Anxiety is a negative emotional state, expressed by a feeling of uncertainty, expectation of bad events. Internally it manifests itself as a feeling of anxiety, an experience of excitement, an unpleasant premonition of impending trouble. External signs of anxiety are absent-mindedness, restlessness, obsessive movements, a pained facial expression. For diagnostics, a survey, observation, psychodiagnostic tests are used: questionnaires, projective techniques. Symptomatic care includes psychotherapy, pharmacotherapy, relaxation techniques.
General characteristics
Anxiety is expressed by vague vague fear in relation to possible future events. It often occurs for no reason, that is, in situations where there is no real danger. A person has a premonition of trouble, but does not know how to avoid or overcome it. Internal tension is partially reduced by motor activity, so restless people cannot sit still, walk around the room, bite their nails, aimlessly turn on the mobile phone screen several times, perform other seemingly meaningless actions.
The expectation of trouble makes you concentrate on finding ways to solve or avoid future problems. There is a distraction, a certain detachment from reality. Thinking becomes selective: a person pays attention to events related to a disturbing situation, ignores all others. In this way, he confirms that his experiences are justified. Sometimes the feeling of anxiety increases to a state of anxiety, disorders of perception of time, space, people, actions develop.
Subjectively, anxiety feels like anxiety – a combination of fear, sadness, shame, guilt for no reason. During the most acute experiences, physiological changes begin to be realized: palpitations, increased sweating, nausea, dizziness, headaches. If there is no understanding of the connection between anxiety and physical malaise, a person looks for the cause of discomfort by contacting somatic doctors – therapists, neurologists, cardiologists.
The restless person’s thinking is directed from the past to the future – an unfavorable or dangerous event is extracted from memories, and then something similar is predicted. At the same time, the previous experience may be old or just happened, personal or someone else’s. For example, after the boss’s reprimand, discomfort increases every time you come to the workplace, since there is a chance to meet the head. Similarly, a restless state can develop before flying on an airplane if a movie about a plane crash has been watched before.
Speaking about anxiety without a reason, it is worth noting that there is usually a reason, but it is not realized or evaluated by others as insignificant. The key function of anxiety is to encourage actions that increase the likelihood of a favorable outcome of events, to prevent potentially dangerous behavior. The biological basis of this experience is the mobilization of psychophysiological processes to overcome a possible traumatic situation. The negative effect of anxiety is a feeling of fear that prevents effective activity.
Causes of anxiety
Depending on the cause of anxiety, there are three types of it: adaptive, primary, secondary. In a situation of immediate danger, conflict or acute stress, anxiety develops as a reaction to the mobilization of the body: all systems are activated, prepare for fight or flight. Primary true anxiety, which develops into anxiety, is observed in neurosis, secondary – in some somatic and mental diseases, taking medications, narcotic drugs.
Adaptive response
In contrast to pathological anxiety without a reason, with a real danger, an adaptation reaction develops. It is manifested by the activation of physiological systems – increased breathing, increased heartbeat, a rush of blood to the muscles, mental readiness to escape or fight. Stressful factors, threats to life or health provoke feelings of anxiety, aggression, anxiety. Such adaptation reactions are triggered in the following cases:
- Strict upbringing. Within families where parents cultivate conscientiousness, integrity, sense of duty, the child does not have freedom of expression of naturally existing fears, aggression. The suppression of these emotions leads to the consolidation of anxiety-suspicious character traits, which is manifested by fear of being open, obsessive fears, doubts, uncertainty. A personality is formed with an increased level of anxiety, anxiety.
- Unpredictability of the behavior of others. A state of constant adaptive readiness is necessary when interacting with unbalanced, emotionally unstable people, strangers. The feeling of anxiety is constantly present in children whose parents often change the rules of behavior (yesterday it was impossible to eat sweets, today it is possible). Other examples are a speech in front of an unfamiliar audience, a conversation with a hot-tempered boss. Stress prepares the psyche for a quick choice of reaction.
- Situations of danger. With a real threat to well-being, concern arises for a reason. When the outcome of a situation is definitely dangerous (injury, serious illness, death), fear appears. If different outcome options are possible, a feeling of anxiety is formed. Examples: waiting for the result of a medical examination in the presence of symptoms of illness, involuntary participation in hostilities, terrorist acts.
- Conflict situations. The clash of interests, different points of view is stressful. The psyche goes into a state of readiness for a quick reaction of defense, attack or withdrawal from conflict. The feeling of anxiety allows you to maintain a high level of tension. The more significant areas of life are affected in the confrontation, the more likely the development of a neurotic disorder with anxiety.
Primary concern
Persistent anxiety without a reason contributes to the appearance of anxiety – the dominant symptom of neurotic disorders. The development of neurosis occurs when situational anxiety manifests itself frequently, begins to spread to an increasingly wide range of events, is felt almost constantly. Often a person understands that there are no reasons for such experiences, but he cannot change his condition. The feeling of anxiety is characteristic of patients with the following neuroses:
- Generalized anxiety disorder. In patients with this disease, the feeling of anxiety and restless experiences are stable. Emotional stress has no connection with real events. Fears are of a general nature: fear of an accident, illness (in the absence of symptoms), sudden death. People report a “bad feeling”, a constant expectation of bad news. Generalized anxiety is more common in women, accompanied by vegetative disorders – trembling, dizziness, nausea.
- Panic disorder. Patients suffer from recurrent panic attacks – sudden fear, physical discomfort for no reason. Panic attacks last from 5 to 20 minutes, accompanied by shortness of breath, palpitations, chest pain. Anxiety is felt before an attack, when panic is approaching. It is associated with the inability to control the attack, the fear of death.
- Phobias. Phobic disorders are characterized by a constant strong fear of specific objects or situations. The experiences are intense, often occur in the absence of a real threat, and are beyond control. They are caused by the potential for the development of a frightening situation or a meeting with the object of fear. Common variants are claustrophobia, a feeling of intense fear from thoughts of meeting a dog, climbing to a height, using a public toilet.
- Post-traumatic stress is the consequences of a traumatic event (war, violence) with a re-experience of what happened in dreams and thoughts, mental numbness, increased excitability. A restless state often develops in the first stage, when a high concentration on the injury is maintained. Patients mentally return to the past, poorly adapt to real life.
- Psychosomatic disorders. In somatoform disorders, concern about the state of health dominates – patients complain of somatic ailments, but medical examinations do not confirm the presence of the disease. A complex of experiences is formed due to increased attention to the signals of the body, the absence of a diagnosis.
- Obsessive-compulsive disorder. Obsessive-compulsive neurosis is represented by obsessive thoughts and repetitive actions that relieve mental discomfort. A person is concerned about the presence of disturbing thoughts, the inability to control them. The most common variant of obsessive-compulsive neurosis is the idea of the contagiousness of surrounding objects and frequent hand washing.
Secondary anxiety
Experiencing anxiety for no reason can be a symptom of mental disorders or somatic diseases, a side effect of medications, the result of taking psychoactive substances. In all these cases, the feeling of anxiety arises a second time, not because of external events and their assessment, but because of physiological changes. Restless states develop when certain areas of the brain are affected, with biochemical shifts with increased production of neurotransmitters, hormones. The symptom is characteristic of a number of diseases, such as:
- Depression. The physiological basis of anxiety depressive disorders is a violation of the metabolism of serotonin and dopamine. The deficiency of these compounds in the areas of the brain responsible for emotional reactions is manifested by a state of depression, causeless anxiety, anxiety. The trigger mechanism of depression can be an external negative event or directly biochemical shifts (hereditary, provoked by diseases).
- Schizophrenia. Restless thoughts are typical of the paranoid form of schizophrenia. They are caused by delusions and hallucinations: ideas about persecution, suggestion by voices of various violent actions. In addition, concern about their own condition is observed in patients at the initial stages of schizophrenia, when for no reason there is a feeling of disorientation in their own personality and the surrounding environment.
- Organic brain lesions. Symptoms of anxiety are found in diseases affecting the functioning of the reticular formation, namely, the activity of the blue spot. Axons from this nucleus go back to the upper layers of the cerebral cortex, the cerebellar cortex, the hippocampus and other structures involved in the formation of emotions. Lesions of these parts of the brain are represented by vascular, traumatic, tumor, neurodegenerative pathologies.
- Endocrine diseases. Hormonal shifts are often accompanied by the development of psychoemotional disorders. Mood disorders are diverse, manifest for no reason. The most common depressive states with anxiety, anxiety, fear. They are provoked by an increase in thyroid hormones, the adrenal cortex. They are observed with thyrotoxicosis, hypercorticism syndrome, Itsenko-Cushing’s disease.
- Receiving psychostimulants. Psychostimulating drugs, including narcotic drugs, have an exciting effect on the nervous system. They enhance the transmission of neural signals in various parts of the brain, causing restless thoughts, panic, and sometimes hallucinations, illusions, psychoses. The most pronounced persistent symptoms of psychoemotional disorder become a consequence of long-term drug use.
Diagnostics
Persistent feeling of anxiety can be a symptom of somatic or mental illnesses. Psychiatrists, psychotherapists, psychologists are engaged in the diagnosis of this condition. When a patient contacts specialists, a clinical survey is initially conducted, during which the duration of the emotional disorder, the frequency and severity of anxiety states, and possible causes are specified. In addition to the conversation, the following diagnostic methods are informative:
- Observation. Patients are characterized by restlessness, emotional instability, and absent-mindedness. It can be difficult for them to distract themselves from their own experiences, to concentrate on the words of the doctor. At the consultation, they often change the position of the body for no reason, touch objects with their hands (clothing fasteners, phone, bag). There may be intrusive actions designed to reduce tension.
- Psychodiagnostic questionnaires. In order to determine the level of anxiety, special psychological tests are used: the Taylor Scale of apparent anxiety, the Spielberger Scale of Anxiety, the Kondash Scale of socio-situational fear. The results allow us to quantify how much anxiety, anxiety, and fear are expressed.
- Projective tests. To identify the emotional state hidden or denied by the patient, projective research methods are used: drawing tests, tests of interpretation of unstructured drawing material. Examples of such techniques are human drawing, Rorschach test, TAT. According to the results, it is possible to determine the presence of anxiety, to assume its origin.
If restless thoughts and experiences exist for no reason, the patient is referred for consultation to a neurologist, endocrinologist. Narrow specialists determine the presence or absence of endocrine and neurological diseases as a factor in the development of emotional disorders. A survey is carried out with the clarification of somatic complaints (pain, malaise), examination, laboratory tests of blood for the content of hormones, instrumental studies of the brain, its feeding vessels.
Treatment
The therapeutic process begins with a conversation with a doctor, where a specialist talks about ways to treat the underlying disease and eliminate anxiety. The methods of symptomatic treatment are selected individually, taking into account the cause and severity of the emotional disorder, the patient’s attitude to it. With neurotic disorders, psychotherapy sessions are more appropriate, with secondary anxiety caused by a somatic disease, pharmacotherapy is more appropriate.
Psychotherapy
The feeling of anxiety is effectively corrected by a combination of cognitive behavioral therapy techniques. At the first stage – the stage of mental elaboration – the therapist discusses with the patient the causes of anxiety, situations that provoke emotional tension. He teaches to identify physical discomfort, changes in thoughts when experiencing anxiety. At the stage of behavioral correction, the exposure method can be used when the patient creates a living mental image of a dangerous situation, while simultaneously applying relaxation and deep breathing techniques, visualizing a successful outcome of the event.
Severe forms of anxiety disorders, accompanied by pronounced vegetative reactions and a sense of fear, require a slightly different sequence of psychotherapy. First, the patient is taught self-control: restoring normal breathing, distraction and switching attention. When a person becomes able to independently avoid attacks of fear and panic, they move on to the stage of behavioral therapy.
Drug therapy
Medications are prescribed for severe anxiety on the background of a mental disorder, neurological or endocrine disease. Medical correction allows you to control the symptom, even if it has arisen without an obvious reason. Its advantage lies in the rapid action – improvement appears before the patient feels the positive effect of psychotherapy or other basic treatment. The use of tranquilizers – anti-anxiety drugs is widespread. Additionally, antidepressants, herbal remedies with a soothing, sedative effect are prescribed.
Relaxation techniques
Mild forms of anxiety are eliminated through regular practice of physical and mental relaxation. Relaxation techniques are taught more successfully in group classes that combine breathing exercises and auto-training. Patients develop muscle feeling, master progressive relaxation, abdominal breathing, applied relaxation. Through the control of muscle tension and the breathing cycle, emotions and thoughts are corrected. Breathing yoga can be considered as an alternative to psychotherapeutic group techniques.