Anxiety, depression and feeling blue

Panic attacks may show unexpected. First experience for the person suffering is very frightening. Many times panic attack shows sudden and they can reach climate very fast, in 10 minutes or so. Physical symptoms showing may be very prominent, and feelings can be very strong. Catastrophic scenarios are very strong in patient head and running from the spot is the only imaginable solution. Escape to a safe place is first thing on patients mind. There is spark of light in this entire situation because duration of the panic attacks is relatively short. Some therapist gave their speculation that panic attacks are stopping because of patient’s exhaustion. On the other hand some of the patients treated have stated that they deeply believe attacks can be terminated simply by escaping from the place they are. Another gateway for some patients is taking medicines quickly hoping that they will make control over the panic attacks. Most close gateway from those panic attacks may be slow breathing techniques in case of hyperventilation. This require previous education and training which is not always provided to the patients. 

Anxiety is getting onset with more gradual approach. It is advancing more slowly than panic attacks and also its peak value is obtained more slowly. Physical symptoms may not be prominent and there is absence of catastrophic scenarios. Also, there is kind of delayed escape like behavioral response and overall duration may be variable, but usually it is longer than in panic attacks.

When taking panic disorders into consideration two components are emphasizing. Anticipatory anxiety and panic attacks. Panic attacks are not reflection of present physical illness, so they cannot be predicted or expected, at least not at the start. Maybe with time some hints may show that “something” is preparing on certain stimulus. Great deal of panic attacks can be predicted, but that situation needs patient and therapist with some previous knowledge about personal history disorder.

Anticipatory anxiety is great fear to situation of having new panic attack. This situation is alive between two following panic attacks. Some number of patients with diagnose of panic disorder may develop agoraphobia, which is fear (avoidance) of such personally embarrassing situations. Patients who do not show developed agoraphobia have diagnosed panic disorder without agoraphobia, while patients showing agoraphobia have diagnostic of panic disorder with agoraphobia.

Nowadays, despite great achievements in medicine, universal panic attack description is not available. Panic attacks differ in great deal by the way how they are manifested and experienced. Also symptoms are different. Those attacks can be part of anxiety manifesting physical symptoms and possible anticipation of unwanted consequences. Person affected, thinks, that something catastrophic will follow and this person very often, develop urge to leave that place instantly. Panic attacks strength is very progressive. They can reach their maximum value within 10 minutes from start and usually last up to thirty minutes. After attack calming, very often, patients feel totally exhausted even ruined. Another parameter worth to mention is frequency of panic attacks. Frequency can vary in different patients, and in fact it can vary great deal in the same patient. There are written therapist reports that panic attacks can appear occasionally in several months, even years or couple dozen attacks in same day.    

As noticed, panic attacks got some features making them unique phenomena. They can appear unexpected without preparation or warning. They can reach their peak value very quickly. All those attacks are followed with some physical symptoms like heart pounding, lack of breath mixed with dizziness. On top, patients feel these symptoms and react to them with feelings that something catastrophic is going on.

Disorders that can be called as anxiety can be divided on “pathological anxiety”; disorder not caused by physical illness, and so called “normal” anxiety. There are certain differences between them and there are several of them.

Pathological anxiety intensity is high to certain situations, last longer, it is manifested trough overwhelming, and distressing and incapacitating experience and it can cause long term behavior changes. On the other hand normal anxiety intensity is relatively low to certain circumstances and situations, generally last shorter, it is manifested trough some unpleasant experience, but not long lasting and only temporarily affect behavior. This conceptualization is going through all anxiety components: cognitive, subjective, behavioral and physiological. It may seem easy on paper, but in practice it’s not so easy to draw a clear line between normal and pathological anxiety.

Term anxiety is coming from 1980. Before that anxiety disorders were conceptualized and categorized as neuroses. As further they were categorized as traumatic neurosis, phobic neurosis, anxiety neurosis and obsessive compulsive neurosis. This field of medicine was new and it needed open validation and confirmation. Splitting of anxiety disorders was made in order to bring better distinction and better treatment according. By that time several medications were developed and have proven certain efficiency on some types of anxiety disorders.

Psychological models of anxiety disorders are including cognitive, psychodynamic and behavioral models. Cognitive models are dedicated to certain beliefs of the patient and patient’s ability to deal with them. These models have not been tested enough and treatment based on them is something that some therapists avoid. The psychodynamic models are emphasizing the fact that anxiety shows as a result of inner conflicts between aggressive and sexual urges and rising defenses against them. So resolving of inside conflicts that are unconscious is main stream in these models. Behavioral models are dealing with avoidance behavior toward disorders. These models are simple but yet effective in dealing with anxiety disorders.

In recent years of clinical daily practice disorders like anxiety are quite common. Those disorders got great negative impact on human’s quality of life. Quite often these disorders can be over looked or minimized. Anxiety symptoms can occur together with some other conditions known to psychiatric science. This mix can cause great deal of problems in diagnostic and treating. That’s why, even today, in our modern society; anxiety diagnostic and treatment don’t have satisfactory level. It’s quite often the case when many people suffering from anxiety will stay untreated just because of diagnostic failure. Never the less treatment side of this problem is really alive. Many patients with diagnostic cannot benefit from treatment just because of their anxiety medicine resistance.

Simple fact that anxiety deals with great deal of subjectivity also places many obstacles on diagnostic and treatment. There are different symptoms in various people showing outside but they all lead to same disease. Despite great achievements on the anxiety research field, there are not many really skilled doctors prepared to treat anxiety. There are many issues connected with state of anxiety. Many times in many actual treatments, different or sometimes even conflicting effects will show. This duplicity can cause great deal of problems to therapists. Same approach can lead to very different effects in different people. It’s not too much to say that every individual is a different world.

When talking about anxiety 6 main categories can be labeled.

Panic disorder

Social anxiety

General anxiety

Specific phobias

Obsessive compulsive disorders

Posttraumatic stress disorder

When burden strike, professional help is most welcomed but many times people can greatly help their doctors to achieve great results. All therapeutic procedures that are relevant and proven cannot work on patient who doesn’t want to be helped. Both sides of the deal, doctors and patients got their responsibility. Both sides have to work hard for treatment to work. It’s not everything in therapeutic procedures, medicines and examinations. There is great deal in positive attitude of patient, positive thinking and of course trust is what values most. When someone wants to make changes in lifestyle and needs help, it really matters if there is positive approach. Combined treatments of psychotherapy and pharmacotherapy can bring great results. There are various anxiety disorders and they all need custom approach and treatment. With all this complexity and different conditions, sometimes therapist may be on unknown or uncertain ground, but there is one beacon that always shows the way, and that is patient’s welfare.

So called disorders of the mood are group of conditions which incorporate different disorders. There is separation of both disorders of anxiety and depression, although sometimes is very difficult to distinct them. There is no perfect cut on boundaries on both disorders. For example if we talk about depression disorders, we have to take into consideration following, manifestations like: change in the mood (lowering), symptoms of reduced energy capability, and lack of interest for certain activities like joy, fun, social amusement etc. If we go deeper there are more symptoms to take into consideration. Pessimistic approach of live is one of them. Also there is great deal of low concentration, low self confidence, broken sleep patterns even suicidal thoughts manifestation. We have to take depression very serious. Depression can cause severe personal and societal consequences. When we take both sex in consideration there is conclusion that women suffer from depression twice more as men. Symptoms in woman can be increased with age. But that is not rigid rule, because there is great deal of relatively younger age groups suffering from depression.

Also there is distinctive difference between depression symptoms and depression illness. Very often, symptoms can be found in people with social and economical difficulties and problems. Yet depressive illness can be located in all sections and layers of society. Depression can cause great increase of mortality due to suicidal negative thoughts, accidents, heart and other internal organs diseases. This can cause severe problems in marital and social life. Also depression causes a great deal of economic burden to whole society. Health care costs will rise, working days will be decreased, and also premature mortality costs will rise. On the other hand, great deal of people have negative attitude toward people suffering from depression and toward medicines that should be used. Great deal of population believes that anti depressive medicines are causing addictiveness. In that way people that really need treatment, very often, refuse to search medical and professional help. It’s only fair to mention that not always professional help is adequate to the level of problems. Taking all these factors into consideration we have to say that depression is one of the major health care problems today.