Anxiety neurosis

Anxiety neurosis is a term used in clinical psychology for a type of neurosis that varies in severity from periods of moderate agitation to states of deep anxiety, characterized by great tension. It has been the object of almost exclusive study of psychiatry and psychology, its fundamentally somatic mode of expression made it part of biomedical branches such as neurology or cardiology.
The first feelings that patients have are terror, hyperventilation, suffocation, dizziness, paresthesias and other threatening sensations that lead the patient to seek urgent medical help.
The main characteristic of a panic attack is the isolated and temporary appearance of fear or intense discomfort. The crisis begins abruptly and reaches its peak quickly (usually in 10 minutes or less), often accompanied by a sense of imminent danger or death and an urgent need to escape.
A panic episode is a painful and debilitating experience; In addition, patients suffer from fatigue, weakness, and irritability between acute episodes of distress.

Characteristic types

There are three characteristic types of panic attacks, which are differentiated by the mode of onset and the presence or absence of environmental triggers:

Unexpected Panic Attacks

Not related to situational stimuli, in which the onset of the panic attack is not associated with triggers environmental (that is, they appear for no apparent reason);

Situational Panic Attacks

Triggered by environmental stimuli, where the panic attack occurs almost exclusively immediately after exposure to or anticipation of an environmental stimulus or trigger (eg, seeing a snake or dog automatically triggers a panic attack);

Anxiety attacks more or less related to a situation

Which are simply more likely to occur when the individual is exposed to certain environmental stimuli or triggers, although there is not always this association with the stimulus nor does the episode always occur immediately after exposure to the situation (eg, the seizures are more likely to appear while driving, but sometimes the individual can take his car without suffering any panic attack, or suffer it within half an hour of driving).

Diagnosis

The diagnosis of panic disorder (with or without agoraphobia) requires the presence of panic attacks unexpected anguish.

Situational panic attacks are more characteristic of social phobias and specific. Panic attacks more or less related to a certain situation are especially frequent in panic disorder, although they can also appear in specific phobia or in social phobia.

Differential diagnosis of panic attacks is difficult if takes into account that there is not always an exclusive relationship between the diagnosis and the type of seizure of anguish. For example, although panic disorder, by its very definition, requires that at Unless some of these panic attacks are described as unexpected, individuals with this disorder frequently declare having suffered situational panic attacks, especially as the course of the disease progresses. Issues related to the diagnosis of seizures of situational distress are discussed in the respective “Differential Diagnosis” sections of the texts corresponding to the disorders in which panic attacks can appear.
When determining the importance of the panic attack, in the differential diagnosis of all these disorders, it is necessary to consider the context in which it appears.

Criteria for the diagnosis of panic attacks

In DSM IV and later, panic attacks are not recorded in an isolated code.
Temporary and isolated appearance of intense fear or discomfort, accompanied by four (or more) of the following symptoms, which start abruptly and reach their maximum expression in the first ten minutes:

1. palpitations, heart shakes or heart rate elevation
   
2. sweating
3. tremors or shakes
4. feel of drowning or lack of breath
5. feeling of choking
6. oppression or chest discomfort
7. abdominal nausea or discomfort
8. instability, dizziness or fainting
9. derealization (sensation of unreality) or depersonalization (being separated from oneself)
10. fear of losing control or going crazy
11. fear of dying
12. parasesthesias (numbness or tingling)
13. chills or suffocations

In anxiety neuroses it is possible that other neurotic manifestations such as obsessions, phobias and hypochondriacal complaints may appear temporarily.

The somatic or cognitive symptoms are multiple consisting of palpitations, sweating, tremors or shaking, feeling short of breath or choking, choking sensation, chest tightness or discomfort, nausea or abdominal discomfort, unsteadiness or dizziness (lightheadedness), derealization or depersonalization, fear of losing control or "going crazy", fear of dying, paresthesias and chills or hot flashes. Seizures with fewer than 4 of these symptoms are called limited symptomatic seizures.

Individuals who seek therapeutic help for these unexpected panic attacks usually to describe the fear as intense, and they relate how at that moment they believed they were about to of dying, losing control, having a heart attack or stroke, or "going crazy." They also describe an urgent desire to flee the place where the crisis has appeared. As it repeats itself, these crises may have a lower component of fear. Lack of air is a common symptom in panic attacks associated with panic disorder with and without agoraphobia. For its part, blushing is common in situational-type panic attacks triggered by by the anxiety that appears in social situations or performances in public.

The anxiety characteristic of panic attacks can be differentiated from generalized anxiety due to its intermittent, practically paroxysmal nature, and its characteristic high intensity.

Panic attacks can occur in a wide range of anxiety disorders (eg, anxiety disorder). anxiety disorders, social phobia, specific phobia, post-traumatic stress disorder, acute stress anxiety disorders).

Physiological somatic disorders include palpitations, hyperventilation, excessive sweating, tremors, insomnia or anorexia.