Anxiety: how to get out of your anxiety disorders

Everyone has their own temperament, but constantly worrying is not inevitable. Anxiety care has been shown to be effective. We take stock with Dr Jérôme Palazzolo, psychiatrist, professor of clinical and medical psychology.

Throat knotted, lump in the stomach … Anxiety echoes an alarm sent by the brain: we feel more or less consciously that a danger awaits us or that we will have to face a difficulty. Although perceived as unpleasant, this emotion is useful and beneficial since it draws our attention to a danger or a risky situation: for example, a sudden high fever in a child or the unexplained delay of a friend who is usually punctual. On the other hand, “anxiety becomes pathological if it goes beyond certain limits, either because it is too important, or because our capacity to overcome it is insufficient “, specifies Dr Jérôme Palazzolo, psychiatrist.

Excessive Anxiety: What Are the Signs?

This state of excessive worry can result in physical symptoms (irregular heartbeat, headaches, abdominal pain, spasmophilia attacks …), but also by difficulty concentrating and inappropriate reactions to situations that are however unimportant. It invades all thoughts and keeps the person in a permanent state of tension and vigilance.

As Sixtine testifies. This hyperactive young quinqua says she worries “from morning to night about anything and everything: an unanswered e-mail, the sentimental setbacks of a friend, the possible consequences of a vaccine, the prospect of a delay. train, etc. ” The person focuses his attention on future events that are perceived as potentially dangerous. She is always afraid of losing control, going mad or dying. She forgets to live the present moments and constantly broods over her worries, as if it could protect her.

Sometimes the anxiety is such that it causes panic attacks, as in the case of phobias. These trigger an uncontrollable fear which prompts the person to avoid all similar situations in which the sapper could suddenly reappear. Another manifestation of pervasive anxiety is obsessive-compulsive disorder (OCD) which pushes people who suffer from it to appease their anxiety through repetitive and irrepressible rituals: washes, checks, accumulations of objects, etc.

What is it due to?

“At the origin of this excessive anxiety, an external element (the dog who bites, the superior who harasses …), but also often a dynamic of learning”, observes the psychiatrist. A particular situation, for example a slight vagal discomfort in the bus, induced anxiety, the brain recorded it and will then generalize this learning to similar situations (other means of transport). Other times, it is a father terrorized by fire or traffic accidents who will pass this learning on.

Then, the anxiety reinforces the anxiety … At the same time, we observe in the brain “a collapse of the level of serotonin, a neurotransmitter which plays a protective role in the brain”. It is also known that the activity of the prefrontal cortex (an area of ​​the frontal lobe) is altered in people with anxiety. The regions involved in the regulation of emotions are underactive, while others such as the amygdala and hypothalamus or the anterior subgenual cingulate cortex, involved in the generation of emotions, are on the contrary overactive.

How to get rid of your anxiety?

“To give the patient the maximum chance to come out of his anxiety disorder, treatment must take into account all aspects of the disorder as soon as possible, assures Dr. Palazzolo. The goal is that this anxiety is no longer a handicap. “

Unmissable, cognitive behavioral therapies allow you to work on avoidance behavior and unlearn an unsuitable way of thinking. It is the standard treatment for anxiety disorders. “These brief therapies focused on the patient’s current problems are based on the observation and regulation of the links between emotions, thoughts and behaviors” explains Dr. Sylvie Wieviorka, psychiatrist. The therapist analyzes with his patient the automatic thoughts and the behaviors that make him suffer and that he maintains despite everything. He will then accompany him towards a more realistic thought pattern. Because more often than not, it is our own interpretation of the situation that makes us suffer and not the situation itself.

At the same time, the therapist offers his patient a set of techniques (breathing, role-playing, muscle relaxation, self-assertion, self-hypnosis, etc.) that go help them manage their anxiety symptoms. Practical exercises allow the patient to gradually confront the anxiety-provoking situation (in reality or with a virtual reality headset), in the office with the practitioner initially, then in real life between two consultations. “The goal,” says Dr. Palazzolo, “is to increase the frequency of positive experiences, to break down patterns of avoidance and hopelessness, and to reduce, if possible, the occurrence of negative events. “

If necessary, a drug treatment will be combined.. Not anti-anxiety drugs as one might think, but antidepressants from the class of selective serotonin reuptake inhibitors (SSRIs), the only ones capable of increasing serotonin levels. And of course, if possible, we will change the anxiety-generating environment (work, old car, etc.). The results depend on the intensity and duration of the anxiety. The earlier we intervene, the easier it is to get out, although an anxious personality will always remain so.

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