Causes of anxiety disorders, symptoms and treatment

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Generalized anxiety disorder smoothly flows from constantly observed stress that a person can experience every day for a long time. If previously he was worried about some mental irritants, then with the pathology described these may be absent: anxiety arises for no reason.

This is an unpleasant disease - a person is in a state of constant internal tension, he concentrates on his disorder, this prevents him from fully working and resting, enjoying the usual joys of life - delicious food, relationships with the opposite sex, beautiful nature, and so on.

Psychiatrists emphasize that it is sometimes difficult to understand at what stage stress nervousness turns into generalized anxiety disorder. Experts believe that at least half of the adult population has experienced a “lightened” and shortened version of this disorder at least once in their lives. Moreover, the person himself understands that he has developed a pathology, but he cannot overcome it only through willpower - patients often describe their condition as follows: “You can’t brush it off.”

More often, representatives of the age category from 18 to 42 years are susceptible to this pathology. As a rule, they suffer in big cities; residents of small villages quite rarely encounter this pathology.

note

Generalized anxiety disorder is more of a women's problem: for every one sick man, there are three to four sick women. This is due to their greater tendency to “digest” events, troubles, gloomy prospects that seemed to loom on the horizon (although this is not necessarily what will happen in real life).

Anxiety and irritability in women for no reason

Feelings of anxiety and restlessness are a kind of “outburst” of negativity that can, over time, destroy not only a person’s inner world, but also negatively affect his relationships with relatives, friends and colleagues. Very often, this condition occurs in women, due to their greatest emotionality.

In the vast majority of cases, it is provoked by:

psychological reasons (constant lack of sleep; overwork; experienced severe stress that left a feeling of fear; addiction of various kinds: alcohol, nicotine, drugs);
physiological reasons (pregnancy; menopause and the period before it; deviations in the normal functioning of the thyroid gland; hormonal imbalances, including in the period after childbirth and before monthly menstruation);

genetic reasons (in this case we mean cases where irritability and anxiety are innate and should be perceived as a character trait).

Causes and development of pathology

There are several theories that successfully try to explain the development of generalized anxiety disorder. These are the theories:

internal contradictions;
conditioned reflex;
neuroregulatory;
congenital disorders;
imitation.

This disease was explained by internal contradictions by the famous Austrian psychologist, psychoanalyst, psychiatrist and neurologist Sigmund Freud. According to his theory, tension and anxiety arise due to a person’s misunderstanding of himself. More precisely, the quintessence of the theory looks like this: between the Id (instinctive drives) and the Super-Ego (principles that were laid down in the family and society) dissonance, disagreement, conflict and even an internal “quarrel” arise. This refers to dissatisfaction with life circumstances that arises due to many restrictions. For example, a person cannot:

have sexual relations with many members of the opposite sex, as this is condemned by society;
cannot eat tasty but unhealthy food, smoke or drink alcoholic beverages in unlimited quantities, because the doctor prohibits this

and so on.

Later the theory was developed. After studying a large number of patients with the described pathology, clinicians came to the conclusion that in such patients, in addition to dissatisfaction, there is anxiety about the future, which cannot be predicted (date of death, successful or unsuccessful course of pregnancy, and so on).

The theory of the conditioned reflex explains the occurrence of the described disorder as a kind of unconditioned reflex to unpleasant things - critical situations, the need to endure pain during medical intervention, and so on. Adherents of this theory consider anxiety to be a natural reaction to the potential occurrence of danger. Several centuries ago it was a fear of a real threat to life due to diseases that were incurable at that time, outright robbery, and so on. Now such anxiety has shifted to a calmer direction - it arises due to:

possible dismissal at work;
risk of not repaying the loan;
scanty chances of entering a higher educational institution

and so on.

The patient, having not yet encountered the problem, does not see its real solutions and painfully thinks about how the situation will unfold, but cannot influence it, if only because it has not yet been observed. In common parlance this is called “pushing yourself too hard.” The patient mentally goes through many times the options for how the problem situation will be resolved - and these options are not optimistic. Particularly affected are patients with a creative mind, with a rich imagination, who come up with whole frightening storylines of what has not yet happened and what in fact may or may not happen. They don't realize that:

the situation may take a drastic turn;
there will be someone who can help solve the problem

and so on.

note

It has been suggested that the creators of bright, sensational, highly rated films on the themes of world wars, the apocalypse, general famine and pestilence and other large-scale troubles are prone to generalized anxiety disorder, which is explained by the theory of the conditioned reflex.

The neuroregulatory theory explains the occurrence of this disease by the fact that the balance of neurotransmitters - biologically active substances - is disturbed. Processes in the brain depend on characteristics such as:

the amount of neurotransmitters;
their ratio;
state of receptors that perceive (or do not perceive) their signals

and so on.

When such factors are violated, a failure of regulation is observed, the brain “paints” distorted pictures of the future, and the patient develops and increases anxiety about the unknown.

The theory of congenital disorders explains the occurrence of generalized anxiety disorder by a congenital disorder in the regulatory centers of the brain.

At the same time, opponents of this theory argue that in a large number of people these disorders developed only throughout life, after a period of well-being.

According to the theory of imitation, generalized anxiety disorder occurs in a person if he is surrounded by pessimistic, anxious people who become role models for their analysis and negative assessment of the present and future.

Factors against the background of which the described disorder occurs more often are also identified (although they do not contribute to its development in all people). This:

psychological problems “originating” from childhood;
complex relationships in the family, society, and professional circle;
a certain lifestyle;
changing the usual way of life;
character traits of the patient;
material insecurity;
experienced violence.

A person’s predisposition to anxiety may arise due to the difficult psychological environment in which he lived in childhood. This:

constant criticism from elders;
ridicule from peers;
inflated expectations and demands of parents

and so on.

Important

Difficult relationships are one of the strongest contributing factors to the development of generalized anxiety disorder. Family and personal conflicts are especially important; problems at work and tense relationships in society also contribute to the development of the described pathology.

What lifestyle can contribute to the development of the described disease? This:

passion for smoking, drinking alcohol and taking drugs;
“recluse” - a person prefers to spend his free time at home, away from the company of friends, locked in a room from his family;
hypodynamia – inactivity;
excessive consumption of stimulants that lead to overstimulation of the nervous system - coffee, strong tea, various energy drinks.

For some patients, life changes triggered the development of generalized anxiety disorder:

changing of the living place;
admission to an educational institution;
a new project, unknown and incomprehensible.

Personality traits largely determine the risk of the described disorder. It occurs more often in people:

psychologically unstable;
susceptible to the influence of others;
worried about the slightest psychological shock.

More often, generalized anxiety disorder develops in people who currently suffer from financial problems or have suffered in the past. Psychotherapists describe clinical situations in which wealthy, successful people who had previously experienced extreme poverty came to see them.

Those who have experienced violence of various types are more prone to the occurrence of the described disease - as a rule, these are:

sexual harassment;
severe pressure at work;
pressure from society and family.

Reasons for development

At the moment, there are no exact causes of anxiety. There are cases when people have an acute feeling of anxiety, but there is no reason for this. In contrast, people experience anxious tension as a result of psychological trauma. There is a theory that anxiety disorders are genetically transmitted. Genes can cause psychological imbalance in the brain under the influence of genetic factors, but this is just a theory.

Let's look at the main recognized causes of anxiety:

Hereditary factor. Some studies have shown that anxiety disorders can pass from close relatives genetically and be congenital.
Features of education. Often parents scare their children with the consequences of certain actions, “if you don’t obey, I’ll give it to the gypsies,” “if you don’t sleep, the old man will come,” and many other nonsense. The child begins to feel fear, and the parents, satisfied with obedience, do not think about the consequences. Therefore, quite often childhood fears haunt people into adulthood.
Overprotectiveness. And again the reason is in the attitude towards the child in childhood. If the parents were unable to teach the child independence, then in adulthood he will most likely expect other people to solve his problems.
The desire to constantly control everything. Any situation that gets out of control brings anxiety and discomfort to a person.

Symptoms of generalized anxiety disorder

Generalized anxiety disorder is characterized by a long, protracted course, with alternating periods of remission (no symptoms) and exacerbations. The clinical picture consists of such signs as:

anxiety;
motor tension;
somatic disorders - in particular, disruptions of the autonomic nervous system.

The main symptom is excessive anxiety, which does not correspond to the real state of things. At the same time, the patient is afraid, worried, and worried more than he should be afraid to worry and worry about. Such anxiety arises from fear:

threats to life and health in the future;
social upheaval;
dollar exchange rate;
possible divorce

and many other situations that could theoretically arise in the future, but are not currently available.

Moreover, some patients “picture” in their imagination an overly pessimistic development of events despite possible solutions to problems:

they think that they may develop a stomach ulcer against the background of real gastritis - although it can be successfully treated with modern medicine;
they assume that their enterprise may be closed in the current economic crisis - although there are no real prerequisites for this;
believe that they will not enter a higher educational institution - although they have a stock of knowledge and systematically prepare for admission;
they are afraid of being robbed - although they live in a prosperous area

and so on.

If the patient does not seek help from specialists, such anxiety can be observed for a long time - many years. Periodically, it self-destructs if a person is busy with real, but non-critical problems, or pleasant events that are extremely significant for him occur in his life. In the latter case it is:

creating a family;
birth of a child;
success in the professional field;
acquisition of real estate;
especially desired trip

and many other factors.

If the illness is prolonged, then constant stress exhausts the patient. He is worried about:

memory impairment;
inability to concentrate;
rapid onset of fatigue during normal activities – mental and physical;
sleep disorders.

In the latter case, the following are characteristic:

insomnia at night;
daytime sleepiness;
nightmares;
easy awakening under the influence of the slightest stimuli.

Psychological exhaustion leads to the development of symptoms such as:

attacks of irritability, which are replaced by tearfulness or indifference to what is happening around;
low threshold to external stimuli - the patient reacts sensitively to sounds, light, and painful stimuli;
psychological depression;
regularly occurring obsessive thoughts.

Motor tension is manifested by such disorders as:

fussiness;
muscle tension, up to the appearance of short-term cramps;
noise in ears;
headache.

The characteristics of headaches are as follows:

by localization - in the frontal, parietal or occipital region;
by distribution - irradiation, as a rule, is not observed, pain is local;
by nature – pressing, aching;
in terms of severity – medium intensity;
by occurrence - at first they appear periodically, then more and more often. They can be bothersome in the form of attacks that last for several hours or even days.

Disorders of the autonomic nervous system manifest themselves in the form of activation of its sympathetic segment. In addition, short-term but regular failures of functions are observed:

cardiovascular system – palpitations, heart pain;
respiratory system – attacks of shortness of breath;
gastrointestinal tract - dry mouth, difficulty swallowing, pain as with gastritis, alternating constipation and diarrhea, bloating, difficulty passing gas;
urinary system – frequent urination;
genital area - erectile dysfunction in men and menstruation in women, decreased libido in both;
organ of vision – “floaters” before the eyes, short-term darkening in the eyes;
organ of hearing – transient tinnitus and hearing loss;
musculoskeletal system – muscle weakness;
central nervous system - dizziness, and in particularly sensitive persons - pre-fainting with especially aggravated anxiety syndrome;
peripheral nervous system – numbness, tingling, “goosebumps” on the skin.

How to recognize anxiety and cope with it. 5 principles and 8 steps

Photo: Alex Bailey/Unsplash

Learn to distinguish between adequate and groundless anxiety

Every emotion has meaning and purpose.
Adequate anxiety is always a response to some real threat. If a person experiences emotional shocks that are short in time and strength, then so-called stress hormones are produced in his body. The three most famous of them are adrenaline, norepinephrine and cortisol. Adrenaline and norepinephrine make us more energetic, and cortisol allows us to absorb more information, causing the hippocampus, an area of the brain involved in the formation of our long-term memory, to function more efficiently. Minor stress allows us to develop, gain new experience and mobilize internal resources. We can talk about an anxiety disorder when a person for a long time - on average, more than six months - feels anxiety without an objective reason, or his reaction becomes inadequate to the real situation. But groundless anxiety is far from the only symptom. A person may suffer from rapid heartbeat, chills, increased sweating, clinically unexplained pain (most often headaches, back and abdominal pain), digestive disorders, as well as frequent fluctuations in blood pressure. Problems may also arise in the sexual sphere.

Change negative parental attitudes

Children of anxious parents are much more likely to develop an anxiety disorder. Most often, the prerequisites for its development are formed by the attitudes of adults. If parents and other significant adults constantly convey to the child that the world is very dangerous - “Don’t go there - you’ll get hit by a car!”, “Don’t touch anything, there are germs everywhere!”, “If you catch a cold, you’ll get sick!” and so on - this can significantly harm his mental health.

It is best to change attitudes and heal childhood psychological traumas in sessions with a professional psychologist who knows psychotherapeutic methods or a psychotherapist. The gold standard for treating anxiety is cognitive behavioral therapy (CBT), which helps change irrational thoughts and beliefs, and as a result, thinking and perception of the world.

However, often cognitive behavioral therapy alone is not enough and work with more in-depth psychotherapeutic methods is required. In this case, CBT can be combined, for example, with emotional-imaginative therapy, which helps to quickly change a person’s emotional state, as well as heal childhood psychological trauma.

Don't be afraid to consult a doctor

An anxiety disorder is diagnosed by a psychiatrist or psychotherapist. The diagnosis itself is necessary in order to select the necessary treatment, including medication when necessary. An anxiety disorder does not affect employment in a company that does not require a certificate from a psychoneurological dispensary. However, it can affect a person’s performance, and to a significant extent.

Photo: Viktor Nikolaienko/Unsplash

Crises help us reach a new level

It is impossible to avoid all shocks in life. If a person's losses are too great, they may experience an existential crisis. Although these crises are often associated with certain periods of a person's life, there is not always a direct connection between them. It is believed that a person must achieve certain milestones by a certain age. And if, contrary to expectations, he does not achieve them, an existential crisis may arise. In essence, such a crisis is a signal that a person’s life lacks meaning.

There is no point in consciously avoiding such crises, because they help to reach a higher level of spiritual development. But at the same time, we can soften their passage by trying to develop awareness in ourselves, that is, the ability to understand what we feel; trying to live rather than suppress your emotions; as well as developing the ability to hear your real desires and follow them. And, of course, if possible, treat your psychological trauma.

Live in the moment

As American psychotherapist and psychiatrist Irwin Yalom said, you need to live your life to the fullest, and not put it off for later. This is the most important point listed. It is also important to live our emotions at the moment when they overtook us. Cry when you want to cry and laugh when you want to laugh. When we are positive, we are very convenient for those around us - our partner, our relatives, our employer - but staying positive all the time does not make us healthier. If you feel very sad, but you are embarrassed to express it because you are afraid of ruining the mood of others, think about yourself first and still express it. You will definitely feel better.

Helpful Techniques for Preventing Anxiety Disorders

- Start expressing pent-up anger without harming others. For example, you can twist a dry bright red towel or strain all the muscles of your body with all your might, and then relax them, and so on several times in a row until you feel relief. Or buy a couple of dozen eggs, go to nature and throw them into a tree with feeling. There will be no harm to the tree, the forest inhabitants will enjoy the treat, and you will feel much better.

- Do any sport you like - from swimming to running, all this is a great stress reliever. Fast walking also counts.

- Learn to relax well. Spas, meditation and massage can help prevent the development of an anxiety disorder.

— Try the Scarlett O'Hara method, named after the main character in Gone with the Wind, who said to herself: “I'll think about it tomorrow.” For example, if a person is unreasonably worried that their partner is cheating on them, they can take 15 minutes three times a day to think about it purposefully. The essence of the method is that when a person forces himself to think about something, and even at a strictly defined time, he quickly gets bored with it. The same mechanism works with emotional dependence: thinking about someone for an hour after lunch and dinner. It turns out that when you can’t think, you want to think, and when you can, you don’t need to.

— Experience sadness and other negative emotions. If you switch yourself to artificial positivity, sadness will be pushed into the subconscious, “accumulate” there and can lead to the development of anxiety, depression and other serious psychological problems.

- Try to avoid stressful situations - for example, unproductive showdowns. And try to manage those that cannot be avoided.

— Try the exercise of the founder of the method of emotional-imaginative therapy, Nikolai Dmitrievich Linde, which helps to live and let go of sadness. If a person cannot afford to cry, then he closes his eyes and imagines a downpour. In the language of the subconscious, rain is tears. You need to mentally look at the rain until it stops and the sun comes out.

- And of course, promptly seek help from a specialist.

Prepared by Tatyana Agababova

Diagnostics

It is not difficult to make a diagnosis based on regularly occurring anxiety sensations, but the problem is that some patients:

perceive anxiety not as a psychological problem, but as a reaction to, in their opinion, the real state of things;
are ashamed to consult a psychiatrist, regarding the status of a patient in a psychiatric clinic as something humiliating.

In general, the diagnosis is made based on the patient’s complaints and anamnesis (history) of the disease. In connection with the development of somatic disorders (palpitations, abdominal pain, urination problems, and so on), for the purpose of differential diagnosis, examination of various organs and systems may be required. To exclude somatic disorders, specialists of a narrow profile are invited to a consultation - a cardiologist, gastroenterologist, urologist and others. They will determine the need to prescribe additional instrumental and laboratory examination methods.

Differential diagnosis

Differential (distinctive) diagnosis of generalized anxiety disorder is carried out with such diseases and pathological conditions as:

panic attacks - severe panic attacks;
phobias – fears of certain things;
depressive states - depressed state;
obsessive states - the inability to get rid of thoughts of a certain nature.

Also, differential diagnosis for somatic manifestations of the described pathology should be carried out with various diseases of the cardiovascular, respiratory, digestive and other systems.

Complications

The main complication of generalized anxiety disorder is neuropsychic exhaustion of the patient. Against this background, other mental disorders may occur:

neurosis is a pathology with asthenic and hysterical manifestations, a transient deterioration in working capacity (mental and physical);
depression

and so on.

Treatment for generalized anxiety disorder

Depending on the severity, generalized anxiety disorder can be treated on an outpatient basis or in a neurosis department.

The treatment is based on:

healthy lifestyle;
psychotherapy;
drug therapy.

Meaning:

compliance with the work, rest, sleep schedule;
proper nutrition - in particular, taking a large amount of vegetables and fruits, avoiding stimulants (coffee, strong tea);
rejection of bad habits.

The main methods of psychotherapy are:

auto-training;
abdominal breathing;
relaxation training – mental and physical;
art therapy – the patient’s contemplation of works of art;
animal-assisted therapy – contact with animals

and other methods.

Drug therapy is used in difficult cases. In this case, the following are assigned:

sedatives;
tranquilizers;
antidepressants.

If symptoms develop in other organs and systems, then it is often necessary to prescribe medications that relieve them - for example, antiarrhythmic drugs for tachyarrhythmia (rapid heartbeat).

Prevention

There is no single “recipe” for how to prevent the development of generalized anxiety disorder. To prevent this pathology, the following are very important:

the general psychological state of a person - patients who have encountered less severe problem situations are not yet psychologically exhausted and can withstand their own anxieties;
general hardening in the face of life’s difficulties - on the other hand, if a person has already successfully overcome some problems and has not suffered psychologically, then he will use his own experience of dealing with anxiety, look for a solution to the problem of how to “get away” from such a state, and if it has begun develop - how to shift attention so as not to “get hung up” on problematic situations that have not yet occurred;
personality type – optimists are less prone to generalized anxiety disorder;
an example of others who, in similar circumstances, do not even perceive a real problem as something critical.

Specific symptoms of GAD

Anxiety is diagnosed based on the following symptoms.

Excessive worry and worry (anticipation anxiety) occurring over more than 6 months regarding a series of events or activities (such as work or school performance).
It is difficult for a person to control anxiety.
Anxiety is associated with three (or more) of the following six symptoms:

Anxiety, feeling depressed or irritable.
Fast fatiguability.
Difficulty concentrating or loss of concentration.
Irritability.
Muscle tension.
Sleep disturbance (difficulty falling asleep or restless, shallow sleep).

Children do not need to meet as many criteria - only 1 of them is required.

Forecast

The prognosis for generalized anxiety disorder varies. It depends on factors such as:

timeliness of contacting the clinic;
correct diagnosis - sometimes somatic manifestations “muffle” mental symptoms, which is why the diagnosis can be made late, and this leads to the progression of the pathology;
patient's mental reserve;
strict adherence to the instructions of the attending physician;
complicity and empathy of the environment (close people).

If the irritating factor that contributed to the development of the described pathology is unexpressed and transient, the treatment is timely, and the patient has not previously suffered from debilitating psychological diseases, then this pathology is stopped. But it should be borne in mind that if there are causative factors, it can occur again.

There is evidence that in half of patients, with proper treatment, signs of pathology disappear within two years, and in the other half - no more than five.

If treatment is not carried out (the patient ignores visiting the doctor), then sooner or later the following will occur:

mental exhaustion;
decreased ability to work, which can lead to problems in the professional sphere, including dismissal;
impaired communication abilities;
worsening sleep;
lack of immunity to life's difficulties.

Kovtonyuk Oksana Vladimirovna, medical observer, surgeon, consultant doctor

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Common symptoms of anxiety

Studies have shown that anxiety for no particular reason is characteristic of 90% of adolescents and more than 70% of young people aged 20 years and older. The state of anxiety in this case has the following symptoms:

feeling of defenselessness, helplessness;
inexplicable panic before an upcoming event;
unreasonable fear for your own life or the lives of loved ones;
perception of standard social functions as an inevitable encounter with hostile or judgmental attitudes;
apathetic, depressed or depressed mood;
inability to concentrate on current affairs due to obsessive anxious thoughts;
critical attitude towards oneself, devaluation of one’s own achievements;
constant “replaying” of situations from the past in the head;
searching for “hidden meaning” in the words of the interlocutor;
pessimism.