Anxiety disorders are a common reason for seeking psychological help. The main indication of these disorders is increased anxiety, which can be severe enough to significantly affect various aspects of an individual's life, resulting in a decrease in their overall well-being. In addition to experiencing daily fear and expressing it, people may also undergo physical symptoms such as heart palpitations, muscle tension, sweating, shortness of breath without physical activity, and disrupted sleep patterns. The intensity and duration of general physical arousal may vary from one patient to another.

There are many causes of anxiety disorders.

In addition to genetic predisposition, risk factors include:

Early childhood experiences (death or divorce of parents, overprotective parents, over-demanding and under-supportive parents, parental beliefs that the world is dangerous, etc.),
stressful life experiences,
poor coping strategies,
unrealistic ideas and demands for themselves and others,
excessive alcohol or caffeine consumption,
gender (the disorder is more common in females).

Often, other mental disorders, such as depression and addictive disorders, are also present at the same time.

The most common anxiety disorders are:

generalised anxiety disorder,
panic attacks,
social anxiety,
specific phobias,
obsessive-compulsive disorder and,
PTSD (post-traumatic stress disorder).

Generalised anxiety disorder

Generalised anxiety disorder is the most common anxiety disorder and is diagnosed twice as often in women. Individuals with generalised anxiety disorder experience prolonged and persistent anxiety, psychomotor tension and arousal of the autonomic nervous system. They are also constantly anxious and constantly ruminate about things that are important to them (e.g. job, money, health, family, other people's opinions, etc.).

Treatment is individualised to each person and mostly involves a combination of prescribed medication and cognitive behavioural therapy. With the help of a trained Cognitive Behavioural Therapist, patients learn, among other things, to reduce their level of autonomic arousal, to identify and confront fears and to change worry-related thought patterns using a variety of techniques .

Panic attacks

Panic attacks are common and are experienced by as many as 30-40% of people, but unlike a diagnosed panic disorder, panic does not escalate to a feeling that the patient is going to die or face catastrophic danger. During a panic attack, the patient begins to misinterpret physical symptoms that are not life-threatening (dizziness, heart palpitations, choking, lump in the throat, empty head, etc.), and thoughts of dying or having a stroke lead to an increase in anxiety. The vicious circle created in this way leads patients to develop a range of protective and avoidance behaviours. Panic attacks can be caused by sleep deprivation, overwork and chronic stress, psychoactive substance abuse, or they can be an associated symptom of various illnesses. There is also anticipatory panic disorder, which is self-sustaining because it is certain stimuli that trigger the attacks (e.g. a thought or memory of an event, a specific smell, music, etc.).

Panic disorder is diagnosed when a patient experiences several panic attacks in a month that have no predictable cause. It is also treated with medication and psychotherapy (mostly CBT).

Social anxiety

Social anxiety refers to excessive and persistent anxiety and fears associated with social circumstances. For example, individuals may be afraid of appearing inappropriate, ridiculous or stupid in front of others. Social anxiety can be discrete and occur only in specific situations (e.g. before a public appearance, in front of the opposite sex, in the course of a situation, when meeting new people, etc.) or it can be widespread and occur in almost all domains. As with other anxiety disorders, the predominant physical symptoms are related to an overexcitation of the autonomic nervous system (e.g. excessive sweating, heart palpitations, tremors, flushing, rapid breathing, etc.). The diagnosis is made when the symptoms have persisted for a minimum of 6 months.

Specific phobic anxiety disorders

Specific phobic disorders are diagnosed when excessive anxiety is triggered by certain circumstances that are not generally dangerous, e.g. spiders, snakes, enclosed spaces, public speaking. Antiscipatory anxiety often occurs, and a general vicious cycle of physical symptoms, amplified by catastrophising, leads to discomfort and a number of protective and avoidance behaviours. They are treated with psychotherapy (CBT).

Obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is a behavioural disorder characterised by intrusive, unwanted and repetitive compulsive thoughts (obsessions) and intrusive, repetitive compulsive actions or rituals (compulsions). Patients cannot interrupt the flow of obsessive thoughts, nor can they interrupt and/or refrain from compulsive actions. The most common compulsive acts are constant hand washing, repeatedly returning home and checking if the stove is turned off, if the door is locked; counting objects, patterns, arranging objects in a specific order, etc. For a diagnosis of OCD, obsessive thoughts and compulsive acts (50:50) must be present on most days for at least two weeks in a row. These symptoms cause the patient discomfort, are unsuccessfully resisted and interfere with his daily functioning in various areas. They are treated with medication (SSRIs; selective serotonin reuptake inhibitors) and psychotherapy (CBT).

Post-traumatic stress disorder

Post-traumatic stress disorder is the result of trauma that has (or may have) threatened a person's life. E.g. natural disasters, serious car accidents, war, captivity, physical or emotional violence, sexual abuse, etc. PTSD can also develop in individuals who have witnessed trauma, e.g. learning that a relative or close friend has been exposed to trauma, and if they have been indirectly exposed to the details of the trauma (e.g. paramedics, doctors, firefighters, etc.).

Patients develop a number of behaviours to avoid the memory of the trauma by reliving it regularly, having nightmares, feeling emotionally numb, or having outbursts of aggression or panic attacks. Depression, anxiety disorders and addictive disorders are often comorbid disorders. It is treated with medication and psychotherapy (CBT or psychoanalytic therapy).

Anxiety disorders and FND

Anxiety disorders are common in patients with FND and often relate to anxiety in relation to the symptoms themselves. Being diagnosed with an anxiety disorder does not mean that it is the cause of functional symptoms and/or that you are 'crazy', 'mentally weak' and 'all in your head'. The truth is that in all likelihood the symptoms FND will not improve until the anxiety disorder is properly treated and managed. If you suspect that you have an anxiety disorder, you should consult your GP who will refer you to appropriate professional help.

These support techniques are not a substitute for proper professional treatment and therapy. If you suspect that you have an anxiety disorder, you should consult your personal doctor who will refer you to appropriate professional help.

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