Anxiety and anguish are manifestations of strictly human and entirely necessary affects and emotions. They are not, in themselves, any disease. We can all experience anxiety at one time or another, as it is a mechanism that puts us in a state of alert and helps us to resolve certain stressful situations in our lives, such as a job interview, meeting new people, giving a public talk… all of them are examples of circumstances that can produce anxiety, but paradoxically, that same anxiety is what allows us to face them, adapt and find a way to resolve them.
It is only when anxiety exceeds a certain threshold that it ceases to be a necessary mechanism for our adaptation to the environment and becomes a problem and a symptom that invades us, makes us fragile and even invalidates us and should be solved.
Distress, anxiety and fear
Anxiety is defined, not so much by the cause that provokes it, but by the effects it produces, by the signs that manifest themselves, basically in the body, in what is called crisis of anxiety or panic attack. This crisis involves the sudden appearance of some of these symptoms: restlessness or intense discomfort with the appearance of pain or discomfort in the chest, tachycardia, choking sensation, dizziness, instability or fainting, hot flushes or chills, nausea, diarrhea, numbness or paresthesia, sensation of death or loss of control, feelings of unreality or strangeness.
Seizures involve many parts of the body so that sufferers often fear that they have a serious medical problem related to the heart, lungs or brain. These crises are also characterized by persistent worry and fear of suffering other similar crises, so that they can lead to changes in behavior in order to avoid a new episode. Such is the fear of anguish crises that often generates confinement, avoiding any type of social contact, travel or others, to the point of producing true agoraphobia.
Anxiety is another mode of expression of anxiety, this time understood as a manifestation of less intensity and of a more chronic format. It can be defined as a stage of restlessness and discomfort, tension and alertness leading to a state of worry and anticipation of some misfortune or disaster. A chronic anxiety, of years of evolution, can coexist in a person, accompanying him and creating maladjustment and emotional discomfort. Its intensity can be very variable, from a slight uneasiness to an intense panic, from a knot in the stomach to uncontrollable nausea or dizziness.
Also, as with pain, the ability to tolerate a given level of anxiety is highly variable from person to person. Some of them seem to adapt quite easily to it even if this implies, as a consequence, behavioral changes or avoidant or inhibitory attitudes, others, on the contrary, find anxiety unbearable. Anxiety can also show itself as an anticipation of a danger, for example, the fear that a loved one suffers an accident, or the fear to suffer an illness up to suffering real states of hypochondria.
There are several situations and moments of daily life that can favor the appearance of anxiety. Moments related to loss. For example, moments of breakup or loss of emotional ties can trigger uncertainties, anxious questions such as: why did she leave me, what were her reasons, am I not enough? And, although it may seem contradictory, there is also anxiety linked to positive results and success that are linked to the fear of not being up to the task, to the desire not to disappoint. Personal career advancement, moving up the ranks of responsibility for example, can be as worrying as being dismissed.
Fear and anxiety
The symptoms of anguish and those of fear can be similar but, unlike anguish, fear requires an object or situation of reality to cause it. Anguish, on the other hand, can be produced without the presence of this concrete object.
Anguish is a strictly human affection.
Anguish requires a process of symbolization and metaphor at the mental level that is indebted to human language and its capacity to travel in time, past and future, and to intuit, imagine and fantasize facts and consequences that do not have to be consistent with objective reality. That is why anguish is not equivalent to fear.
Anxiety is a state of intense uneasiness and restlessness caused by the perception of a threat or danger. Fear has a very clear and recognizable real object that triggers it; anxiety, on the other hand, does not know what it is anxious about. The person suffering from anxiety may have no representation, no thought of the cause of his anxiety, he does not know the reason, the cause for which he is anxious. It would be, therefore, a restlessness that the person does not know exactly where it comes from or why he/she suffers it, that produces a meaninglessness, an emptiness and a loop that feeds back and that finally, he/she suffers anguish before the fear of suffering anguish again. Anguish is a signal, an alert that indicates us that there is something dangerous, that seems to come from outside but that, in reality, comes from within us and is unknown to us.
Therefore, when faced with anxiety, first of all, we should look for an explanation of its origin, a name to fix it, to locate it and, by understanding it, to reduce it.
Diagnosis
Anxiety/anxiety is one of the most commonly used diagnoses in mental health disorders today, competing only with its sister, depression, and even the WHO years ago described it as a certain epidemic, since it is a disorder that can easily spread, especially in our world, marked by uncertainties, a lot of information and few assurances.
The two most frequent types of psychiatric diagnoses are:
- Distress disorder. Panic disorder. With or without agoraphobia. It involves suffering an anxiety crisis, defined as the appearance of fear or discomfort accompanied by any of these symptoms: tachycardia, sweating, trembling, shortness of breath, nausea, dizziness, chills, fear of dying, etc. After this crisis, there is concern that it may be repeated and worry about the consequences of the crisis; going crazy, losing control, suffering a heart attack.
Agoraphobia involves a significant change in behavior in which a set of situations are avoided due to the anticipation that crises may be repeated and help is not available. It usually involves avoidance behavior, stopping driving, traveling, mixing with people, moving away from home, among others.
- Generalized anxiety disorder, GAD, is defined as excessive worry about a series of everyday events or activities. This anxiety and worry can be shown as increased restlessness or impatience, difficulty concentrating, irritability, muscle tension, fatigue…
Treatment
The treatment of anxiety/anxiety is twofold. When symptoms are very acute, it is important to reduce their intensity with pharmacological treatment. But, as we have seen above, anxiety is also a signal, an alarm sign that there is a danger for us, that there is a lion, although that lion is not really out there if it exists for us, so it is advisable a psychotherapy so that everyone can discover what their particular lion is and can face it.