The word “anxiety” is widely used in our daily lives. Whether it’s a marriage, a job or a sporting event, people feel a little worried and anxious about the outcome, and there’s no doubt that anxiety is a normal part of life. In addition to being a common emotion, moderate levels of anxiety can often be a powerful motivator, helping people to blitz memorize for an exam, complete a work assignment or give an energetic speech. Anxiety is not a bad thing, and it can often motivate you to muster the strength to cope with an impending crisis.
However, if you have too much anxiety, then this emotion will have the opposite effect, it will prevent you to cope with, deal with the crisis in front of you, and even hinder your daily life, you may feel anxious most of the time, for no clear reason, you will feel that your anxiety is so hampered by your life, in fact you can not do anything. As you can see, anxiety is not the same as anxiety disorder, so what is a medical anxiety disorder?
Anxiety disorders are neurological disorders in which episodes or persistent emotional anxiety and tension are the main clinical symptoms, often accompanied by obvious somatic symptoms such as dizziness, lightheadedness, chest tightness, palpitations, dyspnea, dry mouth, frequent urination, sweating, tremor and motor restlessness, and whose level of tension or panic does not correspond to reality.
I. What is the difference between normal anxiety and anxiety disorder?
There are certain causes, understandable and moderate reactions. Occasionally worrying about some random event, such as an exam or a lost love, may make you feel depressed. It is an adaptive response or a biological defense phenomenon when people anticipate that a dangerous or painful situation is about to occur, and is a complex combination of emotions.
No clear anxiogenic factor, disproportionate anxiogenic factor and reaction, severe degree, excessive duration. Persistent, chronic, unjustified worry that causes great mental distress, disrupts your social life, or interferes with normal school and work.
Anxiety can also be a symptom of all mental illnesses. Pathological anxiety is a fear that is out of control and has no clear object or content, and its threat is very much at odds with the degree of anxiety.
Second, the causes of anxiety disorders.
What exactly causes anxiety disorders is a very complex issue, and so far we have not been able to fully answer this question. However, the existing research shows that.
1. Although somatic diseases or biological dysfunction will not be the only cause of anxiety disorders, in some rare cases, patients’ anxiety symptoms can be triggered by somatic factors, for example, hyperthyroidism and adrenal tumors. Moreover, many researchers have tried to discover if it is the central nervous system, especially certain neurotransmitters, that is responsible for triggering anxiety disorders in patients with anxiety disorders.
Much research has focused on two neurotransmitters: norepinephrine and serotonin. Many studies have found that when patients are in a state of anxiety, their levels of norepinephrine and serotonin in the brain change dramatically, but it is not very clear whether these changes are a cause or a consequence of anxiety symptoms.
2. Cognitive processes, or your thinking, play an extremely important role in the development of anxiety symptoms. Studies have found that depressed patients are more inclined than the general population to interpret ambiguous, even benign, events as harbingers of crisis, to think that bad things will fall into their laps, to think that failure awaits them, and to underestimate their ability to control negative events.
Third, research has found that anxiety disorders are more likely to occur in the presence of a stressful event.
Third, the causes of anxiety disorders.
Researchers from different schools of thought have different opinions about the causes of anxiety disorders, but these opinions are not necessarily conflicting, but rather complementary.
1, genetic factors: play an important role in the occurrence of anxiety disorders, the rate of homozygosity in their blood relatives is 15%, much higher than normal residents; the rate of homozygosity in dizygotic twins is 2.5%, while monozygotic twins is 50%. It is believed that anxiety disorders are the result of environmental factors acting together through susceptibility qualities, which are determined by genetics.
2, Pre-morbid personality traits: low self-esteem, low self-confidence, timidity, cautiousness, easily nervous about minor setbacks or physical discomfort, anxiety or mood swings.
3.Mental factors: Mild frustration and dissatisfaction and other mental factors can be triggering factors.
4.Biological factors: The physiological basis of the anxiety response is the general hyperactivity of the sympathetic and parasympathetic nervous system, often with excessive release of adrenaline and norepinephrine. The manifestation of somatic changes is determined by the patient’s sympathetic, parasympathetic balance of function.
Some scholars emphasize the connection between the amygdala and hypothalamus and the anxiety disorder, and the discovery of benzodiazepine receptors in the limbic system and neocortex, suggesting the “central theory” of anxiety disorder. Others support the “peripheral theory” of anxiety disorders based on the effectiveness of beta-adrenergic blockers in improving somatic symptoms and relieving anxiety.
The psychoanalytic school believes that anxiety disorders are the result of excessive internal conflict that threatens the ego. Scholars based on “learning theory” believe that anxiety is a habitual behavior and that the conditioned stimuli generalize due to the conditioned association between anxiogenic and neutral stimuli, resulting in widespread anxiety. self-reinforcement, forming an anxiety disorder.
The goal of treatment for anxiety disorders is to increase the clinical treatment rate, complete disappearance of clinical symptoms, restoration of social functions, strengthening long-term follow-up, reducing the recurrence rate of anxiety disorders, and improving the prognosis.
Fourth, the treatment principles of anxiety disorders are.
1.Select medication according to the clinical characteristics of each subtype.
2.Consider drug interactions, drug tolerance, and comorbidities in combination with somatic conditions, and personalize and rationalize the use of medication according to the individual.
3.As far as possible, single medication, adequate amount and full course of treatment can be used, two different mechanisms of action of anxiolytic drugs, but the combination of two or more drugs is not advocated.
4. Observe the adverse drug reactions and changes in condition during treatment.
5. The potential risk of fetal and infant exposure to medications must be weighed against the inherent risk to the mother of not using medications during pregnancy and lactation.
The strategy in the treatment of anxiety disorders should be to start at a low dose and ramp up the medication after 1-2 weeks. For panic disorder, medications are slowly titrated up to the recommended dose after 4-6 weeks, and reassessment of medication reintroduction is warranted if treatment is ineffective for 8 weeks. The range of medications used for OCD is higher than for other subtypes of anxiety disorders.
Is medication and psychotherapy or a combination of the two more effective for anxiety disorders? Psychotherapy is not a substitute for medication in anxiety disorders. Especially for some subtypes of anxiety disorders (e.g., obsessive-compulsive disorder, social anxiety disorder), many national guidelines recommend medication and psychotherapy as first-line treatment options.
Currently, it is generally accepted that the treatment of anxiety disorders: efficacy of medication combined with psychotherapy > medication alone > psychotherapy alone.