Anxiety is a normal human emotion. It arises as a reaction to potential danger. Anxiety has always helped us to survive. In the course of evolution, as a rule, more anxious individuals survive, because they analyze the danger better, and therefore the chance that they will survive increases. In subsequent generations, the genes associated with anxiety are passed on. There is a theory that widespread anxiety disorders are the result of such a selection. But there are different types of anxiety disorders. Some of them are clinical and require proper care.
Many phobias and anxiety disorders are based on the instinct of self-preservation. For example, social phobia or fear of public speaking: try to come to someone else’s tribe and start telling them something – there is a high chance that they will eat you. Hence the innate anxiety when communicating with strangers. Fear of heights is also rational because you can fall and break. Now we are surprised by the fear of spiders or dogs, but spiders can mortally bite, and dogs in the past were less friendly and could even eat. The phobias that prevent a person from living in the modern world are evolutionary inherent wisdom.
But where is the line between normal anxiety and anxiety disorder? If late at night we see a suspicious group of people on the street, we may have an alarm. We are wary. We are trying to protect ourselves. Such anxiety is situational conditioned and adequate. If the situation has long been resolved, and anxiety unreasonably continues to influence a person and distract him from normal life, you should seriously think about the presence of anxiety disorder. When anxiety becomes too intense or prolonged and cannot be managed on its own, a person needs help.
The European Psychiatric Association has investigated the prevalence of anxiety disorders in a population: how often anxiety disorders occur among all people in general. It turned out that depressive disorders have about 10%, and anxiety disorders – from 15–20 to 40%. This is a very big number. Not all studies confirm this data, but different types of anxiety disorders do occur at least twice as often as depression.
Different types of anxiety disorders
Panic disorder: Among different types of anxiety disorders, panic disorder is very common. This category of anxiety disorders is very broad and includes heterogeneous diseases as well. The most well-known panic disorder: a person often has attacks of acute fear and anxiety, which are accompanied by pronounced somatic sensations. It can be a heartbeat, dizziness, a feeling that takes your breath and the heart jumps out of your chest. The sensations are so unpleasant and frightening that it may seem to a person that he either dies or goes mad.
Panic attacks can occur in normal surroundings: in the subway, at home, during a walk. A person begins to fear their repetition, and the more he fears, the more likely they are to overtake him again. Periodically repeated panic attacks form panic disorder.
Social phobia: Social phobia or social anxiety disorder is of two types. With a generalized form, a person is afraid of any large crowds of people. It can be streets, queues, companies, parties – it is unpleasant for a person to be looked at and evaluated. Sometimes it is embarrassing for a person: suddenly, those around him will see that he is anxious and reddening? This may be the fear of evaluation that it is considered ugly, unintelligent, incorrect, and unattractive. There are more specific types of social anxiety, such as the fear of public speaking. All of us are to some extent afraid of them, but there are people who, ongoing on stage, are speechless, they have lost all thoughts from their heads.
Generalized anxiety disorder: Anxiety is the basis of this type of disorder. In Russian, anxiety, and anxiety is synonymous, and in English anxiety and worry are different. Anxiety arises immediately at the moment of danger and is strongly associated with physical experiences. Anxiety – these are thoughts that are formulated as: “What if …” And what if I’m late? And what if my taxi does not arrive and I do not get to the airport? And what if my plane falls? What if I get sick?
This anxiety is constantly spinning in the head, does not give an opportunity to relax and rest. Every step is accompanied by anxiety, the quality of life decreases. Typical symptoms in generalized anxiety disorder are headaches or back problems due to muscular tension.
Specific phobias: Specific phobias are a fear of specific things. For example, fear of heights, fear of airplanes, fear of dogs, fear of spiders, fear of open or closed spaces, and fear of becoming infected with HIV / AIDS. The list of specific phobias is huge.
Hypochondriacal disorder: Hypochondriacal disorder or anxiety about health (health anxiety) also applies to anxiety disorders. A person is afraid that he may get sick with something, and constantly checks himself for the presence of diseases, often goes to doctors, spends a large amount of money on this. After receiving information that he is healthy, the patient calms down for a while, but not for long. Soon, the imaginary symptom again causes suspicion, and the person again runs to be checked. He can spend a lot of time on the Internet, reading about diseases and looking for them at home. These are typical signs of hypochondria. It is usually very difficult for a person, and, moreover, people with hypochondriacal disorder spend a lot of money – either their own or state money – and cause damage to society through the reuse of medical resources.
Previously, obsessive-compulsive disorders were also referred to as anxiety disorders, but now more and more studies include OCD in a separate class. Psychosomatic disorders were also related to anxiety disorders, and anxiety does play a big role in them, but they are also now separated into a separate group.
Among personality disorders emit a cluster of anxious personality disorders. There are three types within it: avoidant personality disorder, obsessive-compulsive personality disorder, and dependent personality disorder. They differ from anxiety disorders. Personality disorders are characteristic of people whose anxiety is part of the character. It is not a reaction to any event, disease, or disorder that began and ended. This is part of a person’s personality. It begins in early adolescence and is present with a person throughout his life, usually adversely affecting his fate. The intensity of the alarm may be different. People with anxious personality disorders are not protected from the development of additional anxiety disorder against the background of personality.
It used to be considered that personality disorders are not treated: if you were born with such a character, nothing can be done about it. To date, views have changed. Psychotherapy methods have emerged, in particular, the scheme-therapy, which is aimed at people with different types of personality disorders, including the anxious pattern of personality disorders. There are studies that show the effectiveness of psychotherapy, and we can help these people. This is a long-term treatment – usually from one to three years. Pharmacotherapy in relation to personality disorders remains ineffective, and it is impossible to change the nature of the pills.
Causes for Anxiety Disorders
Where does the alarm come from? The amygdala (amygdala) is a part of the limbic system, a brain area that is responsible for emotions, including anxiety. The same zone is responsible for the danger and the response to situations of stress. Anxiety as an adaptation reaction exists in all, but not all, anxiety disorders occur.
How are people who have frustration? Biological and genetic prerequisites play an important role. It is believed that people who are prone to anxiety disorders, especially arranged shoulder gene responsible for the production of serotonin. When stressful events, serotonin deficiency is felt stronger, and anxiety disorder occurs.
It is known that, in addition to genetic predispositions, people with anxiety disorders have more reactive amygdala. Under stress, pronounced reactions occur faster and more intense. The prefrontal cortex, which is responsible for the control and rational thinking, maybe functionally less active. Due to the nature of the functioning of the brain, anxious people may be more embraced by emotional experiences, they need more time to analyze and calm down.
But it is also possible to work with biologically determined factors: develop skills of emotional regulation, and thanks to this the prefrontal cortex will be strengthened, and the person will become less vulnerable to the development of anxiety states.
Early childhood experiences play a large role in the development of anxiety disorders. High levels of stress and anxiety during childhood, for example, separation from a mother or living in an unstable, unsafe environment, affects brain development and human psychology. Such people are more vulnerable to anxiety and depressive disorders in adulthood.
Different types of anxiety disorders manifest in adulthood is not spontaneous. There are provocative, trigger situations: the transition to a new job, the birth of a child, a divorce, the loss of something meaningful. External stresses activate the hypothalamic-pituitary system at the biological level, the cognitive system at the psychological level, and along with with them – disturbing ideas about themselves, the world, and people. The complex biopsychosocial machine begins to work, and anxiety disorder develops.
Stress, lack of sleep, excessive use of coffee, alcohol and other vegetative-stabilizing factors make a person’s vegetative system more sensitive, somatic manifestations of anxiety appear easier and more intense. Such situations can be a predisposing factor for the development of anxiety disorders, but not necessarily. When the lifestyle is normalized, the autonomic nervous system returns to normal.
Complicated Anxiety Disorders
Among different types of anxiety disorders, some are complicated and clinical. If a person has been ill for a very long time or has certain features of character, even personality disorder, then he may manifest several anxiety disorders (comorbid anxiety disorders), that is, both social anxiety disorder and panic disorder. Therapy of such disorders is more difficult than normal.
Against the background of chronic anxiety disorders, secondary depressions may occur. For example, a person all his life is very afraid of companies and remains lonely. Basic social needs are not met, and in addition to anxiety disorder, depression arises, accompanied by a painful feeling of loneliness and abandonment.
It is necessary to distinguish secondary depressions that occur on the background of anxiety disorders and anxious depressions. Depression itself may manifest symptoms of anxiety, but this is a separate group of mood disorders. Psychiatrists are able to distinguish between anxiety disorders and anxious depression, where anxiety is one of the symptoms. For anxiety disorders, anxiety is either very high, or it is overly concentrated. In other mental disorders, such as depression, schizophrenia, organic brain lesions, anxiety can manifest itself as a symptom, but in addition to this, other symptoms of the underlying disease will be present, anxiety will not be the only manifestation.
Treatment of anxiety disorders
It used to be that different types of anxiety disorders can be cured only with medication. Then there were very effective methods of psychotherapy, cognitive-behavioral therapy is the most effective in this case.
If untreated, anxiety disorders become chronic. They are much more difficult to treat. If a person has experienced several panic attacks and turned to a psychotherapist for help, he can be helped quickly and without the use of medications. If a person has suffered from panic disorder for 15 years and has ceased to leave the house, treatment will require much more time, resources and efforts on the part of the patient and the therapist.
There is a negative correlation: the higher the anxiety, the lower the quality of life and satisfaction with it. The higher the anxiety, the less the subjective perception of happiness and the experience of oneself as a happy person.