Treatment of anxiety-depressive disorder Moscow

Clinical manifestations

Anxiety-depressive disorder is a neurotic disease in which disorders of the nervous system and internal organs appear. The disease is difficult to diagnose because its symptoms resemble many mental and neurological pathologies.

Experts divide symptoms into clinical manifestations from the nervous system and vegetative symptoms from internal organs. The first clinical manifestations are mild and the patient does not attach any importance to them. Memory deterioration and decreased concentration are observed.

After some time, problems with sleep appear, persistent insomnia is noted, which leads to the development of other disorders. The patient becomes irritable, his mood changes sharply, and mental performance decreases sharply.

The most important clinical manifestation of the disorder is considered to be a constant feeling of anxiety for no apparent reason. It seems to the patient that something terrible and irreparable will happen soon. He retains a persistent feeling of impending disaster.

These manifestations not only disturb sleep, but also affect the patient’s behavior. He becomes suspicious, aggressive, and avoids communication even with close relatives. Gradually, anxiety becomes the most important symptom of the disorder, while other symptoms appear less pronounced. It hurts quickly, but physical fatigue is much less than emotional.

When the process lasts for a long time, there is excessive concern for loved ones. The patient constantly feels that his family is in for some kind of trouble that he cannot prevent. This only worsens the situation, the person’s behavior becomes inappropriate.

Post-traumatic stress

PTSD develops after a painful and frightening event (trauma) that involves physical pain or the threat of pain. A patient who suffers from the disorder may have been hurt by another person, or witnessed a traumatic incident that happened to a loved one or a stranger.

Post-traumatic stress is often associated with war veterans, but it can be caused by traumatic events of a completely different nature:

• aggression
• rape
• torture
• kidnapping
• captivity
• child abuse
• traffic accident
• explosions
• natural disasters such as floods or earthquakes

Those suffering from post-traumatic stress may:

• suddenly get scared
• become emotionally insensitive (especially towards people who were closest to them before the trauma)
• lose interest in activities they enjoyed
• unable to show love
• become irritable
• become more aggressive or even violent

Patients avoid situations that remind them of the traumatic event, and anniversaries often create many problems. It appears that PTSD symptoms are more severe if the triggering event was deliberately caused by another person, as in the case of robberies and kidnappings.

First signs

Anxiety-depressive disorder (symptoms and treatment concern patients of all ages) does not develop suddenly. In most cases, the first signs do not cause concern, and the patient attributes them to manifestations of stress or overwork.

The most common symptoms:

• Waking up several times during the night for no reason.
• Deterioration of mood at the slightest trouble.
• Too strong a reaction to external stimuli.

After some time, the patient notes that sleep has become shallow, short and restless. This worsens his well-being and mood, causing headaches. It is worth noting that such pain is not relieved by conventional analgesics, which also makes the patient more irritable.

Possible consequences

Generalized anxiety disorder, or rather its somatic manifestations, can be indirect causes of the development of a number of real independent diseases. It even happens that the patient does not attach much importance to increased anxiety and unjustified excitement. At the same time, he goes to a medical institution, complaining about:

• disorders of the gastrointestinal tract;
• allergic reactions;
• pathologies of the respiratory system;
• cardiovascular diseases;
• frequent headaches or migraines;
• blood pressure surges;
• skin rashes and infections;
• joint diseases.

Reluctance to accept any kind of uncertainty develops into a constant expectation of something bad. The brain simply gives out its reaction to the stimulus, without analyzing the situation at all. This anxiety is so mentally exhausting and tiring that a person does not want to do anything. Even banal household chores are accomplished with great difficulty and force. There is a risk that GAD will eventually be joined by a depressive state.

Symptoms

As the disorder progresses, manifestations from internal organs and systems appear.

The most pronounced autonomic disorders:

• Tremor of the limbs and trembling throughout the body.
• Increased heart rate and cardiac arrhythmia.
• Shortness of breath even with slight physical exertion.

• Frequent urge to urinate.
• Painful sensations in the solar plexus area, reminiscent of the discomfort that occurs with angina pectoris or coronary heart disease.
• Increased work of the sweat glands, which manifests itself in the form of constantly wet palms.
• Feeling of a “lump in the throat.” The manifestation is often confused with a symptom of hyperthyroidism with an increase in the size of the thyroid gland.
• Disorders of the digestive tract in the form of pain in the abdomen, loss of appetite and upset stool. However, symptoms may vary from patient to patient. Some talk about constipation, others talk about frequent loose stools.
• Pain in joints and muscles.

It is worth noting that in patients suffering from any chronic diseases of internal organs, there is a deterioration in the course of these pathologies and a significant worsening of symptoms.

The relationship between anxiety depression and panic attacks

Anxiety disorder is often associated with panic attacks because the symptoms resemble this neurological disorder and are often treated with similar medications.

The main relationship is that with constant anxiety and depression, the patient will certainly develop panic attacks. It is worth noting that they manifest themselves differently in different patients. As a rule, panic attacks develop with a long course of anxiety-depressive disorder and the addition of symptoms from the nervous system.

Prevention and prognosis

Despite the severe symptoms, anxious depression is quite treatable, so the prognosis for this disease is favorable. However, patients should be prepared for the fact that drug treatment cannot guarantee the absence of relapse of the disease in the future. Prevention is necessary to prevent depression from reoccurring. It lies in the ability to cope with stress and maintaining a daily routine. Patients with anxious depression are recommended to visit a psychotherapist at least once a year.

Forms of anxiety and depressive disorders

There is no generally accepted and approved classification of anxiety-depressive disorders. However, experts conditionally divide the pathology into several forms depending on the severity of a particular symptom.

In addition, doctors distinguish 3 stages of the disease depending on the degree of its neglect. At the initial stage, only mild symptoms of the nervous system appear in the form of irritability and sleep disorders. At the progressive stage, the manifestations worsen, and violations of the internal organs are added.

The advanced stage is accompanied by an increase in anxiety and restlessness, and a worsening of the symptoms of the previous stages. In this case, there is a drop in self-esteem, pronounced apathy, a sharp change in mood with a predominance of negative emotions.

Differences from psychosis

Anxiety-depressive disorder (symptoms and treatment are often interrelated, since medications are selected depending on the severity of manifestations) at an advanced stage are often mistaken for psychosis. But experts note that the latter condition has some signs that are absent in anxiety syndrome.

In psychosis, symptoms appear suddenly, but immediately after some severe stress. The patient cannot control his actions, all emotions are clearly manifested. Symptoms from the internal organs are also present, but appear only when the condition worsens.

This means that headaches, increased blood pressure and increased heart rate are observed only during periods of panic. Excessive motor activity during psychosis also appears only during periods of exacerbation.

With anxiety-depressive disorder, the patient is often passive, interest in life is weak, and symptoms from the internal organs are constantly present.

Mantras for treating panic attacks

In recent years, the treatment of panic attacks with the help of mantras has increasingly come to the fore. There are many mantras, including several that have been popularized to such an extent that they can easily be found on the Internet. The mantra called “So-ham” is especially famous. (Inhale - “So”, exhale - “Ham”). It is done quite simply. The main task is to hear the vibration of the air in your sound, to merge inhalation and exhalation, and both sounds together.

In addition to the profound effect on the human body as a whole, which is attributed to the mantra as a unique ritual, it normalizes breathing and distracts a person from the symptoms of panic. And distraction techniques are the most effective method of overcoming a panic attack.

Not only panic attacks themselves, but also anxiety disorders as such, respond well to treatment with mantras. In the future, having mastered several mantras, you can move on to the techniques of meditation and yoga, which will certainly help change your consciousness, clear your mind of disturbing thoughts and get out of the grip of neurosis forever.

Main risk factors

The disorder is considered a disease of our time, since a person today is daily exposed to various nervous stresses that disrupt the normal functioning of the body.

Stress

Stressful situations accompany modern people constantly. Troubles at work, a busy schedule and a lack of balance between work and rest certainly lead to anxiety.

Gradually, this state becomes habitual for a person. He does not feel relief even during rest or after completing any important task.

Lack of work

Despite the stress associated with intense work, the lack of a permanent position also leads to the development of the disorder. A person constantly experiences anxiety and fear for the future of his family. As a result, nervous tension turns into a serious illness, which gets worse if a person fails to solve the problem over a long period.

Drugs and alcohol

Patients who regularly and in large quantities drink alcoholic beverages, as well as drugs, suffer from anxiety-depressive disorder much more often than people leading a healthy lifestyle.

Unfavorable heredity

Many mental illnesses are hereditary. In anxiety-depressive disorder, the hereditary factor also plays an important role. Family history is considered the first factor that is taken into account when diagnosing the condition.

Elderly age

In patients over 60 years of age, the risk of developing this disorder increases. This is due to the deterioration of the nervous system, the death of neurons in large numbers. In addition, anxiety and other symptoms more often appear in patients who suffer from any chronic pathologies of internal organs.

Low level of education

It is generally accepted that people with higher education suffer from mental disorders much more often. However, this rule does not always work.

Doctors note that uneducated patients are more likely to worry because they cannot explain many things.

Severe somatic diseases

Depression is more common in patients with chronic illnesses.

Physical discomfort provokes a deterioration of the condition; in addition, the patient worries about his future, since he cannot predict how the disease will develop.

Reasons for development

Reasonable fear is, of course, an integral part of everyday life. The instinct of self-preservation is formed on it. But at some point it gets out of control, and a person is no longer able to control it.

All our fears come from childhood. Impaired perception of stressful situations is a consequence of incorrect presentation of information from parents to the child, protection from conflicts and troubles, and excessive care.

The impetus for the development of pathology can be:

• consequences of injury;
• severe, long-term illness;
• divorce of parents or long separation from one of them;
• death of a loved one;
• violence;
• fighting.

In a word, such moments in life, when a person is on the verge of despair and has nowhere to get the necessary support, give rise to the development of generalized anxiety disorder. Characteristic symptoms appear gradually in adults, developing over time and getting out of control.

If a child has not learned basic concepts of safety since childhood, then the likelihood of progression to uncontrollable anxiety increases significantly. The task of parents and other relatives is to teach the child to believe in his own strength and not be afraid of uncertainty. Intimidation, threats and other similar methods of influence are absolutely unacceptable when communicating with children.

Experienced violence of any kind: moral, physical, sexual, never passes without a trace. Similar sensations are experienced by a person who takes direct part in military operations or who becomes an involuntary witness to them. The psyche is failing, and you can’t do without the help of a specialist.

Bad habits are also provocateurs of anxiety. Alcohol and drugs distort the perception of real events. All feelings are heightened, while the instinct of self-preservation, on the contrary, is dulled. During an attack of unjustified anxiety, a person is capable of committing inappropriate actions.

Establishing diagnosis

Anxiety-depressive disorder (symptoms and treatment are determined by the doctor based on the patient’s emotional state) is quite difficult to diagnose at an early stage. When the course is advanced, diagnosis becomes easier.

Analyzes

There are no special tests that could confirm the presence of the disorder. However, the standard examination includes a complete blood count. The method helps to detect general abnormalities and signs of inflammation.

Additionally, the patient donates blood for biochemical testing. Elderly patients are prescribed a blood test to check their cholesterol levels, and their tendency to develop blood clots is also determined. Women of reproductive age are prescribed a blood test to determine the level of sex hormones and thyroid hormones.

Instrumental diagnostics

Instrumental methods are used to confirm the diagnosis.

The most effective of them:

• Ultrasound of internal organs is performed to exclude somatic pathologies. The specialist examines the liver, kidneys, gallbladder and pancreas. Sometimes a bladder diagnosis is required.
• X-rays are also necessary to exclude pathologies of the spinal column. Additionally, the doctor may examine the bones and joints.
• Electroencephalography or brain diagnostics is necessary to rule out epilepsy, the symptoms of which resemble an anxiety disorder.
• MRI is a universal method in which the brain and internal organs are studied to identify abnormalities.

Thanks to instrumental diagnostics, the doctor can exclude or confirm the presence of associated abnormalities.

ECG

An electrocardiogram is considered a mandatory diagnostic method. At the same time, the work of the heart is studied and any deviations are noted. Typically, young patients have no symptoms, but with the development of anxiety-depressive syndrome, the heart rhythm is disturbed and tachycardia is observed.

Differential diagnosis

Differential diagnosis is considered the most important in the examination.

It involves identifying pronounced signs and differences from other disorders with similar symptoms:

• In depressive syndrome, the signs of depression are more pronounced than in anxiety-depressive disorder.

• If the disorder is generalized, anxiety symptoms significantly worsen the general condition.
• Somatoform disorder provokes signs from the internal organs, but neurological symptoms are less pronounced.
• In bipolar disorder, the patient periodically experiences manic episodes, and signs of depression are more pronounced.

In addition, doctors note that with anxiety-depressive disorder, the patient’s quality of life suffers much more than with other diseases.

Multifaceted anxiety disorder: neuroses with panic attacks

We have all experienced anxiety more than once—excitement before an important meeting for us, a final exam, or an important presentation. But what is this feeling really? Anxiety is our body's way of preparing us to take on a challenge. Our heart pumps more blood, saturating the body with oxygen - and it is ready to act. We become alert and more effective at solving physical and emotional problems. It's natural to feel anxious when our safety, health, or happiness is threatened. However, sometimes anxiety can become overwhelming and destructive and come out of nowhere. Excessive, prolonged anxiety attacks may reflect a person's developing anxiety disorder with accompanying panic attacks.

Relief of acute attacks

During the acute stage, patients develop panic attacks or seizures. They are usually relieved with the help of sedatives and some psychological techniques. It is important for patients and their relatives to remember that attacks are not dangerous and cannot provoke any serious complications.

Algorithm of actions during an attack:

1. Sit or lay the patient down.
2. Provide access to fresh air.
3. Unbutton tight clothing.
4. Establish visual contact with the patient.
5. To reassure the patient with words, you need to speak slowly, the tone should be calm and confident.
6. Give the patient water.
7. Offer the patient a mild sedative, for example, 3-5 Valerian tablets, or motherwort tincture. The dosage in each case is determined individually.

If all these actions do not lead to improvement, you should call a doctor.

Symptoms of panic disorder

Let me remind you that panic disorder is the repetition of panic attacks on a regular basis, which is accompanied by all the inconveniences of a person’s life, subject to constant fear of new attacks. There are people for whom panic attacks are reduced to isolated incidents in their lives. For example, one person told me that the attack happened a long time ago when he was riding in a minibus. But it never happened again. Therefore, it cannot be said that such a person suffers from panic disorder; nevertheless, he had a panic attack.

For such people, this is expressed in isolated episodes, so they are unlikely to turn to specialists or read articles on the Internet. Therefore, with a high degree of confidence, we can say that patients of psychiatrists and psychotherapists, readers of this article, are faced with panic disorder (which may be accompanied by symptoms of anxiety disorder, depression, obsessive thoughts, etc.), because it is this disorder that causes problems in life, and, one might even say, is characterized by the presence of these problems. Although, of course, everyone is accustomed to saying “panic attacks,” since this is the most striking symptom of this illness. But such a definition should not be misleading. It should be clear that a person experiencing panic disorder may experience more than just the symptoms of panic attacks per se.

Treatment of anxiety-depressive disorder

Anxiety-depressive disorder (symptoms and treatment should be discussed with a specialist so that he can prescribe the most effective therapy) is treated with medications, physical therapy and psychotherapy methods.

Psychotherapy

Depending on the course of the pathology, 2 methods of psychotherapy are used. For frequent panic attacks, psychotherapists practice cognitive behavioral therapy. With this method, at each session the specialist teaches the patient to control his thoughts and suppress fear that arises for no apparent reason.

Methods may vary depending on the characteristics of each person. Some people are helped by visualization, in which fear is locked in an improvised virtual box in the person’s subconscious. At the slightest manifestation of anxiety, the patient creates a picture in his head that allows him to cope with panic.

In the absence of panic attacks and the sluggish course of the pathology, auto-training is used, that is, the technique of self-hypnosis. The patient visits a psychotherapist 3 times a week for several weeks. At each session, the specialist helps the patient to believe in self-hypnosis, which ultimately leads to cure.

Medicines

To treat a disorder with regular panic attacks, medications from different groups are used. Tranquilizers help calm the patient, normalize the transmission of nerve impulses, reduce the symptoms of depression and completely eliminate anxiety. Prescribed for long-term illness and lack of effect from psychotherapy.

The most effective means:

• Phenazepam The effect is due to the presence of the active component of the same name. Prescribed in short courses of 2-4 weeks. Helps improve the patient's condition and eliminate the most pronounced signs of the disorder. The medication should not be used if you are allergic to its components or during pregnancy or lactation. The medicine is not prescribed for respiratory failure and shock.

  
  Phenazepam is a tranquilizer used to suppress attacks of anxiety and depression.

• Relanium is a diazepam-based solution that has a pronounced muscle relaxant and sedative effect. Helps cope with a panic attack, relieves acute symptoms. Not used during pregnancy and breastfeeding, angle-closure glaucoma.

Antidepressants are used in combination with tranquilizers, but in long courses of 4-8 weeks, which is associated with a cumulative effect. These remedies normalize sleep, improve mental activity, and eliminate anxiety. For panic attacks, the remedies are indispensable, but sometimes they are also used for the sluggish course of the disorder.

Effective means of this group:

• Amitriptyline contains the active ingredient of the same name. Used for neurological disorders, depression and other disorders. Not prescribed for allergies to components, during lactation and pregnancy.
• Doxepin is used for panic attacks and severe pathology. Contains doxepin as the main component. Contraindicated in case of prostate adenoma, pregnancy and lactation. Not used for myocardial infarction, severe damage to the liver, kidneys and hematopoietic system.

Beta blockers are used to reduce heart rate, slightly lower blood pressure and normalize heart rhythm. Usually prescribed for panic attacks. The most commonly used are Atenolol and Propranolol. The medicines contain the same components. They are prescribed in short courses of 10-14 days.

Beta-blockers are not used for cardiogenic shock and chronic heart failure, as well as for bronchial asthma. They are contraindicated during pregnancy and lactation.

Homeopathy

Homeopathy is not used for panic attacks, but is very effective for the sluggish course of the pathology, as well as in its initial stages.

The most commonly used medications are:

• Traumeel S is a homeopathic remedy based on a complex of plant components. Has a general strengthening and tonic effect. By improving well-being, the manifestations of the disorder are weakened. The tablets are taken for 4-8 weeks. Do not use the medicine if you are intolerant of its components, as well as severe damage to the blood system.
• Belladonna – a homeopathic preparation containing an extract of the plant of the same name. Often used for mild anxiety and depressive disorders, it helps reduce symptoms. Do not use if you are allergic to the components of the composition.

It is worth noting that for panic attacks, prescribing medications is not advisable.

Physiotherapy

Among physiotherapeutic methods, it is worth highlighting therapeutic massage and electrosleep. These procedures relax the patient, improve sleep, and normalize the psycho-emotional state. They are carried out in a medical institution 3 times a week for 1-2 months, depending on the severity of symptoms.

For panic attacks, physiotherapy is not used, but can be prescribed after they have stopped.

Other methods

Additional therapies include lifestyle changes. The patient is recommended to start a hobby. Any activity that brings pleasure can distract a person from anxious thoughts. If the process of avoiding negativity takes hold in the patient’s brain, then the risk of relapse of the disease will significantly decrease.

Additionally, doctors recommend playing sports. It is not necessary to exhaust the body with heavy exercise, but swimming, slow running or daily walking will help significantly improve the patient's condition.

If the physical symptoms disappear, the psychological symptoms will also become less severe. It is worth noting that today there are no radical treatment methods that will help instantly cope with the disease.

Who needs help

Specialists at the Preobrazhenie Clinic understand that people who experience high daily stress levels when performing work and personal duties are most susceptible to anxiety-depressive disorder. At the same time, such people face many obstacles when seeking help from specialized organizations. People with the following professions are most susceptible:

• police officers;
• military;
• judges;
• bailiffs;
• teachers.

Surprisingly, this category also includes housewives who raise children and keep order in the house. This work carries increased responsibility and the person experiences high psycho-physical stress. In addition, people holding responsible positions in government organizations or private firms, on whose decisions the well-being of the state of affairs depends, also come under high stress load.

Our programs offer specialized services to restore psychological well-being and combat the development of alcohol and drug addiction. They are designed specifically for men and women in uniform and in a complex psycho-emotional atmosphere, with a high level of responsibility. Various options for recovery care are available, both outpatient and inpatient.

Day hospital rehabilitation program

This day outpatient program allows the patient to develop skills and ability to function in challenging stressful situations. People cope better with difficult life circumstances. In this case, special methods of cognitive behavioral therapy are used, and the skills of dialectical behavior therapy of a wide range are used. This therapy is typically used for mood disorders, anxiety disorders and depression, personality disorders, bipolar disorder, and substance use disorders. An outpatient rehabilitation program is important as a gradual transition from acute inpatient care to normal functioning. It is often used as an alternative to hospital treatment in mild cases of nervous system disorders.

Call us at +7495-632-00-65 for world-class options for adults and teens.

Other treatment programs for anxiety and depressive disorder

We have prepared treatment programs for anxiety-depressive disorder in cases where the patient has previously been treated, but the previous therapy had no effect.

Our specialists encounter such situations quite often. It is in such cases that patients are very wary and distrustful of the upcoming treatment. The programs are specifically designed for patients at different stages of therapy and recovery. Such programs are often used for adolescents during the “acute age” period. It provides intensive, short-term and focused support for young people under 19 years of age with emotional and behavioral difficulties. The duration of active therapy involves a stay in the clinic of 10 days. The program is aimed at stabilizing the situation in conditions of an acute crisis.

Folk remedies

Alternative medicine recipes usually involve taking herbal formulations that help calm the patient and improve sleep.

Motherwort tincture is prepared from 100 ml of alcohol and 20 g of crushed herbs. It must be infused for 2 weeks, then filtered and taken 20 drops 2 times a day. Course duration is up to 3 weeks.

A decoction of mint and lemon balm can be prepared from 500 ml of water, 3 g of dry mint leaves and the same amount of lemon balm. Cook the mixture for 5 minutes, leave for 1 hour.

Take 200 ml of filtered decoction before bedtime, repeat for 10 days in a row.

Chamomile infusion is also considered a mild sedative. You can get it from 5 g of dry raw materials and 350 ml of boiling water. Infuse the product for 20 minutes, filter and take before bed. Course duration is 10-14 days.

Complications and consequences, prognosis

If the disease is detected in a timely manner, the prognosis is favorable. More than 65% of patients recover completely within 6-8 months. When the disorder is advanced, the disease becomes chronic.

Usually the condition does not provoke serious consequences. A chronic course can only lead to changes in a person’s character. He becomes distant, avoids society, and reduces contact with other people to a minimum. In addition, a person’s interest in life disappears. The most serious consequence is the appearance of suicidal thoughts, which can lead to a suicide attempt.

Anxiety-depressive disorder is a fairly common disorder today, the symptoms of which significantly worsen the patient’s quality of life. When the first signs appear, it is recommended to immediately visit a doctor for examination and treatment.

Article design: Vladimir the Great