Anxiety syndrome

Anxiety syndrome (also called anxiety disorder) is a medical condition characterized by excessive worry, anxiety, and intrusive anxious thoughts that can feel continuous and overwhelming. Anxiety disorder can affect various aspects of a person's life, including physical and emotional well-being, as well as social interactions and occupational functioning.

The main signs and symptoms of anxiety syndrome may include:

1. Constant worry and anxiety about various events and problems.
2. Physical symptoms such as insomnia, muscle tension, trembling, sweating and increased heart rate.
3. Difficulty concentrating and focusing attention.
4. Intrusive disturbing thoughts or fears.
5. Panic attacks accompanied by intense fear, physiologic symptoms, and feelings of helplessness.
6. Avoiding situations or places that may cause anxiety.
7. Physical symptoms that can be mistaken for serious illnesses.

Anxiety syndrome can be caused by a variety of factors, including genetic predisposition, stressful situations, neurochemical changes in the brain, and others. Treatment for anxiety syndrome may include therapy, medication, or a combination of the two. Psychotherapy, such as cognitive behavioral therapy (CBT), can be effective in managing the symptoms of anxiety syndrome.

If you suspect that you have an anxiety disorder or if you experience similar symptoms, it is recommended that you see a doctor or psychotherapist. Professional help can help diagnose the condition and develop a treatment plan that best suits your needs. [1]

Causes of the anxiety syndrome

The causes of anxiety syndrome can be multiple and can include the following:

1. Genetic predisposition: People with a family history of anxiety disorders have an increased risk of developing the condition. Genetic factors can affect brain structure and function, making them more susceptible to anxiety.
2. Neurochemical imbalance: The human nervous system is regulated by various chemicals such as neurotransmitters (e.g., serotonin, gamma-aminobutyric acid, norepinephrine). An imbalance of these chemicals may be associated with the development of anxiety disorders.
3. Stressors and life events: Severe stressful events like the loss of a loved one, divorce, job loss, or financial difficulties can be triggering factors for the development of anxiety syndrome.
4. Personality traits: Personality characteristics such as perfectionism, low self-esteem, desire for control, and others may increase the risk of developing anxiety syndrome.
5. Diseases and medical conditions: Some medical conditions, such as hyperthyroidism (overactive thyroid gland), can cause symptoms of anxiety.
6. Exposure to environmental factors: Environmental exposures, including the use of alcohol, drugs, or other substances, can also contribute to the development of anxiety disorders.
7. Other mental illnesses: Anxiety syndrome may accompany other mental disorders such as depression, panic disorder, or obsessive-compulsive disorder.

It is important to note that anxiety syndrome is a multifactorial condition, and its development may be the result of the interaction of several of the above factors.

Pathogenesis

Anxiety syndrome (anxiety disorder) is a group of mental disorders characterized by severe anxiety and worry that can significantly affect a person's quality of life. The pathogenesis of anxiety syndrome is multifaceted and includes various factors such as genetic, biological, psychological and sociocultural. [2]

Here are some of the key aspects of the pathogenesis of anxiety syndrome:

1. Genetic factors: Studies show that the risk of developing anxiety disorders may be increased in people who have a family predisposition. This may indicate that there are genetic factors that influence vulnerability to anxiety.
2. Neurochemical changes: Studies of the brains of people with anxiety disorders reveal changes in neurochemical systems, including decreased activity of neurotransmitters such as gamma-aminobutyric acid (GABA) and decreased activity of the serotonin system.
3. Physiologic aspects: Physiologic factors, such as changes in the function of the neuroendocrine system and autonomic nervous system, may also play a role in the pathogenesis of anxiety syndrome.
4. Stress and trauma: Experiences of stress, trauma, or adverse life events can be strong risk factors for developing anxiety disorders. Stress can provoke or exacerbate symptoms of anxiety.
5. Psychological factors: Psychological mechanisms such as cognitive distortions (misperception of reality) can increase anxiety and contribute to the development of anxiety disorders.
6. Sociocultural influences: Sociocultural factors such as cultural expectations and social pressures can influence the manifestation and expression of anxiety symptoms.
7. Learningand modeling: Learning through observation and modeling may play a role in the development of anxiety disorders, especially in children who may imitate the behaviors and reactions of others to stressful situations.
8. Biological vulnerability: Some people may have biological vulnerabilities that make them more susceptible to anxiety symptoms under similar stressful situations.

It is important to note that anxiety syndrome can come in a variety of forms and manifestations, including generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, phobias, and others.

Symptoms of the anxiety syndrome

Symptoms of anxiety syndrome can include a variety of physical and emotional manifestations. [3] Here are some of the main symptoms of anxiety syndrome:

1. Excessive worry: Constant worry, anxiety and anxious thoughts about various aspects of life, the future and events that may or may not happen.
2. Tension and restlessness: Feeling of constant tension and restlessness, even if there are no specific threats or dangers.
3. Physical symptoms: Anxiety syndrome can be accompanied by physical manifestations such as insomnia, muscle tension, tremors, abdominal pain, dizziness, palpitations, sweating, etc.
4. Avoidance of situations: Patients with anxiety syndrome may avoid situations that trigger anxiety or try to avoid people and social activities.
5. Sleep disorders: Sleep problems, such as insomnia or restless sleep, can be characteristic of anxiety syndrome.
6. Concentrationand irritability: Difficulty concentrating, irritability and fatigue may be associated with anxiety syndrome.
7. Phobiasand panic attacks: Some patients may develop phobias (obsessive fears) and panic attacks, which are accompanied by intense fear and physical symptoms such as rapid heartbeat and sweating.
8. Depression: Anxiety disorder can be accompanied by symptoms of depression, such as low mood, loss of interest in daily activities, and feelings of helplessness.

These symptoms can occur to varying degrees from person to person and depending on the severity of the anxiety syndrome. [4]

Stages

Anxiety syndrome, also known as anxiety disorder, does not usually have clear stages like some other medical conditions. Instead, it is more often characterized by the changing intensity of symptoms and duration from onset to treatment or self-correction. However, to simplify the description, it is possible to identify a few common "stages" or milestones that are often associated with anxiety syndrome:

1. Initial stage: In this stage, a person may begin to feel increased anxiety, restlessness, and nervousness. Symptoms may be mild and temporary, and may be triggered by stressful situations or events.
2. Worsening of symptoms: If anxiety is untreated or unmanaged, symptoms may become more intense and prolonged. A person may experience more frequent and severe panic attacks, physical symptoms, and other manifestations of anxiety.
3. Stabilization or improvement: With the right treatment and appropriate therapy, many people with anxiety syndrome can achieve a stable condition or improvement. This may require both psychotherapeutic intervention and, in some cases, drug therapy.
4. Relapses and management: Anxiety disorder can be relapsing in nature, and people may experience new symptoms or an intensification of old ones. However, with proper management and support, most patients are able to cope with relapses and reduce their impact.

It is important to note that anxiety syndrome is an individualized condition, and each person may have different manifestations and patterns of symptom development.

Forms

In medical practice, several forms of anxiety syndrome are distinguished, including:

1. Generalized Anxiety Disorder (GAD): This form is characterized by excessive anxiety and worry about different aspects of life, the future, and various events. Patients with GAD may experience anxious thoughts and worry even in the absence of specific threats or dangers.
2. Social anxiety disorder (SAD): This is a form of anxiety syndrome in which patients experience excessive anxiety and fear of social situations and interactions with others. SAD can manifest as a fear of speaking or a fear of social events and gatherings. [5]
3. Panic disorder (Panic syndrome): Patients with panic disorder periodically experience panic attacks, which are accompanied by intense fear and physical symptoms such as rapid heartbeat, sweating, trembling, and feelings of loss of control. Panic attacks can occur unexpectedly and can be associated with a variety of situations or factors.
4. Mixed anxiety and depressive disorder (MADD): Some patients may have symptoms of anxiety and depression at the same time. This is a form of MDDD that is characterized by the simultaneous presence of anxiety and low mood.
5. Anxiety-depressive syndrome (also known as mixed anxiety-depressive disorder) is a mental condition characterized by the simultaneous presence of symptoms of anxiety and depression. Patients with this syndrome may experience anxiety, negative thoughts, low mood, loss of interest in daily activities, and other symptoms of both anxiety and depression.
6. Astheno-anxiety syndrome (also known as asthenic syndrome) is a condition characterized by feelings of weakness, fatigue, irritability, and restlessness. Patients may experience physical and mental exhaustion, as well as anxiety and nervousness.
7. Anxious Expectation of Failure Syndrome (sometimes called anxious expectation of failure ideal personality syndrome) is a condition in which a person experiences anxiety and restlessness due to fear of failure, failure, or lack of performance. It can lead to avoidance of certain tasks or situations, as well as self-criticism and perfectionism.
8. Anxiety-Neurotic Syndrome: This syndrome is associated with anxiety and neurotic symptoms such as fears, phobias, intrusive thoughts, etc. Patients with this syndrome may experience mental distress and inability to cope with intrusive and disturbing thoughts.
9. Anxiety-phobic syndrome: This syndrome is characterized by the presence of phobias and anxiety. Patients may have obsessive fears and avoid situations that trigger these phobias.
10. Anxiety anticipation of sexual failure syndrome: This syndrome is associated with anxiety and worry before sexual intercourse and fear of failure or unsatisfactory sexual function. This disorder can affect sexual satisfaction and quality of sexual life.
11. Anxiety-hypochondriac syndrome: This syndrome is characterized by anxiety and intrusive thoughts about having serious illnesses or diseases. People with this syndrome may constantly worry about their health, and even minor physical symptoms can cause them to feel anxious and fearful. Hypochondriac syndrome can accompany other forms of anxiety disorders, such as generalized anxiety syndrome.
12. Generalized Anxiety Syndrome (GAS): This syndrome is characterized by excessive and disproportionate anxiety and worry about various aspects of life, such as work, health, finances, and relationships. People with GTS may experience constant tension, anxiety, and physical symptoms such as muscle tension and insomnia.
13. Anxiety-subdepressive syndrome: This syndrome combines symptoms of anxiety and subclinical depression. People with this syndrome may feel depressed, lose interest in life, and experience anxiety and worry at the same time.
14. Anxiety-Pain Syndrome: This syndrome is characterized by the presence of physical pain that is associated with anxiety and stress. Anxiety can increase the sensation of pain and make it more severe. People with this syndrome may often see medical professionals in search of an explanation for physical symptoms.
15. Anxiety-panic syndrome (panic disorder): This disorder is characterized by sudden and unwarranted panic attacks that may be accompanied by severe anxiety, physiological symptoms (such as rapid heartbeat, sweating, trembling), and fear of dying or losing control. People with panic disorder may also experience agoraphobia, which is the fear of places or situations in which they might experience panic attacks. [6]
16. Anxiety-paranoid syndrome (paranoid personality disorder): People with paranoid personality disorder have a suspicious, distrustful attitude toward others and tend to interpret the actions of others as hostile and threatening. They may have fixed beliefs that they are being persecuted or intend to harm them.
17. Anxious attachment syndrome (anxious attachment disorder): This is a disorder that usually develops in childhood and is characterized by excessive anxiety related to close relationships, such as the fear of losing someone close to them. People with this disorder may experience anxiety when they are away from their loved ones and constantly need reassurance about other people's feelings toward them.
18. Astheno-vegetative anxiety syndrome (neurocirculatory dystonia syndrome): This syndrome is characterized by marked physical and psychological weakness, fatigue, dizziness, palpitations and other symptoms. It may be associated with increased anxiety and feelings of depersonalization.
19. Anxiety-dyssomnia syndrome (or anxiety-insomnia syndrome) is a condition in which a person experiences anxiety that severely affects their ability to fall asleep and maintain a normal sleep pattern. Anxiety can cause insomnia or lead to awakenings during the night. The condition can lead to chronic fatigue and poor sleep quality.
20. Obsessive-anxiety syndrome (or obsessive-anxiety syndrome) is a condition in which a person experiences intrusive anxious thoughts (obsessions) and performs compulsive behaviors (compulsions) in an attempt to cope with these thoughts and anxiety. For example, a person may constantly worry about dirt and constantly wash their hands. This condition can affect quality of life and requires psychotherapy and possibly medication.
21. Narcissistic Anxiety-Depression Syndrome (or Narcissistic Anxiety and Depression Syndrome) is a combination of narcissistic personality traits (such as inflated ego, desire for attention and validation) with symptoms of anxiety and depression. People with this syndrome may experience feelings of being unappreciated, while at the same time being very sensitive to criticism and criticism of others.
22. Other forms and mixed disorders: In actual practice, other forms of anxiety syndrome can occur, as well as mixed disorders that include elements of anxiety and other psychiatric conditions.

Each form of anxiety syndrome can have its own characteristics and features, and consultation with a psychotherapist or psychiatrist is required to determine the specific type of disorder and prescribe appropriate treatment. [7]

Complications and consequences

Anxiety syndrome, if left untreated or unmanaged, can have a variety of complications and effects on a person's physical and mental health. Here are some of them:

1. Mental health complications:

   • Depression: Anxiety disorders can increase the risk of depression, especially if anxiety symptoms persist for a long time and have a strong impact on a person's life.
   • Panicdisorder: In some people, anxiety syndrome may progress to panic disorder, with intense anxiety attacks and physiologic symptoms.

2. Physical complications:

   • Heart problems: Prolonged stress and anxiety can increase the risk of heartproblems such as arterial hypertension (high blood pressure) and heart disease.
   • Systemic disorders: Anxiety disorder can affect various body systems, including the immune system, which can increase vulnerability to infections and disease.
   • Sleep: Anxiety can cause insomnia, leading to chronic sleep deprivation and poor physical and mental health.
   • Gastrointestinal problems: Stress and anxiety can cause gastrointestinal disorders such as irritable bowel syndrome (IBS) and other gastric problems.
   • Muscle and joint problems: Prolonged muscle tension under the influence of anxiety can cause muscle and joint pain.

3. Social and behavioral complications:

   • Isolation and loss of quality of life: Anxiety syndrome can lead to social isolation, loss of interest in usual activities, and reduced quality of life.
   • Relationship Problems: Prolonged anxiety can create tension with family and friends.

Diagnostics of the anxiety syndrome

Diagnosing anxiety syndrome involves an extensive evaluation of the patient, including taking a medical and psychological history, performing a physical examination and psychological tests. It is important to establish that the symptoms of anxiety are not caused by other medical or psychiatric disorders. [8] Here are the basic steps in diagnosing anxiety syndrome:

1. Interview and history: The clinician interviews the patient to learn about his or her symptoms, the duration, frequency and intensity of symptoms, and possible stressful situations or traumatic events that may have triggered the anxiety. It is also important to find out how the symptoms affect the patient's behavior and quality of life.
2. Physical Exam: Your doctor may perform a general physical exam to rule out other medical causes of symptoms, such as thyroid disease or cardiovascular abnormalities.
3. Psychological assessment: A psychiatrist or psychologist may conduct a psychological assessment of the patient, including the use of standardized questionnaires and tests that help determine the presence of an anxiety disorder and its characteristics.
4. DiagnosticCriteria: To diagnose anxiety syndrome, the clinician refers to the diagnostic criteria set forth in ICD-10 (International Classification of Diseases, 10th Revision) or DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Revision), which include characteristic symptoms and criteria for duration and intensity.
5. Exclusion of other conditions: It is important to rule out other medical and mental health conditions that can manifest anxiety symptoms such as depression, bipolar disorder, panic disorder, post-traumatic stress disorder, and others.
6. Laboratory and instrumental studies: In rare cases, laboratory tests or neurophysiologic techniques (e.g., EEG or brain MRI) may be required to rule out other possible causes of symptoms.

After diagnosis, a doctor can diagnose anxiety syndrome and develop a treatment plan that may include psychotherapy, pharmacotherapy, and recommendations for lifestyle changes. [9]

Differential diagnosis

Differential diagnosis of anxiety syndrome means identifying and distinguishing this condition from other medical and psychiatric disorders that may have similar symptoms. This is important in order to correctly identify the cause of the symptoms and choose the appropriate treatment. Below are some disorders and conditions that may have similar symptoms to anxiety syndrome and that need to be ruled out in the differential diagnosis:

1. Panic disorder: Panic attacks and anxiety are common features of both anxiety syndrome and panic disorder. Differentiation involves assessing the frequency and intensity of panic attacks.
2. Obsessive-compulsive disorder (OCD): Uncontrollable intrusive thoughts and compulsive behaviors may be similar to some symptoms of anxiety, but OCD is characterized by unique clinical manifestations.
3. Social phobic disorder (social anxiety): This condition is accompanied by intense anxiety and fear of social situations. It is important to distinguish it from generalized anxiety.
4. Generalized anxiety disorder (GAD): GTR and anxiety syndrome may have overlapping symptoms, but GTR is characterized by anxiety over a wide range of events and situations.
5. Somatic conditions: Some medical conditions, such as hyperthyroidism (overactive thyroid gland) or neurological disorders, may manifest with anxiety. The differential diagnosis of anxiety may require a physical assessment.
6. Substance use: Some drugs and alcohol can cause symptoms of anxiety. Avoiding substance use may be necessary for an accurate diagnosis.

The differential diagnosis of anxiety syndrome is usually made by a physician or psychiatrist based on history, physical examination, and symptom assessment. It is important to conduct a comprehensive evaluation to rule out other potential causes of symptoms and to choose the best treatment and management plan. [10]

Treatment of the anxiety syndrome

Treatment for anxiety syndrome (anxiety disorder) can involve a variety of methods, and the choice of specific approaches depends on the severity of symptoms, individual patient characteristics, and patient preferences. Typically, treatment for anxiety syndrome includes the following:

1. Psychotherapy (talk therapy): Psychotherapy is one of the main treatments for anxiety syndrome. Cognitive behavioral therapy (CBT) and psychodynamic therapy may be helpful. The goal of psychotherapy is to help the patient become aware of and change the negative thoughts and behavioral reactions associated with anxiety.
2. Medication: In some cases, your doctor may prescribe medication to reduce the symptoms of anxiety. Medications such as anxiolytics (such as benzodiazepines) or antidepressants (especially serotonin reuptake inhibitors) may be recommended to control anxiety.
3. Relaxation techniques: Relaxation techniques such as deep breathing, meditation, yoga and progressive muscle relaxation can help manage anxiety and stress.
4. Lifestyle changes: Making lifestyle changes can help manage anxiety. This may include exercising regularly, eating a healthy diet, normalizing sleep, and eliminating factors that can cause stress.
5. Self-help and support: Teaching self-help strategies such as mindfulness and developing adaptive coping techniques can be helpful.
6. Support from loved ones and group therapy: Participating in group therapy sessions or receiving support from loved ones can reduce feelings of isolation and help manage anxiety.

Treating anxiety syndrome often takes time and patience, and may require a combination of different methods. It is important to discuss with your doctor or psychotherapist the best treatment plan that fits your individual situation. Psychotherapy and medication can be effective ways to control anxiety and improve your quality of life. [11]

Drug treatment for anxiety syndrome

Treating anxiety syndrome with medication can be an effective way to manage anxiety symptoms. However, the prescription and selection of specific medications should be made by a physician who takes into account the individual characteristics of each patient and the severity of their condition. Below are some of the classes of medications that can be used in the treatment of anxiety syndrome:

1. Anxiolytics (anti-anxiety medications): These medications are designed to reduce anxiety and restlessness. Examples of anxiolytics are benzodiazepines, such as diazepam (Valium) and alprazolam (Xanax), and some antidepressants.
2. Antidepressants: Some antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine receptor inhibitors (SNRIs), can be used to treat anxiety. Examples include sertraline (Zoloft), escitalopram (Lexapro), and venlafaxine (Effexor).
3. Beta-blockers: Beta-blockers such as propranolol may help control physical symptoms of anxiety, such as increased heart rate and tremors.
4. Gamma-aminobutyric acid (GABA): Drugs that increase GABA levels in the brain can have a calming effect. An example of such a drug is gabapentin (Neurontin).
5. Other medications: In some cases, your doctor may prescribe other medications, such as antihistamines or antipsychotics, to manage symptoms of anxiety.

It is important to note that medications can have side effects and require careful medical supervision. Medication treatment is often combined with psychotherapy, such as cognitive behavioral therapy (CBT), for best results.

Treatment of anxiety syndrome with medication should be done under the supervision of a doctor, and the patient should follow the recommendations and dosages prescribed by the doctor. Changing the dose or stopping medication on your own can be dangerous.

Forecast

The prognosis for people with anxiety syndrome can vary depending on a variety of factors, including the severity of symptoms, the duration of the condition, and the effectiveness of treatment and management. It is important to note that anxiety syndrome can usually be successfully treated and managed with appropriate medical and psychotherapeutic approaches. Here are some aspects to consider:

1. Seeking help in atimely manner: The earlier a person seeks medical attention and begins treatment, the better the prognosis. Early detection and intervention usually increases the chances of a positive outcome.
2. Severity of symptoms: Anxiety syndrome can range in severity from mild anxiety to severe panic attacks. More severe symptoms may require longer and more intensive treatment.
3. Compliance with treatment: Ad herence to doctor's recommendations and regular participation in psychotherapy and treatment can significantly improve prognosis.
4. Learning to manage stress: Developing stress management skills and practicing relaxation skills can also reduce the likelihood of recurrence of anxiety symptoms.
5. Associated conditions: If a person has other psychiatric disorders such as depression or narcolepsy, this may also affect prognosis and require additional attention in treatment.
6. Social support: Support from family and loved ones can be an important factor in improving prognosis and facilitating recovery.

Overall, with proper medical care and adherence to doctor's recommendations, many people with anxiety syndrome can achieve a reduction in symptoms and an improved quality of life. It is important to remember that each person is unique and the prognosis can be individualized. Regardless of the severity of symptoms, it is important to seek help and begin treatment to achieve the best possible outcome.

Anxiety syndrome and the army

Policies regarding military recruitment for individuals with anxiety syndrome may vary from country to country and depend on many factors, including the severity and extent of the anxiety syndrome, the presence of symptoms, medical evaluation, and the judgment of military medical doctors.

In many cases, if the anxiety syndrome is severe and interferes with normal life and functioning, it may be grounds for deferment or exemption from military service. However, this decision is made by doctors after a medical evaluation and assessment of the health of the individual recruit.

If you have anxiety syndrome and are concerned about being drafted into the army, it is advisable to contact your country's military doctor or military medical service. They will be able to carry out the necessary assessment and make specific recommendations regarding your suitability for military service.

List of popular books on the subject of Anxiety Syndrome

1. "The Anxiety and Phobia Workbook" - Author: Edmund J. Bourne (Year of release: 2020)
2. "Coping with Anxiety and Phobias by Shirley Babior (Year: 2005).
3. "The Anxiety Toolkit: Strategies for Fine-Tuning Your Mind and Moving Past Your Stuck Points" - By Alice Boyes (Year of release: 2015)
4. "The Worry Cure: Seven Steps to Stop Worry from Stopping You" - By Robert L. Leahy (Year of release: 2006)
5. "The Nature of Anxiety" - By David H. Barlow (Year: 2004)
6. "Generalized Anxiety Disorder: Advances in Research and Practice" - Editor: Richard G. Heimberg and team (Year: 2004)
7. "The Anxiety and Worry Workbook: The Cognitive Behavioral Solution" - By David A. Clark and Aaron T. Beck (Year of Release: 2011)

Literature used

• Alexandrovsky, Y. A. Psychiatry : national guide / ed. By Y. A. Alexandrovsky, N. G. Neznanov. Y. A. Alexandrovsky, N. G. Neznanov. - 2nd ed. Moscow : GEOTAR-Media, 2018.
• Robichaud, Duga: Generalized anxiety disorder. Cognitive behavioral therapy. Williams, 2021.
• Jio Sararri: Goodbye Anxiety. How to learn to live with an anxiety disorder. ACT, 2023.