Why do we worry and how to deal with it? Advice from a psychotherapist

It is known that evening and night are the times of day when anxiety especially actively “visits” people prone to it. If right now we are experiencing stress and feeling that we are not coping with our own lives, then these feelings will intensify if we are left alone with ourselves in the silence of the bedroom.

“We're often so busy during the day that we don't have time to really think about everything that's bothering us,” explains psychotherapist Shelley Treacher. “Our entire body is in fight or flight mode, so it can be extremely difficult for us to slow down and think.” But at night we do it better than ever, unfortunately.

“Another problem is that it is difficult to use the same anti-stress techniques at night that work during the day,” adds psychotherapist Christy Taylor. “The anxiety accumulated in our body is looking for a way out, and it’s not easy to give it at night, as well as to try to resort to rationalization. And here we lie, hour after hour, looking at the ceiling and chasing the same thoughts in circles.”

So what to do? Experts recommend several steps that are likely to improve your condition.

4.Do the exercise

Have you heard anything about the vagus nerve? This is a paired nerve that runs from the brain to the abdomen and can help reduce anxiety if you train it.

To do this, you need to sit or lie down comfortably and turn your head to the right “all the way.” That is, until the moment you can and feel comfortable. The gaze should also be directed to the right and directed as far as possible. Stay in this position until you feel like yawning, taking a deep breath or sighing, then do the same on your left side.

Anxiety disorder - symptoms and treatment

• Generalized anxiety disorder

Generalized TD is a common disorder characterized by long-term anxiety that is not focused on any one object or situation.
People suffering from generalized TD experience nonspecific, persistent fear and become overly anxious about everyday activities. Generalized TR is “characterized by chronic excessive worry, accompanied by the following symptoms (at least three of the following are required to make the diagnosis): restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances.”[6]

Generalized TD is the most common anxiety disorder among older adults.[7] Anxiety can be a symptom of another medical condition or occur in association with substance abuse problems, which should be considered by the physician during diagnosis. The person may have trouble making daily decisions and remembering commitments due to lack of concentration/concern.[9] Externally, the patient looks tense, there is increased sweating of the hands, feet and armpits.[10] The person may be tearful, which indicates depression.[11] Before diagnosing an anxiety disorder, a physician must rule out drug anxiety and other medical causes.[12]

In children, this type of anxiety disorder may be associated with headaches, restlessness, stomach pain and palpitations. It usually begins between the ages of 8 and 9 years.[13]

• Phobic disorders

The single largest category of anxiety disorders is phobias, which include all cases where fear and anxiety are caused by a specific stimulus or situation. Between 5% and 12% of the population worldwide suffers from phobic disorders.[8] Patients typically anticipate terrifying consequences from encountering the object of their fear, which can be anything from an animal to a public place. Common phobias: air travel, blood, water, driving, tunnels. When people are exposed to a phobia, they may experience trembling, shortness of breath, or rapid heart rate.[14] People understand that their fear is not proportional to the actual danger, but still they cannot overcome it.[15]

• Panic disorder

In panic disorder, a person experiences brief episodes of intense fear and anxiety, often marked by trembling, confusion, dizziness, nausea, and/or difficulty breathing. Defined as fear or discomfort that occurs suddenly and reaches a peak in less than ten minutes, these panic attacks can last several hours.[16] Attacks can be caused by stress, irrational thoughts, general fear, or fear of the unknown. However, sometimes the trigger is unclear and therefore attacks can occur without warning. To prevent an attack, you must avoid the trigger. However, not all attacks can be prevented.

In addition to recurrent, unexpected panic attacks, a diagnosis of panic disorder requires that said attacks have chronic effects: either anxiety about the potential consequences of the attacks, persistent fear of future attacks, or significant changes in behavior associated with the attacks. Often, normal changes in the heartbeat noticed by patients make them think that something is wrong with their heart, and they may have another repeat panic attack.

• Agoraphobia

Agoraphobia is the fear of crowded places and open spaces. It is closely related to panic disorder and is often caused by the fear of having a panic attack. Manifested by the need to find a door or other escape route in a constant field of view. In addition to the fears themselves, the term agoraphobia is often used to refer to avoidance behaviors that often develop in patients with panic disorder.[18] For example, after a panic attack while driving, a person with agoraphobia may develop anxiety about driving and therefore avoid driving. This avoidance behavior can often have serious consequences and increase fear.

• Social anxiety disorder

Social TD (also known as social phobia) describes an intense fear and avoidance of negative social control, feelings of embarrassment, humiliation, or social interaction. This fear may occur in specific social situations (such as public speaking) or generally in most (or all) social interactions. Social anxiety often manifests itself with specific physical symptoms, including flushing, sweating, and difficulty speaking. As with all phobic disorders, those people who suffer from social anxiety will often try to avoid the source of the anxiety. In the case of social anxiety, this is especially problematic, and in severe cases can lead to complete social isolation.

• Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) was previously classified as an anxiety disorder (now, according to the foreign classification of mental disorders, PTSD has moved to traumatic and stressor-related disorders). It is the result of a traumatic experience. PTSD can be the result of an extreme situation such as combat, natural disaster, rape, hostage situations, child abuse, bullying, or even a serious accident. Anxiety disorder can also result from long-term (chronic) exposure to severe stress (for example, soldiers who endure individual battles but cannot cope with continuous combat).[19] People may experience sleep disturbances.[20] There are a number of treatments that form the basis of an anxiety treatment plan for those suffering from PTSD. Such treatments include cognitive behavioral therapy, psychotherapy, and support from family and friends.[8]

Research on PTSD began with Vietnam veterans as well as victims of natural disasters. These studies found that exposure to a natural disaster was the best predictor of PTSD.[21]

• Emotional disorders whose onset is specific to childhood

This type of AD involves feeling an excessive and inappropriate level of anxiety about being separated from another person or place. Anxiety disorders affect approximately 4% of children and 7% of adults, but they typically experienced severe psychological situations in childhood. In some cases, even a short separation can cause panic.[22][23] Treating your child early in the disorder can prevent further problems. Therapy includes teaching parents and families how to deal with this type of TD. Often parents increase anxiety because they do not know how to properly work with their child. In addition to parenting training and family therapy, medications such as SSRIs may be used to treat anxiety.[23]

• Situational anxiety

Situational anxiety occurs in connection with new situations or changing events. It can also be caused by various events that cause a person some discomfort. This type of TR is quite common. Most often, in specific situations, a person will experience panic attacks or high anxiety. A situation that makes one person feel anxious may not affect another person at all. For example, some people become anxious in crowds or small spaces, so being in a densely packed vehicle or store can cause them extreme anxiety and possibly a panic attack.[24] Others may experience anxiety when major life changes occur, etc.

• Obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD), like post-traumatic stress disorder, was previously classified as an anxiety disorder according to the foreign classification of mental disorders. OCD is a condition in which a person experiences obsessions (anxious, persistent, and intrusive thoughts or images) and/or compulsions (urges to repeatedly perform certain actions or rituals) that are not caused by drugs or physical influences. This condition causes anxiety or social dysfunction.[25][26] Compulsive rituals are personal, individual rules that should be followed in order to relieve anxiety.[26] OCD affects approximately 1-2% of adults (more women than men) and less than 3% of children and adolescents.[25][26]

A person with OCD knows that the symptoms are unreasonable and therefore struggles with both thoughts and behavior.[25][27] Symptoms may be associated with external events that cause fear (imagining a house burning when thinking about what the person has forgotten turn off the iron) or worry about misbehavior.[27]

Behavioral, cognitive, genetic, and neurobiological factors may be involved in OCD.[26] Risk factors include family history, loneliness (although this can result from the disorder), higher socioeconomic class, or lack of paid employment.[26] About 20% of people with OCD will overcome the disorder and its symptoms with at least decrease over time in most people (another 50%).[25]

• Selective mutism

Selective mutism is a disorder in which a person who is able to speak does not speak in certain situations or when exposed to certain people. Selective mutism typically coexists with shyness and social anxiety.[28] People with selective mutism remain silent even when the consequences of their silence include shame, social ostracism (expulsion), or even punishment.[29] Selective mutism affects about 0.8% of people at some point in their lives.[2]

Nightmares

Panic attacks that occur during sleep are usually caused by nightmares. Nightmares are considered a form of sleep disorder that affects the nervous system, causing unusual behavior.

Nightmare

Nightmares are episodes of intense fear during sleep, usually occurring in the first third of the night. You may wake up terrified with a frantic intensity of physical symptoms that trigger a panic attack.

Where does OCD come from?

Several hypotheses have been put forward regarding the cause of the disorder. Neurophysiologists believe that excessive reuptake of serotonin in synapses, limiting the amount of neurotransmitter, reduces the degree of conduction of nerve impulses, which may be the cause of the disease. This theory is confirmed by the positive effect of taking selective serotonin reuptake inhibitors, which reduce the amount of the mediator during reuptake.

The theory of PANDAS syndrome is interesting. Its apologists believe that the formation of OCD is influenced by streptococcal infection. Once in the body, streptococcus provokes the release of antibodies, which, in addition to pathogenic organisms, affect its own cells, in particular the basal ganglia.

A connection has been established between the disorder and certain brain diseases:

• demyelinating diseases (multiple sclerosis) – among such patients, OCD occurs in 16% of cases;
• vascular lesions of the brain (stroke), although there are cases where OCD receded after a stroke;
• Parkinson's disease and other extrapyramidal disorders;
• epilepsy.

The disease can occur in parallel with another mental disorder: depression, bipolar disorder, anorexia, or act as a symptom within an existing disease, for example, schizophrenia.

OCD is more likely to be associated with exposure to stress factors: a powerful sudden shock, experienced psychological trauma, or chronic stress.

Character traits play a role. The following personality traits predispose to the development of OCD:

• low, high self-esteem;
• selfishness;
• tendency to self-flagellation;
• desire for dominance;
• constant doubt on any issue, long thoughts, hesitation before a decision is made.

The risk of illness is high when a person mentally constantly returns to traumatic memories and fixes attention on them.

Manifestations of obsessions

Obsessions are expressed in various obsessive forms.

Actually, obsessive thoughts are single words, phrases, sentences, songs, poetic expressions of a negative nature that irritate and interfere with the patient.

• Impulses . A strong desire to commit an indecent act: while sitting at a meeting, an irresistible urge to yell at employees arises. Arriving at a restaurant, you suddenly want to hit the waiter. The urge to harm loved ones is considered common. There is a fear that the impulse will come true. In reality, persistent desires remain unfulfilled.
• Images . Unflattering scenes appear intrusively in a vivid form before a person’s eyes without his desire. Example: a man systematically has a picture of his friend being hit by a car popping up before his eyes.
• Doubts . They pop up against the background of an already accomplished event: did you lock the door, did you turn off the iron. A man, having worked his last working day, goes straight from work to the station. Here he will take the train and go to the sanatorium, where he will spend his vacation. On the way to the station, he begins to be tormented by doubts about whether he set the office alarm. I arrived at the station just as the train was leaving and had no opportunity to return and check the office. On the way to the sanatorium, the poor man already had a chain of tragic events: the office is located in a presentable area, in the city center. It has a convenient location, a balcony from which it is easy to get inside. There is a safe in the office. Surely the robbers found out that he was going on vacation, the office would be empty. For professionals, choosing a code for a safe is very simple. In the sanatorium he thinks only about work. Every day he checks the news to see if there are any reports of theft. Calls a colleague to find out how work is going. Exhausted by doubts, he returns from vacation ahead of schedule. On the road, the closer the patient gets to the house, the more anxiety and fear gripped him.
• Aggressive obsessions . Or contrasting thoughts relate to an unreasonable feeling of hatred towards relatives, towards any other person, object. Such antipathy is not supported by anything, it arises out of the blue. Patients do their best to drive away such feelings, understanding their irrationality. Example: the flaring up of negative feelings in a priest towards the saints. Aggressive obsessions are accompanied by a strong emotional outburst. There is a tireless desire to spoil any line with an unpleasant addition, to shout obscene, immoral phrases.

Imagery obsessions are classified as a separate group . These include obsessive thoughts and memories.

Intrusive thoughts are expressed in a long internal monologue on meaningless topics. A long chain of conclusions is born in the head, which does not lead to productive conclusions.

Such thoughts are so stupid that they are called “mental chewing gum”!

Fruitless obsessive reasoning within oneself is comparable to reasoning. The main difference is the patient’s critical attitude to his reasoning during obsessions.

A woman, walking down the street, thinks: who will I meet first among the passers-by, will it be a man or a woman? If a woman, what kind of haircut or long hair? Perhaps the first I will see is a man. Which direction will he go from? Such a series of questions/answers can continue for a long time in the patient’s head. Useless reasoning prevents you from focusing on significant events.

Intrusive memories force a person to systematically return mentally to a specific, already accomplished event that is insignificant or unpleasant.

What to do if you have causeless anxiety and worry

It's hard to live in constant stress. If you are experiencing causeless anxiety and fear, the following list will tell you what to do:

1. Talk to someone you trust. This could be a relative, a close friend, a psychotherapist or a helpline employee. People are social creatures, so communication is a good way to relieve internal stress.
2. Find a way to calm down quickly. There is not always someone nearby with whom you can share. Therefore, it is important to find a suitable method that will help you relax: breathing techniques, soothing music, aromatherapy, self-massage and more. If you cannot independently choose a technique that quickly helps with anxiety for no reason, a specialist will tell you what to do.
3. Add physical activity to your life. It is a natural and effective remedy for anxiety. Moderate exercise relieves tension, reduces stress hormones and strengthens the nervous system. Get at least 30 minutes of exercise every day.
4. Normalization of lifestyle. Get enough sleep, eat well, give up bad habits. This stabilizes physical performance and neurotransmitter levels, which helps maintain emotional balance.
5. Start keeping a journal. Taking notes can help you identify patterns of anxiety flare-ups, understand the causes, and spot early signs of them. Also, thanks to this, you will begin to focus more on positive events that you may not have noticed before.

When worried for no reason, everyone who regularly encounters this wants to know what to do. There is no universal method, but the 5 steps listed above are recommended for every person with increased anxiety. This may be enough to alleviate symptoms. But if self-help techniques do not give the desired effect, then if you regularly experience anxiety for no reason, you need to find out what to do from a specialist.