Neurosis due to mystical fears. Fear neurosis: causes and methods of treatment. What is fear

Panic attacks. Treatment.

Some patients complain of an altered perception of the world (the world seems to lose color), and panic attacks. Panic fear occurs spontaneously, often in a crowded place (shop, train, subway, bus, elevator), but patients tend to discuss not the attack itself, but its consequences, for example, deterioration in general condition, without presenting specific complaints. On the other hand, when asked directly, the patient usually confirms that at that moment he felt a strong heartbeat, lack of air, sweating, weakness in the legs, abdominal cramps, chest pain, tremor, trembling.
Often patients distinguish between dizziness and lightheadedness, and in some cases they cannot describe their condition at all. Depersonalization and derealization (feelings of the world around you being unreal or alienated from yourself) are typical symptoms of panic disorder and only make the panic attack worse.
In addition to these somatic symptoms, patients may describe a state close to panic. Usually they have a feeling of approaching danger, confusion and powerlessness to the point of fainting. Patients think they are having a myocardial infarction or stroke and ask to be taken to the nearest emergency room.
Describing the onset of an attack, the patient reports a “blow” to the head or heart, a feeling of shock, a beating throughout the body, a rush of blood to the head, an increase in blood pressure, etc. During an objective study, changes are recorded much less frequently. Daily monitoring of heart rate and blood pressure showed that their average daily values do not differ from those of healthy people. Significant fluctuations are observed during periods of “panic attack” or its anxious anticipation: in 30% of patients, subjective sensations were accompanied by an increase in blood pressure and heart rate - in 60% of patients, in 20% there were no objective changes at all. Along with typical symptoms, there may be others - atypical, not included in the criteria for a panic attack: local pain (in the head, abdomen, spine), numbness, burning sensation, vomiting, “lump” in the throat, weakness in the arm or leg, gait disturbance , vision, hearing. In some patients, there is no anxiety at all - “panic without panic” occurs. During the interictal period, the vast majority of patients experience autonomic dysfunction of varying degrees of severity - from minimal, when patients feel practically healthy, to maximum, when the border between an attack and the interictal period is blurred due to the strong severity of disorders between PA (panic attacks).
Clinical manifestations of autonomic dysfunction in the interictal period are characterized by polysystemicity, dynamism and other signs characteristic of autonomic dysfunction syndrome. Most often, the character of vegetative-vascular dystonia is flexible: a little effort on your part and it will leave you alone. Well, if you don’t pay attention to the alarm bells, the disease can rage like a river overflowing its banks. Such storms, which shake the body in 5 minutes or at most several hours, are called vegetative-vascular crises by doctors.

They occur more often in females during menstruation, especially if
critical days coincided with unfavorable weather or a major showdown, as well as for women who had entered menopause. They need to protect their peace of mind with redoubled force. The close connection between vegetative crises and emotional shocks has been known since the time of Chekhov: in such cases, his colleagues said that the patient had a panic attack, and to combat panic attacks it is necessary to prescribe the strictest rest.
Sympathetic-adrenal crises are most susceptible to people of the sympathetic type. Usually, in the late afternoon or at night, headaches intensify, stabbing, constricting, pressing and driven heart beats (pulse - up to 140 beats/min, pounding in the temples, blood pressure rises to 150/90-180/110 mm Hg, there is not enough air - every breath is difficult, you feel chills, your arms and legs go numb, your body becomes covered with goose bumps, the temperature rises to 38-39°C, you always want to urinate in the toilet). And although there is not the slightest threat to life in this case, there is such a fear of death that it is not difficult to lose your head, rushing around the apartment in indescribable excitement.
Stop! Pull yourself together! By coping with panic, you will already help yourself. Open a window, unbutton your shirt, loosen your collar, loosen your belt, sit in a comfortable chair or lie down in bed with a few tall pillows tucked under your back to help you breathe easier.
Apply napkins or a towel moistened with cold water to your forehead, temples, neck and wrists. Slowly drink a glass of cold boiled water, focusing on your sensations. To calm your heartbeat, close your eyes and press 10 times with the pads of the middle and index fingers of both hands on your eyeballs 3 times within a minute. Massage the point in the center of the chin with circular movements of the index finger of both hands (9 times clockwise and the same number against it). Squeeze, knead and slightly stretch your middle finger for 2-3 minutes on each hand. Take 30 (for strong heartbeat - 40-45) drops of Valocordin or Corvalol in a small amount of water, or 20 lily of the valley-valerian or lily of the valley-motherwort drops, a no-shpa tablet and then wait 10-15 minutes. Didn't it get any better?
Vagoinsular crises often cause anxiety in people of the parasympathetic type. Troubles usually happen in the morning and during the day - in the evening you don’t have to worry about your well-being. Weakness, a feeling of heat and heaviness appear in the head, it begins to spin, blood rushes to the face, there is a feeling of suffocation, nausea, and sometimes abdominal pain and diarrhea, “throws” into sweat, the heart stops, the pulse becomes rare (up to 45 beats). /min), blood pressure drops to 80/50-90/60 mmHg. Art., in a word, it seems that the soul is parting with the body, and such a panic takes over, even if you run to the ends of the world, but you just don’t have the strength.
To calm down, take 1-3 tablets of bellataminal or bellaspon (cannot be used during pregnancy) or 20 drops of novopassit or valerian tincture, open the window and go to bed without a pillow, placing your feet on a blanket folded several times: with low pressure, the brain experiences oxygen starvation , and the horizontal position will ensure blood flow to the head. Brew strong sweet tea or prepare a cup of black coffee with sugar. Has there been any relief? Call a doctor!
When treating panic attacks, you need to master the art of balancing in order to skillfully balance the scales of the autonomic nervous system. And she “loves” stability and order in everything.
. Schedule your day by the hour: getting up, exercise, breakfast, work time, lunch, rest, favorite TV series, household chores, dinner, evening walk - try, if possible, not to deviate from this schedule.
. Move more and spend at least 2 hours a day in the fresh air. Don't have time for this? Start small - use transport less often and walk more often. Encourage yourself to jog or visit the pool twice a week, and on weekends, a bathhouse: swimming and hardening water procedures will maintain “balance” in the autonomic nervous system.
. Massage your fingers. By taking turns squeezing, kneading and slightly stretching them for several minutes 2-3 times a day, you can normalize body functions disturbed by neurocirculatory dystonia. Pay special attention to the thumb, massaging it stimulates the brain, and the middle finger - the effect on it normalizes blood pressure.
. Take care of your nerves! If they have to test their strength, mix equal parts valerian (or motherwort), mint and horsetail, 1 tbsp. l. pour a glass of boiling water, heat for 15 minutes covered in a water bath, cool for about 45 minutes, strain. Take 2 tbsp. l. 4-6 times a day.
. Peace. Please note: elenium, sibazone, phenazepam, rudotel, meprobamate cause lethargy and drowsiness. As long as you accept them, you are not an important worker. Take Grandaxin, Mebicar, Trioxazine. They keep their head clear.
. If you are a sympathetic type of person, it is strictly forbidden to indulge in gluttony at night: a late dinner can provoke a sympathoadrenal crisis.
Every evening go to bed with the intention of getting a good night's sleep: a long, sweet sleep helps to avoid troubles during magnetic storms and when exposed to other provoking factors. Do not deny yourself the pleasure of soaking in a warm, pleasantly relaxing bath for 10-15 minutes in the evening, adding a little salt to it, and in the summer try to relax by the sea. Representatives of the parasympathetic type benefit from taking a cool bath or shower with tight streams every morning and spending a vacation in the mountains.
Panic attacks are treatable. To do this, you need to contact a psychotherapist or psychiatrist.

ANXIETY AND FEARS. TREATMENT OF PHOBIAS AND FEARS

Anxious depression can manifest itself as a meaningless feeling of tension, anxiety or fear (for one’s health, the fate of loved ones), fears of appearing incompetent in society - social phobia.
Symptoms of an anxiety disorder do not occur in any particular order; at the first examination, patients present with somatic complaints, since only physical discomfort prompts them to seek help from a doctor. Patients prone to anxious reactions to one degree or another exaggerate not only their failures and failures in life, but also the existing symptoms of the disease.
The increased alertness or “hypervigilance” of these patients is explained by the fact that, unlike others, they see the world as if through a magnifying glass, paying attention to the slightest changes in their internal state and external environment.
Patients with anxiety disorders often complain of depressed mood, but when asked how the condition affects their daily life, they say that they have become more irritable, restless, or even overactive.

Anxiety conditions: general and specific symptoms
General symptoms
. Anxiety - a feeling of restlessness, nervousness, nervousness for no apparent reason, concern about feelings of anxiety;
. Irritation towards oneself, others, familiar life situations (for example, increased sensitivity to noise);
. Excitement - restlessness, tremors, biting nails, lips, involuntary movements of the hands, rubbing fingers
. Pain - often a headache with psychological stress, in the back of the head or diffuse pain in the back (due to unconscious muscle tension)
. The “fight and flight” reaction is a sharp increase in sympathetic tone, accompanied by profuse sweating, palpitations, chest pain, a feeling of dry mouth, and discomfort in the abdomen
. Dizziness - feeling of lightheadedness, near fainting
. Difficulty thinking - inability to get rid of disturbing thoughts, decreased concentration, fear of losing self-control and going crazy
. Insomnia is primarily a disturbance in falling asleep, and in some cases in the duration of sleep (patients usually complain of constant fatigue)
Specific symptoms

Panic attacks (attacks):
. They arise spontaneously, without any visible connection with external stimuli (“like a bolt from the blue”) (< 10 мин)
. Feeling of strong fear, panic, horror
. Palpitations, irregular heart rhythm (“fading” of the heart, “thumps in the chest”)
. Feeling of suffocation, often rapid breathing
. Sweating, hot flashes
. Nausea (including vomiting, “dizzy with fear”)
. Tremor, internal shaking
. Dizziness, lightheadedness (“as if something happened to the head”)
. Loss of a sense of reality (derealization) (“a veil or curtain has fallen between me and the outside world”). Patients have difficulty describing this condition (“...I can’t find the words...”)
. Paresthesia of the hands, with rapid breathing - of the face
. Constant premonition of misfortune (fear of going crazy, dying, etc.)

Phobias (persistent unreasonable situational anxiety accompanied by an avoidance reaction):
. Agoraphobia (fear of crowded places - shops, subway, elevators, buses):
- fear is always associated with a panic attack that occurs in such places;
- patients avoid leaving home alone, even if this interferes with their professional activities and normal life
. Social phobia (fear of communication that occurs in the presence of strangers):
- patients are afraid of appearing funny, clumsy or humiliated;
- in such situations, patients experience severe anxiety (sometimes panic attacks) and try to avoid them in every possible way (for example, some cannot eat in the presence of strangers), despite remaining criticism of their condition;
- often patients try to overcome difficulties in communication and professional activities with the help of alcohol, tranquilizers, and drugs
. Simple phobias (situational anxiety that occurs in a frightening situation or in response to the presentation of a known frightening stimulus: fear of snakes, spiders, injections, heights, flying on airplanes, blood, vomiting, etc.):
- avoidance reaction, disruption of normal social/family adaptation of varying degrees of severity.
A patient with anxiety-depressive disorders, as a rule, when visiting a doctor, presents a lot of vegetative complaints.
The main manifestation of anxiety-depressive disorders is vegetative dystonia syndrome. In most cases, autonomic disorders are secondary and occur against a background of mental disorders.
The disease is most pronounced in those suffering from agoraphobia (fear of crowded places). At home, surrounded by relatives or in a medical facility, the patient may not experience any complaints or they may be extremely mild. When moving away from home, in transport (especially in the metro), multisystem somatic disorders suddenly arise for no apparent reason - dizziness, suffocation, pain in the heart, tachycardia, nausea, reaching significant intensity and accompanied by fear of death - panic attack.

Treating symptoms of panic disorders

There are strong clinical links between anxiety and depression. Our experts include their common manifestations: unexplained physical weakness and a feeling of discomfort, falling asleep late at night, lack of a feeling of pleasure from anything, constant reference to unpleasant thoughts and images, persistent pain or other unpleasant sensations in the head and body; difficulty concentrating, hypochondriacal ideas.

We can distinguish different variants of pathological anxiety: situational pathological anxiety (immediate fear of a certain phenomenon or object), anxious obsessions, phobias; free-floating anxiety (generalization of anxiety, turnover and increase in the number of objects that cause anxiety); pointless anxiety (unaccountable, “vital”, depressive).

How does panic disorder manifest itself? A person experiences anxiety, inner restlessness, tension, and anxious exaltation. He develops signs of autonomic imbalance and sudden autonomic-vascular disorders. Anxiety manifests itself in facial expressions, gestures, rate of speech, up to general anxious agitation. Inconsistency of actions, narrowing of interests, fluctuations in appetite, decreased libido.

With panic disorder, there are disturbances in attention, memory, uneven tempo of thinking, a tendency towards hypochondria, and concern for one’s health. Confusion and even disorientation in time and space appear.

Our clinic has accumulated extensive experience in treating panic disorder. It is easily treatable in the hands of an experienced psychotherapist. Acupuncture and various types of psychotherapy are effective here: individual, pathogenetic, emotive-rational and others in combination with the prescription of sedatives, antidepressants, tranquilizers and drugs of other groups.

An individual treatment program is selected for each patient. Come to us and you will be surprised at the changes that will happen to you.

Therapy for panic disorders

The goals of therapy for panic disorders are:

Alleviating the patient's anxiety and improving his quality of life.

Mobilization of the patient's adaptive mechanisms to combat stress.

Preventing the transition of adaptation disorder into a chronic anxiety state.

Basic principles of therapypanic disorders.

Individuality is therapy not for the disease, but for the patient.

Validity - the use of treatment methods that are most appropriate in a particular situation.

Complexity is a combination of various therapy methods.

Basic methods of therapypanic disorders

When adequate methods are used, panic disorders can be cured well. For their therapy, special techniques are used:

1. Social-environmental methods (patient education):

Pedagogical, didactic methods;

Family therapy;

Self-help groups;

Literature for patients;

Media.

2. Methods of psychotherapy:

Breathing and relaxation training;

Biofeedback;

Cognitive psychotherapy;

Behavioral psychotherapy;

Other types of psychotherapy.

3. Pharmacotherapy:

Benzodiazepine anxiolytics;

Non-benzodiazepine anxiolytics;

Tricyclic antidepressants;

Selective monoamine oxidase inhibitors;

Serotonin reuptake inhibitors;

Neuroleptics;

Histamine H1 receptor blockers;

. β-blockers.

When prescribing anxiolytic drugs, it is necessary to distinguish a “normal” anxiety state from a clinically significant one, which depends on the severity of the emotional reaction, the level of adaptation, as well as the degree of correspondence between the significance of the stress stimulus and the response.

In the psychotherapy clinic at the Department of Narcology and Psychotherapy, a special combination of methods of psychotherapy, acupuncture, herbal medicine, and pharmacotherapy has been successfully used in the treatment of panic disorders for more than 20 years.

Panic disorders, symptoms

A panic attack is characterized by the following symptoms:

· this is a temporary but recurring episode of intense fear or discomfort;

· this episode usually has a sudden onset;

· the maximum of symptoms is observed within a few minutes and lasting several minutes;

· the clinical picture contains symptoms of 4 different groups.

Autonomic symptoms: increased or rapid heartbeat, sweating, shaking and tremors, dry mouth.

Symptoms from the chest and abdomen: difficulty breathing, a feeling of suffocation, chest pain and discomfort, nausea, or abdominal distress (eg, a burning sensation in the stomach).

Symptoms related to mental state: a feeling of dizziness, unsteadiness, faintness, a feeling that objects look unreal or that one’s self is distant, “not here,” fear of loss of self-control, madness, or impending death.

General symptoms: hot flashes or chills, numbness in different parts of the body, or a tingling sensation.

With the use of adequate treatment programs, panic disorders can be cured. The following methods are used for their therapy:

1. Social and environmental methods: pedagogical, didactic, family therapy, treatment in self-help groups, informing patients (supply of special literature).

2. Methods of psychotherapy: breathing-relaxation training, biofeedback, cognitive psychotherapy, behavioral psychotherapy, other types of psychotherapy.

3. Pharmacotherapy: drugs from the group of tranquilizers with an anxiolytic effect, non-benzodiazepine anxiolytics, tricyclic antidepressants, selective monoamine oxidase inhibitors, serotonin reuptake inhibitors, antipsychotics, histamine H1 receptor blockers, β-blockers.

The most effective combination of different types of psychotherapy with pharmacotherapy within the framework of outpatient treatment programs of varying durations.

Prepared the article. The clinic at the Department of Narcology and Psychotherapy provides treatment for panic disorder.

Feelings of fear and anxiety treatment

Feelings of fear and anxiety are inherent in generalized anxiety disorder.

Its main features are:

A. Excessive anxiety and worry (expecting bad things) in connection with various events or activities (such as work or school), observed for more than 6 months.

B. The patient has difficulty coping with anxiety.

B. Anxiety or restlessness is accompanied by the following symptoms (with at least 1 symptom persisting for more than 6 months)

1. Restlessness, fussiness, or impatience

2. Fatigue

3. Concentration or memory problems

4. Irritability

5. Muscle tension

6. Sleep disturbances (difficulty falling asleep, irregular sleep duration, or sleep that does not bring a feeling of freshness)

Anxiety, restlessness, or somatic symptoms cause clinically significant distress or impairment in social, work, or other areas of functioning.

Treatment of fear and anxiety is complex and long-term.

Prepared the article. The clinic at the Department of Narcology and Psychotherapy provides treatment for anxiety and fear.

Anxiety disorder, treatment

Anxiety is a pathological condition characterized by a feeling of danger and accompanied by somatic symptoms (the latter are associated with hyperactivity of the autonomic nervous system). Anxiety should be differentiated from fear, which arises in response to a specific threat.

Anxiety is one of the most common psychopathological phenomena in medical practice. It is necessary to note the breadth of the range of manifestations of anxiety - from mild neurotic disorders (borderline level of disorders) to severe psychotic states of endogenous origin. Anxiety belongs to the sphere of human experiences. The substantive uncertainty of the phenomenon of anxiety is subjectively expressed in the feeling of its painfulness and difficult tolerability. But if a person finds a subject of anxiety, then he develops fear, which, unlike anxiety, appears in response to a specific reason.

Symptoms of anxiety disorders can be divided into physical and mental (psychological). Somatic symptoms include:

Trembling, twitching, body shaking

Back pain, headache

Muscle tension

Lack of air, hyperventilation

Fatigue

Startle response

Hyperactivity of the autonomic nervous system

Hyperemia, pallor

Tachycardia, rapid heartbeat

Sweating

Cold hands

Dry mouth (xerostomia)

Frequent urination

Paresthesia (numbness, tingling sensation)

Difficulty swallowing

Psychiatric symptoms include:

Feeling Dangerous

Decreased ability to concentrate

Hypervigilance

Insomnia

Decreased libido

"Lump in Throat"

Gastrointestinal disorders (“dizzy with fear”).

Treatment for anxiety disorders is usually carried out on an outpatient basis and over a long period of time. At least 4-5 months. A combination of different methods of psychotherapy, acupuncture and psychopharmacotherapy is effective. Typically, patients are prescribed different combinations of drugs that have antidepressant, anti-anxiety and sedative effects.

Prepared the article. The clinic at the Department of Narcology and Psychotherapy provides treatment for anxiety disorders.

Panic disorder, treatment

Panic disorder is characterized by spontaneous panic attacks and can be combined with agoraphobia i.e. fear of being in an open space, alone outside the home or in a crowd. Agoraphobia is usually accompanied by panic, although it can occur as a separate disorder. Anticipation anxiety is characterized by a feeling of danger that is associated with the anticipation of a panic attack, as well as the possibility of being in a powerless and humiliating position when it occurs. People with Agoraphobia may be so attached to their home that they never leave it or do so accompanied by someone else.

In modern classifications of disorders, panic disorder is defined in the group “other anxiety disorders.”

In addition to panic disorder, the group of anxiety mental disorders includes:

Generalized anxiety disorder. Characterized by chronic generalized anxiety that persists for at least 1 month. Includes increased anxiety in childhood.

Specific phobia. An irrational fear of an object, such as horses, or a specific situation, such as heights, and the need to avoid them.

Social phobia. Irrational fear of situations related to communication, for example, fear of public speaking.

Obsessive-compulsive disorder. Recurrent obsessions, urges, thoughts (obsessions) or behavior patterns that are foreign to the personality and, when attempted to resist, cause anxiety.

Post-traumatic stress disorder and acute stress response. Anxiety caused by unusual and significant life stress. The event clearly manifests itself in a dream or in thoughts while awake. Symptoms of re-experiencing, avoidance, or extreme arousal persist for more than 1 month. Patients who have had symptoms for less than 1 month may be diagnosed with an acute stress reaction.

Mixed anxiety and depressive disorder- to designate conditions when the patient’s mental status is approximately equally present with symptoms of anxiety and depression and it is not possible to talk about a significant predominance of one or the other.

During a panic attack, severe fear or a feeling of general discomfort occurs, during which the following symptoms are observed:

1. Tachycardia

2. Sweating

3. Trembling or shaking of the body

4. Feeling short of breath

6. Pain or discomfort behind the sternum

7. Nausea or stomach discomfort

8. Dizziness, unsteadiness or weakness

9. Derealization (feeling of unreality) or depersonalization (feeling of alienation from one’s own body)

10. Fear of losing control or going crazy

11. Fear of dying

12. Paresthesia

13. Fever or chills

Treatment of panic disorders is carried out primarily on an outpatient basis. Effective methods of psychotherapy, acupuncture therapy and a combination of psychopharmacotherapy individually selected for each individual patient.

Prepared the article. The clinic at the Department of Narcology and Psychotherapy provides treatment for panic disorder.

State of anxiety treatment

The main symptom of an anxiety disorder is the feeling of fear and worry that a person often experiences. This condition usually meets three criteria.

The first is a long-term illness, when complaints exist for more than half a year and if the disease itself proceeds either monotonously or progresses, without prosperous periods and “bright intervals”.

The second is the all-encompassing nature of the feeling of fear and anxiety. A person experiences discomfort almost all the time. Its components: groundless misgivings, tied or not tied to a specific object, inability to relax, constant tension, expectation of trouble, unmotivated anxiety, and sometimes panic fear.

Third, the state of anxiety arises and exists on its own, regardless of how prosperous or unfavorable a person’s life is.

Symptoms of anxiety are divided into 3 groups.

The first is various sensations of internal tension and a feeling of fear (sometimes panic fear), which the patient himself cannot explain.

The second is motor restlessness, the need to move, muscle tension, trembling, and general discomfort.

The third is autonomic reactions that arise due to overexcitation of the nervous system: sweating, palpitations, difficulty breathing, nausea, dry mouth, cold hands and feet.

Against the background of anxiety and fear, insomnia at night and drowsiness during the day usually appear. Possible increased irritability, decreased performance, absent-mindedness, low concentration, fatigue, and weakened memory.

Peptic ulcer disease may worsen. Symptoms such as difficulty swallowing, increased urination, decreased erection in men and decreased sexual sensation in women may occur. When people are anxious, they are more likely to have nightmares.

Treatment of feelings of fear and anxiety, as a rule, is complex. Used: individual psychotherapy, training in relaxation techniques in combination with drug therapy. In the treatment of anxiety, tranquilizers, beta-blockers, antidepressants with a sedative effect, etc. are usually used. It is important to understand that it is not possible to cure anxiety in a short period of time, so the patient must patiently tune in to long courses of treatment, which, as a rule, lead to to a good and lasting result.

Prepared the article. The clinic at the Department of Narcology and Psychotherapy provides treatment for anxiety.

Treatment of panic disorders

Panic refers to a type of anxiety disorder that manifests itself in sudden attacks called panic attacks.

Treatment of panic disorders is successful in most cases. Thanks to the possibilities of pharmacology and psychotherapy, more than 90% of patients become completely healthy after a few months.

If a person tries to fight panic attacks on his own for a long time, and even resorts to the help of alcoholic beverages or Corvalol, he may develop alcohol dependence or alcohol-drug dependence in addition to the underlying disease.

A successful approach to the treatment of panic disorders, including panic fears, is a combination of different methods of psychotherapy with the prescription of sedatives of plant origin, beta-blockers, benzodiazepines, antidepressants with a sedative effect, and mild antipsychotics.

To achieve a lasting effect, these drugs must be used for several months. The withdrawal of medications is carried out gradually, under the supervision of a doctor.

Treatment of panic disorders is always effective if a doctor with experience in treating this disease takes on the matter, and the patient is ready for a long course of treatment.

Prepared the article. The clinic at the Department of Narcology and Psychotherapy provides treatment for panic disorders.

Fighting panic attacks

In the complex treatment of anxiety disorders, including panic attacks, tranquilizers are always used. These may be: alprozolam, clorazepate, diazepam, phenazepam, clonazepam. To relieve panic attacks, parenteral administration of clonazepam is preferable. Tricyclic antidepressants are also commonly used - imipramine, clomipramine, doxepin, amitriptyline. They are especially effective when administered intravenously.

Isantidepressants of other groups are often effective: mianerin, trazodone, and paroxetine.

Typically, carbamazepine in combination with individual nootropics, such as Pantogam and Phenibut, is effective in combating panic fears.

In combination with antidepressants, it is advisable to use beta-blockers - Razicor, propanolol, etc.

In the fight against panic attacks, different methods of psychotherapy are always effective. Preference is given to cognitive-behavioral and short-term psychodynamic.

The duration of treatment is from 6 to 12 months. Shorter courses do not lead to reliable results.

During the treatment of panic attacks, the intensity of fear and its vegetative-somatic manifestations decreases, the frequency of panic attacks decreases, the anxiety of anticipating panic attacks goes away, and the intensity of comorbid disorders, in particular depression, decreases.

The article was prepared by Professor Igor Anatolyevich Nikiforov. The clinic at the Department of Narcology and Psychotherapy treats panic attacks.

Treatment of fear

Fears or phobias are often found in obsessive-compulsive disorder. The clinical picture of this type of neurosis is characterized by the presence of phobias (obsessive fears) and - much less often - other obsessive phenomena (actions, memories, desires). All obsessions are characterized by constancy, repetition, the inability to free themselves from these disturbances by force of will, the feeling of their alienness, the awareness of their incorrectness and painfulness.

The clinical picture of neurosis may include rituals - protective actions (for example, in order to protect himself from danger, the patient must touch the table several times or arrange things on the table in a special way).

Obsessive-compulsive disorder neurosis, with proper treatment, can end in a few months with complete recovery, but can sometimes take on a protracted course with a gradual worsening of symptoms.

In the dynamics of neurosis, three stages are conventionally distinguished: at the first - fear arises only in a situation of which the patient is afraid, at the second - at the thought of the possibility of being in it, at the third - the conditioned stimulus is a word in some way connected with the phobia (for cardiophobia - “heart”, for claustrophobia - “cabin”, etc.). With a protracted course of obsessive-compulsive neurosis, as well as with other protracted neuroses, in addition to aggravation of the main symptoms, the development of depressive disorders and hysterical forms of reaction is possible.

Treatment of patients with neuroses (treatment of fear) should be aimed primarily at eliminating the psychogenic influence that contributes to the occurrence of neurosis. If it is impossible to remove a traumatic situation, it is recommended to use various psychotherapeutic methods to change the patient’s position and his attitude towards this situation. An important place in the complex treatment of neuroses is occupied by restorative therapy, physiotherapy, and vitamin therapy. Nootropic drugs (nootropil, aminalon, etc.) have become widely used in the last decades for the treatment of fear and concomitant asthenic conditions. Many neurotic symptoms can be easily relieved by the use of various tranquilizers (phenazepam, librium, valium, tazepam) or small doses of some antipsychotics (sonopax, neuleptil ). Great importance in the treatment of patients is given to various options for psychotherapy in its pure form or in combination with drug therapy, diet therapy, music therapy, and bibliotherapy. Most often, suggestive psychotherapy (for hysterical neurosis), rational psychotherapy (for obsessive-compulsive neurosis), and autogenic training (for all types of neuroses) are used.

The article was prepared by Professor Igor Anatolyevich Nikiforov. The clinic at the Department of Narcology and Psychotherapy treats fear.

How to get rid of fear

Do you need treatment for fear? How to get rid of fear? How to overcome fear? Fighting is an unnatural human state that takes too much energy. The unknown scares us, so we strive to find an explanation for everything. Fear must be understood and accepted. Understanding the nature of fear will give awareness, and conscious fear can already be controlled.

Fears, phobias...what else is there?

Normal fear is a manifestation of the instinct of self-preservation; such fear warns us of possible danger and informs us of our internal limits. It’s too early to talk about treating fear. A certain man was afraid to jump with a parachute and resolutely struggled with his fear of heights, believing that being a coward was unmanly. Making his fifth jump, he died.

All fears that are not related to the instinct of self-preservation are far-fetched and often pathological. Pathological fear is a different type of phobia. Such fears often arise due to the cultivation of negative images and memories. You need to learn to free yourself from them.

Fear rating

Sometimes we get very scared. We are afraid of doctors, the anger of our boss, the disapproval of friends, the loss of a loved one. Fear has learned to hide and disguise itself so cleverly in our minds that we live side by side with it, not noticing how often it makes decisions for us.

When we realize that fear kills our cherished dreams and high aspirations, the moment of truth comes and the question arises: “How to overcome fear?”

In order to free yourself from fears, you need to find them and determine the cause of their occurrence. Napoleon Hill, in his book Think and Grow Rich, offers a simple way to identify and eliminate fears.

In accordance with a specific phobia, a person’s behavior is also disrupted (for example, if a patient is afraid of closed spaces, then he avoids public transport, elevators, etc.). That is, fear neurosis is always associated with certain ideas of a person or a specific situation.

Obsessive actions that arise with this disease usually take the form of certain measures to overcome the phobia (for example, with an obsessive fear of infection, a person takes the following measures: constantly washes and wipes everything, sterilizes his hands, dishes and clothes, etc.) .

Treatment is selected individually, taking into account age, duration of the disease, symptoms and severity.

Causes and signs of the disease

Fear neurosis arises on psychological grounds. The reason may be stress (conflict in the family, problems at work, etc.) or simply a situation that is very significant for a person (moving to a new home, the birth of a child, a new place of work).

In addition to clearly expressed fear (a specific phobia), the disease also has the following physiological symptoms:

tremor of the limbs and trembling throughout the body;
feeling of chills and the appearance of “goose bumps”;
severe headache;
symptoms of stomach discomfort, nausea, vomiting;
rapid breathing and heart rate, heavy sweating;
symptoms of sleep disturbance (frequently wakes up in the middle of the night, cannot fall asleep for a long time);
excessive anxiety and motor agitation.

In childhood, symptoms of fear neurosis are also expressed in the fact that the child bites his nails, sucks his finger, logoneurosis (stuttering) and enuresis (urinary incontinence at night) may occur.

A special type of fear neurosis is affective-shock neurosis (fright neurosis), which most often occurs in children. It can be caused by a strong unexpected stimulus - a sharp light or loud sound, the sight of an unusually dressed person (for example, in a carnival costume or mask) or a person in an inadequate state. Usually, young children and simply sensitive, impressionable children are susceptible to such fear.

Typically, fear neurosis manifests itself in attacks, during which there is high irritability, excitability, tearfulness, and symptoms of panic attacks may occur. Between attacks there is a period of remission. It is very important to begin treatment of fear neurosis in a timely manner, since over a long period of time it can develop into serious and severe mental disorders (hypochondria, obsessive-compulsive neurosis, and others)

Treatment methods

Before starting treatment, it is necessary to undergo a comprehensive medical examination. This is due to the fact that anxiety neurosis has symptoms similar to other serious diseases. It is advisable to be examined by an endocrinologist, cardiologist and neurologist. They must exclude diseases of their profile, or confirm their presence. If any somatic disorders are detected, then treatment should begin with them. Otherwise, their course will only worsen the neurosis.

If doctors do not find other disorders, then the treatment of fear neurosis is carried out by a psychotherapist.

Psychotherapeutic treatment of fear neurosis solves the following problems:

Teaching the patient to manage the symptoms of his illness.
Teaching the patient a different attitude towards the symptoms of illness.
Training in relaxation methods (muscular and respiratory).
Conducting hypnotic sessions if necessary.

The goal that psychotherapeutic treatment generally pursues is to help the patient understand what determines his behavior and help in forming the patient’s conscious attitude towards his problems. All this leads to a significant reduction or complete elimination of fears and phobias.

Sometimes, it becomes necessary to use drug treatment to relieve the symptoms of the disease (at the initial stage or in severe cases of the disease). Tranquilizers, sleeping pills, antidepressants and antipsychotics can be used. The doctor selects medications individually, based on the patient’s condition.

Anxiety neurosis

Anxiety neurosis belongs to the group of reversible psychological disorders caused by exhaustion of the nervous system. It is characterized by a strong aggravation of feelings of anxiety due to prolonged experiences or a one-time exposure to powerful stress. Hence the second name of this disease is fear neurosis or anxiety neurosis.

Symptoms of anxiety neurosis

Fear neurosis is characterized by:

A pronounced, uncontrollable, unreasonable feeling of fear and anxiety (the patient is afraid of what is not there, or significantly exaggerates the potential danger). Attacks in such cases last no more than 20 minutes and may be accompanied by trembling and general weakness.
Loss of orientation in space and time.
Loss of strength and rapid fatigue.
Sudden and frequent mood swings.
Excessive worry about your own health.
High sensitivity to bright light and sounds.
“Floating” headache and dizziness;
Increased heart rate;
The appearance of shortness of breath and a feeling of oxygen starvation;
Stool disorders, nausea;
Disorders of the stomach;
Increased sweating.

The indicated symptoms may appear together or alternate. Some of them are also characteristic of other diseases not associated with mental disorders. For example, some different vegetative manifestations of fear are possible if the patient takes medications prescribed for withdrawal from narcotic drugs. Also, if a person is sick with hyperthyroidism (a syndrome caused by hyperfunction of the thyroid gland) or diseases of the cardiovascular system.

Therefore, medications and other treatments for anxiety neurosis should be prescribed by a specialist based on the medical history and a complete medical examination.

Fact: according to statistics, women suffer from this disease 2 times more often than men, which is associated with changes in hormonal levels. At the same time, the predominant age group of patients is people from 18 to 40 years old.

How does the patient's behavior change?

Unexplained sudden attacks of anxiety negatively affect a person’s social, family, and personal life and reduce his or her productivity. Chronic depression, possible aggression towards others, apathy, and fatigue are the first signs of the disease.

In the initial stages of the disease, the patient himself notices them, but may not attach serious importance, attributing such behavior to previous stressful situations or fatigue (both physical and mental). For example, fear of an interview, fear of not finding a common language with a new team, an upcoming performance, exam or passing a project put psychological pressure on a person. He attributes his excessive irritability and anxiety to preparation for important events.

In the absence of a predisposition to the development of neurosis, such a reaction goes away after these events have occurred. In some cases, on the contrary, it worsens: fatigue associated with psychological overstrain is added to irritability and attacks of fear. In addition, the patient often begins to “play out” scenes of the implementation of his performance (or other important situation). In his imagination, he changes dialogues and his own actions, trying to choose the best option for himself.

While the patient’s imagination is occupied, in reality his behavior becomes inadequate and is accompanied by inhibition of reaction, sudden irritability and other characteristic symptoms of anxiety neurosis.

What to do for loved ones

Anxiety neurosis interferes with the life of not only the patient himself, but also those close to him, since attacks of fear can manifest themselves at any time and in any place. For example, a patient may call his family in the middle of the night and report his suspicions about some danger that he thinks will happen soon. During such a sudden awakening (and even for an unfounded reason), it is difficult to restrain emotions; a person suffering from anxiety neurosis can easily run into a wall of misunderstanding and a raised tone of voice.

Meanwhile, this is exactly what cannot be allowed. In any such situation, those around you must take into account the very fact of the disease, and show exceptional calm and attention towards the patient. This does not mean that you need to play along with the patient, agreeing with his fears. But it does require moral support. The patient needs to be reassured, explained that nothing bad will happen (everything is under control), that if there is some difficult situation, you will overcome it together.

With anxiety neurosis, a person is aware of his mental health problems. At the same time, his independent attempts to restore peace of mind do not lead to a positive result. In especially advanced cases, the disease completely “eats” the neurotic from the inside, imposing thoughts of suicide. Therefore, support and help from outside are vital for him. The patient needs to be persuaded to see a specialist (neurologist, psychologist, psychotherapist).

What can cause the disorder

When occurring latently, anxiety neurosis can worsen against the backdrop of global changes in life: change of place of residence, loss of a loved one, serious illness. Anxiety neurosis can only be provoked by stress, either single or caused by long-term effects on the psyche.

Among the factors predisposing to the development of the disease are:

Diseases and disorders of the endocrine system.
Hormonal imbalances.
Organic changes in the adrenal cortex and individual brain structures.
Hereditary predisposition (the risk of the disease increases by 2 times compared to people who do not have relatives with this disorder).
Fatigue associated with excess physical activity.
Psychological factors.

The feeling of anxiety in itself does not threaten a person’s physical health, but is a somatic manifestation of a mental disorder.

How does neurosis differ from psychosis?

The disease occurs without organic brain damage, but requires treatment (often protracted). It is forbidden to carry out it yourself, otherwise the patient’s condition may only worsen. Incorrect drug treatment of anxiety neurosis can lead to serious disruptions in the functioning of internal organs and a deterioration in mental state.

The course and duration of treatment for this disease is prescribed by the doctor. Consultation with a specialist is necessary at the first symptoms, since a short period of time is enough for the disease to become chronic.

Often, in order to make an accurate diagnosis, it is enough for a doctor to conduct a conversation with the patient, for example, in order to rule out psychosis that has similar symptoms. The difference between psychosis and neurosis is that with psychosis the patient is not able to realize the fact of the disease itself, and with anxiety neurosis, as a rule, he understands that he has certain mental health problems. Therefore, it is extremely important to undergo a complete medical examination to make an accurate diagnosis.

Prevention

It is always easier to prevent a disease than to get rid of it later. Prevention of anxiety neurosis involves following simple and well-known rules. Namely:

Maintaining a balance between physical activity, mental stress and rest.
Balanced and timely nutrition, plenty of vitamins consumed.
Refusal of habits that interfere with a healthy lifestyle (in addition to smoking, drinking alcohol and psychotropic drugs, you should also limit your own time spent at the computer, if it is not part of work).
Sports help keep the body in good shape, distract and provide emotional relief.
Sound and long enough sleep. To exclude any violations, you need to drink a glass of warmed milk with a spoonful of honey or a glass of green tea before going to bed.
Having a hobby that provides emotional pleasure.
Self-development and self-education.
Healthy communication (offline).
Listening to auto-trainings to help overcome stress.

All this requires not so much material investments as discipline and willpower.

How to treat anxiety neurosis

Treatment of anxiety neurosis is carried out comprehensively, drug therapy is combined with psychotherapy sessions. Taking medications without talking to a psychiatrist will be ineffective, since medications can only lower the anxiety threshold, but if the very reason for exceeding it remains, relapses will occur. Specialists in the field of psychiatry and psychology should identify the cause of excessive and sudden anxiety and help eliminate it. Only after this (or in parallel with consultations) can the patient be prescribed medication.

The types of drugs, rules and frequency of taking them are prescribed individually depending on the stage and duration of the disease, the presence of other diseases in the patient and individual intolerance to certain components in the drugs.

How to treat anxiety neurosis with medication

If the patient turned to specialists at the initial stage of anxiety neurosis, treatment will be carried out with mild antidepressants. If the situation improves, he will also be prescribed maintenance therapy, the course of which ranges from 6 months to 1 year. In particularly difficult cases, the patient needs treatment in a hospital under the constant supervision of doctors.

Among the sedative drugs acceptable for the treatment of anxiety neurosis, the combined drug “Novo-Passit” is distinguished, the formula of which contains extracts of medicinal plants and guaifenesin. It is sold in pharmacies without a prescription. Taken strictly according to the instructions and recommendations of the attending physician.

To increase general tone in cases of anxiety-depressive neurosis, “Glycine” is used, which is a replaceable amino acid.

Antidepressants are prescribed for all types of neuroses accompanied by symptoms of depression. Different drugs in this series have different effects on the patient’s body and his problem, therefore they are selected by a specialist depending on the symptoms of the disease. For the treatment of anxiety-depressive neurosis, Gelarium, Deprim, Melipramin, Saroten, Cipramil and others are prescribed.

Homeopathy and multivitamin complexes, such as Duovit and Magne-B6, are prescribed as auxiliary medications.

Psychotherapy for anxiety-depressive neurosis

Drug treatment is only an auxiliary way to eliminate the problem. The main role is given to psychotherapy sessions, during which, in addition to analyzing the patient’s behavior, his thinking is studied and corrected. After identifying a situation that causes anxiety attacks in the patient, the psychiatrist again and again forces the patient to plunge into it. Thus, a person fights his illness under the supervision of a specialist, and learns step by step to overcome the problem.

The principle of experiencing anxiety in full (without trying to overcome or suppress attacks of fear) refers to cognitive behavioral psychotherapy. This method consists in the fact that after each acute experience of fear, the symptoms of anxiety neurosis will manifest themselves less intensely until they disappear completely.

From 5 to 20 procedures help a patient with anxiety neurosis to get rid of irrational beliefs and negative thinking patterns that force oneself to “wind up” and provoke excessive fear.

When treating anxiety neurosis, infusions of medicinal plants are also taken: chamomile, motherwort, valerian. These drugs, along with medications, are considered auxiliary, since the main emphasis is on psychotherapeutic treatment.

All this has not been classified as neuroses for a long time, because the very concept of “neurosis” is controversial and vague. It's called generalized anxiety disorder. In ICD10, the word “neurosis” was removed from the definition, and rightly so. It is impossible to say for sure what provokes it, since it can be an independent syndrome, or it can be part of agoraphobia or a mixed anxious and depressive reaction caused by an adaptation disorder. And here we are already moving into an area about which they politely say “the etymology is not completely clear.”

Looking for stress behind everything is a very funny activity. What if you have an anxiety disorder, but there was no stress? But try to find a person who has not had stress. Therefore, you can always talk about stress.)))

This stress has nothing to do with it, to be honest? Generalized anxiety disorder can be endogenous, just like depression.

How to identify and treat anxiety neurosis

Anxious neurosis is caused by constant stress, overwork, lack of movement, combined with a serious conflict between desires and capabilities. Advanced forms of fear neurosis (anxiety) in combination with phobias and obsessive states are treated only by specialists. But anxiety neurosis in the initial stage can be corrected independently.

What's happened

In modern psychotherapy, there is a concept of three types of neuroses - obsessive-compulsive neurosis, neurasthenia and hysteria. In this article we will talk about fear neurosis, one of the forms of obsessive-compulsive neurosis. With this type of neurosis, the experience of fear and anxiety becomes a priority. Against the background of general anxiety when faced with real or imaginary danger, phobias develop. A phobia is an obsessive fear of objects, situations or activities that interferes with an individual’s social life.

A person with increased anxiety may hear on TV that an earthquake has occurred somewhere in the world, and begins to experience obsessive fear, is afraid to live on the floor above the second and cannot fall asleep, imagining terrible pictures of natural disasters. Phobias tend to expand their “sphere of influence.” So, if a dog frightens a person while walking, he will first be afraid to walk in the same place, then of all dogs, even small ones, and finally, he will begin to experience panic fear even when leaving the house to go to the nearest store.

The most common types of phobias in anxiety neurosis:

agoraphobia (fear of open spaces);
social phobias (fear of public speaking, “disgracing yourself” in public);
fear of germs (plus an obsessive state of frequent hand washing, wiping door handles);
cancerophobia (fear of getting cancer);
claustrophobia;
fear of going crazy;
fear that something will happen to relatives.

Symptoms of fear neurosis (anxiety neurosis)

Anxiety neurosis is perceived by the psyche as stress, to which it reacts with increased readiness - that is, by straining all the body’s forces and releasing adrenaline. The body experiences fatigue, and due to fear neurosis, physiological manifestations such as headache, sweating, pain in different parts of the body and internal organs, goose bumps, dizziness, appetite and digestive disorders, frequent urination, tremors of the limbs, darkening of the eyes.

Psychiatric symptoms include obsessive thoughts and actions, low or high self-esteem, hypochondria, sudden mood swings, aggressiveness to mild stimuli, and increased sensitivity to light, sounds and temperature. In response to a stressful situation, a person in a state of anxiety neurosis withdraws into himself, becomes fixated on one action or thought, or chooses avoidance - for example, never again going to the place where he experienced stress.

Often, fear neurosis coexists with such conditions as derealization (a feeling of the unreality of what is happening) and depersonalization (a “strange” feeling of oneself). Panic attacks and hyperventilation often occur.

In general, a person with fear neurosis constantly feels emotional stress, gets tired quickly and does not get enough sleep. He also worries about everything and has difficulty choosing priorities in life and fulfilling his social roles. Therefore, it is necessary to treat it as early as possible, at the first manifestations, while they do not yet interfere with a person’s life.

Causes of the disease

The main cause of fear neurosis is the conflict between a person’s desires and goals and the impossibility of achieving them. In this case, a pathological focus of excitation constantly operates in the brain. Neuroses, including anxiety, always arise as a result of the long-term stressful impact of any situation on the psyche. Fear and anxiety become “chronic” - as a reaction to a painful internal conflict.

For example, the cause of anxious neurosis can be a long process of divorce, an exhausting job that a person wants to leave but cannot for some reason, an illness of a loved one that cannot be influenced, etc. Anxiety neurosis can also be caused by an overprotective parent who does not allow you to make independent choices in life. In this case, the internal conflict “I want - I can’t” is complicated by feelings of resentment towards the parent and guilt towards him.

Treatment methods

First of all, treatment of fear neurosis includes searching for its cause and, in accordance with it, selecting appropriate treatment tactics. Anxiety neuroses are treated using several methods:

Behavioral therapy.
Cognitive therapy.
Hypnosis.
Drug treatment.

Behavioral psychotherapy aims to teach a person to correctly respond to anxiety, fear, panic and physical discomfort. A psychologist can advise techniques for relaxation, auto-training, and concentration on positive thoughts. Cognitive psychotherapy identifies thinking errors and corrects the way of thinking in the right way. It often helps people with anxiety neurosis to talk through their fears and get support.

If the fear neurosis has become overgrown with severe phobias, hypnosis may be effective, in which the effect is not on the conscious mind, but on the patient’s subconscious. During a hypnosis session, a person is restored to a sense of security and trust in the world. If the above methods do not help, medications are prescribed - antidepressants and tranquilizers. But in most cases, fear neurosis can be alleviated or eliminated in milder ways.

How to cope with the disease yourself

You can cope with the initial stage of anxiety neurosis on your own if you approach your condition consciously and draw up the right treatment regimen. It is necessary to eliminate all destructive influences - unhealthy diet, alcohol and nicotine abuse. When self-medicating, the rule “a healthy mind in a healthy body” applies. For effective treatment, try to spend more time in the fresh air, be in the sun, start doing exercises and walking more often. Make sure you eat regularly, drink enough clean water and eat foods rich in vitamins. This approach will help you avoid depression and the use of antidepressants.

But all these, although necessary, are time-consuming methods. What to do if you need quick relief from the neurosis of fear, stress, aggression? If fear arises at its very beginning, try to overcome yourself. Of course, this method is not suitable in case of serious phobias. Eliminate negative information from your life - stop watching and reading the news, refrain from watching scary films and television programs, do not communicate with people who like to discuss world disasters and their own problems. If you feel a lack of air, breathe into the bag, convince yourself that the panic that arises is just a condition, and there is no reason for fear. Relaxing music is a good distraction to relieve anxiety.

The main condition for self-healing is to find and eliminate internal conflict. Without this, all measures will bring only temporary relief. Analyze the changes in your condition: when did the symptoms of the disease begin, what was happening in your life? It is possible that some difficult situation is still ongoing and is causing tension and anxiety. If you cannot find it on your own or it cannot be eliminated, be sure to consult a psychotherapist.

Thus, fear neurosis (anxiety neurosis) is a non-threatening condition for life and psyche, however, it is very unpleasant and painful, and can greatly reduce the quality of life. Therefore, it is necessary not to ignore its presence, but to treat it, while simultaneously eliminating the cause - the deep internal conflict.

What is FEAR NEUROSIS and its symptoms

At the end of the 19th and beginning of the 20th centuries, psychasthenia and fear neurosis were isolated from neurasthenia as an independent form. The latter was first described in 1892, that is, several years before he created psychoanalysis.

The main symptom of the disease is the appearance of feelings of anxiety or fear. Most often it occurs acutely, suddenly, less often - slowly, gradually intensifying. Once this feeling arises, it does not leave the patient throughout the day and often lasts for weeks or months. Its intensity fluctuates between a slight feeling of anxiety and pronounced fear, followed by attacks of horror.

Fear does not depend on any situation or any ideas; it is unmotivated, meaningless, devoid of plot. Fear is primary and cannot be derived from other experiences in a psychologically understandable way.

Often, under the influence of fear, anxious concerns arise that are psychologically understandably associated with it. They are unstable. The degree of their intensity depends on the strength of fear.

With the disappearance or weakening of the feeling of fear, these fears also disappear. Anything that increases feelings of anxiety or fear can cause or aggravate these fears. Thus, unpleasant sensations in the heart area or hearing a story that someone died of a myocardial infarction, cerebral hemorrhage, got cancer, or “went crazy” can give rise to corresponding fears. In this case, fear is primary, and the fear of dying from a heart attack, cerebral hemorrhage, getting cancer or a mental disorder is secondary. It is not of the nature of a persistent, overvalued hypochondriacal idea or phobia, but only of an anxious fear. Under the influence of persuasion, the patient often agrees that he is not in danger of dying “from heart paralysis,” but the fear persists and either immediately changes the plot (“Well, I don’t know, maybe it’s not a heart attack, but another terrible disease”), or temporarily becomes meaningless, “free-floating” fear.

Sometimes, depending on the content of the anxious fears, patients take certain “protective” measures - more or less adequate to the content of the fears, for example, they ask not to be left alone so that there is someone to help if “something terrible” happens to them, or they avoid physical activity, if they are afraid for the condition of the heart, they are asked to hide sharp objects if there is a fear of going crazy (there are no rituals in this case).

The state of fear can periodically intensify sharply, giving way to attacks of horror with unmotivated fear or, most often, with the expectation of death, for example, “from cardiac paralysis,” “cerebral hemorrhage.”

Due to the dominance of feelings of anxiety or fear, patients note difficulty concentrating on any activity, increased excitability, and affective instability. At times they are anxious, agitated, and seek help. They often experience painful, unpleasant sensations in the area of the heart or epigastrium, giving the feeling of fear a vital connotation. During the period of illness, blood pressure in patients remains within the normal range or at its lower limit. At the height of the affect of fear it increases somewhat. At this time, there is an increase in heart rate and breathing, dry mouth, and sometimes an increased urge to urinate.

During illness, appetite is reduced. Due to a constant feeling of anxiety and loss of appetite, patients often lose weight, although not very sharply. Sexual desire is usually reduced. Many people experience difficulty falling asleep, anxious sleep with nightmares. The galvanic skin component of the orienting reaction often occurs spontaneously and is unquenchable throughout the study.

The duration of fear neuroses most often ranges from 1 to 6 months; sometimes the disease takes a protracted course and can last for years. In general, in the involutionary period, as is known, states of fear arise more often than in other periods of life. During this period, fear neurosis easily takes a protracted course.

Causes of fear neurosis

The cause of fear neurosis can be a strong mental shock, as well as less severe, but longer-acting psychotraumatic factors leading to conflict (the coexistence of conflicting aspirations).

The first attack of fear, which marked the beginning of the disease, plays a major role in the formation of fear neurosis. It can be caused not only by psychogenic, but also by physiological reasons.

According to psychologists, the emergence of fear neurosis in adults can be facilitated by strong emotional shocks experienced in childhood that cause stress. Their reasons may be fear, separation from parents, a sudden change in the usual environment, or experiences associated with the fact that the child begins to receive little attention in connection with the birth of a brother or sister.

Sometimes fear neurosis, as V.V. Kovalev notes, turns into hypochondriacal neurosis. At the same time, the paroxysmal imagery characteristic of fear neurosis gradually smoothes out and disappears, and fears take on a more permanent, although not so acute, character.

Anxiety neurosis

Phobias and various fears are very diverse, they are the most common. At the same time, the nature of the patients’ behavior is appropriate. Signs of fear neurosis are not difficult to determine, since the patient’s behavior demonstrates them quite eloquently. For example, the patient begins to be afraid of certain objects, he asks his loved ones to remove this object from him as far as possible. If a person is afraid of closed spaces, then he can hardly tolerate public transport and cannot stay indoors if it is closed, especially alone.

With fear of contamination, the patient may wash their hands all day long, even without stopping when the skin begins to change. At the same time, such people constantly try to boil towels, linen, various rags, achieving their sterility. If the neurosis of fear is expressed in heart attack phobia, then such a person is constantly afraid that he may have a heart attack on the street, and no one will notice it or provide help. In this regard, the patient chooses a route to work that is close to pharmacies or clinics. But if such a person sits in a doctor’s office, then he understands that his fears are unfounded and calms down.

Thus, fear neurosis is caused by various phobias associated with specific situations and a group of ideas. Basically, obsessive actions are of the nature of actions taken above the necessary measures, when a person cannot stand a closed room, is afraid of open areas, and so on. Sometimes patients say that they are inexplicably drawn to count windows, train cars, passing cars of a certain color, and so on. Some tics, especially complex ones, can be included in this category.

Separation of states in anxiety neurosis

In anxiety neurosis, obsessive states can be divided into obsessive ideas, fears and thoughts, but such measures are conditional. The fact is that each obsessive phenomenon is very conditional, since it contains certain ideas, drives and feelings that are closely related to each other. Many patients have their own rituals and obsessions. The fear neurosis observed in psychasthenic psychopaths is considered as a special form of neurosis called psychasthenia. Among the main features of psychasthenics are timidity, indecisiveness, constant doubt, and a state of anxious suspiciousness. In particular, they are characterized by such qualities as an increased sense of duty and anxiety.

The basis is reduced mental stress, and as a result, full-fledged higher mental acts are replaced by lower ones. Fear neurosis can be expressed in the inability to perform a certain function, since a person is constantly afraid that he will fail. Moreover, this can apply to absolutely any area. More often this has to do with public speaking, sexual functions, and so on. In addition, fear neurosis has no age restrictions; both children and elderly people are susceptible to it. For example, a speech disorder may occur due to the fact that there was an unsuccessful reading of a report in public, during which the person was worried, and speech inhibition occurred. It is not surprising that in the future, the anxious expectation of failure during public speaking is reinforced and spreads to any normal setting.

According to the same principle, the development of the expectation of failure during sexual intercourse occurs when one of the partners felt not up to par. Anxiety neurosis is always accompanied by significant anxiety; this is its main symptom. Fear itself is not dependent on the situation or certain ideas; rather, it can be called meaningless, without motivation. Such fear is primary and psychologically incomprehensible; it is not derived from other experiences, but arises on its own. Sometimes, under the influence of such fear, anxious fears arise that have no connection with this fear. Fear neurosis is often associated with a hereditary predisposition. A significant role in the formation of the disease is assigned to the first attack, which is the beginning of the disease.

Variants of fear neurosis

The occurrence of this disease can be influenced by certain somatic causes; the presence of traumatic and psychogenic factors is also important. A special variant of this disease is considered to be affective-shock neurosis, otherwise it is called fear neurosis, which has its own forms. The simple form is characterized by a slow course of mental processes, as well as certain somato-vegetative disorders. The course of the disease is acute, it occurs after a mental shock injury, signaling danger. In this case, the person turns pale, tachycardia occurs, blood pressure fluctuates, and breathing becomes rapid.

In particular, this form is characterized by increased frequency of urination, loss of appetite, and dry mouth. A person may lose weight, his hands begin to tremble, and his legs feel weak. Thought processes are also inhibited, and verbal and speech reactions worsen. Recovery occurs gradually, but the most difficult thing to restore is disturbed sleep. In the assisted form, anxiety typically occurs, there is motor restlessness, and verbal and speech reactions are also slowed down. The stuporous form of fear neurosis is combined with mutism, when numbness is observed.

Fear neurosis occurs especially easily in childhood; infantile children and toddlers are more likely to suffer. The cause is irritants of an unusual type. Sometimes these are sharp sounds, a sharp imbalance, or the sight of a person in a mask or fur coat. Older children may be very frightened when they see a scene of a fight or a drunk person. The moment of fear may be accompanied by numbness, psychomotor agitation, and trembling. In the future, this fear may become entrenched and require treatment.

Let's get to know your child better - online children's tests

It is impossible to imagine the life of a modern person without psychology; this science is an indispensable assistant at any age. Thanks to the simplest psychological techniques.

Treatment of nervous tics

This condition occurs quickly and involuntarily, it is expressed in a monotonous muscle contraction, reminiscent of normal movement. Every person has it though.

Bruxism

This disease is characterized by the presence of a symptom such as teeth grinding, which is involuntary. Bruxism can occur due to strong emotions.

The main signs of nervous exhaustion. Treatment methods

Unfortunately, almost every modern person is familiar with the concept of “nervous exhaustion” or chronic fatigue syndrome. The causes of nervous exhaustion are:

Neurasthenia: symptoms and treatment

Neurasthenia is a disease accompanied by mental disorders, which are based on nervous overstrain and exhaustion. A mental disorder such as neurasthenia.

The effect of stress on the body

The concept of “stress” was first used by Walter Cannon, denoting a state of emotional tension in connection with an obvious threat. I studied it in more detail.

Neurosis of the stomach. Symptoms

Many people know about such problems, and heaviness in the stomach, belching, and heartburn are a familiar condition. There is also a localized burning sensation.

How to cure neurosis

Throughout their lives, people experience a significant amount of stress, depression and overexertion. Many events are unpredictable, which of course affects the psyche.

Autonomic neurosis

Vegetopathy, autonomic function, autonomic dystonia - all this is a group of diseases that develop when the functioning of the higher autonomic centers is disrupted.

Pain due to neuroses

Neuroses very often disrupt a person’s state of mind, and of course, are accompanied by a lot of unpleasant sensations. In this case, the person complains about.

Anxiety neurosis is a neurotic disorder in which the leading symptom is a certain fear or phobia. Phobias, or obsessive fears, are very diverse. In accordance with a specific phobia, a person’s behavior is also disrupted (for example, if a patient is afraid of closed spaces, then he avoids public transport, elevators, etc.). That is, fear neurosis is always associated with certain ideas of a person or a specific situation.

Treatment is selected individually, taking into account age, duration of the disease, symptoms and severity.

Causes and signs of the disease

Fear neurosis arises on psychological grounds. The cause may be stress (conflict in the family, problems at work, etc.) or simply a situation that is very significant for a person (moving to a new home, the birth of a child, a new place of work).

In addition to clearly expressed fear (a specific phobia), the disease also has the following physiological symptoms:

tremor of the limbs and trembling throughout the body;
feeling of chills and the appearance of “goose bumps”;
severe headache;
symptoms of stomach discomfort, nausea, vomiting;
rapid breathing and heart rate, heavy sweating;
symptoms of sleep disturbance (frequently wakes up in the middle of the night, cannot fall asleep for a long time);
excessive anxiety and motor agitation.

A special type of fear neurosis is affective-shock neurosis (fright neurosis), which most often occurs in children. It can be caused by a strong unexpected stimulus - a sharp light or loud sound, the sight of an unusually dressed person (for example, in a carnival costume or mask) or a person in an inadequate state. Usually, young children and simply sensitive, impressionable children are susceptible to such fear.

Treatment methods

If doctors do not find other disorders, then the treatment of fear neurosis is carried out by a psychotherapist.

Psychotherapeutic treatment of fear neurosis solves the following problems:

Teaching the patient to manage the symptoms of his illness.
Teaching the patient a different attitude towards the symptoms of illness.
Training in relaxation methods (muscular and respiratory).
Conducting hypnotic sessions if necessary.

When a person is in danger, it is normal to feel fear and anxiety. After all, in this way our body prepares to act more effectively - “fight or flee.”

But unfortunately, some people tend to experience anxiety either too often or too intensely. It also happens that manifestations of anxiety and fear appear for no particular reason or for a trivial reason. In cases where anxiety interferes with leading a normal life, the person is considered to have an anxiety disorder.

Symptoms of Anxiety Disorders

According to annual statistics, 15-17% of the adult population suffers from some form of anxiety disorder. The most common symptoms are:

Cause of anxiety and fear

Everyday events are often associated with stress. Even such seemingly ordinary things as standing in a car during rush hour, celebrating a birthday, lack of money, living in cramped conditions, overexertion at work or conflicts in the family are all stressful. And we are not talking about wars, accidents or diseases.

In order to cope with a stressful situation more effectively, the brain gives a command to our sympathetic nervous system (see figure). It puts the body into a state of arousal, causes the adrenal glands to release the hormone cortisol (and others), increases heart rate, and causes a number of other changes that we experience as fear or anxiety. This, let’s say, “ancient” animal reaction helped our ancestors survive in difficult conditions.

When the danger has passed, the parasympathetic nervous system is activated. It normalizes heart rate and other processes, bringing the body to a state of rest.

Normally, these two systems balance each other.

Now imagine that for some reason a failure occurred. (A detailed analysis of typical causes is presented).

And the sympathetic nervous system begins to become excited, reacting with feelings of anxiety and fear to such minuscule stimuli that other people do not even notice...

People then experience fear and anxiety with or without reason. Sometimes their condition is constant and enduring anxiety. Sometimes they feel nervous or impatient, have difficulty concentrating, or have trouble sleeping.

If such anxiety symptoms persist long enough, then, according to the DSM-IV, a doctor may diagnose generalized anxiety disorder» .

Or another type of “failure” - when the sympathetic nervous system hyperactivates the body for no particular reason, not constantly and weakly, but in strong bursts. Then they talk about panic attacks and, accordingly, panic disorder. We have written quite a bit about this type of anxiety-phobic disorder in others.

About treating anxiety with medications

Probably, after reading the text above, you will think: well, if my nervous system is unbalanced, then it needs to be brought back to normal. Let me take the appropriate pill and everything will be fine! Fortunately, the modern pharmaceutical industry offers a huge selection of products.

Some of the anti-anxiety drugs are typical “bullshit” drugs that have not even undergone normal clinical trials. If anyone is helped, it is through the mechanisms of self-hypnosis.

Others - yes, they really relieve anxiety. True, not always, not completely and temporarily. We mean serious tranquilizers, in particular those of the benzodiazepine series. For example, such as diazepam, gidazepam, Xanax.

However, their use is potentially dangerous. First, when people stop taking these medications, anxiety usually returns. Secondly, these drugs cause real physical dependence. Thirdly, such a crude method of influencing the brain cannot remain without consequences. Drowsiness, problems with concentration and memory, and depression are common side effects of treating anxiety with medications.

And yet... How to treat fear and anxiety?

We believe that an effective, and at the same time gentle on the body, way of treating increased anxiety is psychotherapy.

Just not outdated conversational methods like psychoanalysis, existential therapy or gestalt. Control studies indicate that these types of psychotherapy produce very modest results. And then, at best.

What about modern psychotherapeutic methods: EMDR therapy, cognitive behavioral psychotherapy, hypnosis, short-term strategic psychotherapy! With their help, you can solve many therapeutic problems, for example, changing inadequate attitudes that underlie anxiety. Or teaching clients to “control themselves” in stressful situations is more effective.

The integrated use of these methods for anxiety neuroses is more effective than treatment with medications. Judge for yourself:

the probability of a successful result is about 87%! This figure is not only the result of our observations. There are many clinical trials confirming the effectiveness of psychotherapy.

noticeable improvement in condition after 2-3 sessions.

short-termism. In other words, you don’t need to go to a psychologist for years; usually 6 to 20 sessions are required. This depends on the degree of neglect of the disorder, as well as other individual characteristics of the person applying.

How is fear and anxiety treated?

Psychological diagnostics- the main goal of the first meeting between the client and the psychotherapist (sometimes two). Deep psychodiagnostics is what further treatment is based on. Therefore, it must be as accurate as possible, otherwise nothing will work. Here is a checklist for a good diagnosis:

the real, underlying causes of anxiety have been found;

a clear and rational treatment plan for anxiety disorder has been drawn up;

the client fully understands the mechanisms of psychotherapeutic procedures (this alone gives relief, because the end of all suffering is visible!);

you feel sincere interest and care about you (in general, we believe that this condition should be present everywhere in the service industry).

Effective treatment, in our opinion, this is when:

scientifically proven and clinically tested methods of psychotherapy are used;

the work is carried out, if possible, without medications, which means no side effects, no contraindications for pregnant and nursing mothers;

the techniques used by the psychologist are safe for the psyche, the patient is reliably protected from repeated psychological trauma (and sometimes “victims” of amateurs of all stripes turn to us);

the specialist helps to increase the independence and confidence of his client, and does not seek to make him dependent on the therapist.

Sustainable results- this is a consequence of intensive joint work between the client and the psychotherapist. Our statistics show that on average this requires 14-16 meetings. Sometimes you come across people who achieve excellent results in 6-8 meetings. In particularly advanced cases, 20 sessions are not enough. What do we mean by “quality” result?

Sustained psychotherapeutic effect, no relapses. So that it doesn’t happen as often happens when treating anxiety disorders with medications: if you stop taking them, fear and other symptoms return.

There are no residual effects. Let's turn again to drug treatment. Typically, people taking medications still feel anxious, albeit through a veil. From such a “smoldering” state a fire can flare up. It shouldn't be this way.

The person is reliably protected from possible stress in the future, which (theoretically) could provoke the appearance of anxiety symptoms. That is, he is trained in self-regulation methods, has high resistance to stress, and is able to properly take care of himself in difficult situations.