The CENTURY EVIL: ANXIETY!!!

We live in an urgent, fast and eager society. Never people had a mind so agitated and stressed. Patience and tolerance to setbacks are becoming luxury items.

Within portion of this work of Augusto Cury, called Anxiety: how to face the evil of the century, I start the last post in the series about anxiety!

We hear much talk about anxiety disorders and often we wonder if the anxiety that we feel needs to be addressed, since the main signs and symptoms of pathological anxiety are identical to those of "normal" anxiety. Anxiety disorders are a condition in which anxiety as directly reported or observed symptoms, is abnormally high or is disproportionate to the environmental context and leads to functional, enduring commitments (whether professional or personal).

Anxiety disorders can be understood as repeated or persistent emotional states in which the pathological anxiety plays a key role. They are the most common mental disorders in the population: 23% of people have had, have or will have lifelong anxiety disorder.

But when does anxiety becomes a disorder? When its manifestation is disproportionate as the intensity, duration, frequency; when it negatively interferes with performance; when it brings functional impairment.

The following will be addressed anxiety disorders classified by diagnostic manuals: panic disorder, generalized anxiety disorder, posttraumatic stress disorder, phobic disorders, obsessive compulsive disorder and racing thoughts syndrome.

PANIC DISORDER

Panic disorder is characterized by unexpected and recurrent panic attacks about which one feels constantly worried. These attacks occur spontaneously; a false alarm may be what determines the first panic attack, but subsequent depend on the psychological vulnerability: "fear of fear" increases the perception of bodily sensations and the interpretation of these changes, leading to a vicious circle.

In people predisposed to have anxious reactions, these attacks may become conditioned to start externally (places or situations) or internal (thoughts or body sensations).

In the presence of panic attack, a person can evaluate it negatively as imminent danger sign (death, to be going crazy or losing control), which leads to increased anxiety, physical symptoms and catastrophic anticipations. The person is apprehensive, hiperventilante anticipates the signs that a new attack will happen and may make avoidance behaviors and phobias, avoiding situations where you think you may have attack again and places from which escape or escape may be difficult; not going out or staying alone; not participating in any situation where it can not receive immediate help in case of need.

Stress has been identified as a predisposing factor to panic disorder. People with this disorder are able to identify stressors that preceded their first episode of panic. Approximately 80% of patients are able to describe one or more adverse events vital before the first sign of panic. Is a contiguous relationship between panic disorder and previous adverse life events your event. The loss of someone important, the loss of social support, often precede panic disorder not only last year but throughout life. The association between the mother's death and divorce / separation of parents in childhood with agoraphobia (uncontrollable fear of having panic attacks or losing their physical and / or emotional control in an environment where help may not be available, or simply ineffective be embarrassing) and panic attacks was found by some researchers.

Another line of research is in regards to coping strategies of stress. In a survey of the Hospital das Clinicas, Faculty of Medicine, University of São Paulo Institute of Psychiatry Anxiety Clinic found an association present in coping difficulties of stressful events because of the meaning that people attributed to these events and also because it did not have an appropriate repertoire to deal with stress, ie, considered the most impactful event than it actually was or did not know what to do before it (on this subject, recently shared an excellent text on my personal Facebook profile, the magazine Simple Life: HOW NOT TO HAVE MORE PROBLEMS). Coping strategies most commonly used by panic patients were ineffective and maladaptive ways of coping with stress and everyday problems.

Patients who experienced the first panic episode when older had lower comorbidity with other psychiatric disorders, use the health system a lot less, are less hypochondriac and have more positive coping behaviors.

Panic disorder is considered by some authors, a negative adjustment to life events associated with failure to use effective coping strategies.

GENERALIZED ANXIETY DISORDER

Generalized anxiety disorder is a chronic disorder characterized by ongoing concerns, unrealistic or excessive, or even uncontrollable, with small everyday problems.

Patients with generalized anxiety disorder think they have regular or low emotional health; their concerns are linked to stressful life events, whether adverse or not.

It is believed that genetic factors may interfere with the predisposition of the individual for this type of disorder. A stressful environment, particularly in children, can also be predisposing generalized anxiety disorder, just as certain beliefs or certain principles of life may predispose an individual to anxiety.

POST-TRAUMATIC STRESS DISORDER

The post-traumatic stress disorder, as its name indicates, is derived from critical events, traumatic, such as violent assault, kidnapping, torture, natural disasters, sexual violence, combat experiences of soldiers, police or firefighters.

This disorder is diagnosed, usually if the trauma cause impairment in social and work-related, or if the following symptoms persist for an average of four weeks:

Symptoms of revival: the trauma is constantly revived by the individual affected by intrusive memories (pictures of the event, thoughts or perceptions), nightmares involving the traumatic event, flashbacks that cause the feeling of the event to be happening again and great psychological distress when the individual is faced with stimulus that remind the trauma;
Symptoms of physiological reactivity: the individual feels irritable or is replaced by angry outbursts, remains vigilant all the time, is easily startled and difficult to focus on routine activities;
Symptoms of avoidance and emotional numbing remains: efforts to avoid thoughts and feelings associated with the trauma, efforts to avoid activities, places or people associated with the trauma, diminished interest in activities, feelings of detachment from others, feeling emotionally numb or unable to have loving feelings for the people that are closest and lack of positive expectations about the future.

It is believed that during a post-traumatic stress disorder the person has difficulty processing the trauma of the event all together and other information that keeps stored in the memory. The situation experienced by us are registered in our autobiographical memory, which has a specific spatio-temporal context, that is, remember when and where they occurred.

The memory of a traumatic event, not to be a habit, but a situation that was lived, should be filed along with the other autobiographical memories, but affected individuals from post-traumatic stress disorder have difficulty integrating the traumatic system memory of autobiographical memory and tend to keep the information into the memory system related to implicit memory, which includes, among others, issues related to habits or emotions.

PHOBIC DISORDERS

Fear can be classified by the situation or the stimulus that generate or intensify the reaction. So the fear reaction can become very intense, and when that happens, happens to be called phobia.

Phobia is a persistent and irrational fear of a specific object, activity or situation not considered dangerous - it doesn't usually affect many people. Results in an overwhelming desire to evade or avoid such a stimulus. The person recognizes that their fear is excessive and irrational.

If the escape behavior or avoidance is not possible, contact is made with great suffering and individual commitment, which appears tense, apprehensive, uneasy, with physical, cognitive and autonomic nervous system.

According to the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, there are three major groups of phobic tables: agoraphobia, social phobia and specific phobias.

Phobia of the now is to present connotation "fear of fear" that is, the fear of suffering panic attacks and be unable to escape to a safe place where it can have medical aid, for example. Or, the original definition, is described as the fear of being in situations in which escape might be difficult and / or requiring the presence of a company.

Social phobia is also characterized by the appearance of phobic reactions, but that only occurs if the individual is to play in the presence of others. Involves panic reactions such as panic disorder, with all those sensations: tachycardia, shortness of breath, numbness or tingling, tremors, unsteady legs, flushing, etc .. The main fear that affects a person with a phobia is what happens in the situation of public speaking. At such times, social phobics believe others will realize all its shortcomings.

Finally, the third type of pathological fear is made up of specific phobias. These are characterized by fears of heights, enclosed, insects (cockroaches, spiders), small animals (dogs, cats, rats, bats, birds), snakes, lizards, blood, injection, etc .. Weathered object phobia, as one of those mentioned, the individual will also have panic attacks with all bodily sensations already described, together with cognitions as "will fall", "I'll faint if that touch me," "will hurt a lot."

OBSESSIVE-COMPULSIVE DISORDER

Obsessive compulsive disorder is characterized by obsessions and compulsions sufficiently severe time-consuming and cause marked distress or significant damage to the carrier and are considered excessive or unreasonable.

Obsessions are thoughts, impulses, repeated and unwanted images, experienced as intrusive and inappropriate and that cause anxiety or distress. Compulsions are repetitive behaviors or mental acts that the person feels driven to perform in response usually to an obsession.

It is a chronic treatment, occurring phases of improvement and worsening under stress, even if positive. Triggering may be internal or external. Feeling an uneasiness similar to that caused by the symptoms of panic, the patient seeks reassurance from people around you and presents urgency ritualise, finding post-ritual relief.

The avoidance behavior leads to an extremely limited life, bringing sense of fragility and vulnerability, while the awareness that it is absurd, illogical thoughts, distressing superstitions and imperative. In general, patients have responsibilities exaggeration and excessive guilt.

There is evidence of injury in professional or school performance, repeating some unnecessary questions, constant delays, it takes to complete routine tasks, reddish hands, paper expense and slowness.

ACCELERATED THINKING SYNDROME

It is common among those with the racing thoughts syndrome have the feeling of being overwhelmed by routine, with that impression that 24 hours are insufficient to meet all that you have planned for the day. There is the persistent feeling of apprehension, lack of memory, attention deficit disorder, irritability and even altered sleep.

Experts say that rapid thinking syndrome is not a disease but rather a symptom linked to an anxiety disorder frame, as well as the above mentioned.

Augusto Cury already said that it is a singular disease, with specific causes and symptoms. And going further, says the author that evil of the century is not depression, as many claim, but rather an evil which considers more serious, though less noticeable: the racing thoughts syndrome.

For him, thinking is good, think clearly is great, but think too much is a bomb against mental health, the pleasure of living and creativity. It adds that it's not just addictive psychotropic drugs, but also the excess of information, intellectual work, activities, concern for mobile use. [...] Slow down our thoughts and learn to manage our mind are fundamental tasks.

The author lists some of the symptoms of accelerated thinking syndrome. Notice how these symptoms are directly related to other diseases, especially chronic:

Anxiety
Restless or agitated mind
Dissatisfaction
Exaggerated physical tiredness (fatigue); waking up tired
Suffering in advance
Irritability and emotional fluctuation
Impatience; everything has to be fast
Difficulty enjoy the routine (boredom)
Difficulty dealing with slow people
Low threshold to deal with frustration (small problems cause major impacts) Headache
Muscle pain
Other psychosomatic symptoms (hair loss, rapid heartbeat, increased blood pressure etc.)
Poor concentration
Memory deficit
Sleep disorder or insomnia

The racing thoughts syndrome, commonly listed as the memory deficit and attention, which affects many different people at various levels. There are people with such short memory loss that will find it difficult to remember the name of co-workers, where they put the car keys or where parked. Ordinary forgetfulness are a positive sign of the brain, warning us that the red light came on, that's racing thoughts syndrome stifled our mind to the point that is seriously compromising the quality of life. The commonplace memory deficit is a way for the brain to protect itself and not a problem, as many physicians think.

The brain blocks certain files from memory in an attempt to decrease the excess thoughts produced by the racing thoughts syndrome. People who have an excessive intellectual work, such as judges, prosecutors, lawyers, executives, doctors, psychologists, teachers, in theory, develop this syndrome more intensely. And the most dedicated and efficient people are often more strongly stressed, linked to the causes of the accelerated thinking syndrome, which are: