How to get rid of anxiety and worry

Experiencing anxiety is unpleasant, but it does not always have a negative role! Anxiety makes us weigh the pros and cons, look for the most correct solutions, and not rush to do the first thing that comes to mind. However, anxiety does not always "play for the whites." In some cases, it becomes excessive, chronic, begins to arise spontaneously, regardless of the presence of a stressful situation, interfere with work and personal relationships. Then it is legitimate to talk about pathological anxiety and consider it in the structure of mental disorders.

Fright/anxiety/fear? Who is who?

Anxiety is a non-specific emotional reaction of a defensive nature. The closest "relatives" of anxiety are fright and fear, but despite the same mechanisms of their occurrence and external manifestations, they should not be considered synonymous concepts.

Thus, fright is an involuntary, simple defensive reaction that is a precursor to anxiety and fear. Its main defining characteristics are spontaneity, short duration and sufficient differentiation in relation to the object that caused it.

Fear also arises in real time in response to the threat of contact with an unwanted and very specific object and usually disappears after the threat is removed from sight.

The boundaries of the object of anxiety are always blurred; in clinical practice, situations are often impossible to determine what causes anxious experiences in the patient.

In addition, in contrast to the paradigm of fear and fear “here and now”, the experience of anxiety is more extended in time and is directed to the future - these are vague premonitions that something bad will happen, tense anticipation of potential danger.

Mechanisms of occurrence anxiety

Fear and anxiety are vital from an evolutionary point of view, because it is thanks to them that in an extreme situation the body can quickly mobilize all its resources and be ready to implement one of two possible scenarios: a fight, if there is a chance of victory, or an escape, if defeat is promised.

The frontal-limbic system of the brain, as well as the thalamus and the sympathetic nervous system, are responsible for the development of fear and anxiety reactions in the body. The frontal-limbic system is responsible for recognizing dangerous situations; in our body, it acts as a watchtower and sends an alarm signal to other parts of the brain. The thalamus is the first to respond to its message, which in turn initiates the release of the stimulating hormone norepinephrine. Norepinephrine is commonly called the hormone of rage and courage, thanks to its influence a person acquires the necessary confidence and readiness for decisive action, meeting face to face with a threat.

At the same time, the hypothalamus begins to produce "stress hormones" cortisol and adrenaline, the reactions of the sympathetic part of the autonomic nervous system are activated. It is due to the involvement of the sympathetic nervous system in the process and the action of "stress hormones" that a person breaks out in a "cold sweat", the heartbeat and breathing quicken, the muscles of the body tense up, and the body comes into full combat readiness.

How does anxiety manifest itself?

Anxiety has many faces in its manifestations, often the symptoms by which it can be identified are internal tension, excitement, fears, the inability to relax and concentrate, but anxiety also has numerous "somatic masks", such as headaches, palpitations, discomfort in the heart area, pressure fluctuations, dizziness, a feeling of shortness of breath, etc.

Anxiety can arise suddenly in attacks, and then it is legitimate to talk about panic disorder, accompany most life situations, as happens with generalized anxiety disorder, or even be combined with depressive symptoms in mixed anxiety-depressive disorder.

If you are bothered by obsessive thoughts, doubts, fears and you are forced to perform certain protective tiring actions (frequent hand washing, double-checking whether electrical appliances are turned off, etc.) in order to cope with the anxiety that arises in response to these thoughts, then in this case we are talking about obsessive-compulsive disorder. The group of anxiety disorders also includes phobic disorders, manifested in the form of various fears of heights, snakes, air travel, enclosed spaces, public speaking.

Who should I turn to for help? What is the placebo effect?

Imagine a person in the midst of a panic attack (PA): his heart is pounding at a frantic pace, he is either hot or cold, there is a catastrophic lack of air, his arms and legs are shaking, his head is spinning, he does not understand what is happening to him, but perceives it as threatening his own life.

Of all the possible existing diseases, suspicion usually falls on a heart attack, stroke, cancer, schizophrenia. First of all, such a person, of course, calls an ambulance team, but without fully understanding what the matter is, goes to therapists and neurologists, and this is the most favorable case. But his path to choosing traditional methods of treatment can be long. For cultural or other reasons, the search for getting rid of panic attacks sometimes leads a person to herbalists, magicians, osteopaths, yogis, homeopaths and other specialists. Undoubtedly, there will be an effect from such treatment, but not for everyone.

The effect of all methods that have not been clinically proven is essentially a placebo effect or comparable to it. The basis of the placebo effect is the suggestion that the drug is effective, and the expected is realized in the following way: our brain, having believed, begins to stimulate the production of endorphins, which cause the effects of drugs that we expect, in addition, this leads to an increase in immunity and mobilization of the body's defenses. However, this does not work for everyone; the probability of the placebo effect is high in people who are easily influenced, usually anxious, insecure, gullible, dependent on the opinions of others, and with low self-esteem.

Placebo is a kind of psychotherapy, where the very fact of taking medication has psychotherapeutic power.

According to statistics, 25% of patients with mental disorders never get to specialized specialists, such as a psychiatrist or psychotherapist. Despite the fear of turning to such specialists and existing myths about the harm of psychopharmacotherapy, it is necessary to overcome doubts and fears and begin to restore your mental health. Otherwise, it will be very difficult to get rid of chronic anxiety.

How are anxiety disorders treated?

There are three approaches to the treatment of anxiety disorders: drug therapy, psychotherapeutic treatment, or a combination of psychotherapeutic methods and medications. Treatment is selected individually, taking into account the severity of the condition, age, concomitant somatic pathology, and personality traits.

The "gold" standard for the treatment of anxiety disorders is the use of antidepressants of the selective serotonin reuptake inhibitor (SSRI) group. The mechanism of their action is quite simple (unlike the name) and is based on the idea that anxiety is associated with low serotonin levels.

Serotonin is a neurotransmitter (messenger) that is produced by brain cells and helps establish contact between neurons. Neurotransmitters live at the point of contact of neurons - synapses, or more precisely in synaptic clefts. SSRIs, prohibiting serotonin from releasing the synaptic cleft, contribute to its increase in the synapse, which is manifested in a decrease in the level of anxiety, normalization of the mood background. Along with antidepressants, anxiolytics can also be used, which have a rapid anti-anxiety effect, and in severe cases, "minor" neuroleptics.

As for psychotherapeutic treatment, the most effective here is the use of cognitive-behavioral psychotherapy, in which the patient, in cooperation with a specialist, recognizes dysfunctional stereotypes of thinking and behavioral errors that cause a feeling of fear and anxiety, gradually gets rid of the symptoms of psychological problems, forms adaptive skills and returns to the previous level of social functioning.

Unfortunately, it will not be possible to get rid of anxiety disorder quickly. Thus, the course of psychotherapeutic treatment on average is 10-20 sessions, and taking medications reaches six months. The effect of treatment usually occurs within the first month, but the goal of treatment is not just to quickly relieve anxiety, but to achieve a stable effect and prevent the return of similar symptoms in the future.