Home Health what it is and how to recognise it

what it is and how to recognise it

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This is the source of at least three risks.

  • The first, and more general, risk is the administration of medications that are not specific to that “type” of anxiety, but antidepressants (generally of the SSRI[serotonin reuptake inhibitor]type) and antidepressants. A combination of anxiety drugs may be used as needed.
  • A second risk is that little attention has been paid to aspects of personality, the “types” of people affected by specific anxiety disorders.
  • Third, anxiety disorders have not been given the names (i.e., descriptions) they deserve.

This is a serious problem of iatrogenic disease (i.e. error, failure to prescribe or diagnose), with a not indifferent social dimension (50% of the world’s population have at least a diagnosis of anxiety disorder during the course of treatment). received once). lifetime).

Remember, from a functional point of view, the relevant brain dysfunction is a change in the hypothalamic-pituitary-adrenal axis, that is, in short, the hormonal axis that connects the limbic structures, the hypothalamus, and the pituitary gland. must be Together with the adrenal glands to release cortisol – when elevated – lead to anxiety-related behavioral manifestations.

In fact, long-lasting anxiogenic events have the same effects as changes in depressive status. This means not only a decrease in neurotransmitters such as serotonin and norepinephrine, but above all, a significant increase in precisely the hormone cortisol in the blood, resulting in hyperactivation of the aforementioned axis. , necessary to counteract or support responses to sudden changes in circumstances.

This irrefutable fact should guide pharmacological prescribing more appropriately.

In addition, it would be appropriate to consider the “predisposition-stress” paradigm, that is, the interplay between predisposition (including predisposition, personality aspects) for the development of a particular disorder and the conditions of existence for its manifestation. (This includes the emotional aspect).

As proof of the importance of personality traits associated with anxiety disorders, DSM 5 provides the following separate categories in addition to the actual classification of anxiety disorders.

  • Avoidant Personality Disorder (Phobic Personality Disorder)
  • obsessive-compulsive personality disorder
  • Good clinical practice should adhere to at least these criteria for correct treatment indications
  • Thoroughly investigate the nature of the anxiety disorder according to all indications from listening carefully to a careful medical history and description of symptoms
  • describe the patient’s personality as believably as possible
  • Understanding Patient Subjective Anxiety
  • Observe lifestyle and obstacles to work and social relationships, if any
  • By listening empathetically to the patient’s suffering and in close cooperation with psychiatrists and psychotherapists, it is almost always absolutely necessary in conjunction with or instead of drug therapy with remission of acute conditions. Validate a patient’s ability to tolerate psychotherapy (antidepressants and anti-anxiety drugs are the fourth most prescribed drugs). Delorazepam is the most widely marketed drug in the world in the pharmacological category, especially among anti-anxiety drugs.
  • Don’t underestimate the dynamics of anxiety disorders and superficially classify them as the “evil of the century.”

Diagnostic practices using DSM 5 should follow the following two criteria for two anxiety disorders that are themselves considered to be included in personality disorders: avoidant disorder and obsessive-compulsive disorder.

1) Criterion A: Impairment level assessment of the four components of personality function:

Self Domain: 1) Self Identity – 2) Self Determination

Interpersonal domains: 3) empathy – 4) intimacy

2) Criterion B: At least two subdomains or characteristics:

Negative emotions (emotional instability, anxiety)

Separation (avoidance).

The following hierarchy must also be adhered to:

  • Anxious/Avoidant Personality Disorder: A Spectrum of Internalizing Disorders (i.e., “withdrawal” into oneself)
  • Obsessive Compulsive Disorder: A spectrum of neurotic disorders.

Regardless of diagnostic modality, the need and utility of sufficiently differentiating different types of anxiety disorders to manage and prescribe optimal treatment has been emphasized.

Generalized Anxiety Disorder (GAD)

This is certainly the seemingly easiest anxiety disorder to diagnose.

But this is not the case. The signs and symptoms make the diagnosis of reactive depression much easier, so it is sometimes treated as such.

Generalized anxiety disorder can appear from day to day for no apparent reason and never go away. On the contrary, it becomes a “frightened” state of mind.

A person who can normally cope with the general needs of life suddenly becomes unable to do so and everything becomes a source of worry and suffocates.

He “doesn’t know why”: all he knows is that he can’t help “worrying” about everything, and every event, even a minor one, is the least protective. It frightens him to the point of not being able to carry out therapy.

If you feel sad, it’s because you have a frustrating feeling that drains your energy. Therefore, it is fear, not loss of interest (as in depression), that mobilizes all investment.

People feel suddenly overwhelmed by thoughts that seem too big to deal with, at any time of the day or night, as they are filled with anxiety that has gotten out of hand.

Even legitimate anxiety and worry become insurmountable and cause immobility.

Everything seems gigantic and beyond one’s potential, and in a moment of calm, your throat suddenly tightens, leaving you defenseless against everything.

The social and relational significance of such situations is clear, and a course of action should be kept in mind by those who are close to someone in such a state.

Fear gives fear, but when the whole brain becomes alert, generalized anxiety freezes and hardens, and nothing can be done.

The thread that must be grasped is contained in the commonly used phrase “I don’t know why.” We need help to “know” because we don’t know why.

A common tranquilizer during the day and one of the milder hypnotics at night may be sufficient. For hypersensitive asthenia, perhaps combining with some nutritional supplements would be good.

Instead, psychodynamic or behavioral psychotherapy is mandated.

A Clinical Vignette on Generalized Anxiety Disorder (GAD)

Carla is in her thirties. She is a very beautiful, elegant and sophisticated young lady who does a wonderful job as a translator.

She explains that she is characteristically anxious due to the concurrent nature of her work. She’s also always a bit afraid that she won’t keep up with the job, but her experiences keep her fears in check.

She is preparing for her upcoming wedding. Her fiancée is a German doctor whom she met at a conference.

Suddenly, Carla becomes ‘sick’ with anxiety and can no longer do anything.

Unable to cope, she decides to consult a psychoanalyst.

During her first cognitive interview, Carla becomes very anxious and exhibits behaviors and attitudes that clearly do not match the style of the help-seeker.

She is agitated and all her postures are tentative (torso upright, sitting on tip of torso). Chairpurse at her feet) as if she had suddenly left.

This is considered a good predictive signal as it can be seen as an unconscious attitude in the setting of the session to spot and scare “something” she escapes from.

In the continuation of the interview, an anamnesis is collected, comprehension and motivation for change are checked, along with capacity for commitment and tolerance for frustration, and a short, focused psychodynamic psychotherapy is proposed. The purpose (focus) of shedding light on the nature of anxiety.

Already from the first session it became clear that anxiety is indeed generalized in all aspects, but the trigger factor is found in marriage decisions.

Short-term treatment relies heavily on the emergence of highly stimulating unconscious emotions of the analyst.

It didn’t take long for me to unleash a very contorted and violent feeling of the sexual kind. Analysts claimed they wanted to go down the path of provocative staging of violence and unleash an underlying motive for her general anxiety. Worry and treat because of the memory of some repulsive and charming scenes in the movie “Night Porter” (a highly complex sadomasochistic story between a former German SS general and an ex-prisoner) I can’t stand it.

Attraction and repulsion were well removed and buried unconsciously, but the need to print the participation in Italian and German ignited the bomb fuse.

At issue is the quality and choice of sexuality, and the ability to distinguish between facts and people.

This clinical setting illustrates both the need to deal with the person, not just the symptoms, and the difficulty of untangling anxiety.

Also read:

Emergency Live More… Live: Download Newspaper’s New Free App for IOS and Android

What’s the Difference Between Anxiety and Depression: Let’s Find Out About These Two Widespread Mental Disorders

ALGEE: Discover Mental Health First Aid Together

Rescuing Patients with Mental Health Issues: The ALGEE Protocol

Basic Psychological Support (BPS) in Panic Attacks and Acute Anxiety Disorders

What is postpartum depression?

How to Recognize Depression? Three Rules: Asthenia, Lethargy, and Anhedonia

Postpartum Depression: How to Recognize and Overcome the First Symptoms

Postpartum Psychosis: Knowing It and How to Deal with It

Schizophrenia: what it is and what are the symptoms

Childbirth and emergencies: postpartum complications

Intermittent Explosive Disorder (IED): What It Is and How It’s Treated

What is baby blues and why is it different from postpartum depression

Depression in the elderly: causes, symptoms, treatment


Pazin Medike

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