurring in nature often pathological.

An anxiety attack can be experienced in many ways, but more often it is noted that hardly breathe, you feel chest pain, tingling in the hands and feet, feeling of numbness around the mouth (parentheses), muscle cramps and even and dizziness. All these symptoms "physical" are accompanied by intense anxiety and the feeling that one is going to die or go crazy soon. As these symptoms are very similar to those experienced when having a heart attack, many people who have to go first emergency room of a hospital or cardiologist, and is usually a doctor not a psychiatrist who explains that they have suffered a panic attacks (usually usually indicate some additional examinations before - electrocardiogram analysis often-negative result)., The patient may worry about whether this "going crazy", which contribute to other symptoms of this crisis like the feeling that one is not oneself (depersonalization) or the reality that surrounds him is strange or changing (serialization). The first thing to do in these cases is to reassure the patient, for although crises are experienced as very threatening, actually no vital danger, and indeed once triggered anxiety is compounded by the experience of those who , and creates a vicious circle (the higher the more anxiety symptoms, and the more anxious symptoms becomes the subject). Very often, that the anxious patient hyperventilate (ie breathing faster than normal), and that this will cause alterations in blood gases that produce symptoms.

A common problem of who has panic attacks is that progressively avoiding the circumstances that led to believe that, with what has just developed a phobia or agoraphobia places (this symptom is explained below in section, of phobias) that can end up completely or partially confine the subject in his home with an irrational fear of leaving the protection provided by your home. At the end of a poor outcome may eventually triggered also at home. However, there are effective treatments against panic attacks and should never reached these extremes.

Treatment

Drug treatment is the benzodiazepines mentioned above, which have the advantage of cutting the crisis shortly. Some are taken or placed under the tongue and act very quickly, so that the person suffering the panic attack can always carry in your pocket in case presents a sometime. However, the most effective treatment, although in the longer term are different antidepressants, as inhibitors of the reuptake of serotonin by a mechanism of action independent of their antidepressant effect, able to control seizures in a variable period of time some weeks. Typically, until it begins to make the antidepressant effect is maintained after treatments with benzodiazepines are withdrawn gradually to keep the antidepressant about six months after the last crisis. Many people balk at the prospect of such a long treatment, but clearly compensates be free of crisis. Also useful psychotherapies (related to medication) that help individuals to feel control over the situation by mechanisms that vary by type of therapy.

Phobias (agoraphobia, social phobia, simple phobia)

What is it?

Agoraphobia is an irrational fear and end of open spaces and crowded places such as department stores, public transportation, in crowds, etc.; Like all phobias are a fear that the patient considers excessive and irrational despite what they can not help feeling, and when exposed to what they fear (the phobic stimulus) triggers a panic attack. The problem of agoraphobia, as already said, is progressively prevents the subject places, public transport, etc.. To the extent that, for example usual places can go into a long path through which avoids large avenues, or go to the workplace becomes an hour walk can not take the subway, in the end the severe agoraphobic patient can stay confined to home, only to leave it in the company of someone you trust.

The person with social phobia experience symptoms of anxiety when exposed to situations where it is watched by a crowd or a small group of people, so, for example, to the fact lecture, attend a party or any other event social, the subject suffers from tachycardia, sweating, tremor, anxiety and other symptoms described above. This leads the individual to avoid such social situations and for that reason appears to others as someone extremely shy, almost no speech or out. Treatment is similar to those described for other phobias, although in these cases may be of use beta-blockers (drugs used in cardiology generally) acting through inhibition of the sympathetic nervous system response (one of those responsible for the symptoms anxious) and thus help to control the individual's anxious response to these social events.

In specific phobias phobic stimulus is unique, for example, a person may have a phobia of dogs, another aircraft, another of heights, etc., And can deal appropriately with daily life, if not exposed their specific phobic stimulus. In many cases these people never consult their disorder and is not a major constraint for them, until there is a change in life (for example, a promotion that requires multiple air travel make a person with phobia flying).

Treatment

The pharmacological treatment with these benzodiazepines phobias usually done at the time of exposure to the phobic stimulus accompanied by some form of specific psychotherapy. Behavioral techniques are helpful and quick in its effect. The so-called systematic desensitization involves presenting the patient to progressively more phobic stimuli as being overcome fear (eg, in the first dog phobia could show a picture of a dog, then a tape of a dog barking, then get closer distance to a dog leash, etc.., ... to be able to touch and pet a dog loose). The technique of flooding (which, for obvious reasons, is accepted by a smaller number of patients than before) is suddenly present the phobic stimulus until the subject as alive as the stimulus is not actually dangerous (for termination of his anxiety response). There are other techniques. Also used psychoanalytic psychotherapy type, although the effects of this are usually longer term, and is more aimed at the subject understands why his phobia to eliminate within a short period of time. Of course you can combine several types of therapy according to each case.

Obsessive Compulsive Disorder (OCD)

What is it?

In OCD life of an individual may be impoverished and trapped in endless repetitive behaviors and rituals. Rituals and superstitions are widespread in humanity, and its purpose seems to be to provide security and sense of control over life conditions that are unpredictable. There are very superstitious person, they develop ritualistic behaviors associated with random events, many of these people, if asked, they will not know exactly why they do it, but still do not want to stop. Obsessive-compulsive disorder is somehow an exaggeration to the limit of these behaviors. The main symptoms of this disorder are obsessions and compulsions, terms that do not mean exactly the same language in the colloquial psychiatric. In psychiatry, obsessions are defined as thoughts that are intrusive and parasites, because who's got the live as strangers, not intended and can not voluntarily give them up despite considering them extremely unpleasant. However Compulsions are acts that makes the person to get rid of anxiety produced by obsessions, and that although it could avoid if he wanted, and in fact may be able to do, this will increase both anxiety that ultimately ends up repeating compulsion again, despite knowing that it makes no sense or rationality. For example, a patient may think of his father as if he had died, this thought pops into your head repeatedly, even though he knows that his father is alive and healthy, and not consciously want any harm to him (obsession) , to avoid the thought comes into your head the patient may, for example, begin to keep off the rays of the pavers, so he feels that if his father die treads (compulsion). If asked about what he thinks and does say it's all nonsense, who knows that her father will die if he stepped on the stripes, but can not stop because, if he tries, the anxiety is so, that ultimately ends up succumbing to the compulsion. Of course, within this disorder's degrees (in the above example, from having to step on the lines from time to time to go out, stay locked up in a room for fear of stepping on any line, and its shadow brush one any wall stripe). They are very common compulsions associated wash cleaning obsessions or compulsions of evidence (eg, see if the gas has been closed or the door to leave the house countless times to the point, take hours to terminate the verification task).

Treatment

Pharmacological treatment of OCD, is usually done with specific antidepressants have proven effective in these disorders (one tricyclic structure and practically all inhibitors of serotonin reuptake), to which is sometimes added a particular type of benzodiazepines and sometimes, if not the desired effect, other drugs such as neuroleptics or mood stabilizers. For mild to moderate cases are useful psychotherapies cognitive behavioral type also help to alleviate the most serious cases associated with the above drugs.

Posttraumatic stress disorder (PTSD)

What is it?

As the name suggests this disorder occurs after suffering an extremely traumatic event such as a major catastrophe, an assault or an attack. Of course, any human being, having undergone intensive stress presents an adaptive time, where they can be symptoms of anxiety and depression that disappear gradually and although never forget what happened, you learn to overcome it.; It is not easy to define where normalcy ends and begins PTSD, (although surely this is not the most important, and the main task of the psychiatrist, but the best way to help patients suffering from symptoms of PTSD after major trauma and tragedies).

The symptoms of PTSD is primarily anxious type, but also produce depressive symptoms such as sadness, feelings of guilt for having survived, or for failing to prevent what happened, etc.. Are characteristic sleep disturbances, insomnia and nightmares related to the stressful event. There are also difficulties in concentrating, tendency to relive the event in the form of vivid imagery (flashbacks or "flashbacks") and recall the event after any stimulus that is associated (eg slam revives an explosion, etc.). The likelihood of these symptoms depends on characteristics of the person and what happened, and is less likely to occur if the victim can do something after the disaster and help other victims, participate in the salvage, after an earthquake, etc. PTSD occurs most likely after aggression and acts of human cruelty, that after natural or accidental traumatic events.

Treatment

Treatment requires crisis intervention (to avoid) and supportive psychotherapy and other. The pharmacological treatment of anxiety symptoms usually done with benzodiazepines and antidepressants if needed. For treatment of flashbacks or "flashbacks" are used mood stabilizers.

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