Anxiety Disorders Essay

Anxiety Disorders

Introduction

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Anxiety disorder is the most widespread disease of XX century. It is a dangerous disease, which causes unfeigned suffering.

Anxiety disorders can be caused differently: by internal factors and by the external environment. That was researched by the scientists in the following scientific works: The authors of the given literature discuss and describe the reasons, representations and treatment of anxiety disorder caused by the external environment factors. They proved that not only physical state of the organism but the conditions of our life can be the reasons of anxiety disorder.

As a rule, psychologists and psychiatrists speak about light depressive disorder already at the presence of two typical symptoms and at least two additional symptoms. George Stewart in the “Nature of anxiety disorder states: “If there are all three typical symptoms and more than four additional, that state is already called heavy depressive disorder”.  “The psychotherapy held within several years, may not give effect in a case of endogenous anxiety disorder, as well as the most strong medicines are powerless at exogenous” (Clark 2005) Henry Black in his work “Psychology” states: “First step out of anxiety disorder is an attempt to reveal and realize the traumatic situation, the reason of anxiety disorder. You may do that yourself or with the help of the psychologist. Comprehension of the reason is a guaranteed victory over anxiety disorder.”
The importance of right diagnosis

The right diagnosis of the kind of anxiety disorder is very important. The right diagnostic of anxiety disorder and its kind is a guarantee of the right treatment. Presentations of anxiety disorder: increased or decreased activity of a person, inability to fall asleep or, on the contrary, excessive drowsiness; memory impairment and concentration of attention; the long periods of physical overactivity or inertness – indifference to himself or to others; feeling of inferiority, uselessness, fault; loss of ability to enjoy life; lowering of libido, repeating ideas about death; loss or, on the contrary, increase of weight, inexplicable physical weakness, constant feeling of weariness and lack of energy; lowering of appetite or constant feeling of hunger. Quite different treatment is used for curing of exogenous and endogenous anxiety disorder. Endogenous anxiety disorder is cured with the help of different medicines, which cannot be applied to exogenous anxiety disorder that needs to be cured with the help of conversation. Unfortunately, it is very difficult to define the right kind of anxiety disorder.

That is why it is very difficult to make distinctions. There are some of researchers who adhere to the point of view that anxiety disorders represent certain continued line, and there is no basic division into exogenous and endogenous anxiety disorders. Therefore, such doctors always use antidepressants in complex therapy. However, patients usually badly bear medicines with strong effect. It conducts to the irregularity of their taking and even to its termination. If anxiety disorder is environmentally caused it cannot be cured by using medicines, it needs special therapy. As it was mentioned above, anxiety disorder may have the same symptoms, but not the same reasons.

Most unreasonable fears are groundless, such as fears of worms, spies, speaking to an audience, meeting strange people. Unfortunately, such fears have a tendency to excess and influence the person’s emotional condition on a larger and larger scale. Some authors suggest that such situations that may produce no real harm derive from imaginary awful consequences of these situations, existing only in person’s mind. Thus, these negative ideas are associated in person’s mind with any similar situation, and this produces fears. For instance, a timid person imagines the situation when he meets someone and then he experiences a feeling of loss, not knowing what to say and how to behave. This makes the person more and more shy and closed. There is another example, described by the specialists. A large number of people are afraid of dark, although very few people faced a real danger in the dark. These are imaginary monsters or ghosts, that people are afraid of. Children start to be afraid of dark in the age when their imaginations is functioning and they may fancy possible dangers that are waiting for them in the dark, and these groundless fears remain when the children grow up. Thus, it is evident that the fears are produced by the person’s identity, by person’s imagination. (Abela 2002)

Patient’s needs and necessary care

There are various approaches to meet the needs and demands of the patients. A multidisciplinary team approach is one of these approaches, providing the possibility to care the patients better, compared to care provided by physicians to individual patients. In case this approach is implemented carefully, it has significant outcomes. As it is described by the specialists, “with a diverse group of healthcare professionals, such as physicians, nurses, pharmacists, dieticians, and health educators with the patient at the center of the team, the team can ensure treatment goals are maintained for chronic diseases”. (The Care Programme Approach) A multidisciplinary approach includes satisfaction and self-control of the patient, working out and advancing community support, mutual understanding, cooperation, use of various tools and technical mechanisms, use of computer system and, which is of a great importance, evaluating the results.

            Treatment therapy starts from identifying an idiosyncratic variant of such loop, carried out by the patient with a specialist’s assistance. As soon as client starts to realize that anxiety and fears derive from physical sensations and thoughts of negative nature, related to these sensations, the specialists start to apply various cognitive treatment procedures that help people deal with their erroneous interpretations of physical feelings. These behavioral and cognitive treatment procedures comprise determining observations that are harmful for patient’s emotional condition. This patient learns more about symptoms of ungrounded fears or anxiety and learns to recognize them. Behavioral procedures comprise bringing about sensations that cause fears, when a patient pays attention to his physical condition, or looking through word pairs that describe sensations that produce fears to point out the reasons of anxiety symptoms to appear. (McGinn 2007)

As far as the cognitive therapy is concerned, it has a special structure and duration for each special kind of mental disorder. A schedule is made at the beginning of a course of treatment, the process and the results are controlled within the process via observing changes in beliefs. Making up summaries during sessions also help in achieving understanding between a patient and a client. Sometimes a patient is prescribed special treatment exercises at home. (McGinn 2007)

Curing approaches and Cognitive therapy

There are various approaches in modern psychotherapy that are regarded as useful and effective. Some specialists prefer one of available methodologies; the others combine strategies and methods from several theories. Cognitive theory is one of the most popular theories that are used in the field of psychotherapy at present.

            The essence idea of cognitive therapy is to make a persons change their attitude to the things. One of the specialists that base their practice on the concepts of cognitive theory was Albert Ellis. He worked out Rational Emotive Behavior Therapy. This author stated that emotions derive from “an interaction between events in the environment and beliefs and expectations which we have”. (Simon 2006) Sometimes these beliefs are so powerful that they affect person’s emotional conditional. The purpose of emotive behavior therapy is to make these emotions less powerful and not badly influence person’s emotional condition. (Clark 2005)

            Another famous author who worked in the field of cognitive therapy was Aaron Beck. He worked out a special methodology and strategies to treat depression and anxiety that were based upon the conceptions of cognitive theory. Clients are to perform a dialogue within his inner world to define the patterns that are to be changed to improve client’s condition. Treatment strategies worked by Beck help a client to find out depressive beliefs and change his way of thinking. The commentators describe the essence of Beck’s approach as following: “According to Beck and Emery, the way we process information is governed by structures called schemata. These schemata are made up of rules for explaining incoming information, and for retrieving what we have already learned. They are capable of exerting powerful effects on how we experience and relate to the world. For example, the schemata of a person with a social phobia cause them to become anxious and avoidant by explaining incoming information and memories in terms of social threat. Treatment consists of correcting faulty or illogical thinking by repeatedly confronting cognitive schemata with discrepant information from role-playing and homework assignments.” (Abela 2002 )

            Modern medicine includes treating depression and anxiety with psychotherapy or medications, or combining both these treatments. The experiments and researches show that a combination of these two methods is mostly effective, especially because antidepressants rarely result in dependence. Companies that produce medicine encourage doctors to prefer medical treatment to psychotherapy, but there are cases in which referring to a specialist in psychotherapy is necessary. In case the person takes antidepressants and this brings no results, a visit to professional in mental health may be more effective. (Clark 2005)

            According to the cognitive theory, the reasons for depression, anxiety and worries appear due to several reasons:

Sometimes it is enough just to see a model of behavior to take it over, when a person expresses intense fears or nervous condition. Sensitive people often answer such behaviour the same way.
Sometimes a person inadequately estimates the situation and interactions with people around. People’s reaction is perceived as more negative that it has been, a person may have excessive feeling of fault for insignificant mistakes.

It happens when a person applies unreasonable expectations to an imaginary situation, and when something goes wrong in the person’s imagination, negative emotions make a person disappointed or in other way affecting his emotional background.

Such person may also imagine various situations of interacting with other people, and possible negative results of such interaction make the person afraid of communication. Self-critique grows and determines person’s behavior, his sense of guilt influences person’s actions and his viewpoints. (Beck 2004)

According to the concepts of cognitive theory, all unreasonable and reasonable fears or derive from person’s thoughts. Logical thinking should help the person tell the difference between these two fears, but in case the person feels frightened, it is hard to see distinctions between reasonable and unreasonable. In this situation solution will depend upon person’s capacity to recognize real dangers to avoid them and not pay attention to imaginary problems. Psychologists state that people are inclined to fear the situations where their ego may suffer, rather than the situations that may be physically dangerous for the person. As the specialists state, “ordinarily rational cognitive processes run amuck and exaggerate the dangers, as when beginning spelunkers think the cave will crash down on them or speakers fear the audience will think they are dumb or people avoid revealing their personal opinions and intimate feelings”. (Beck 2004)

Cognitive therapy combines treatment consisting of 10-15 sessions. This treatment is based upon conceptions of cognitive theory. According to these concepts, people experience anxiety because they are inclined to interpret slight physical feelings as signs of coming mental or physical disaster. For instance, palpitation may be regarded as the sign of coming heart attack. This abnormality has a cognitive nature, and it is supposed to create a loop, when such erroneous interpretation produces strengthening of physical feelings, which, in turn, leads to excessive fears and panic. (McGinn 2007)

From my observation more and more treatments seem to be now short term due finance issues and due to following multi-disciplinary team treatment plans. I think sometimes when working with patient for a short term can cause difficulties. From my research I have found that in the old days it was possible for a patient and a doctor to work together for a long period of time was more common. I believe that that working with patients in the long run can put the therapist in a better position. This gives the therapist a better opportunity to build a trusting relationship with the patient, make more concrete observations and a chance to explore images to a deeper extent. Also the therapist gets the opportunity to follow the patient’s progress of over the years. From my experience working at the day hospital I think sometimes it can be very difficult to run a group because short term patients can effect the turn over of the group which really impacts the dynamics of the whole session.

In art therapy especially when starting a group at first it can be an overwhelming experience being around other patients. Not knowing who they are why they are there and what art therapy group means can make them feel anxiety.

I think, in mental health it is very nice experience to have the opportunity to work with an individual for a long term. The sessions are less likely to be disrupted which gives the therapist and the patient to build a trusting relationship.

There are various approaches to meet the needs and demands of the patients. A multidisciplinary team approach is one of these approaches, providing the possibility to care the patients better, compared to care provided by physicians to individual patients. In case this approach is implemented carefully, it has significant outcomes. As it is described by the specialists, “with a diverse group of healthcare professionals, such as physicians, nurses, pharmacists, dieticians, and health educators with the patient at the center of the team, the team can ensure treatment goals are maintained for chronic diseases”. (The Care Programme Approach) A multidisciplinary approach includes satisfaction and self-control of the patient, working out and advancing community support, mutual understanding, cooperation, use of various tools and technical mechanisms, use of computer system and, which is of a great importance, evaluating the results.

Art therapy

Individual art therapy settings are based upon individual approach, accounting individual needs and demands. Images or other works of art that are made by individuals involved in art therapy can then become a starting point for further discussions, that often involve the issue that wouldn’t appear otherwise. (Clark 2005) As soon as visual images may serve for multiple purposes, revealing contradictory ideas of the personality, feelings and emotional background, art therapy provides the patients with comfort and help in their lives. Art helps people examine their own thoughts and feelings from new angles of vision, and this could be impossible without art therapy. “Art provides a balance for feelings, thoughts, and experiences. It is this balance which provides hope and nurturing” (Clark 2005) From my observation more and more treatments seem to be now short term due finance issues and due to following multi-disciplinary team treatment plans. I think sometimes when working with patient for a short term can cause difficulties. From my research I have found that in the old days it was possible for a patient and a doctor to work together for a long period of time was more common. I believe that that working with patients in the long run can put the therapist in a better position. This gives the therapist a better opportunity to build a trusting relationship with the patient, make more concrete observations and a chance to explore images to a deeper extent. Also the therapist gets the opportunity to follow the patient’s progress of over the years. From my experience working at the day hospital I think sometimes it can be very difficult to run a group because short term patients can effect the turn over of the group which really impacts the dynamics of the whole session.

In art therapy especially when starting a group at first it can be an overwhelming experience being around other patients. Not knowing who they are why they are there and what art therapy group means can make them feel anxiety.

I think, in mental health it is very nice experience to have the opportunity to work with an individual for a long term. The sessions are less likely to be disrupted which gives the therapist and the patient to build a trusting relationship.

Conclusion

The most “simple” way of struggle with anxiety disorder is attempts to find yourself in creativity. People, inclined to anxiety disorder, have more advanced verbal intelligence. So they can express themselves in writing: “if you are an impotent, do not write about infinite quantity of sexual partners in detail, write about your impotence. If you are a businessman, write how you started the business and how you got such poor results. If you are a manager, write about the employers, forgetting all decencies, the theme of employers is simply inexhaustible.” (Simon) Write the story, the novel, you may even write poems. It is necessary to make people read your works. Do not be afraid to recognize that society and you are quite different and do not be ashamed of this conflict.

The psychological health of our people depends on the environment in our country. In Japan, the level of depressive disorders is historically lower, than in the USA and Europe that is, probably, connected to the Japanese approach to education of children and with the doctrine of collectivism in Japanese management. However, Japanese gradually comes up to the Western World. Now people write much about anxiety disorder because this phenomenon became extremely widespread in our life. According to the statistics, cases of “frustration of mood in advanced countries stand on the second place after illnesses of cardiovascular system by the influence on people’s serviceability” . However, we were happy to be born in the country where everybody can receive necessary help on time.

References

Abela, J. R. Z., & D’Allesandro, D. U. Beck’s cognitive theory of depression: The

diathesis-stress and causal mediation components. British Journal of Clinical

Psychology, 41, 111-128, 2002

Beck, A. T.  Anxiety Disorders And Phobias : A Cognitive Perspective. Basic Books, 2004

Clark, D. M. Panic disorder and social phobia. In D. M. Clark & C. G. Fairburn

(Eds.), Science and practice of cognitive behaviour therapy (pp. 121-153). New York:

Oxford University Press, 2005

McGinn, L. K.  Cognitive behavioral therapy of depression: Theory, treatment, and

empirical status. American Journal of Psychotherapy, 54, 2007, 254-260.

Irwin, H.J. The depiction of loss: Use of clients drawings in bereavement
counseling. Death Studies, 15, 2000, 481-497.

Simon, R. Bereavement Art. American Journal of Art Therapy, 20, 2006, 135-143

Peckman, M. Man’s Rage for Chaos: Biology, Behavior and the Arts.
Philadelphia, PA: Chilton, 2005

Hatcher, E. Art as Culture. Landham, MD: University Press of America, 2005

Dissanayake, E. What is art for? Seattle, WA: University of Washington Press, 1988

Raymer, M. & McIntyre, B.B. An art support group for bereaved children and
adolescents. Art Therapy, 4, 2003, 27-35.

Codispoti C., Douglas M. R., McCallister T., Zuniga A. The use of a multidisciplinary team care approach to improve glycemic control and quality of life by the prevention of complications among diabetic patients. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15212108

The Care Programme Approach. Available at http://www.markwalton.net/Userguidea/walkthru/cpa.asp

Schaverien, L. & Cosgrove, M. A biological basis for generative learning in technology-and-science: Part II – Implications for technology-and-science education. International Journal of Science Education 22(1): 2005: 13-35.

Schaverien, L. & Cosgrove, M. (). A biological basis for generative learning in technology-and-science: Part I – A theory of learning. International Journal of Science Education 21(12): 2005: 1223-1235.

Case, C., Dalley, T. (Eds). Working with children in art therapy. London: Routledge

Kramer TL, Daniels AS, Zieman GL, et al. (2004) Psychiatric practice variations in the diagnosis and treatment of major depression. Psychiatric Services 51: 2005: 336–340.

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