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Treatment of anxiety and panic disorders. Treatment of Anxiety Disorders

There are several types anxiety disorders.

Generalized anxiety disorder

The patient suffers from constant unjustified or exaggerated fears and worries about his family, health, work or material well-being. This disorder occurs independently of a specific life event and is thus not reactive.

Phobias

In this case, anxiety is associated with certain situations (situational anxiety that occurs in response to the presentation of a stimulus) and is accompanied by an avoidance reaction.

There are three types of phobias:

Simple phobias
Social phobia
Agoraphobia

TO simple phobias This includes fear of snakes, spiders, darkness, thunderstorms, heights, etc. Because of simple phobias, patients, as a rule, do not consult a doctor; treatment is usually not required.

Patient with social anxiety constantly fears situations that could make him a target close attention those around you. He tries to avoid any actions that could put him in a humiliating or funny position. A person gets this feeling in crowded places. The difficulties that people with social anxiety experience have a significant impact on their personal and professional lives.

At agoraphobia patients avoid being away from home, in crowded places, in unfamiliar rooms; It is especially difficult for them to endure underground transport - the metro. Patients with agoraphobia are afraid of having a panic attack, are afraid of fainting or simply losing self-control in specified places. They come to the doctor accompanied by relatives, their social activity is sharply limited due to the inability to be outside the home.

Obsessive-compulsive disorder

This type of disorder includes an obsessive and compulsive component. The obsessive component is characterized by a predominance of intrusive, repetitive ideas that the patient is unable to suppress. Among such ideas, the most typical is the fear of pollution, accompanied by constant doubt. The forced component is repeated stereotypical actions performed by the patient in response to obsession. Similar actions are in the nature of a ritual aimed at neutralizing an obsession. The most common ritual actions are repeated hand washing, various kinds of double-checks, exaggerated accuracy, and the desire to count.

Reactive forms of anxiety disorders

This form of anxiety disorders is “tied” to a specific stressful situation V family life, social or professional activities. In other words, it is an excessive, inappropriate or painful reaction to some life event. IN in some cases reactive anxiety disorder can be a consequence of concerns about health conditions and be associated with serious illnesses. Reactive anxiety disorder has been described as a response to acute stress - post-traumatic stress disorder. This type in lately occurs quite often and is formed as a result of exceptional, life-threatening circumstances: earthquakes, plane crashes, taking a patient or his relatives hostage.

Anxiety and depression

A differential diagnosis between depression and anxiety is quite difficult in some cases due to the fact that the mental symptoms of anxiety and depression are largely similar and overlap each other. With the long-term existence of an anxiety disorder, the patient develops depression, which is often accompanied by symptoms such as chronic pain syndrome, weight loss, sleep disturbances, etc., which can worsen the condition of patients with anxiety disorders. Thus, a vicious circle develops: the prolonged existence of anxiety causes the development of depression, and depression increases the symptoms of anxiety. A combination of anxiety and depression is observed in 70% of patients.

Anxiety disorders is a group of disorders in which the predominant symptoms are irrational, uncontrollable fear and persistent feelings of anxiety, which can occur in situations that do not actually pose a current threat.

The experience of anxiety is a normal adaptive reaction of the body to changing conditions or threatening events. However, fears may represent serious problem for a person if the level of anxiety reaches . This places restrictions on the patient’s normal functioning, which significantly reduces his quality of life. Also, the long-term existence of an anxiety disorder sharply increases the risk of developing other mental disorders such as depressive disorder(about 15 times) and pathological addictions (about 20 times).

Major anxiety disorders include the following:

Panic disorder– the main symptoms of the disease include repeated attacks of irrational anxiety (panic), not limited to a specific situation or any specific circumstances.

Dominant symptoms: unexpected tachycardia (rapid heartbeat), sweating, tremors, dry mouth, chest pain, difficulty breathing, a feeling of suffocation and nausea, as well as dizziness and a feeling of unreality.

Agoraphobia– a group of anxiety disorders covering a number of phobias, which include painful fear open spaces and public places. Patients experience uncontrollable anxiety when being in a crowd, refuse to visit stores and other crowded places, limit leaving the house unaccompanied, and experience difficulty in using the public transport. Agoraphobia is one of the most maladaptive types of phobic disorders.

Dominant symptoms: when immersed in a frightening situation, patients experience a sharp increase in anxiety, heart rate and breathing become more frequent, sweating and dizziness appear, and in some cases a panic attack develops. As a rule, such patients try in every possible way to avoid those situations that cause them a panic attack, which contributes to the consolidation of an anxiety disorder, changes their usual way of life and interferes with normal life activities.

Generalized anxiety disorder– manifests itself constant feeling anxiety, tension and persistent anxiety about a variety of life events, the likelihood of which is extremely low. Anxiety is not limited to any specific external circumstances, so it is often difficult for the patient to outline the range of situations that trigger panic.

Dominant symptoms: the most typical complaints are a feeling of constant nervousness, trembling, muscle tension, sweating, tachycardia, dizziness, discomfort in the epigastric region. Often the patient experiences fear for his loved ones and suffers from gloomy forebodings. To be diagnosed with generalized anxiety disorder, the symptoms described must be present for at least 6 months.

Social phobia– this anxiety disorder is based on the fear of being seen by others, as well as being in an awkward position, being ridiculed or humiliated, which leads to the formation of an avoidance reaction similar situations. Often this disorder is combined with low self-esteem and fear of criticism. Fears can manifest themselves when eating in public place, the need to maintain a conversation during a chance meeting with friends in the presence of strangers, visiting public places and group classes.

Dominant symptoms: hand tremors, nausea (fear of vomiting may be present), imperative urge to urinate or defecate (or fear of such urge), facial flushing. Sometimes the patient takes one of these side effects anxiety about the underlying disease. Avoidance of frightening situations causes significant psycho-emotional stress, since the person himself realizes that his reaction is excessive and has no reasonable basis.

Specific phobias– these are fears limited to highly specific situations, such as, for example, being in close proximity to certain animals biological species, being in the dark, at a height, in a confined space. Specific phobias also include fear of air travel, fears about using certain types groceries, doctor visits, medical manipulations and type of blood. When faced with frightening stimuli or having thoughts about them, a person's anxiety is triggered and the symptoms described above are observed.

Advantages of treatment at EMC

Thorough diagnosis mental state patient, identification of risk factors.
Compilation individual program treatment, including pharmacotherapy, cognitive behavioral therapy, and, if necessary, TMS.
The Clinic of Psychiatry and Psychotherapy regularly organizes trainings that teach relaxation skills and coping with anxiety symptoms.

Anxiety disorder crosses out plans for life and does not allow you to take a sober look at the real state of affairs. A person, like a squirrel in a wheel, is constantly fixated on little things - from a forgotten light in the corridor to worries about gifts for the birthday. New Year. Being under constant pressure from fears and worries, such people stop enjoying life, become depressed and often project unfounded fears onto loved ones.

Pathological anxiety lasts a long time and at some point becomes unbearable. It is impossible for a person with an anxiety disorder to relax even on a warm beach, not to mention an evening relaxation with his family. Work efficiency decreases, relationships with relatives become tense, friends stop answering calls. However, many of the problems that a mental disorder brings with it are easily compensated for quick treatment diseases.

Treatment for generalized anxiety disorder begins with diagnosis. The diagnosis is made by a psychiatrist or psychotherapist if pathological anxiety persists for 6 months. Treatment of an anxiety disorder is a feasible task for a psychotherapist, who, in the presence of depression and concomitant mental disorders, will prescribe medication (maintenance) therapy.

Generalized anxiety disorder is usually accompanied by physical discomfort, headache, rapid heartbeat and excessive sweating. This condition can occur anywhere and make you worry about your health. In addition, insomnia and other sleep disorders that directly affect overall well-being and concentration become frequent accompaniments of anxiety disorders. Therefore, we advise you not to delay contacting a doctor at the first signs of an anxiety disorder.

Test: "Spielberger Anxiety Scale"

Read each of the sentences given carefully and choose an answer based on how you usually feel.

Start testing

Number of questions in the test: 20

Clinic doctor on treatment of anxiety disorder

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Psychiatrist appointment	Sign up	3,500 rub.
Appointment with a psychotherapist	Sign up	3,500 rub.
Hypnotherapy	Sign up	6,000 rub.
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Treatment in hospital	Sign up	RUB 5,900

Causes of generalized disorder

Young people are most susceptible to this disease. The risk group includes young people aged 20–30 years with an alarming type of character accentuation who are subject to negative impact various types of stressful situations.

Formation and development alarming type personality occurs in early childhood, school and adolescence. Such people are unsure of themselves and lack initiative. They are afraid of making a mistake, have a heightened sense of fear and causeless anxiety. They are constantly haunted by various phobias.

If such people are exposed to factors that can traumatize the psyche, then there is a high possibility of developing an anxiety disorder. This can be either neurosis or GAD, which is one of the most severe manifestations.

The disease can be caused by:

Persistent stressful situation. This situation is usually associated with death loved one. People are not prepared for death, so this fact causes deep stress, sometimes lasting for a very long time. Stress can be caused by troubles at work, demotion, staff reduction, or dismissal.
Prerequisites of hereditary nature. If there are (were) people in the family who are prone to nervous disorders, anxiety, prone to depression, then there is a high probability that this type nervous system can be inherited.
Injuries emotional nature . IN childhood the development of the disease occurs against the background of frequent punishment, injustice, despotism on the part of parents, and strict upbringing. For people who experienced the death of relatives in childhood, this situation can provoke anxiety and worries in adulthood. Lack of parental love and care in childhood can lead to the development of a disease such as basal anxiety. It is characterized by helplessness, loneliness, a feeling of uselessness and lack of demand, on the basis of which various inferiority complexes develop.
Diseases associated with nervous system disorders.

GAD can arise and develop in completely healthy person prone to nervous diseases, as well as in those people who are susceptible to the disease at the genetic level. Absolute prerequisites causing GAD, medicine cannot name it. Absolutely, the main reasons cannot be only the presence of a stressful situation, as well as the presence of injuries of a physical or emotional nature.

Symptoms of generalized anxiety disorder

The sense of self-preservation, which is based on justified excitement, helps people to be more attentive and careful. This indicator increases the chances of survival in this complex world, full of dangers.

However, if such fears and anxiety arise constantly and without cause, then such a condition can be confidently classified as pathological. It interferes with normal life social environment and in everyday life.

Symptoms of generalized anxiety disorder:

Long period (several weeks or months) manifestations of symptoms, expressed in feelings of fear, excitement, nervous tension and anxiety. Usually, after six months of constant observation of these symptoms, one can confidently state the disease.
No reason. Symptoms of anxiety occur without a specific reason in a normal environment and in a calm situation.
Strong character. A person gets worried in any life situation, the slightest deviation from the usual rhythm of life causes fear and panic.
Muscle tension and pain, expressed in hypertonicity of the limbs, trembling and tremor. Pain in the head can be characterized as a “muscle helmet”, which, like a vice, compresses the temples and the back of the head. Diagnosing muscle weakness is less common but can lead to complete loss mobility of hands and feet.
Emotional disorders. Feelings of anxiety, fear and panic are uncontrollable and have no justifiable reasons. The patient may feel restless after he has had a good rest and sleep.
Pathological processes autonomic system . Violations are expressed in increased sweating, dry mouth, angina attacks. Anxiety may be accompanied by dizziness, fainting and loss of consciousness. The patient may feel a feeling of tightness in the chest, lack of air, pain when breathing, visual and hearing disturbances;
Insomnia and sleep disturbance. At generalized disorder Patients have trouble falling asleep and are haunted by nightmares that force them to wake up in a cold sweat. Sleep is characterized by incoherent dreams, after which patients feel tired, irritable and anxious.

In generalized disorder there is deterioration general condition patient. Often with GAD, patients believe that the reasons for their fears and anxiety state lie in somatic illness. They complain of lethargy and general weakness, painful sensations in the abdomen, heaviness and compression in the chest and other negative sensations.

Diagnosis of GAD

To install accurate diagnosis GAD, symptoms expressed in constant unreasonable fear and anxiety should persist steadily for many weeks or months on end.

A diagnosis of GAD can be made if:

Uncontrollable fear and anxiety;
Muscle tension(tremor of limbs, trembling, fussiness);
Manifestations autonomic disorders (profuse sweating, rapid breathing and pulse, dizziness, fainting and others).

Pay attention! Generalized anxiety disorder affects 3 to 5% of the country's population. Before making a diagnosis, doctors at our clinic conduct testing and other studies, based on which they exclude the possibility of developing other diseases, for example, neurasthenia, which has similar symptoms.

At the first appointment, our specialists usually determine the extent of the disease. And only after this, the psychiatrist prescribes a course of psychotherapy and selects individually for each patient medicinal method traditional therapy.

In our clinic we provide the following therapy using medications:

As first aid, our specialists use medicines, such as phenazepam and similar benzodiazepine tranquilizers. We do it step by step. We usually prescribe a course of treatment with tranquilizers for two months or more short term. More long period may lead to the development of drug dependence.
During periods of sleep disturbance, our doctors prescribe Ivadal for him as well. similar drugs, helping to normalize sleep at night.
If the patient experiences fear and anxiety, and at the same time he has bright severe symptoms depressive state, then in our clinic the patient is usually prescribed the use of Zoloft, Paxil and the like medications, as well as tranquilizers. Only with this combination will the treatment be most effective.

Treatment of Anxiety Disorder for anxiety, we treat with taralen, tizercin and other drugs belonging to the group of neuroleptics. For each specific case and each specific patient, we select individual techniques.

Once again, we draw your attention to the fact that we first establish an accurate diagnosis, thoroughly study, check and test the patient’s condition. And only after that we confirm the diagnosis.

To treat GAD in our clinic, we also give preference to psychotherapeutic methods: cognitive-behavioural, short-term psychodynamic, autogenic training, biofeedback methods (BFB).

The advantages of biofeedback are the identification of the internal forces of the body. The patient learns to control himself, his behavior, to free himself from anxiety, worry and fear.

Psychotherapy methods are also selected for each patient individually, based on the diagnosis.

Therefore on initial stages diseases, when the symptoms are especially pronounced, anxiolytics are added to the treatment of anxiety. These drugs have quick action and patients often use them as self-medication. They can provide quick relief, but true cure no anxiety disorder occurs. IN in this case Only the symptoms are relieved. There is another side to these drugs. Uncontrolled use of anxiolytics can lead to the formation of dependence and a decrease in the effectiveness of the main treatment.

Therapy experience

Our experience shows that anxiety disorder and dependence on anxiolytics are much more difficult and longer to treat. It is necessary to use more complex and expensive drugs. In addition, long-term abuse of anxiolytics leads to a decrease in intelligence and memory. Thus, while remaining an excellent first aid remedy, tranquilizers are not suitable for long-term maintenance therapy and treatment of anxiety disorders. Therefore, the use of anxiolytics in our clinic is strictly limited in dosage and time frame. We use anxiolytics for no more than 10 days and only in emergency cases.

To quickly stabilize the condition, we use drugs included in the active neurometabolic therapy developed at the Preobrazhenie Clinic. Active neurometabolic therapy has been used in the clinic for more than twenty years and has shown not only high efficiency, but also safety. Contrary to the fears of many patients, neurometabolic therapy used in the clinic to treat anxiety disorders is never addictive.

Symptoms of Anxiety Disorder

The severity of anxiety disorder symptoms can vary.

With moderate, situationally caused anxiety, you can limit yourself to psychotherapy and the prescription of herbal medications. With an expanded version of the anxiety disorder, joining panic attacks, there is often a need for inpatient treatment.

One of the main mistakes patients make when treating anxiety disorders is stopping medication on their own.

Anxiety disorders often co-occur with other symptoms, such as depression and drug addiction. psychoactive substances, as well as with personality disorders. It is also closely related to agoraphobia and panic states. For more precise definition We often use full pathopsychological diagnostics and special anxiety scales.

Sometimes this is due to side effects - lethargy, drowsiness, dry mouth, sometimes with the arrogance of patients who “decide” that they are completely healthy. Unfortunately, the treatment time for an anxiety disorder, even with rapid and lasting improvement, is quite long.

When treating an anxiety disorder, medications can only be discontinued with the knowledge of the doctor!

Finally, big role Psychotherapy plays a role in the treatment of anxiety disorders. It is this that allows a person to develop new strategies for responding to stress, strengthen nervous system. Often during psychotherapy, the patient acquires skills for independent relaxation and increased self-confidence, which will serve him throughout his life.

Treatment in the clinic

We help in the most difficult cases!

We treat anxiety disorders using individually adapted schemes based on the differential diagnosis anxiety disorder. Diagnosis takes into account not only the presence of a mental disorder, but also such somatic diseases such as ischemia, lung diseases and others.

Not all anxiety disorders need to be treated in a hospital. If the symptoms are not very pronounced and the quality of life is impaired in moderate degree, we offer outpatient therapy programs. However, inpatient therapy for an anxiety disorder is indicated if the patient exhibits severe discomfort, complications, or other comorbid disorders. For example, a person has secondary depression, suicidal thoughts or alcohol abuse.

Indications for treatment of anxiety disorder in a hospital setting are:

Presence of indicators of possible suicide;
Resistance to standard treatments;
Concomitant pathology requiring more active therapy.

Along with individual therapy, in the clinic patients receive “psychoeducation” about their condition and the mechanisms of action of our treatment methods. The treatment plan is selected based on the data differential diagnosis. Individually selected techniques containing drug therapy, psychotherapy and possible means, are selected only after careful consideration of individual parameters. The patient’s preferences, history of previous treatment attempts, severity of the disease, and concomitant disorders are also taken into account.

We believe that we should be informed about possible side effects, interactions, safety, contraindications and treatment plan. Our patients receive information about the possibility of treatment and its duration, as well as the need to change their daily routine. Unfortunately, many patients with anxiety disorders are often afraid to take medications due to fear side effects. Therefore, we control all stages of therapy and monitor quality.

There is an opinion that in patients receiving drug therapy, after its cessation, a return of the disease is observed. With psychotherapeutic treatment, the effect remains significantly long term, up to several months or more. “Public opinion” is being formed, however scientific research And practical medicine completely refutes this opinion. We believe that only complex therapy anxiety disorder can reach maximum effect. With properly organized therapy and following all the recommendations of our doctor, the effect of treatment is observed for several years. Relapse occurs only if the patient violates the doctor’s recommendations.

On this page you can find information about treatment of anxiety disorders.

An anxiety disorder is a condition in which anxiety is the primary symptom without an external cause.

This anxiety state has flexible symptoms, where states quickly flow from one to another. Symptoms of anxiety can appear all together or individually. How does a person feel with an anxiety disorder?

Heart rate increases.
There is fussy nervousness and a surge of physical strength.
Excited appears emotional state. A little later, emotional and physical condition in their activity they begin to tend to zero and are replaced by apathy, sometimes weakness. (These primary ones can be used to recognize an impending attack of an anxiety disorder.)
Without visible reasons The oral mucosa dries out.
Unmotivated fear appears.
The man is covered in perspiration.
Muscle tone increases.
Tremors begin in the limbs.
There is a feeling of impending madness.
Dizziness begins.
Heaviness in the chest area makes breathing difficult.
Discomfort appears in the gastric area.
There is a lump in the throat and a nervous state.

Women are more likely to have anxiety disorders than men. A stimulating factor influencing the emergence and development of an anxiety disorder can be external stress, which, if not eliminated, can cause the disease to become a chronic condition. Anxiety disorder is felt as a fear of accidents, a premonition of impending trouble, disaster, illness, etc.

Diagnosis of an anxiety disorder

Under diagnosis anxiety disorder implies the need to separate the symptoms of the disease from similar but different conditions. After all, some individual manifestations - dizziness, heaviness in the stomach, excessive sweating- can also signal other physical diseases.

Typically, to establish a diagnosis of an anxiety disorder, an anxiety severity scale is assessed and a cumulative analysis of all symptoms is done.

The main indicator signaling the development of the disease is a persistent state of anxiety over a long period of time - several weeks or even months.

Treatment for Anxiety Disorder

With mild flow illnesses, doctors usually recommend psychological therapy, which may include behavioral and family psychotherapy, as well as psychoanalysis, massage sessions and physical education. If the anxiety disorder is more severe, pharmacological treatment may be prescribed.

Doctors of the clinic: Dr. med. Just a minute along with standard methods Treatment of anxiety disorders uses pharmacological monotherapy, which involves prescribing a specific drug in a strictly controlled concentration. In addition, the clinic practices the so-called biofeedback method. Light therapy is also used.

Synthesis of individual approach and innovative therapeutic methods, makes it possible to achieve excellent, sustainable treatment results in an extremely short period of time.