Regarding anxiety, the medical community has identified six types of problems that are referred to as “anxiety disorders” because they have similar biological components and their treatments are similar.

Note that the stability of anxiety disorders varies greatly. They can be constant or come and go for no apparent reason; in many people, they manifest themselves more intensely in times of stressful events. They can also go into spontaneous remission and reappear years later, sometimes never.

Chronic or generalized anxiety. It is the mental state of a person who is overly apprehensive, that is, often worried about what is likely to happen: that the roast is overcooked, that the house is not clean enough, that the baby gets sick, partner has an accident, etc. The areas of concern are not limited to one industry. The physiological mechanisms are the same as during the resistance phase of stress, when the body mobilizes certain resources to accomplish a “crucial” task.

Symptoms of the disease. Muscle tension, irritability, palpitations, fatigue, difficulty concentrating or remembering, sleep disturbance.

Panic disorder. Characterized by sudden terror attacks that last for several minutes, sometimes longer, and repeat in a random fashion without identifying a primary trigger. This disorder usually appears at the beginning of adulthood and often generates phobic avoidance behaviors (out of fear, avoiding places where one has already experienced a panic attack or avoiding the activity that one practiced during an attack has occurred).

Symptoms of the disease. Tightness in the chest, rapid heartbeat, sweating, tremors, dizziness, fear of losing control, etc .; the symptoms of a panic attack are so intense that people think they are having a heart attack and fear dying.

phobia. It is an intense and irrational fear caused by an object (knife, spider, etc.) or a situation (being on a plane or at the dentist) which, objectively, does not really present a danger. While phobias trigger panic attacks, they are different from panic disorder because these attacks are always related to the same cause (although one can suffer from more than one phobia). Claustrophobia is the fear of closed places while agoraphobia is that of open public places; everything, or almost everything, can become the object of a phobia. This disease leads to avoidance behavior.

Symptoms of the disease. Similar to those of a panic attack, varying in intensity.

Social phobia. This unreasonable fear of being in a group or in public, or of being exposed to the observation of others, presents a set of particular characteristics and constitutes a category in itself. More than just shyness, this type of phobia can make you unable to meet new people and lead to isolation.

Symptoms of the disease. Similar to those of a panic attack, varying in intensity.

Obsessive-Compulsive Disorder (OCD). Certain thoughts are constantly imposed on the mind – obsessions – and the person cannot free themselves from them; she then tends to develop compulsive habits (which she can’t help but do), such as washing her hands very frequently.

Symptoms of the disease. Obsessive thoughts are unpleasant, frightening, or violent. Compulsive behaviors have no logical justification.

Post-traumatic stress disorder (PTSD). The discomfort affects people who have experienced a violent event, whether as victims or bystanders, which has aroused intense fear and a feeling of helplessness. In half of the cases, the symptoms disappear within three months; when they persist for several months, the problem may be permanent unless treated. The faster the therapeutic intervention after the event, the better the chances of preventing the onset of PTSD.

Symptoms of the disease. Invasive memories, repetitive dreams, affective detachment, in particular, as well as physiological manifestations of stress attributed to hyperactivity of the nervous system (irritability, exaggerated startle reactions, etc.).

As with stress, you have to look at the problem from the point of view of the mind: it is the mind that communicates its concern to the brain, the latter then sending nerve signals to the metabolism. This is the psychological aspect. Furthermore, it is known that, in people suffering from anxiety disorders, the mechanisms of the physiological stress reaction to a danger function abnormally, in a hyperactive mode. This is the physiological aspect.

The medical community suggests that these disorders – like most diseases – are likely due to a combination of three interrelated factors: heredity, biology and environment. As always in the body / mind, the biological dimension influences the psychic dimension and vice versa.

Hereditary cause. Anxiety is often “in the family”, as they say, and children of anxious parents are more likely to suffer from it. While this may be learned behavior, influenced by parenting pattern, animal studies as well as observations of twins – identical or not, living together or separated at birth – confirm some genetic predisposition.^3-5 However, it is not believed that a specific gene is responsible for anxiety disorders, but a certain combination of genes could activate the metabolism in this direction. It is possible that some anxiety disorders (agoraphobia, panic disorder) have a stronger genetic component than others.⁶

Biological cause. As the blood levels of certain hormones (serotonin, cortisol, catecholamine, etc.) are generally abnormal in people with anxiety disorders, anything that can influence the hormonal system is therefore dangerous. Pregnancy, for example, can be a trigger. On the other hand, it is necessary to be aware that several diseases cause a temporary hormonal imbalance, and therefore symptoms of anxiety disorders; a medical diagnosis is required.

Environmental cause. Many social and relational factors are decisive in the onset of anxiety disorders, such as early childhood trauma or disrupted family relationships. We also know that a large dose of intense and repeated stress can “disrupt” the nervous system and give rise to an anxiety disorder problem (but we also know that anxious people are more prone to stress and suffer more from its perverse effects. ).

Psychological perspective. From the psychological perspective, anxiety is not the problem per se, but rather the signal for an underlying problem. Depth psychology and psychoanalytic theory suggest that anxiety disorders are due to a constant psychic struggle, while the conscious seeks to repress desires or manifestations of the unconscious. The French psychologist of Austrian origin Paul Diel (1893-1972), author of several books on the meaning of life, advances, in Fear and anguish (Payot), that the unconscious would thus express its dismay at living an existence which is not appropriate to its deep nature.

According to psychologist and author Michelle Larivey, anxiety is “a discomfort that results from rejecting an emotional experience, an important concern or an action to take to respect yourself. It almost becomes a “way of being” for some people, who do not dwell on their current experience. […] Being anxious or anxious is both a fear of facing up and a feeling of putting oneself in danger by neglecting to take care of an aspect of one’s life ”.⁷

Nutritional perspective. According to naturotherapist Gilles Parent, anxiety attacks can also have nutritional causes. “A deficiency in amino acids such as tryptophan required for the synthesis of serotonin and tyrosine for the synthesis of catecholamines may be responsible for anxiety attacks. […] Hypoglycemia turns out to be another common cause of anxiety and symptoms appear frequently during the day, usually three to four hours after meals. Deficiencies in magnesium, folic acid, vitamin B12 have also been associated with anxiety. “⁸

Alcoholism and drug addiction. Faced with the difficulty of dealing with the problems associated with their illness on a daily basis, people with anxiety disorders are likely to seek relief from alcohol or drugs. 25% to 50% of them develop an addiction.⁹

On the other hand, all symptoms of untreated anxiety disorders can become so severe that they become a health problem in itself or an illness. Here are some examples.

Irritable bowel syndrome. Many of those who see a doctor for irritable bowel syndrome suffer from mental problems, including panic disorder, chronic anxiety, post-traumatic stress disorder and depression.¹⁰ Stress would have a great influence on the perception, severity and chronicity of the symptoms of this disease.

Hypertension and heart disease. According to several studies, anxiety seems to be linked to an increased risk of hypertension and cardiovascular diseases (angina pectoris, myocardial infarction, heart rhythm disturbances, etc.).^11,12 The anxiety and the intense emotions it conveys increase the work of the heart.

Depression and other mental problems. Anxiety disorders seldom exist on their own and several studies report that more than 90% of sufferers also suffer from another psychiatric problem; 50% to 60% of people with major depression report having suffered from one or more anxiety disorders throughout their life.¹³ Some authors speak of an anxiety depression as a particular form of illness; when anxiety disorders and depression coexist, both anxiety and depression would be particularly serious.

The classic medical treatment of anxiety disorders (with certain specificities depending on whether it is one or the other of the six types) consists of combination of medication and psychotherapy.

When it comes to medication, doctors have two lines of attack when it comes to anxiety problems. For the short term (to relieve the symptoms of an acute attack), anxiolytics (tranquilizers). For the medium term, while the person is gathering their means and following therapy, for example, we prescribe Antidepressants. There are several types, the most frequently prescribed for anxiety disorders are SRIs (serotonin reuptake inhibitors), of which Prozac is the most famous example. Sometimes, especially in cases of panic disorder, people take antidepressants all their lives.

Several studies have revealed the existence of a strong placebo effect in the treatment of anxiety disorders, that is to say that the symptoms of patients (at least those moderately affected) seemed to be relieved by both a placebo and the drug. tested, to varying degrees, but sometimes up to 100%.^14-16 Researchers hypothesized that placebo could reduce symptoms without improving quality of life.¹⁷

In the medical environment, the psychotherapeutic approach generally recommended for this type of problem is the cognitive-behavioral therapy. Its objective is to defeat the harmful mental mechanisms, results of learning and reinforcements. To bring about a modification on this level, it is a question of making conscious the thoughts (the cognitive process), and to see how they determine the emotional reactions and the choice of the strategies of action. Changing the way the cognitive process works in a given situation is called “cognitive restructuring”; changing the way you behave in a given situation is called “behavior modification” – hence the name of therapy.

The efficacy superiority of cognitive behavioral therapy over other forms of psychotherapy has not been demonstrated. According to several studies, it was found to have a positive impact in about 50% of cases when its effects were measured within the next six to 12 months. In a systematic follow-up carried out 8 to 14 years later (with the participants of two controlled and randomized studies), it was observed that 50% of the patients showed definite improvement and that 30% to 40% of these were cured. (without any more symptoms); in contrast, in 30% to 40% of the total sample, especially those with the most severe symptoms at baseline, improvement was weak.¹⁸

For children and and Adolescents suffering from chronic anxiety, cognitive behavioral therapy, individual or group, and family training in anxiety management appear to work; medication is also used, but there is no research establishing the effectiveness of different medications in children.¹⁹

A new therapeutic tool was developed at the end of the 1980s: neuro-emotional integration through eye movements or EMDR (for Eye Movement Desensitization and Reprocessing). Originally developed to treat people with post-traumatic stress disorder (PTSD), it seems to have a good success rate in these cases according to several studies.²⁰. EMDR is said to stimulate the emotional brain to “digest” traumatic events from the past. However, opinions are divided on it, and several doctors are critical of this surprisingly simple method.

Relying on the hypothesis that depression is caused by traumatic events, psychiatrist David Servan-Scheiber recommends EMDR for this condition, claiming that “when the dysfunctional trace of emotions is finally cleared by EMDR, the symptoms often disappear completely ”.²¹ However, the approach would work best with healthy adults suffering from a single, well-identified trauma or specific phobia, rather than a more diffuse disorder. Both in France and Canada, trained and certified psychotherapists now use it within psychotherapy (classic or unconventional type).

To relieve the symptoms of anxiety disorders, the indicated approaches to reduce stress and its negative impact on health are also suitable. These include provoking the natural mechanisms of relaxation. On this subject, see our text Better resistance to stress: acting on the soul and the body. Readers may also wish to consult our text Resisting Stress Better: Changing Your Attitude, which centers around the question “Why is this situation causing me so much stress?” “.

For someone who adheres to the psychological theory of anxiety, antidepressants are a barrier to recovery, since they mask symptoms and, therefore, reduce motivation to seek out the root causes of the discomfort. It is then necessary to consider a treatment which is primarily psychological – although the anxiolytics can be used to allow the person to be “operative”.

Choosing one psychotherapeutic approach over another depends on personal considerations. Several approaches are described on PasseportSanté.net in the Therapies Guide, but not all. Our Psychotherapy sheet gives an overview of the different approaches. You can consult the following sheets in particular: body abandonment, bioenergetic analysis (bioenergy), art therapy, focusing, Gestalt, postural integration, neurolinguistic programming (NLP), rebirth and therapy primal.

Large therapeutic systems can also represent a means of treatment. These holistic approaches bring different perspectives to anxiety disorders and how they can be cured. See our sheets Traditional Chinese Medicine, Traditional Vietnamese Medicine and Ayurvedic Medicine.