What is Anxiety?
Anxiety is expressed in everyday language as fear, anxiety, distress or overwhelm. In addition to these feelings, people with anxiety also experience negative thoughts, also called apprehensions and delusions, and physical symptoms such as heart palpitations, shortness of breath, and chest pain. Feeling anxious from time to time is part of normal life, and anxiety forces us to be cautious. However, when anxiety lasts for a long time (days to weeks) and is severe, it disrupts normal life and requires treatment.
What are the symptoms of anxiety? What is Anxiety Crisis?
Physical symptoms of anxiety may cause a person to worry that there is a disorder in their physical health.
Physical symptoms of anxiety can be listed as follows;
Shortness of breath,
Sudden rise or fall in blood pressure,
Headache and other pains,
Trembling in hands,
Insomnia and waking up in the middle of the night
Psychological symptoms are;
A state of fear that can be as severe as the fear of death,
Expectation that something bad will happen,
inability to calm down,
Is not quick to anger.
The person needs to be reassured over and over again that he or she does not have a life-threatening physical illness.
How Is Anxiety Diagnosed?
In the diagnostic evaluation of anxiety disorders, physical diseases must first be distinguished. Due to heart palpitations, shortness of breath and chest pain, cardiology evaluation and especially ECG (electrocardiogram) examination, as well as routine blood and urine tests are required. Common diseases that may cause anxiety symptoms are screened (e.g. hyperthyroidism, lung diseases, sleep apnea, anemia).
It is important to start psychiatric treatment without delay in order to improve the patient’s quality of life as soon as possible and to prevent psychological problems such as depression and agoraphobia from being added to the picture.
Meanwhile, the possibility that anxiety symptoms may be caused by another psychiatric disorder is also taken into account. (e.g. depression, post-traumatic stress disorder).
Who Gets Anxiety Disorder?
Anxiety or anxiety disorder is caused by biopsychosocial factors.
Genetic predisposition is important; it is common for extended family members of the person to have similar anxiety disorders.
Psychological features include;
Meticulous and anxious personality structure,
Frequent encounter with anxiety-provoking events throughout life (health problems, sudden deaths, loss of mother or father at an early age, accidents)
Showing insecure attachment characteristics in human relationships,
Difficulty getting used to change,
They can be considered as rigid thought structures.
Social factors include threatening events that affect society in general (economic crisis, terrorism, natural disasters, epidemics).
What are Anxiety Disorders?
The most well-known example is panic disorder. We can consider this situation as an anxiety crisis. The duration of these attacks can vary from a few minutes to several hours. Those who have frequent panic attacks go into a state called anticipatory anxiety with the worry that the seizure will come again. This makes them tense outside of attacks and makes it easier for attacks to come.
When anticipatory anxiety sets in, an anxiety disorder called agoraphobia is added to the picture. The person with agoraphobia does not want to be alone and avoids entering narrow places such as elevators or crowded places such as concert halls and buses. The reason for this is the concern that he will not be able to get help during a possible anxiety attack and that he will not be able to leave the place he is in.
Another type of anxiety disorder is known as generalized anxiety. The anxiety in question here continues throughout the day and is not limited to attacks.
Another group of anxiety disorders is known as phobias. Unlike panic attacks and generalized anxiety, anxiety in people with phobia only occurs in certain situations. For example, those with specific phobias (cats, dogs, airplanes) or those with situational phobias (heights, open spaces), those who are afraid of bloodletting and injections can be counted among these.
Social phobia is also an example of situational fears. When such people encounter strangers, eat at a restaurant, attend a meeting, or go on stage, they fear that they will get into trouble by making a wrong move. In fact, they like to be social, but they may avoid such situations because they experience anxiety. Avoiding social environments reduces a person’s performance in business and social life.
What are the Causes of Anxiety Disorders?
Anxiety or anxiety disorders consist of both intellectual (expectation that something bad will happen), emotional (fear) and physical (palpitations) components. Therefore, biological predisposition, learning from the environment and experiences, tendency to get excited, as well as problems in interpersonal relationships are among the causes of anxiety. Especially negative conditions such as traumatic experiences before adolescence and growing up in a dysfunctional family can lead to anxiety disorders in later life.
What are the Methods for Coping with Anxiety? How to Treat Anxiety?
Mild and temporary anxiety is part of normal life. Treatment may not be required unless it disrupts the person’s daily life and reaches a damaging level in the person’s inner world. In this case, lifestyle changes, addressing neglected problems (at home, at work, in social life), and improving communication within oneself and with others would be beneficial.
For those who require treatment, coping with anxiety is important until they benefit from treatment. The person should take into account that pessimistic thoughts caused by anxiety may not reflect the real situation and think optimistically. Turning one’s attention to hobbies one likes can help distract one’s attention and thoughts from fear and anxiety.
It would be appropriate for everyone to increase their awareness of what is good for them. Stimulating drinks like coffee and cola don’t feel good because they often increase heart palpitations. Walking outdoors, taking care of animals and nature, and relaxation exercises are useful.
What are the Anxiety Treatment Methods? How to Treat?
Drug Treatments and Psychotherapy
Anxiety, like other psychiatric disorders, is addressed with medication and psychotherapy. It must be acknowledged that, especially in the early stages of severe anxiety and frequently recurring panic attacks, it cannot be prevented and soothed with psychotherapy alone. At that time, drug treatments were very effective and were at the forefront of treatment.
On the other hand, supportive psychotherapy is necessary from the very beginning in terms of reassurance. A reassuring, calming attitude and information (psychoeducation) reduces the person’s feeling of panic. Providing brief information to the person’s relatives and family members, with the patient’s permission, prevents wrong attitudes that may cause an increase in the patient’s panic. For example, attitudes that will increase excitement, such as taking the patient to the hospital unnecessarily for every attack or calling an ambulance, are prevented. When the patient has a panic attack, it is recommended not to gather in a crowd and have one person take care of him.
The main medications used to treat anxiety or anxiety are substances also known as antidepressive agents. However, if the anxiety is very severe, medications called anxiolytics can be given daily for this treatment to help the patient spend this period more comfortably.
The feature of anxiolytic drugs is that their effects begin quickly (within half an hour) but disappear in a period that does not last a whole day. A negative feature of this second group of drugs is that tolerance (loss of effect) develops when used for a long time (for months) and the use has the potential to turn into an addiction. Therefore, they cannot replace antidepressant medications as long-term treatment. Different types of psychotherapy have short, medium and long-term effects in the treatment of anxiety.
Another important aspect of this is that it is beneficial in reducing the need for medication in the long term. While psychotherapy is more supportive in the first period of treatment, when the person is better, it would be appropriate to establish a dialogue about his life and inner world and to evaluate with a more investigative approach. In addition to psychoeducation in the first weeks of treatment, teaching breathing exercises and systematic relaxation (muscle relaxation techniques) will be useful to make the time until a response to the medication is received more comfortable.
In addition to medication, a type of behavioral psychotherapy called systematic desensitization is used in the treatment of phobias. In this approach, the person is gradually exposed to conditions similar to the object or situation he fears. This work is done according to a program with the guidance of the therapist. The encounter that initially causes high anxiety decreases and disappears over time with the desensitization work carried out step by step. In some cases, Eye Movement Desensitization and Reprocessing (EMDR) can also be used as a type of psychotherapy.
How Long Does Anxiety Disorder Treatment Take?
Initial (emergency) treatment of anxiety disorder lasts about one to one and a half months. In terms of follow-up, support and, if necessary, further psychological analysis, it would be appropriate to continue the entire treatment for up to 6 months. It is necessary to use the antidepressant drug, which is determined to be effective after one month, for at least six months, often up to a year. This practice, known as maintenance treatment, aims to prevent symptoms from returning in the short term.
However, as in every medical condition, a resistant or complicated process may be encountered. For example, not getting the expected positive responses to the medications used, experiencing undesirable effects, and adding other disorders such as depression and agoraphobia to the picture can be counted among these. When a certain drug treatment is increased to the appropriate dose and there is no response after waiting for one or one and a half months, it becomes inevitable to change the drug.
Can Anxiety Be Treated Without Medication?
Mild anxiety can be treated without medication. However, when it exceeds a certain level of severity, persistent avoidance of medication reduces the quality of life. Severe anxiety also leads to impatience and restlessness during psychotherapy sessions. Considering psychotherapy together with drug treatment provides support in reducing and discontinuing the drug dose in the long term. However, in the initial stages when the distress is severe, conducting this psychotherapy in a supportive rather than analytical manner will yield more positive results.
What Happens If Generalized Anxiety Is Untreated?
Failure to treat generalized anxiety negatively affects quality of life. The person’s mood turns depressive and unhappy, and when this situation persists, complete depression may be added to the picture. It is common to encounter people who turn to alcohol and similar substances to relieve stress, or who use medication irregularly on their own. Lack of concentration, sleep disturbance, and fatigue due to constant distress also affect business and social life. As long-term effects, stress-related physical and functional symptoms such as high blood pressure, tachycardia, and problems with the digestive system may occur.