Anxiety Depression Treatment

What is Anxiety?

Anxiety has long been recognized as a prominent symptom of many psychiatric disorders. It was Freud (1895b) who first suggested that cases with mainly anxiety symptoms should be separated under the name of anxiety neurosis

Freud's original anxiety neurosis included patients with phobias and panic attacks, but subsequently he divided it into two groups. The first, which retained the name anxiety neurosis, was for cases with mainly psychological symptoms of anxiety; the second group, which he called anxiety hysteria, was for cases with mainly physical symptoms of anxiety and with phobias.

Thus anxiety hysteria included the cases we now diagnose as agoraphobia. Freud originally proposed that the causes of anxiety neurosis and anxiety hysteria were related to sexual conflicts, though he later accepted a rather wider range of causes. By the 1930s most psychiatrists considered that a very wide range of stressful problems could cause anxiety neurosis.

The components of the anxiety response are summarized as follows.

Psychological components - The essential feelings of dread and apprehension are accompanied by restlessness, narrowing of attention to focus on the source of danger, worrying thoughts, increased alertness (with insomnia) and irritability (that is a readiness to become angry).

Somatic components - Muscle tension and respiration increase. If these changes are not followed by physical activity, they may be experienced as muscle tension tremor, or the effects of hyperventilation.

Autonomic components - Heart rate and sweating increase, the mouth becomes dry, and there may be an urge to urinate or defecate.

Anxiety Disorders and Obsessive Compulsive disorders

The relationship between obsessive-compulsive disorders and anxiety disorders has been and remains uncertain. Freud thought at first that

phobias and obsessions were closely related. He proposed later that anxiety is the central problem in both conditions and that their

characteristic symptoms - phobias and obsessions - resulted from different kinds of defence mechanisms against anxiety. Others considered that obsessional disorders were a separate group of neuroses of uncertain etiology. As explained above, this division of opinion is reflected today in the two major classification systems. As explained above, obsessive-compulsive disorders are classified as a subgroup of the anxiety disorders in DSM-IV, whilst in ICD-10, anxiety disorders and obsessive-compulsive disorders have separate places in the classification.

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