Fear, anxiety, panic are among the most common psychological conditions. Any stresses and experiences cause anxiety, fears. And in our unstable time everything more people experience these conditions. Some people can quickly and independently cope with their fears and anxieties. And others cannot cope, and these states begin to influence their life, sometimes turning it into a nightmare. Then fear becomes obsessive, it haunts a person, causes panic, becomes the cause of mental disorders.

However, there are also positive aspects of anxiety and fear - they warn us of real dangers, the possibility of injury, pain. It's normal for a person to be nervous about going to an exam or worried about arriving on time for an important meeting.

Fears, anxieties, panics are a large group of different states, united by the emotions of fear and anxiety, with corresponding thoughts and often accompanied by various sensations in the body.

Fears (phobias)- this is a negative emotional experience that a person experiences when meeting with a specific threat or while waiting for it. They can relate to anything: movement, transport, living and non-living beings, etc. The most common phobias are the fear of being outside the home, the fear of people (crowds), fears related to illness (including “going crazy”), as well as fears of traveling in transport (often in the subway), etc. The degree of manifestation of these fears is strong differs. For example, the vast majority of people, to one degree or another, are afraid of flying on airplanes, but at the same time, people usually cope with this fear and this subsequently does not affect their lives. But when fears turn into an independent psychologically difficult problem, they begin to actively interfere with the normal course of a person’s life, limiting it. To live such a life filled with fears, a person spends a lot of energy, loses health. In addition, depression, feelings of guilt and shame are often mixed with phobias, which greatly aggravate the condition.

Alarm states(generalized anxiety disorder) is a state of almost constantly expressed anxiety that is not associated with a specific situation. Anxiety is a vague, prolonged and vague fear about future events. Anxiety is expressed in a person’s constant thoughts: fears “with or without”, the expectation of failures, “that it will only get worse”, “bad forebodings”, etc. It lasts most of the time for at least a few weeks in a row, sometimes turning into decades of life. All anxieties and fears are directed to the future. Often depression is mixed with an anxious state, and then not only the future, but also the past and the present are painted in gloomy colors. The anxious person becomes agitated, irritable, is on the verge of a breakdown, easily frightened, cannot concentrate, suffers from insomnia (“spinning” and disturbing thoughts do not fall asleep). Attacks of intense anxiety can be manifested by increased heart rate, rapid breathing, sweating, trembling, "sucking in the stomach", muscle tension, etc. This hard-to-experienced condition significantly worsens the quality of a person’s life, and in itself becomes a source of constant stress for them and their loved ones. In an effort to get rid of an anxiety state, people can abuse alcohol, which in turn often leads to the development of specific problems with its own range.

The most acute experiences of anxiety and fear are panic attacks (panic).

Panics (panic attacks)- these are short-term acute states of emotions of fear and anxiety in combination with various physiological and behavioral manifestations. It can be pronounced heart palpitations, cold sweats, feelings of suffocation, nausea, sudden muscle weakness. In a state of panic, a person, as a rule, has little or no control over his behavior and thoughts. The feeling of fear during a panic attack is usually very strong, although sometimes a panic attack is manifested only by bodily sensations - "panic without fear." At first glance, it seems that panic develops without any reason, "out of the blue." However, during psychotherapeutic work, certain thoughts and situations are identified that are “provocateurs” of panic attacks (use of transport, being in a crowd or confined space, the need to leave the house, etc.). A person who first encounters this condition is very frightened, begins to think about some serious disease of the heart, endocrine or nervous systems, digestion. He begins to "go to doctors" of various profiles (therapists, cardiologists, neuropathologists, etc.), trying to find out the causes of "attacks". Specialists, as a rule, prescribe various methods of diagnosis and treatment, which does not help. This gives the person the impression of the complexity and uniqueness of their disease, often leading to hypochondria (the belief that there is a severe incurable disease). In most cases, panic attacks are not limited to one attack. The first episodes leave a significant mark in the memory of a person. This leads to the emergence of anxiety "waiting" for an attack, thoughts about its inevitability, which in turn leads to the recurrence of panic. The repetition of attacks contributes to the formation of restrictive behavior, that is, the avoidance of potentially dangerous ones for development. panic attack, places and situations. Because of fear, a person is not able to leave the house or stay alone, dooming himself to house arrest, becomes a burden for loved ones. In the future, depression joins, which aggravates the course of the disease.

All these states can be combined into one group according to the mechanisms of occurrence and development, as well as the similarity of the impact on the life of a person suffering from them: they limit the thoughts, feelings and actions of a person, focusing his life around fears and anxieties.

Let's try to figure out how this happens. Fear is a natural innate reaction that protects us in case of danger. Therefore, to feel fear in a situation of real danger and stress is normal, and sometimes even necessary. The state of moderate fear causes the release of hormones (adrenaline, etc.), activates the work of muscles, increases breathing, speeds up thinking, etc., thus mobilizing the body to danger or stress. This mobilization helps to look for and find ways out of the current situations. Everyone can remember examples from their lives when fear mobilized their forces, and a person coped with a dangerous or stressful situation (exams, important events etc.). But the described mechanism works for the benefit only when the strength (intensity) of fear does not exceed the norm. With a higher level of fear, on the contrary, it “paralyzes” the body and the person feels helpless in front of the situation, often without even trying to resolve it. This reaction strong fear and helplessness can be fixed in the memory, subsequently forcing a person not to resolve situations of emerging fear, but to hide and avoid them. He begins to think about the fact that he cannot cope with his fear, about the many terrible consequences for himself and others, involuntarily exaggerating and "inflating" them. Under the influence of developed fear, a person does not analyze these thoughts, does not think about how real these dangers are. Gradually, the condition worsens, and fears begin to arise not only in specific situations, but even with some memories of them. Thoughts that “unwind” fear are quite typical: “it will become bad”, “I will die”, “I won’t cope”, “I won’t survive”, “what if ...”, etc. At the same time, a person, often realizing the inadequacy of these thoughts, cannot cope with them in any way. As a result, fears grow and limit life. To get rid of painful fears, a person begins to seek various ways avoid situations in which these fears arise. And here various obsessive thoughts, actions etc., called "protective rituals" (for example, "so that nothing bad happens" you need to pull the door handle five times when leaving the house). At first, this brings short-term relief. Then the ritual ceases to help and the next more complex ritual is required. As a result, rituals take a lot of time and effort, and become a significant problem in their own right. Human life remains filled with fears. The number of fears increases, and life becomes like a nightmare. I have repeatedly had to work with people who, for months and years, could not simply leave the house due to expressed fears.

What to do?

Most practicing psychotherapists immediately begin with the appointment of medications (usually antidepressants and tranquilizers, sometimes antipsychotics). In my opinion, this may be necessary only in the most extreme and difficult cases. Why?

1). There are no drugs that can change a person’s thoughts (and it is precisely the repeating circle of certain thoughts and memories that triggers these states), and the maximum that potent drugs (tranquilizers, antipsychotics) can do is to suppress all thoughts for a short time (including those that cause fear). ).

2). Any active drug has its own side effects, and sometimes they are significantly pronounced, and it is possible to predict their development in a particular person only with a certain degree of probability.

3). Taking drugs that suppress thinking (tranquilizers, antipsychotics) not only does not improve the quality of human life, but also interferes with Everyday life and serves as a source of increased danger for him (driving, working with moving mechanisms, responsible decisions, etc.). In addition, it interferes with full-fledged psychotherapeutic work.

4). The most commonly used drugs - antidepressants require long periods of admission (at least six months) and begin to fully work after about a month of admission. At the same time, they artificially change emotions, that is, they affect the consequences, and not the causes of disease states.

5). Even with the gradual withdrawal of long-term drugs, there is often a "withdrawal effect" with increased negative experiences and imbalance of emotions.

6). Long-term drugs can cause psychological dependence in a person, and tranquilizers can also cause physical dependence.

In my practice, the most effective method of working with these states is cognitive therapy. During the sessions, the patient learns to analyze thoughts that disturb him, to cope with the emotions of fear, anxiety, panic, depression, freeing himself from the nightmare of anxiety and discovering new facets in himself that contribute to the acquisition of inner harmony and development.

Come and let's walk this path together.

In this article, you will learn what fear, panic attacks, panic disorder and agoraphobia and how to learn to distinguish and understand these conditions.

Fear

Fear is an emotion given to us by nature for salvation and survival. If we do not experience fear, we will not be able to adequately respond to danger. For example, if you are walking down the street in the evening, and a robber jumps out from behind a corner, then fear makes you gather strength and run away or fight back. In the absence of this emotion, your survival would be in jeopardy.

And one more important point. Fear is given to us by nature for salvation, which means that it is absolutely safe. Yes, it is a very unpleasant emotion. It causes a lot of discomfort. We don't like to be afraid. But the main purpose of these sensations is to draw our attention to a situation that may be threatening to us.

What happens in the body when you are afraid?

To do this, we need to understand how our nervous system works. I will make it as simple and affordable as possible.

The autonomic nervous system has two branches: sympathetic and parasympathetic.

The sympathetic department mobilizes the body's resources for vigorous activity and joins in a period of danger. To this end, the adrenal glands produce activating hormones: adrenaline and norepinephrine. As a result of their action, the heart rate and blood pressure increase, the level of sugar in the blood rises, breathing quickens, muscles unconsciously tense. All these changes occur in order for a person to perform some action and save his life. In our burglar example, the person escapes by fleeing or self-defense. At the moment of his salvation, he does not pay attention to what is happening with the body, but reacts to the actions of the attacker.

After the situation is over, the parasympathetic department turns on nervous system. His task is to restore the body and the spent resources. The activation of the parasympathetic nervous system is associated with the process of relaxation and sleep. Under its influence, wound healing, stress reduction, energy accumulation occur.

Now imagine a different situation. Imagine a person who has not completed the task of his boss and understands that he is in for a scolding. He starts to worry about it. In this case, there is no real threat to life. After all, the boss will not put a knife to his throat. But the body reacts as if it were a real danger. The sympathetic part of the nervous system also turns on, adrenaline and norepinephrine are released, and the process is started. But there is no external threat to which attention can be shifted. There is only imagination in the head about scolding from the boss. There is no action to be taken. After all, you can’t run away from the boss and you won’t fight with him. At this point, a person may listen to their body and notice some of the symptoms that come with adrenaline. And he can perceive these symptoms as threatening. For example, heartbeat and breathing changes can be mistaken for the onset of a heart attack. Thus, a vicious circle of panic is formed.

Panic attack

A panic attack is an attack of intense fear that occurs during a period of non-danger. An attack can last from 5 to 30 minutes. The following factors could have influenced the onset of an attack: stress, lack of sleep, alcohol, etc.

Most people have experienced a panic attack at least once in their lives. If a person did not attach any importance to this attack, then panic attacks do not recur. But if a person is very frightened of their symptoms and began to perceive them as catastrophic, then there is a high probability that panic attacks will develop into a panic disorder.

panic disorder

Panic Disorder - Panic attacks can occur without any reason and last from 1 hour to several days. The person feels constant anxiety. Lack of energy and vitality.

What is panic disorder characterized by?

• Sudden recurring panic attacks.
• Fear of a possible recurrence of an attack, expectation of a recurrence of panic symptoms.
• Seizures are not explained by any other disease.

In panic disorder, a person begins to avoid the places where the attack occurs. For example, an elevator or subway. The brain remembers this information and you begin to avoid other places that cannot be quickly left. Today a person does not go down the subway, tomorrow he cannot be in a traffic jam, cinema, theater, supermarket. The brain begins to perceive all situations from the position of “you can escape”, “you can’t escape”.

If a person does not seek help, then panic disorder turns into agoraphobia.

Agoraphobia

Agoraphobia is a state of intense fear of open spaces. Forces a person to stay at home most of the time. A person feels helpless and constantly seeks the support of relatives or friends.

Conclusions:

• Panic attacks are based on fear.
• Fear is an unpleasant but safe feeling.
• Fear of one's symptoms causes panic disorder.
• Avoidance only aggravates the condition and leads to agoraphobia.

In order to quickly and effectively cope with all of the above conditions, you need to seek help from a professional who knows how to work with similar conditions. If you liked the article, then share it on social networks Victoria Repetskaya