More often, the term “anxiety” is used for description of the emotional state, characterized by a feeling of anxiety, and apprehension on the one hand, and the symptoms of activation of the vegetative nervous system on the other hand. When some situation is seen as a part of danger, threat and harm, the anxiety state occurs.
Almost every person experiences anxiety during the whole life. It may be, for example, the difficult life situation in which there is lack of time or information to make well-considered decision, or inability to overcome the conflict. Of course you have had the anxiety before the interview or during the exam and it is a normal emotional reaction. The anxiety is a temporary feeling in the healthy person. But at pathology it becomes constant and is not connected with stress situation.
The anxiety leads to a lack of confidence in the human capabilities. People with high anxiety tend to perceive the world as threatening and dangerous in much greater extent than the person with low anxiety.
According to epidemiological studies, the frequency of anxiety disorders is approximately 1.5%.
They are characterized by a complex psychopathological structure, which includes both acute manifestations of anxiety (panic attacks, autonomic paroxysms, accompanied by a fear of death) and “avoidance behavior” (the desire to avoid situations that could repeat a panic attack). Chronic anxiety disorders lead to severe social maladjustment of patients up to disability.
The clinical picture of anxiety disorders is made up of psychic and somatic symptoms. Mental anxiety includes worry, hot or cold flush, a feeling of tension and stiffness, inability to relax, irritability and restlessness, nervousness, inability to concentrate, memory loss, sleep disturbance, fatigue, and fears.
Somatic symptoms are palpitations, sweating, cold and wet hands, a feeling of “coma” in the throat, a feeling of lack of air, pain in the chest and abdomen, nausea, diarrhea, dry mouth, dizziness, and precollapse, tremor, muscle twitching, tremors, tension and muscle pain, frequent urination, decreased libido and impotence.
Several Kinds of Anxiety Disorder
Generalized anxiety disorder
The patient suffers from constant unjustified or exaggerated fears and anxiety for his family, health, work or material welfare. This disorder is formed regardless of the specific life event and, thus, is not reactive.
Phobias
In this case, the anxiety is connected with certain situations (situational anxiety that occurs in response to the stimulus presentation) and is accompanied by an avoidance reaction. There are three types of phobias: simple phobia, social phobia, and agoraphobia.
The simple phobias include fear of snakes, spiders, darkness, storms, heights, and etc. Because of the simple phobias, patients usually do not go to the doctor, treatment is usually not required.
The patient with social phobia is constantly concerned with the situations that could make him/her be the object of attention. The person tries to avoid any action that could put him/her in a humiliating or ridiculous situation. Such feeling occurs in the crowded places. These difficulties influence on the private and professional life.
The patients with agoraphobia avoid being away from home, in crowded or unfamiliar places, especially the subway. They afraid of panic attack, faint or lose his/her self-control in these places. They go to the doctor, accompanied by relatives, and their social activity is limited due to the inability to be away from home.
Obsessive-compulsive disorder.
This type includes obsessive and compulsive components. The obsessive component is characterized by the domination of persistent, repetitive ideas which the patient is not able to suppress. The typical fear is the fear of pollution, accompanied by constant doubt. The compulsive component is repeated stereotypical actions performed by patients in response to an obsession. Such actions are like some ritual, which intends to neutralize the obsession. The most common rituals are repeated hand washing, various rechecking, exaggerated accuracy, and desire for calculations.
Reactive anxiety disorders.
This form of anxiety is “tied” to a specific stressful situation in family life, social or professional activities. In other words, it is excessive, inadequate or painful reaction to any life event. In some cases, reactive anxiety disorder may be the result of anxiety about health, and severe disease. This type often occurs and is formed due to exceptional, life-threatening circumstances such as earthquakes, air disaster, hostage-taking of the patient or his/her relatives.
Anxiety and depression.
It is difficult to implement the differential diagnosis between depression and anxiety because the mental symptoms of anxiety and depression are similar in some cases and overlap each other. With a prolonged anxiety disorder the patient may have a depression. This depression is often accompanied by such symptoms as chronic pain, weight loss, sleep disturbance, etc. Thereby the circularity appears: the prolonged anxiety causes the development of depression, the depression increases the anxiety symptoms. The combination of anxiety and depression is noted in 70% of patients.
Drug Treatment of Anxiety and Depressive Disorders
Antidepressants are prescribed for patients with anxiety and depressive disorders . Currently, the most frequently used drugs are the selective serotonin reuptake inhibitors (paroxetine, citalopram, fluoxetine, fluvoxamine, sertraline). But not all drugs are equally effective in patients with anxiety disorders. The most optimal are the drugs of balanced action with anxiolytic effect, e.g. Paxil (paroxetine). The experience has shown its high anti-anxious action even in cases when there are frequent and intense panic attacks.
It was established that the long usage of the drug has no effect on the social activity of patients and does not lead to the limitations in the professional sphere. Paroxetine (Paxil) can be combined with hypotensive, vascular, cardiologic, and other anti-diabetic drugs, which are often necessary for patients. And Paxil (Paroxetine) does not cause the addiction.
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