The term Anxiety neurosis Was coined by Sigmund Freud for Define periods of deep anxiety and high body tension.
In this article we will talk about the characteristics of this psychopathology, we will discuss its symptoms, its consequences and the therapeutic strategies Which currently exist to remedy such problems.
What is neurosis?
Before venturing to define the anxiety neurosis, I would like to pause for a moment to explain what is meant by neurosis.
Surely, for many of us the term anxiety is a highly familiar and easily understood concept from the world of psychology and mental diseases.
However, the term neurosis can be somewhat more ambiguous, being a word that is less and less used in modern clinical practice, done Which causes that this term appears little in the recent psychological and psychiatric bibliography.
The term of neurosis was proposed by the Scottish doctor William Cullen When referring to sensory and motor disorders caused by Diseases of the nervous system.
Thus, neurosis is the word used to refer to mental disorders that distort rational thinking and social functioning, Family and working life.
However, it should be noted that popularly the use of the word neurosis is usually something different, a fact that can cause confusion on some occasions.
In everyday usage, neurosis can be understood as synonymous with obsession, eccentricity, or nervousness.
Surely you've heard someone say,"There's no remedy for this kid, he's a neurotic."
Within this sentence, it becomes clear how the word neurosis is being used to describe the person as someone who is obsessed with everything, is Unable to think clearly and is permanently distressed by minor aspects.
It is true that this use of the word neurosis is not far from its professional meaning, however, it would be a mistake to equate neurosis With obsession.
And it is that in the professional practice, the term neurosis covers many more aspects than the simple obsession, since it refers to a mental disorder Which is characterized by the presence of a very high level of anguish .
Thus, when we speak of neurosis, we are talking about a mental illness that is characterized by the presence of a high anxiety that Causes a significant deterioration in the welfare and functionality of the person.
What is anxiety neurosis?
Before the first description of neurosis realized by William Cullen, Sigmund Freud Developed a number of works and developed a classification in which Distinguished several types of neurosis.
Neurosis anxiety, phobic neurosis, obsessive-compulsive neurosis, Depressive neurosis , Neurasthenic neuroses, depersonalization neuroses, Hypochondriac neuroses and hysterical neuroses were described by Freud.
Thus, we quickly see that the anxiety neurosis that concerns us in this article, refers to a particular subtype of this disease.
The neurosis of anxiety or distress can be defined as a state of high excitability that the patient himself expresses as an"anxious waiting" On which the subject elaborates fateful expectations of the future based on symbolism.
At first glance, this definition postulated by Sigmund Freud can be very psychoanalytic, something bizarre and little applicable to reality or practice clinic.
However, the concept of anxiety neurosis is vitally important for understanding problems and anxiety disorders.
Thus, it seems opportune to define anxiety neurosis in a more intelligible, symptom-centered and less process-centric way Interpersonal appearances.
Thus, anxiety neurosis can be understood as a condition in which a person has episodes of intense fear or anxiety, in a way Sudden and without prior notice.
These episodes that are suffered in anxiety neurosis are known today as panic attacks, which can last from minutes to hours.
Likewise, they may occur only occasionally or may occur quite frequently.
So, today the term of anxiety neurosis is no longer used in clinical practice so if you have this problem and you go to a Specialist of mental health, in the diagnosis that provides you possibly does not appear the nomenclature of anxiety neurosis.
Currently, instead of anxiety neurosis, a diagnosis of panic disorder or panic attack is often used.
This fact is explained by Freud's classification of neurosis, despite providing a great deal of information and evidence on The characteristics of anxiety disorders, has now become obsolete.
Thus, what Freud cataloged as phobic neuroses today are known as social phobia, specific phobia or agoraphobia, which he knew as Obsessive-compulsive neurosis is known as obsessive-compulsive disorder, and what he cataloged as anxiety neurosis is called panic attack,
What is a Panic Attack?
So far we have understood that anxiety neurosis is a special condition in which the person suffers a series of episodes of fear and / or anxiety Extreme known as panic attacks.
So, let's define what these are panic attacks And what sensations and symptoms have a person who suffers this type of alterations.
The panic attack also known as panic disorder is a situation in which the person suffers a sudden crisis of intense anxiety upon possessing Extreme thoughts of fear and the irrefutable belief that something bad will happen.
This crisis begins suddenly, that is, the person is not able to recognize that he will suffer until he is already suffering.
Its duration can be variable, but it usually lasts for a few minutes and the maximum sensation of fear usually appears during the first 10-20 minutes. Some symptoms may last for an hour or even longer.
Due to their characteristics, the symptoms that produce this type of intense anxiety are often confused with a heart attack.
The main symptoms of a panic attack are:
Thought of excessive fear to lose control, to go crazy, to die or to suffer some type of damage or extremely negative consequence.
Constant shaking and shaking throughout the body.
Excessive sweating and body shivers.
Feeling that the heart beats very hard or extremely fast.
Sensations of severe pain or discomfort in the chest (as if you are suffering from a heart attack).
Feeling of shortness of breath, difficulty breathing, and belief that you will drown.
Feeling of suffocation and inability to calm down.
Nausea and feeling of need to vomit.
Cramps or other discomfort in different parts of the body.
Dizziness, feelings of weakness and loss of balance.
Feeling that he is coming out of his own body.
Tingling and / or numbness of the hands, arms, legs or feet.
Sensation of strange heats in different parts of the body.
Normally you do not usually experience all these symptoms at the same time, but you do suffer a significant part of them during the crisis of distress.
These symptoms are often experienced with much discomfort, extreme fear and extreme levels of anxiety.
Also, due to the great discomfort that originates and the unpredictability of appearance, people who suffer panic attacks live with apprehension Possibility of experiencing new crisis of distress.
Individuals with this disorder are constantly on the alert about this possibility and, despite the fact that doctors have discarded it Possibility of suffering a medical illness, continue to express great fear of suffering a new crisis that could end their life.
As expected, this state of activation and hypervigilance in which people with panic disorder live, causes them great interference in Its day to day.
The person with an attack of distress will find it very difficult to be calm, not think about the possibility of suffering a new crisis, will feel discomfort Constant and your normal behavior will be greatly interfered.
What are the diagnostic criteria for a panic attack?
In order to catalog this specific type of anxiety as a panic attack, the following characteristics must be connoted:
Temporary and isolated appearance of intense fear or discomfort, accompanied by four (or more) of the following symptoms, which are initiated Abruptly and reach their maximum expression in the first 10 minutes:
Palpitations, heart shaking, or heart rate elevation.
Sweating.
Shaking or shaking
Feeling of choking or shortness of breath.
Feeling of choking
Oppression or chest discomfort.
Nausea or abdominal discomfort.
Instability, dizziness or fainting.
Derealization (feeling of unreality) or depersonalization (being separated from oneself).
Fear of losing control or going crazy.
Affraid to die.
Paresthesias (tingling sensation),
Chills or suffocations.
B. Despite its similarities to a heart attack, the possibility that the symptoms are caused by a medical illness or Consumption of chemicals.
As we see, not all symptoms appear, since the presentation of 4 of the 13 commented, is enough to make the diagnosis. Further, It is very important to demonstrate the absence of cardiac problems that may cause the episode.
What are its consequences?
The panic attack can present itself uniquely to especially stressful events. At that moment, the person can be overcome by the Demands of the situation and to experience this series of symptoms.
However, the problem begins when panic attacks begin to occur frequently and the person begins to live with apprehension Possibility of suffering new episodes.
In these situations, the person will live in a state in permanent hyper-vigilance and tension, and anxiety will become his habitual companion.
In addition, under these circumstances, it is quite common for the panic attack to be accompanied by the onset of a new disorder, agoraphobia.
Agoraphobia consists in the experimentation of extreme anxiety when being in places or situations where escape can be difficult and for that reason So, in the event of an unexpected distress crisis, you may not have help.
In this way, the person begins to restrict his behavior and the places in which he remains due to the extreme fear of suffering some evil when he is not Finds in safe place, reason why it ends up taking phobia to certain places or situations.
This disorder can be very disabling since the person may end up not wanting to leave home or not attending habitual places like work place, Restaurants, typical streets of their area of residence, and avoid entering vehicles or other enclosed sites.
How can it be treated?
The goal of treatment for anxiety neurosis (panic attacks) is to help the sufferer to properly defibrillate In their daily lives, to mitigate the symptoms of anxiety and to make their fears interfere as little as possible in their daily life.
The most effective therapeutic strategy currently available to combat this problem is to combine pharmacological treatment with psychotherapy.
As far as drugs are concerned, the most commonly used drugs are Antidepressants Selective serotonin reuptake inhibitors (SSRIs), the Sedatives and, occasionally, anticonvulsants. These medicines should always be administered under a doctor's prescription.
For its part, psychotherapy focuses on working distorted points of view about the possibility of suffering a panic attack and suffer Extremely negative consequences.
The patient is taught to recognize his or her panic-stricken thoughts and work together to be able to modify them and reduce Feeling of helplessness.
Stress management and relaxation techniques often help the patient to live more calmly and make it less likely that new Symptoms of anxiety.
References
- American Psychiatric Association. DSM-IV-TR. Diagnostic and Statistical Manual of Mental Disorders. 1st Edition. Barcelona, Spain:
Elsevier Masson; 2002. - Botella C. and Ballester, R, (1997). Panic Disorder: Evaluation and Treatment . BARCELONA: Martínez Roca.
- Escobar F. Diagnosis and treatment of anxiety disorders. Colombian Association of Neurology [online]. Available at: www.acnweb.org.
- Freud, S. (1973). Lessons to Psychoanalysis and Psychiatry. Tomo I. Madrid. New Library.
- Hyman SE, Rudorfer MV. Anxiety disorders. Brochure of the National Institute of Mental Health. U.S. Publication 09 3879. 2009.
- Mavissakalian, M. Michelson, L (1986). Two year follow-up of exposure and imipramine treatment of agoraphobia. American Journal of Psychiatry , 143, 1106-1112.