Anxiety is a tense and unpleasant emotion in anticipation of an impending bad situation. According to studies in Europe and the United States, the prevalence of anxiety disorders in the general population is 5 per 1,000, while it accounts for about 10-14% of patients in cardiology outpatient clinics.
The etiology may be related to the following.
1, neurotransmitters: central NEergic system, DAergic system, 5-HTergic and -aminobutyric acid (GABA) and other four neurotransmitter system doctrines.
2.Lactate doctrine.
3.The benzodiazepine receptor ligand theory.
4.Autonomic dysfunction hypothesis.
5. The behaviorist theory theory may be related to the pathogenesis of anxiety disorders.
Clinical manifestations
Acute anxiety (panicattack) is a panic attack:
Expressed as a sudden panic experience. It is often accompanied by a sudden sense of death, a sense of impending disaster, a sense of lack of breath, a sense of suffocation, a feeling of going crazy, a loss of mental control, and often lasts for tens of minutes.
The attack is often accompanied by three types of autonomic dysfunction symptoms.
1, cardiac symptoms: chest pain, tachycardia, irregular heartbeat.
2. Respiratory symptoms: dyspnea or choking sensation.
3, neurological symptoms: headache, dizziness, lightheadedness, vertigo, syncope, abnormal sensation.
4. Sweating, shivering, abdominal pain, and generalized weakness are also common. Acute anxiety state starts rapidly, discontinues quickly, and lasts for tens of minutes and then relieves itself. Intermittent palpitations and weakness are common. Most of the episodes are recurrent and it is common to see the emergency department, internal medicine department, and especially cardiology department.
Chronic anxiety (generalanxiety) i.e. generalized anxiety
It is the most common clinical condition. Symptoms develop chronically and persist, but are less severe than in the acute phase. Chronic anxiety is different from normal anxiety: first, anxiety is unprovoked, anxiety, tension and fear without clear object and content; second, it seems that some threat is coming, but the patient himself cannot figure out what it is; third, it lasts for a long time, weeks, months or even years, and is accompanied by a variety of other symptoms.
1. Anxiety and emotional symptoms.
Patients’ emotions are often uneasy and nervous, often overly worried about certain things in real life or certain things in the future, and can also be worried without a clear goal. This kind of worry is often extremely disproportionate to reality, making patients feel very painful. Patients are distracted, impatient, irritable and temperamental. When interacting with people, they are nervous and anxious, unable to calm down, panicking and thinking of bad things; even when resting, they are worried and afraid, distracted and worried about bad news or bad things.
2, autonomic dysfunction and other common symptoms.
Palpitations and chest pain panic and chest tightness:is one of the most common symptoms of anxiety disorders. Chest pain: often thought of as “angina pectoris”, for which you may go to the cardiology department. Shortness of breath and hyperventilation can lead to dizziness and swelling, numbness in the fingers and toes and around the mouth, further aggravating anxiety and creating a vicious circle. Sweating, dry mouth, frequent urination, urinary urgency, constipation or diarrhea, red or pale skin, impotence and premature ejaculation, menstrual disorders, fatigue (which cannot be relieved even after rest), hypersensitivity, narrow-mindedness, easily provoked to lose temper and regret afterwards; feeling allergic, afraid of light, unable to tolerate noise, afraid of crowding, unwilling to visit doors, often stay at home. It is also common to be easily moved (such as crying while watching TV), insomnia such as difficulty in falling asleep, easy to wake up, and dreaming a lot. Increased alertness: sensitivity to various external stimuli such as sound, light, etc., easy to have startle reaction, easy to have startle reaction and wake up during sleep.
3. Tension and restlessness with muscle pain symptoms.
Restlessness, fidgeting, shaking limbs, whole body flesh jumping, whole body muscle tension and pain (e.g. neck soreness, pain), tongue, lip and finger tremors, etc.
4. Other symptoms.
Depression, compulsion, fear, fatigue, panic attacks, etc., are not the main clinical phase of the disease.
Precautions
Anxiety disorders should be diagnosed early and treated early to avoid prolonged illness and other psychiatric problems. Patients with depression are often accompanied by significant anxiety symptoms. Physical disorders often associated with anxiety are acute myocardial infarction, mitral valve prolapse, coronary artery disease, paroxysmal hypoglycemia, sedative drug and substance use, abuse, etc. The diagnosis still needs to be made by a psychiatrist or mental health professional.
Treatment
Psychiatric treatment is effective, and pharmacotherapy has progressed tremendously in recent years. Previously commonly used hypnotic sedative drugs such as phenobarbital have been eliminated due to poor treatment and side effects. The efficacy of anti-anxiety treatment is certain, the use is becoming more widespread, and the side effects are smaller than before, but its use still needs to be implemented by a psychiatric specialist to avoid serious problems, and the treatment becomes a cause of illness, regretting it too late.