Anxiety is a term that is often heard in daily conversations and in the media. But what is it exactly?
In essence, anxiety is an emotional state characterized by feelings of tension, worry, and unease. It is derived from the Latin word 'angĕre', which means to tighten. It is a common part of human life and can occur in various situations. However, anxiety is not always a sign of illness. It is crucial to distinguish between normal anxiety and pathological anxiety.
Normal Anxiety vs Pathological Anxiety
Normal anxiety, also known as physiological or alarm anxiety, is a state of psychological and physical tension that results in a generalized activation of an individual's resources. This allows for the implementation of initiatives and behaviors useful for adaptation. It is directed against a truly existing stimulus, often well known, and represented by difficult and unusual conditions.
Pathological anxiety, on the other hand, is when anxiety disrupts psychic functioning in a significant way, resulting in a limitation of the individual's ability to adapt. It is characterized by a state of uncertainty regarding the future, with the prevalence of unpleasant feelings. Pathological anxiety can be vague without a precise recognizable cause, or it can concern specific objects and events. It can also accompany other psychological and psychiatric problems, as well as unresolved personal conflicts.
Causes of Anxiety
The causes of anxiety are not yet fully understood. However, it is agreed that various factors contribute to the onset of the disorder. These include:
Hereditary factors: In approximately 50% of cases, individuals with anxiety disorders have at least one family member affected by a similar pathology.
Biological factors: Alterations in the quantity of some neurotransmitters, such as excessive production of norepinephrine, reduced availability of serotonin (which regulates well-being), and of GABA (one of the most important inhibitory neurotransmitters in our body), may be related to the onset of anxiety.
Unconscious factors: According to Sigmund Freud, the founder of psychoanalysis, anxiety stems from an unconscious conflict that can date back to childhood or develop in adult life.
Symptoms of Anxiety
Anxiety is a complex condition that affects individuals on multiple levels: general, psychological, and neurovegetative. Each category of symptoms stems from the activation of the autonomic nervous system, which operates independently of an individual's conscious control. Here is a detailed breakdown of these symptoms:
General Symptoms
General symptoms of anxiety are primarily emotional responses that include:
Fear of imminent danger or catastrophe
Engaging in behaviors to avoid perceived threats
Constant state of nervousness or unease
Apprehension and hypervigilance
Persistent feelings of unease or worry
Psychological Symptoms
These symptoms affect cognitive functions and emotional regulation, including:
Excessive worries
Irritability and impatience
Concentration difficulties and poor attention
Feeling disconnected from oneself
Difficulty in recalling past events
Sleep disorders
Neurovegetative Symptoms
These physical manifestations of anxiety are related to the body's involuntary functions:
Sensory symptoms: Tingling sensations, hot or cold flashes, dizziness, lack of balance.
Classification of Anxiety Disorders
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), anxiety disorders encompass a range of conditions characterized by significant feelings of anxiety and fear. These disorders are classified into several specific types, each with distinct diagnostic criteria:
Separation Anxiety Disorder: This condition involves excessive fear or anxiety about separation from those to whom the individual is attached. The fear exceeds what might be expected for the individual's developmental level and causes significant distress or impairment in social, academic, or other important areas of functioning.
Selective Mutism: Often occurring in children, this disorder is characterized by a consistent failure to speak in specific social situations where there is an expectation for speaking (e.g., at school), despite speaking in other situations.
Specific Phobia: This is an intense, irrational fear of or aversion to specific objects or situations (e.g., flying, heights, animals). The phobic object or situation almost always provokes immediate fear or anxiety.
Social Phobia: A profound fear of social or performance situations in which embarrassment may occur. This includes fears such as speaking in public or interacting with unfamiliar people.
Panic Disorder: Involves recurrent, unexpected panic attacks—sudden surges of intense fear or discomfort that reach a peak within minutes, accompanied by physical and cognitive symptoms such as heart palpitations, trembling, or feelings of unreality.
Agoraphobia: Fear or anxiety about two or more of the following situations: using public transportation, being in open spaces, being in enclosed places, standing in line or being in a crowd, or being outside of the home alone. These situations are avoided or endured with intense fear or anxiety.
Generalized Anxiety Disorder (GAD): Excessive anxiety and worry occurring more days than not for at least six months, about a number of events or activities. This disorder features symptoms such as restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbances.
Substance/Medication-Induced Anxiety Disorder: Anxiety symptoms that develop during or soon after substance intoxication or withdrawal or after exposure to a medication.
Other Specified Anxiety Disorder and Unspecified Anxiety Disorder: These categories are used for disorders that cause significant anxiety or fear but do not meet the full criteria for any of the disorders above.
Treatment
Pathological anxiety necessitates the involvement of a healthcare professional who can accurately diagnose the specific type of anxiety disorder affecting the patient and determine the most appropriate treatment plan tailored to their individual needs.
There are several effective treatments for managing anxiety:
Psychotherapy: This is often the first line of treatment. Cognitive Behavioral Therapy (CBT) is particularly effective, as it helps patients identify and challenge the negative thought patterns and behaviors that contribute to their anxiety.
Medication: Anxiolytics, such as benzodiazepines, are commonly prescribed to reduce anxiety symptoms quickly. However, due to their potential for dependence, they are typically recommended for short-term use. Other medications, such as antidepressants, may also be used to manage anxiety, especially if it is chronic or accompanied by depression.
Natural Remedies and Supplements: Some individuals may find relief through natural remedies such as mindfulness meditation, yoga, and the use of supplements like omega-3 fatty acids, green tea extract, and herbal teas known for their calming properties.
Each treatment plan should be customized by a specialist after a thorough assessment, and may also include lifestyle changes, regular physical activity, and nutritional adjustments to support overall mental health.
