Mental Health: Anxiety: Psychiatrist explains what the disorder is and how to treat it

Catastrophic thoughts, constant fear and excessive worry are some of the symptoms of anxiety.

According to the WHO (World Health Organization), Brazil is the country with the highest number of anxious people in the world. There are about 19 million Brazilians who live with the disorder, that is, around 9% of the population that reaches 213.3 million people.

Anxiety can also cause physical symptoms, such as shortness of breath, tremors, and muscle tension.

To face the disease, it is necessary to understand how it works, how to differentiate normal from pathological anxiety, explains psychiatrist Marco Abud.

“In order to achieve real and sustainable improvement, the first and most important step is to have a clear treatment plan, knowing what type of anxiety exists, which tools have the best chance of working and in how long”, says the doctor.

Abud maintains the Saúde da Mente YouTube channel, where she gives tips and answers questions about mental health. This Thursday (13), he starts the Anxiety Free marathon, which runs until the 24th of this month.

Read the interview with the psychiatrist below.

How can a person know if they are just experiencing a period of anxiety, because of daily events, or if what they are feeling is already characterized as an anxiety disorder?

Anxiety considered normal is an unpleasant automatic reaction that occurs when the body perceives a future danger. It is composed of physical sensations of agitation, alertness, restlessness and thoughts focused on threats, that is, worries. The body alert plus worry makes us prepared to solve or escape problems.

Anxiety disorder, that is, pathological anxiety, has the brain “fooled”. He sees danger where it doesn’t exist and doesn’t recognize our ability to face it.

In these cases, anxiety becomes a pattern, a toxic habit of sensations, negative thoughts and escape behaviors that cause a lot of suffering, not allowing the person to make their choices. In addition, it makes her hostage to anxiety with damage to work, relationships and health.

In practice, if you have anxiety attacks, cannot let go of your worries, are intensely afraid of embarrassment and of being judged, are afraid of feeling sick and not having help and feel that this harms or makes your life difficult, it is possible that there is an anxiety disorder present.

There are people who say they are anxious by nature, that they don’t have a disorder. Is there this, an anxious personality?

Important to explain that anxiety is a normal and healthy reaction to protect us from dangers and solve problems efficiently. What we want to fight is the paralyzing anxiety, present in anxiety disorders that keep in a vicious cycle of negative thoughts, bad feelings and escape behaviors.

A key step towards this is separating the anxiety disorder from who you are. Pathological anxiety is something related to the current state of your symptoms, not a characteristic of your personality.

It is also important to say that no anxiety disorder has a 100% genetic cause. Genetics can provide a greater or lesser sensitivity to negative stimuli, but being someone more sensitive to attacks is not a bad thing, on the contrary, it can be something very advantageous, giving greater responsibility, problem solving and care for others.

Many people who suffer from anxiety, even before seeking help from a mental health professional, turn to meditation, yoga, herbal remedies and calming teas to relieve symptoms. What do you think of these practices?

I always say that having too many options causes more anxiety than not having options. This is especially true of the overload of practices, advice, and therapies that the internet gives us.

To achieve real and sustainable improvement, the first and most important step is to have a clear treatment plan, knowing what type of anxiety exists, which tools have the best chance of working and for how long.

The best method is evidence-based practice that takes into account three factors: scientific evidence, practitioner experience, and patient choice. Based on this, we know that mild and moderate anxiety, which are not generating much of an impact on the person’s life, should be addressed with non-drug methods.

The method that has the power of improvement is cognitive behavioral therapy, a specific training to change the pattern of anxious thoughts, sensations and behaviors.

Physical exercise, mindfulness meditation, dietary changes, yoga, some herbal medicines like passionflower, valerian, chamomile and supplements can also be used in these cases. Typically, you should see significant improvement in about 4 to 8 weeks.

There is no evidence for remedies, but I do not recommend remedies that contain alcohol, as alcohol worsens anxiety over time.

In the most intense, chronic cases that interfere a lot with daily activities, the use of specific medications along with cognitive behavioral therapy is indicated.

It is worth remembering that this evaluation must be carried out by a mental health professional and that the role of the drug is to provide relief from symptoms and allow other strategies to be implemented.

When should a person look for a mental health professional, such as a psychologist or psychiatrist, to treat the anxiety disorder? What are the signs that anxiety is already taking a toll on this person?

The search should be done when anxiety is preventing or getting in the way of work, social life and relationships, or when anxiety does not improve or worsens even with non-drug methods after 8 to 12 weeks.

Furthermore, if the person is unable to put into practice any treatment method due to
intensity of symptoms, it is also important to look for a specialist.

What differentiates panic disorder from anxiety disorder?

Panic syndrome or disorder, which would be the official name, is one of the ways pathological anxiety can manifest itself. It is composed of three elements that imprison the person and take away their ability to choose:

– panic attacks, which are crises of intense fear, arise for no obvious reason, with many bad physical symptoms and a feeling of imminent death;

– constant preoccupation with having other crises, with a hyperfocus on bodily sensations;

– avoidance or behavior change for fear of having a panic attack and not getting help. The person can avoid driving, going to places where there is no hospital, avoiding going out alone, for example.

Because of the coming and going of the worsening Covid pandemic, have you noticed more people with symptoms of anxiety?

Uncertainties, dilemmas, safety, health and finances are the biggest anxiety triggers there are. That’s for every human being. That is, if you do not present any anxiety at this moment, we can say that something is very wrong. This is normal anxiety, which is productive, motivates us to solve or get a problem out of our way.

Our enemy is pathological, toxic anxiety, which tricks the brain into saying that there is danger where there is none and that we are unable to deal with it.

There are two main fuels for this type of anxiety:

– catastrophic thoughts, for example, “it’s going to be horrible and I won’t be able to handle it” or “what if I get on this plane and it crashes?”;

– avoidance, avoidance and distraction behaviors, which in normal anxiety can appear as “I don’t know if my mother took the third dose of the vaccine. What if she gets Covid? I need to write it down on the agenda to check it as soon as I get home”. Already in pathological anxiety, they appear like ” did my mother take the third dose? What a terrible daughter I am, I should have seen this. I always do stupid things. She will definitely get Covid and it will be my fault. my brother is going to talk. Wow, I’m sweating a lot. What’s this shortness of breath? No, I can’t start feeling sick here in front of everyone, I have to leave now.”

In the Free Anxiety Marathon, which you will promote on your YouTube channel, which aspects of the disorder will be addressed to face this problem? What can the public expect from the marathon?

In the marathon I will cover the following topics:

– unravel all about anxiety, how it acts on the brain, symptoms and true causes;

– discover the types of anxiety and which one may be happening to you;

– understand everything about medicines used, how they work, side effects and care;

– learn practical techniques, supplements and herbal medicines that work and how to use them;

– know the best plan, step by step, to get rid of anxiety without using drugs and in a sustainable way, without relapses.

Follow the Mental Health blog on Twitter, on Instagram and Facebook.