Phobia, generalized anxiety disorder. The symptoms and treatment of these disorders have similarities and differences. With phobias, fear at the sight of the object of fear (or the thought of it); During a panic attack, the anxiety is intense and short-lived. With GAD, anxiety is usually not associated with a specific subject, extends to almost everything and is constantly present.

A psychotherapist is involved in the treatment and rehabilitation of patients with generalized anxiety disorder.

Can Anxiety Disorder Be Cured Permanently? If we are talking about neurosis, then this is a functional, completely reversible condition. The doctor must make sure that the patient has neurosis and exclude organic and endogenous causes. The first include metabolic disorders, hormonal disorders, and neurological disorders. Endogenous diseases are characterized by signs that can be identified by a psychotherapist and a clinical psychologist. .

Is it possible to cure anxiety neurosis without drugs, non-medicated? The drugs effectively relieve (remove) acute, strong manifestations - anxiety, low mood, sleep problems. But it is non-drug methods that help fight the cause of the disorder.

How to cure anxiety disorder? Treatment standards for GAD include:

1. Drug correction of symptoms.
2. Individual psychotherapy.
3. Biofeedback therapy.

Psychotherapeutic techniques for treating anxiety disorders

The doctor begins drug treatment simultaneously with psychotherapy for anxiety disorders. He prescribes medications with the patient’s consent and always individually - depending on the clinical picture (symptoms), age, gender, and other human diseases.

Pharmacotherapy includes:

• modern antidepressants- normalize mood, relieve apathy, irritability, anxiety, emotional stress; they are as effective as drugs of the previous generation, but are better tolerated and rarely cause side effects;
• anxiolytics (anti-anxiety)- relieve acute attacks of anxiety;
• sedatives (calming)- relax a person, normalize mild sleep problems.

When treating generalized anxiety disorder in adults, you cannot do without a course individual psychotherapy. GAD is a neurosis, and its cause is often a long-standing conflict, a psychological problem. If you do not solve it, the disease will return again and again.

One of the most common methods is cognitive behavioral therapy. The therapist helps the patient identify thoughts that cause anxiety and negative emotions, actions that a person performs “automatically”. The patient learns to change them to positive, constructive ones. This way a person gets rid of thoughts that provoke an anxiety disorder. How to treat this condition in a particular case is always decided by the doctor - he creates a plan individually.

The nervous system resists stress for a long time and finds resources to “withstand the blow.” If it malfunctions or becomes exhausted, be prepared - it will take a long time to restore it.

At the maintenance stage of treatment (there are practically no symptoms or they can only be identified by a doctor), the patient continues to work with psychological problems. A group form of work is possible - group members share emotional experiences and cope with them together, learn to solve communication problems, if any.

For anxiety disorder, treatment without antidepressants includes another modern methodology - biofeedback therapy (BFB therapy). A specialist, using a computer program and sensors, teaches a person to control the basic physiological parameters of the body - breathing rate, heartbeat, muscle tone, blood pressure level.

Autonomic reactions (heart beat faster, sweating, difficulty breathing) always accompany and intensify anxiety. Therefore, learning to control them is a necessary step towards defeating the disorder. A person can then consciously apply relaxation skills in difficult situations and not be afraid of losing control of himself.

If a person suffers from an anxiety disorder, long rest, vitamin therapy, and self-prescription are unlikely to help. Without qualified medical care, symptoms can get worse. It is better to consult a psychotherapist so that after a comprehensive diagnosis and treatment you can return to a full life, work, and communication with loved ones.

Treatment of anxiety syndrome - current question for modern medicine. Panic attacks, obsessive thoughts, anxiety, which we cannot overcome on our own, are phenomena characteristic of a significant percentage of our compatriots. manifesting itself with such symptoms is treatable, so there is no need to endure discomfort. Several effective approaches have been developed: exposure, medication, cognitive-behavioral. As part of the course, the doctor will teach the patient to keep his mental status under control, overcome fears and disturbing thoughts.

Starting from the beginning: what are we talking about?

Before considering the basic postulates of treating anxiety in adults and children, you should understand the terminology. What kind of condition is called anxiety? Modern medicine This term refers to several subspecies. Treatment is chosen based on the nuances of the case. Often anxiety is a concern against the background of OCD, when neurosis is associated with obsessive thoughts and states. This requires a specific approach. A unique course is prescribed if the main manifestation is panic attacks. The duration of treatment depends on the severity of the condition. However, the predominant percentage of treatments are aimed at a fairly short-term cooperation between the patient and the doctor. From statistics it is known that improvement is observed on average by the tenth session.

Treatment of anxiety in children often requires drug therapy or somatic disease. Provoke deterioration mental state may be fears - for example, related to studies, parents, the future. Doctors say that anxiety is based on a feeling of mistrust of the environment. Many expect a catch, trouble literally at every turn. Adults pass on this pattern of thinking to children, and memorization occurs automatically. Doctors have also found that anxiety can be transmitted between generations and across generations.

Therapy: the basic idea

Treatment of anxiety, depression, OCD, restlessness and other mental disorders involves choosing the optimal program and approach that is useful for a particular person. Currently, the most successful methods for treating anxiety are cognitive behavioral therapy (CBT) and exposure therapy. It is not necessary to plan a course using the approaches of only one therapy option: you can combine different methods and means, as well as supplement the main option in other, less common ways. For some patients, an individual course of therapy is optimal; for others, group treatment, which involves bringing together people with similar problems, is more suitable.

CBT for anxiety

This therapeutic technique has proven itself to be effective, gentle, and safe. Currently, it is widely used in the treatment increased anxiety, and the accumulated official information confirms the reasonableness and effectiveness of this approach. Based on research, we can conclude that CBT helps with panic disorders and general anxiety. This approach can be used when dealing with phobias. It is recommended as a primary treatment for people suffering from social anxiety.

The idea behind the effect of cognitive therapy on anxiety symptoms in the treatment of this condition is to study and evaluate the impact of negative thoughts, medically called cognitions, on a person. The doctor helps the patient understand to what extent this phenomenon greatly affects general condition concerns. The behavioral aspect of the therapeutic course is devoted to the nuances of human behavior, helping to control the patient’s reaction when exposed to anxiety and the factors that activate it.

The main idea of ​​CBT is to understand that feelings are determined by thoughts, not external factors. For symptoms of increased anxiety, treatment involves, first of all, awareness of the dominance of feelings and ideas about the current situation over the situation itself.

Using examples

Suppose a person is invited to some event. The first thought that comes to this is usually positive - people remember how much they enjoy attending such events, what fun awaits on the spot. The emotional state is elevated, the person is animated. With anxiety, thinking may change color: a person may think that parties are not suitable for him, and it would be much more comfortable to spend the evening alone. This sets the state to neutral. A different way of thinking is possible when, immediately after receiving the invitation, the object begins to think about difficulties in communication and imagines negative situations that could happen at the meeting. This gives rise to concern.

The diagram described gives a clear idea of ​​how much emotional state influences the perception of some event. Treatment of anxiety is aimed primarily at combating negative thinking that provokes anxiety and fear. CBT aims to correct this method of belief and thinking in order to influence the feelings experienced by a person.

CBT: a therapeutic approach

The course of treatment for increased anxiety in adults using CBT begins with an assessment of the person’s inherent type of thinking. The first step is to question the correctness of the target's thoughts. This is called restructuring, which is the process by which negative patterns are changed into realistic ones. The process is step-by-step and consists of three stages. Let's look at them one by one.

Step one

Treating anxiety in adults through CBT ideas begins with identifying and identifying negative thoughts. Mental disorders force a person to evaluate any situation as much more dangerous than they are in reality. A classic example is fear of microflora. People suffering from this form of anxiety disorder cannot even shake another person's hand.

Identifying fears on your own, without qualified help, is extremely difficult. Some realize the irrationality of the disturbing factor, however, the situation does not become easier. The main task of the first stage of CBT is to give a correct answer to the question of what kind of thoughts were in your head when the anxiety came.

Step two

The next step in treating anxiety is to question the negative thoughts that arise in your head. A person’s task is to correctly evaluate all those thoughts against the background of which anxiety arose. Negative beliefs should be analyzed in detail, examined for the presence of indisputable evidence of the truth of the fear factor. It is necessary to analyze how likely it is that the situation of concern will actually occur.

Step three

At this stage of anxiety treatment, you should work on negative thoughts, replacing them with ones that reflect reality. By identifying and accurately formulating troubling irrational assumptions and becoming aware of negative thought disorders, you can take steps to correct them towards more correct ones. As part of the course, the doctor will help you formulate calm statements that reflect reality. When expecting an alarming situation, a person will have to concentrate on such thoughts and pronounce them to himself.

Replacing thoughts with realistic ones is quite a difficult task. Negative thinking in most cases is a formed pattern. Changing it takes time, patience and a lot of practice. A person’s task is to consciously break the habit that provokes anxiety. For this reason, CBT is not only about working with a doctor, but also about actively independently adjusting your assessment of reality.

Exposure therapy

Anxiety is a rather uncomfortable and unpleasant state that a person subconsciously tries to avoid. For example, if he is afraid of heights, he would rather make a large circle, but avoid having to cross a high bridge. Fearing public activity, such a person will find a reason not to attend the event. At the same time, treating anxiety in conditions of complete exclusion from one’s reality of situations that provoke anxiety is impossible. By avoiding such cases, a person loses the chance to be stronger than his own phobias. Moreover, trying to hide from a frightening event makes it even scarier.

Exposure therapy was developed to combat this cycle. This course of treatment involves maximum immersion in frightening circumstances. Repeated repetition helps to recognize fear and take control of what is happening, thereby reducing the manifestation of symptoms of increased anxiety. Treatment in adults and children occurs according to one of two scenarios. A doctor can help imagine frightening circumstances or provide assistance in overcoming them in reality. This approach can be combined with the CBT described above, or can be used on its own to correct a person’s condition.

Therapy: how it all happens

The exposure course is based on the idea of ​​systematic habituation. For symptoms of increased anxiety, treatment of adults and children never begins with a confrontation with a situation that causes severe fear - such an approach can cause psychological trauma. The optimal start is simple situations. Gradually added. Gradual habituation is called a systematic decrease in the susceptibility of a frightening phenomenon. The patient becomes more confident in his own abilities and has at his disposal various ways to control the panic state.

The first step of treatment is to develop methods and methods of relaxation. The doctor teaches relaxation through breathing and relaxation of muscle tissue. Once you have learned to resist your fears, you can use relaxation to reduce your physical response to anxiety. This helps eliminate trembling, excessively rapid and shallow breathing, and similar external symptoms another attack.

Continuation of the program

The next step in desensitizing the fear factor is developing a list. It is necessary to imagine and record on paper 1-2 dozen circumstances that give rise to anxiety, and sort the list by level of fear. To combat fear, create a sequence of actions from simple to complex, realizing the purpose of each stage. For example, if a person is afraid of flying, they first begin to look at photos of airplanes, and gradually progress comes to flying in reality.

All formulated tasks must be carefully worked out. The easiest way to go through the steps of the list is with the help of a doctor, but if you can’t contact him, you can try self-treatment anxiety according to the same program. You should be aware of the goal of therapy - being in frightening circumstances until you manage to overcome your fears. Sooner or later, a person realizes that there is nothing terrible, and previous ideas about the situation did not reflect the real state of affairs. The formation of an alarming situation should be accompanied by the use of relaxation techniques. The success of its implementation helps to return to the frightening factor again. Gradually, step by step, such therapy gives a pronounced result.

Additional techniques

Were developed special methods and means of reducing stress levels. By resorting to them, it is easier to achieve peace of mind. The simplest and most basic option is physical activity. Exercises are a good counterbalance to stress and any internal unrest. As we have been able to prove, by doing some kind of sport for half an hour 3-5 times a week, a person thereby significantly increases his emotional status and stabilizes his psyche. The best results come from those who dedicate an hour every day to enjoyable forms of sports. For example, you can introduce aerobics or swimming into your daily routine.

An equally useful technique is relaxation. By regularly resorting to it, you can achieve good results. It is recommended to master meditation or visualization. Your doctor can teach you ways to control your breathing. A fairly popular method is progressive muscle relaxation.

What else should I try?

Feedback is a way to combat anxiety using special sensors. These are a variety of heart rate monitors, drugs for monitoring breathing rate and muscle activity. Analysis of instrument readings helps to assess the body's response to a disturbing factor. Therefore, it is easier to figure out which one will be most useful.

In some cases, patients are recommended to resort to hypnosis. While in this combination, the psychotherapist will use specific approaches aimed at conveying the essence of fears. As part of the treatment course, the client learns to evaluate fear factors differently.

Medication assistance

Drugs are relatively rarely prescribed to treat anxiety. The choice of specific names depends on the specifics of the case and the presence of somatic disorders. Often anxiety is explained by the medication program a person is undergoing or drugs which he accepts. To make it easier to get out of this state, the substances are withdrawn gradually. Sometimes treatment for withdrawal symptoms is required. For primary anxiety disorder and long-term persistence of symptoms after discontinuation of the compounds that caused it, a combination of psychotherapeutic treatment and medication is indicated.

Quite a few medications have been developed that are effective for anxiety. In general, they are well tolerated and show a pronounced effect. Most often they resort to benzodiazepines. Drugs in this group are indicated for a short course - up to two months. The drugs are effective against anxiety and sleep disorders, problems with adaptation and acute stress. Taking benzodiazepines for two months helps you cope with yourself and your emotions, and learn to cope with everyday tasks. In addition, against the background of drug therapy, the patient works more effectively with the doctor as part of the psychotherapeutic course.

Nuances and cases

PTSD (a disorder that appeared against the background of psychological trauma) requires treatment not only with medication; the course should be chosen by assessing the patient’s condition, and the treatment regimen should be drawn up taking into account an integrated approach. As a rule, anxiety is accompanied by depressive or panic disorders, dysthymia. PTSD is often observed in combination with addiction to alcohol or drugs.

For panic disorders, antidepressants are indicated. The most common practice is to prescribe SSRIs and tricyclics. You can combine these groups with benzodiazepines. The choice is based on individual tolerance, negative consequences, and previous experience with use. SSRIs are the most common options in general practice currently. These medications give effect a few weeks after the start of the course, sometimes after a month or even longer, so the program is usually long: from six months or more. The most popular drugs are Fluoxetine, Paroxetine, Sertraline.

Psychotherapy for anxiety disorders eliminates anxiety and internal restlessness without the use of medications; anxiety is treated using psychotherapeutic methods.

Anxiety and Anxiety Disorder

Anxiety is a normal reaction healthy person before a significant event in his life - an interview, an exam, a date. But if disturbing concerns appear in everyday life every day, you should think about contacting a psychotherapist. Anxiety should not interfere with a person’s study or work process, or in his relationships with others. In some cases, a person becomes upset due to alcohol consumption - in this case, it is better to seek help.

What indicates an anxiety disorder

Anxiety disorders are several conditions that share a common symptom: persistent or severe worry when a person does not feel safe.

Additional signs of an anxiety disorder:

• feelings of apprehension or fear
• irritability
• tension and nervousness
• constantly expecting something worse

Physical symptoms of anxiety may also appear: palpitations, rapid pulse, sweating, upset stomach, dizziness.

Types of Anxiety Disorders

Experts distinguish types of anxiety disorders:

• generalized anxiety disorder
• panic disorder
• obsessive-compulsive disorder
• phobia
• social anxiety disorder

At generalized anxiety disorder anxiety persists almost all the time, the person cannot leave the feeling that something is about to happen. Fears and worries constantly distract from normal life.

Panic disorder- these are unexpected and repeated panic attacks, often accompanied by a fear of being in safe places - in shopping centers, in confined spaces, in transport.

Obsessive-compulsive disorder are unwanted thoughts or behavior that a person cannot control. These are thoughts about the iron not being turned off or the tap not being turned off, worries that a person has caused pain to another person.

Phobia- fear of a specific object or situation, greatly exaggerated, unrealistic.

Social anxiety disorder is called excessive shyness when people try to avoid social situations.

Post-traumatic stress disorder is an anxiety disorder after events that threaten a person’s life - accidents, conflicts.

How to Treat Anxiety Disorder

The help of a psychotherapist is the best solution for those who want to get rid of constant anxiety in your life. Anxiety treatment is carried out in the form of individual psychotherapy sessions.

Anxiety disorder develops when there is an incorrect perception of the surrounding world and strict demands on oneself.

The main method of treating anxiety disorders is cognitive behavioral psychotherapy. It is based on the idea that the sensory side of a person depends on how he perceives what is happening, and not on the events themselves. What matters to a person is not what happened, but what he thinks about it. If the problem is in thoughts, then you need to influence thoughts in order to eliminate the main source of anxiety.

During psychotherapy sessions, the doctor helps the patient correct thought processes and get rid of stereotypes.

The result of psychotherapy for anxiety is:

• Ability to identify negative thoughts that trigger anxiety
• the patient's realistic assessment of his thoughts and experiences
• control of emotions and behavior
• overcoming shame and internal discomfort

• Session 50 rub.