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GENERAL ANXIETY

GENERAL INFORMATION

Anxiety is a very common symptom in most people, and everyone at some point in their lives has felt anxiety in response to all sorts of events, however, sometimes it occurs without an apparent trigger. Anxiety, though, does have a certain purpose—the survival of the individual; when facing danger, the body will defend itself by fighting or fleeing, and it prepares itself to do this. The changes that occur for this to happen are both physical and psychological.

Physical symptoms include an increase in blood flow to the skeletal muscles creating muscle tension and a cooling of the skin due to the decreased blood circulation at this level; an increase in heart rate and blood pressure; and a feeling of sickness, nausea, etc.

Psychological symptoms include an initial feeling of fear that moves a person to get away from danger. It can be experienced as a most intense feeling of panic and the sensation of imminent death, that is to say, a sense of knowing that at that precise moment the person can die. All the previous sensations serve to mobilize the person and to move away from danger and to survive; but when all these responses occur in situations that do not require it, we start talking about an Anxiety Disorder, with the symptoms being what has been described.

When anxiety is already the nature of a disorder, symptoms may increase. Initially a person will feel his or her anxiety to be at a low level of intensity in certain situations, later the anxiety increases in severity until it becomes panic, and the situations where the anxiety and panic are experienced extend to other similar situations. For example, if someone was initially anxious to walk alone at night, they will then become anxious just to go out into the street at all. Doing so or even thinking of doing so will aggravate the symptoms until the point of a panic attack.

A panic attack is the most serious symptom of an anxiety disorder. It can occur quite frequently and be very disabling; without warning a person feels afraid, has thoughts of imminent death, feels his or her heart and blood pressure raise, a sense of dizziness, nausea, pain in the chest, shortness of breath, cold sweating, and other sensations. As the minutes pass, these sensations diminish until they disappear completely, but they leave the person feeling that they could happen again at any moment. This makes it difficult, if not impossible, to lead a normal life.

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FREQUENTLY ASKED QUESTIONS

What is anxiety?
Anxiety is a normal response that the organism has in the face of a threat, whether external or internal. Anxiety can occur in different ways: alteration in thinking (worry and negative thoughts), appearance of physical symptoms (tension, tachycardia, dizziness) and manifestation of behaviors (avoidance of dreaded situation, smoking, stuttering).

Is anxiety always bad?
In many cases it is not. Anxiety adapts itself to a situation, for example, during exam time or before playing an important game where it is normal to feel anxious. In the case of feeling anxious at exam time, the anxiety makes a person better prepared, inspiring them to study in order to ace the exams.

What is the difference between anxiety and fear?
Fear and anxiety are similar. We speak of fear as a basic emotion. With anxiety there is also a natural response by the organism that is internal and anticipatory. In both cases, the body prepares itself before facing or experiencing the possible negative consequences of any given threat.

What is the difference between fear and phobia?
Fear is a normal emotion that occurs in the face of a true threat. On the other hand, a phobia is IRRATIONAL fear in the face of a stimulus that is not in and of itself dangerous or at least not so dangerous in relation to the intensity of the fear experienced (the person “afraid” of cockroaches, spiders, etc.). It is normal to feel afraid when watching a horror movie or witnessing a robbery. On the contrary, it is not normal to not leave home for fear of encountering an aversive stimulus that may cause harm; in this case, that would be a phobia.

What is the difference between stress and anxiety?
We talk about stress when the demands of the environment are greater than the resources the person has to satisfy the demand. Therefore, stress will depend on a person´s ability to adapt. With both fear and stress, there is a threat, but with anxiety, the threat feels continuous. Anxiety and stress share many similar aspects, and stress can trigger anxiety, but also other emotions, like joy or anger. In addition, stress is associated more with fatigue or exhaustion.

Does anguish often accompany fear?
We know that fear is a response of the body to a threat. We speak of anguish when the threat is not recognized from outside the person feeling it. Anguish is rather a feeling of internal malaise that is difficult to identify clearly.

Do all people have the same fear in the same situations?
Definitely not. Each person experiences fear in various situations differently, in the same way that each person perceives reality in a different way. Fear can be associated to an object, person or concrete situation, but what produces fear is not that object, person or concrete situation. What produces fear is the previous ideas or experiences (past) and the ideas or experiences that we believe we will feel (future) when facing that object, person or concrete situation again.

What physical symptoms does anxiety produce?
The most common physiological responses are: muscle tension (to flee or face the threat), tachycardia (to send more blood to the muscles) and rapid breathing (to send oxygen to the muscles). Other symptoms can be: sweating, nausea, instability, feeling of unreality, tingling, tightness in the chest and chills. All these physiological responses are intended to keep us forewarned.

If anxiety helps us, how can it be so harmful?
The problem of anxiety is what is called "Fear of Fear.” When feeling very anxious, which negatively impacts the body and the ability to perceive threat, a person will tend to fear that some situation may occur again. The person will think that at any moment they can have an anxiety crisis (explained below: very intense anxiety) and will want to avoid it at all costs. The normal reaction to this situation is what is called "fight or flight." A person can face fear or avoid the situation, with both responses causing anxiety. Avoidance may seem the easiest and simplest way to avoid feeling afraid, but it actually increases the fearful feeling. The next time a person faces the same or similar situation, the fear will be much greater and costlier.

When does anxiety become a problem?
Anxiety becomes a problem when it interferes with a person´s life—his or her personal, relational life and work life. In short, it becomes a problem when it alters the daily life and mood of the person. A person may feel anxious all day for no apparent reason and avoid situations that he or she used to do before. Unlike Pathological Anxiety where states of anxiety are intense, of prolonged duration and often repeated, Normal Anxiety is construed of episodes that do not usually repeat so frequently, and they are of a lower intensity and duration.

What is the difference between anxiety and an anxiety crisis?
There are different types of anxiety. Anxiety can manifest itself in a prolonged way (more a generalized anxiety) or suddenly (an anxiety crisis). In an anxiety crisis (also called anguish crisis or Panic Attack) there are sudden and unexpected episodes with or without an identified cause of intense fear of losing control or that something bad is going to happen. There are usually symptoms such as, shortness of breath, chest pain, palpitations, sweating, tremors, feeling dizzy and unsteady, tingling and nausea. It is usual during crises to have thoughts like: "I'm going to lose control," "I'm going to go crazy," or "I'm going to die." It is important to keep in mind that the symptoms that occur during an anxiety crisis are not bad in and of themselves because the person is not going to suffocate, have a heart attack or likely faint. It is important to work on the thoughts that occur during a Panic Attack and that the person be aware of their body. Anxiety Disorders found in the DSM-V are: Separation Anxiety Disorder, Selective Mutism, Specific Phobia, Social Anxiety Disorder (Social Phobia), Panic Disorder, Agoraphobia and Generalized Anxiety Disorder, among others.

Do all the different anxiety disorders arise frequently and equally?
Anxiety disorders are the most common problems seen by psychologists, and the ones that tend to be more frequent are Agoraphobia, Social Phobia or Generalized Anxiety. Agoraphobia: Intense fear of open spaces where it is difficult to escape. Social Phobia: Fear of being judged by others or being ridiculed in different social situations. Generalized Anxiety: The person suffers anxiety and nervousness most of the time, without the anxiety being attributable to a specific situation.

OUR TREATMENT MODEL

CADE offers a multidisciplinary treatment according to the characteristics and needs of the patient that is based on the patient´s diagnosis and an individual intervention plan.

A psychological or psychiatric disorder generally has a genetic or biological origin detonated by difficult and early or current traumatic experiences that lead the individual to become ill. Therefore, the clinical intervention in these disorders necessitates the multidisciplinary work of psychiatry, psychology, medicine, nutrition and complementary therapies. The treatment can be outpatient, inpatient or semi-inpatient based.

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