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Generalized anxiety – Article series: “How to heal the soul?” Part 22!

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Generalized anxiety – long-lasting (at least 6 months) moderately or mildly expressed anxiety in everyday situations, which is not linked and does not arise from any specific external conditions. The main symptoms are variable, mostly there are complaints of constant nervousness, tremors, muscle tension, sweating, dizziness, palpitations, dizziness, unpleasant feeling in the chest. There is often a fear that the patient or his relatives will soon get sick, or that some misfortune will happen to them, as well as patients in moments of more pronounced anxiety note the fear of “going crazy” or dying, fear that “something is wrong with me”. [1, 2, 5, 8, 9]
Manifestations similar to generalized anxiety can be observed with some physical illnesses, such as increased activity of the thyroid gland, increased blood pressure, as well as during the use of certain medications. [2.]
Anxiety is the body’s normal response to stress (it is natural to experience it episodically) – a real or imagined danger situation, because the biological task of anxiety is to protect. In cases where anxiety becomes excessive and causes disturbances in daily functioning, it is considered pathological. Prolonged stress contributes to biochemical and structural changes in the central nervous system, which lead to a deterioration in work capacity and social functioning, so it is essential to diagnose anxiety in time and treat it. [3, 4, 10]

How to recognize anxiety?

At first, you should be guided by the above-mentioned signs, but accurate diagnosis can be made difficult by panic attacks or depression layered on top of anxiety. The diagnosis is determined by a specialist doctor – a psychiatrist or a psychotherapist, in milder cases, a family doctor can also be involved in the treatment.

NB In case of anxiety, physical illnesses should be ruled out.
The GAD-7 self-test is used to assess anxiety.
GAD-7 self-report scale.
How often in the last 2 weeks did you encounter any of the problems listed below?
One answer per line.

  • 1. You feel nervous, anxious or tense
  • 2. You could not calm down or control your anxiety
  • 3. You worry excessively about various things
  • 4. Had difficulty relaxing
  • 5. You were so restless that you could not sit still
  • 6. You became irritable easily
  • 7. You feel fear that something terrible could happen

Number of points:

  • 5 – 9 points – mild anxiety;
  • 10 – 14 points – moderate anxiety;
  • 15 – 21 points – Severe generalized anxiety disorder [7.]

When should you go to the doctor?

If the following symptoms appear, which are combined with a feeling of daily anxiety, you need the help of a specialist. In Latvia, it is usually a psychiatrist. [10.]
Signs:
  • If your concern is so severe that it affects your work, relationships or other parts of your life.
  • If your anxiety upsets you or is uncontrollable.
  • If you feel depressed, problems with alcohol or drug use appear.
  • If you think your anxiety may be related to physical problems.
  • If you have suicidal thoughts or behavior – Seek help immediately!!!

What are the causes and risk factors?

It is usually a combination of various factors – genetic, developmental, environmental and psychological. [5.]
However, in the life of patients, before the appearance of anxiety, you can often observe:
  • prolonged stress,
  • psychotraumatic situation or violence in childhood,
  • certain personality traits (emotionality, avoidance, timidity, lack of independence),
  • certain physical illnesses – pain syndrome, hypertension, cardiovascular and gastrointestinal disorders,
  • the use of certain medications,
  • other mental disorders for yourself or someone close to you. [2nd, 9th, 10th]
NB Alcohol and drug use can cause anxiety or increase the risk of anxiety. [2.]

What complications can anxiety cause?

In prolonged and severe cases of anxiety, co-morbidities appear, such as [10.]:
  • Depression
  • Addictions
  • Sleep disorders
  • Digestive problems, metabolic disorders
  • Chronic pain
  • Social isolation
  • Problems at work or school
  • Decreased quality of life
  • Suicidality

What is happening in Latvia and elsewhere?

In Latvia in 2016, neurotic, stress-related and somatoform disorders accounted for 19.4% of all psychiatric disorders diagnosed for the first time in that year. These disorders are second only to organic disorders. On the other hand, from previously diagnosed disorders, neurotic and stress-related and somatoform disorders accounted for 12.1% in 2016, and occupy the fourth place among all groups of mental disorders. [6.]
According to the American Psychiatric Association, anxiety is one of the most common disorders and affects approximately 30% of adults at some point in their lives. [5.]

How can you help?

Various types of assistance are available [2, 8, 9]:
  • Psychotherapy – cognitive behavioral therapy (exposure, desensitizing).
  • Support groups – people with similar disorders discuss their experiences, such groups will help you feel less alone with your problems.
  • Medicines – should be used only according to the doctor’s prescription, following the recommendations. Anti-anxiety medications and/or antidepressants are used. Anti-anxiety medications from the tranquilizer group have a risk of developing addiction. The first choice of antidepressants are the SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin and noradrenaline reuptake inhibitors).
  • Changing the way of life – exercise, meditation, yoga, relaxation techniques, breathing exercises – “Inhale as if you are smelling a flower, exhale as if you are trying to blow out a candle”, etc.
NB Breathing exercises and relaxation techniques should be practiced in a state of rest in order to learn how to apply them in times of anxiety. You can’t learn to swim by drowning!

Anti-anxiety measures.

  • Anxiety is more difficult to treat in the chronic stage, so don’t wait!
  • Choose activities that make you feel good. Maintain relationships with people who reduce anxiety.
  • Avoid alcohol and drug use!

Recommendations for loved ones.

It is advisable to provide your loved ones with anxiety (or any mental disorder)[2.]:
  • A sense of security
  • Acceptance, because the stigma against mental illnesses still remains
  • Praise
  • Respect and appreciation

Avoid [2.]:

  • For general phrases with formal support – “Everything will be fine!”, “There’s nothing to worry about!”, “It’s all in your head!”
  • Giving advice if it was not asked for
  • Criticizing and condemning
Author of the article: doctor – psychiatrist, narcologist Júlija Lice