We know that after the Pandemic, anxiety symptoms have increased in the general population and, therefore, consultations. What is the reason for this increase in cases?
The increase in cases of Anxiety during the pandemic has increased considerably in all ages. The causes of this increase are due to different variables: at the beginning of the pandemic there was a lot of uncertainty about what Covid-19 was, what it could cause in the short, medium and long term. Added to that, the confinement during the Quarantine, where we had to get used to doing absolutely everything in the same square meters (working, studying, eating, sleeping, hygiene) and living 24 hours a day with our family members. The lack of routine generates disorder in our habits, such as sleep, eating, physical activity, work, academic and social activity. And all this is what causes Anxiety to explode at a symptomatic level on the physical side. (from palpitations, shortness of breath, sweating, dizziness, fainting, headache, nausea, diarrhea, etc.) and cognitive (obsessive thoughts, fear of death, losing control, going crazy, getting sick). And all these issues condition behavior, such as not wanting to leave the house, fear of taking public transportation, or simply going outside for fear of decompensating and not being able to get the necessary help.
What are the symptoms most frequently reported by patients who come to consultation and how do they affect their quality of life?
Within the great world of Anxiety Disorders, symptoms can be very variable. But, in general, patients arrive at the consultation mentally and physically exhausted. He “doctor, I don’t give any more”is a phrase that is heard frequently in the office. The habit of poor sleep (from falling asleep or maintaining sleep) is a very common symptom in anxiety disorders, in addition to the immense range of physical symptoms and ruminative thoughts, which generate a lot of distress and alterations in the different activities of the body. daily life of the person.
What factors indicate that Anxiety has become a Disorder?
Like any psychiatric condition, When the patient’s quality of life begins to alter in various spheres (work, academic, personal, family and social) and when the symptoms become more frequent and intense, we can say that an Anxiety Disorder is constituted. Then, according to the prevalence of symptoms, it can be a Panic Disorder, a Generalized Anxiety Disorder, Social Anxiety Disorder, Specific Phobias, Obsessive Compulsive Disorder, etc.
What factors can contribute to the increase in symptoms? And which ones can help neutralize it?
The increase in anxious symptoms can be generated by external factors of daily life, such as: the economic situation, family conflict, health problems of a loved one, work problems. And, on other occasions, they can increase due to having what in Psychiatry we call “medical comorbidities” (which is when, along with the Anxiety Disorder, the patient has another clinical illness, for example, Diabetes or High Blood Pressure), or “psychiatric comorbidities” ( It occurs when there is a diagnosis of two psychiatric pathologies, for example, Anxiety Disorder together with problematic use of psychoactive drugs or alcohol, or a Personality Disorder).
The symptoms can be neutralized with appropriate psychiatric treatment, where mostly, depending on the symptoms present in the patient, medications that are within the SSRI (Selective Serotonin Reuptake Inhibitors) are indicated. In many cases, at the beginning of the treatment, indicated together with Anxiolytics, since SSRIs have an onset of action of 15, 20 or 30 days. CBT (Cognitive Behavioral Therapy) also generates many tools for patients to use in their daily lives that help neutralize anxiety symptoms. And also, other activities such as: practicing physical activity frequently, Meditation, Yoga, and doing activities that give the patient pleasure (reading, watching a movie, gardening or some artistic activity, going out with friends) are also important as part of the treatment.
Is pharmacological treatment always necessary? What other indications can be suggested?
Pharmacological treatment is not always necessary. It is only indicated when, despite undergoing therapy, the patient’s symptoms persist or worsen, altering the patient’s quality of life.
It is always good to suggest that the patient take care of their physical health, which is why in the first consultation I always request a general check-up to rule out any medical illness that could be generating psychiatric symptoms. In addition to always always encouraging the patient to do physical activity. It is scientifically proven that frequent physical activity is a “natural anxiolytic, that is, it reduces anxiety.
Ivanna, what advice would you give to a person who suffers from anxiety and does not consult a Mental Health professional out of fear or shame?
Don’t stop taking care of yourself, and the best way to do it is by prioritizing Mental Health.
Unfortunately, we live in a society where there are many prejudices about consulting or starting psychiatric treatment. And just as if we have a fracture, or if we have high blood pressure or recurring headaches, we consult with a specialist, it should also be done when we realize that our emotional and/or mental part is not well.
Like health in general, the more one lets it go, the more difficult it is to find improvement and daily functionality.
Being able to ask for help does not make us weaker, but stronger, because we recognize our limitations and our weaknesses, and that is what it means to be brave. Recognizing a problem is the beginning of a change, and sometimes we cannot do it alone, and that is why it is so important to raise your hand and ask for help. Because Mental Health really matters.
DR. IVANNA MELONI CAFARELLI – MN129.301
PSYCHIATRIC PHYSICIAN
ESP. IN ANXIETY DISORDERS
NEUROSCIENCES AND HIGH PERFORMANCE SPORTS
Htal. Pirovano
Scientific Secretary of the APSA Anxiety Disorders Chapter
IG: @dra.ivanameloni
by CEDOC