All you need to know about Anxiety disorder

While it is normal to experience occasional anxiety, it becomes acute when it is irrational and excessive. it causes great distress and affects the quality of life. We then speak of anxiety disorders, which can take the form of generalized anxiety, and/or a more acute form with panic attacks. Management includes therapy and medication when necessary.

When anxiety becomes acute

The beating heart, dry mouth, terrible tension, and pervasive and painful anxiety are the sign. These are some of the debilitating symptoms of anxiety disorders, ailments experienced by many people, champions of the consumption of anxiolytics.

Anxiety is different from stress, which is a mechanism for adapting to aggression: in stressful situations, the body secretes hormones like adrenaline, cortisol, and norepinephrine to mobilize its physical and psychological capacities and "escape danger."

On the contrary, anxiety is a complex emotion, of the order of the mind, which does not require adaptation: while stress is a response to a particular event, anxiety is an anticipation of a negative situation, source of uncontrollable and irrational fear. It can occur in response to stress when symptoms persist, and the causes of stress are no longer present.

Causes of anxiety

We are not all equal when it comes to face the anxiety, some manage anxiety better than others, but everyone can suffer from an anxiety disorder. It is probably the result of several factors, environmental (in connection with stressful life events), biological with the production of neurotransmitters (serotonin, noradrenaline), and genetic, with a favorable ground. A study had shown that the anxiety disorder and the shortening of the genes were linked, without it being known which of the two had occurred first.

Everyone sooner or later experiences the unpleasant emotion of anxiety, before an exam, in the event of a health problem or accident. But if it is well-tolerated and punctual in some, it becomes acute and harmful in others. The anxious feeling then hinders everyday life, prevents decision-making and action, while negative ruminations become permanent and painful. It is a source of suffering and alters personal, family, or professional life. We then speak of anxiety disorders, which include generalized anxiety, panic attacks (or anxiety attacks), which are detailed below, but also phobias, obsessive-compulsive disorders, generators of great anguish.

Generalized anxiety

Generalized anxiety, also called "generalized anxiety disorder," is a chronic form, with a permanent anxious background and diffuse anxiety, without a specific object. It may be associated with depression or another form of anxiety (panic disorder, phobias, obsessive-compulsive disorder).

- Excessive, persistent and irrational anxiety in most everyday situations.

- Major difficulties in reasoning and controlling concerns.

- At least three of the following six: restlessness, irritability, difficulty concentrating, memory impairment, sleep disturbance, irritability, muscle tension.

Therapies, proven effectiveness

The first approach to treatment includes therapies, both cognitive and behavioral. These brief therapies learn to spot anxious thoughts and inappropriate behaviors and then learn new ways of reacting (what psychologists call "thinking restructuring"). They are as effective as drug treatments in generalized anxiety disorder and help reduce drug dosages.

Analytical therapies could be effective in certain patients who have a personality disorder and would allow the patient to understand why he/she developed this anxiety disorder.

Panic attack

This panic disorder is defined by the occurrence of panic attacks in an unpredictable and repeated manner, at least once a month, associated with the pervasive fear of having a new anxiety attack (what is called anxiety anticipatory).

The symptoms are varied: an intense fear with the impression that we are going to die or that we lose control, palpitations, the feeling that we are suffocating, sweating, tremors, and general malaise. Those who suffer from it are aware of the irrational nature of their fears.

The 2 to 5% of the population would face a panic disorder during their lifetime and the disorder affects more women than men. It develops chronically, and it is not uncommon to see depression, addiction to alcohol, benzodiazepines, OCD, phobia. It only requires treatment if there are several attacks. only the patient suffers dread with anguish the occurrence of the next attack.

Medication: anxiolytics and antidepressants

Taking psychotropic drugs may be essential, and the doctor will determine which is more suitable. They are generally prescribed in case of insufficiency or failure of therapy, or when the disorders are disabling. They have a short action because they "anesthetize" the anxiety, but have no effect on their cause.

The recommended treatments include anxiolytics, which must be taken less than 12 weeks and then stopped by very gradually reducing the doses. The main drugs used are alprazolam (Xanax®), bromazepam (Lexomil®), oxazepam (Seresta®), or even prazepam (Lysanxia®).

Another family of drugs is used: these are certain antidepressants that act on anxiety, apart from their antidepressant action. It can be escitalopram (Séroplex®), paroxetine (Deroxat®) or venlafaxine (Effexor®).

The herbal medicine is often used by patients with extracts of hawthorn, passionflower, valerian, etc., but is usually insufficient in case of anxiety disorders. It is usually incompatible with medication.

If left untreated, the disorder becomes chronic and may worsen: panic attacks are added to chronic anxiety, depression may occur, increased use of anxiety medication or alcohol, cannabis. With the right contact (some trained general practitioners, psychiatrist, or psychologist) and appropriate care, the anxiety disorder can improve and disappear.

Anxiety Management

Management involves therapies and / or certain antidepressant drugs, the same as those used in generalized anxiety. It is when they are associated that management is most effective.

Cognitive and behavioral therapies are as effective as antidepressants after 3 to 6 months. They act on the symptoms, allow the patients to understand how it works and how he can get out of anxiety. He gradually becomes aware of the irrational and conditioned nature of his fears and learns techniques to defuse crises, using deep abdominal breathing exercises, in particular.

After 3 to 6 months, the effectiveness of the therapy is evaluated, and if it is insufficient, a drug is prescribed, using certain antidepressants (which have anxiolytic properties and are not addictive, conversely anxiolytics). It should be started at a low dose and then gradually increased. It is important to know that the therapeutic effect only occurs after 6 to 12 weeks.

Treatment is generally long, more than one year, with a gradual reduction in doses. The breathing exercises, relaxation, and meditation are important aids in learning to manage your anxiety. The intense physical activity, at the rate of 45 minutes three times a week, for several months, could be great in the prevention of attacks.

Author: Vicki Lezama