Occasional anxiety is normal, but if you experience excessive anxiety for a long time, it is an anxiety disorder.
Similar to depression, anxiety is a common mental illness. According to the Global Burden of Disease Project, as of 2019, before the pandemic, more than 300 million people worldwide suffered from anxiety disorders, which is about 4% of the global population. Due to the early onset of the disease and its gender orientation, the prevalence of the disease is higher among adolescents, especially women.
Very common, but misunderstood
Unfortunately, similar to depression, although there are more effective treatments for the disorder, the proportion of patients who have received treatment is low, with an estimated 75% of patients receiving no treatment at all. Again, there are a lot of misconceptions surrounding anxiety. For example, this condition can be simply understood as a person who has recently been stressed, has a temporary heart disease, or a person who has a poor ability to cope with stress.
But in reality, anxiety is a feeling that everyone feels in a particular situation, and people who suffer from anxiety suffer from this fear and worry for a long time. From a contextual analysis, the degree of this anxiety is often excessive and unnecessary. As a result, it is clear that this will greatly interfere with the normal work and life of the person concerned, and bring about a series of health problems.
Due to the early-onset nature and gender orientation of anxiety disorders, the adolescent population, especially women, will have a higher rate of the disease. Visual China|Figure
Regarding the treatment of anxiety disorders, the basic way is based on cognitive behavioral therapy psychological intervention, the main content is to help people learn new ways to cope with anxiety through the form of conversation, and change the thinking pattern of the brain, so as not to be overly afraid in the face of stressful events. At the same time, some patients may also be candidates for antidepressants such as selective serotonin reuptake inhibitors to treat anxiety symptoms.
Since 2024, a number of studies have further shown that anxiety disorders are not only heart diseases, but also treatment is not only psychological interventions, but may also include targets such as gut microbes.
In fact, there are many specific types of anxiety disorders, which can be divided into generalized anxiety disorder, social anxiety disorder, separation anxiety disorder, agoraphobia, and other situation-specific phobias. Generalized anxiety disorder refers to persistent excessive worrying about very ordinary things in daily life, while social anxiety disorder refers to feeling fear in social situations, also known as social phobia.
Following clues that gut microbes can regulate brain and behavior, researchers at University College Cork in Ireland have tried to explore the relationship between gut microbes and social anxiety disorder. They transplanted gut microbes specific to people with social anxiety disorder into healthy mice, and found that the mice were more sensitive to social phobia.
The study, published in January 2024 in the Proceedings of the United States Academy of Sciences (PNAS), found that while the mice in the experiment showed no other behavioral abnormalities, the enhanced social phobia response was superimposed on changes in immune function and brain abnormalities, suggesting that microbes may be a potential target for the treatment of social anxiety disorder.
This further proves that the cause of the disease is extremely complex, and the crux of the problem is not only in the mind. From the perspective of the onset of anxiety disorders, scientists have long realized that such mental illnesses may be induced by a combination of physiological, social and psychological factors. Although the exact cause is unknown, a number of factors, including genetics and traumatic experiences, can increase a person's risk.
The United States Preventive Services Task Force's latest screening recommendations in 2023 consider that the main risk factors for anxiety disorders include sociodemographic, psychosocial, physical and spiritual health, stressful life events, smoking and drinking habits, and parental psychiatric history. For example, women and people with low socioeconomic status are at higher risk of developing anxiety disorders.
Stress causes anxiety
Those who have been abused in childhood, or who have experienced other major negative events, are also at greater risk. In addition, they suffer from serious illness, failure to complete their work tasks, discrimination, death of a loved one, long-term unemployment, and living difficulties...... Life stressors such as these, large and small, are estimated to increase people's risk of anxiety disorders if they accumulate over a long period of time. These risk factors also apply to depression, perhaps due to similar risk factors, the proportion of people with depression who also suffer from anxiety disorders is high, and some studies have found that the proportion coincides with nearly 70%.
Because of the negative role that stress plays in the process of promoting anxiety disorder, the treatment of this disorder emphasizes the management of stress in addition to psychological interventions, including how to train the patient's attention and master the skills to relax and unwind. After all, it is difficult to avoid stressful events at work and in life, and more importantly, how to avoid overreacting to stress, so as to continue to fall into anxiety and fear.
This pathological anxiety is different from ordinary anxiety in that it is not only more persistent and frequent, but also more intense, more than the average person reacts to. It is also often accompanied by various obvious physical symptoms, such as palpitation, sweating, nausea, abdominal pain, etc., and at the same time, it is difficult to sit and sleep. How to further cope with these anxiety-related symptoms determines the development trend of anxiety disorders.
This type of reaction is focused on anxiety sensitivity, which refers to a person's perception of the negative effects of anxiety. Steven Reiss·United States a clinical psychologist, invented the concept in the 1980s. If a person is more sensitive to anxiety, then the person will tend to react more fearfully when they experience anxiety-related bodily sensations, believing that this negative effect of anxiety will cause more damage to their body and mind.
From the perspective of etiology, some scientists believe that anxiety sensitivity may predict the development of anxiety disorders and is an important indicator for predicting anxiety disorders. If a person is more sensitive to anxiety, there is a greater risk of developing an anxiety disorder later on. And when treating anxiety disorders, it can also effectively improve the symptoms of anxiety by changing a person's sensitivity to anxiety. Research has proven that this is also a basis for cognitive behavioral therapy to work.
Need social support
In January 2024, researchers at the University of California, Los Angeles, using a long-term study, also found that a gradual reduction in anxiety sensitivity could also be achieved by increasing social support. Data from a year-and-a-half-year study of nearly 1,000 patients showed that an increase in a person's perceived social support was associated with a decrease in anxiety sensitivity, and conversely, if anxiety sensitivity decreased, the perceived social support also increased.
The study, published in Behavior Therapy, also provides new ideas for the treatment of anxiety disorders. It means that, in conjunction with relevant cognitive-behavioural therapy, patients can be specifically designed to improve their perceived social support, making them aware that someone is there to help them in the face of challenges and stress, so that the negative impact of anxiety-related symptoms can be reassessed and anxiety symptoms improved.
When people reassess their anxiety symptoms due to reduced sensitivity, they also perceive more social support, which may lead to a positive cycle of less anxiety. Of course, these latest studies have certain limitations, whether it is social support to assist in the treatment of anxiety disorder, or the identification of gut microbes as a new target for the treatment of social anxiety disorder.
The anxiety pathway from the microbe, gut to the brain discovered in animal experiments only provides a potential direction for the development of new therapies in the future. In the study of the relationship between social support and anxiety sensitivity, the measurement of subjectively perceived social support did not record the source of the corresponding social support in detail, nor did it analyze the size and accessibility of relevant social networks, which obviously affects the understanding of the role of social support.
After all, there are many sources of social support in real life, it can come from anyone, such as relatives, friends, treating physicians, etc., and the form of support varies widely. It may be to help with ideas when encountering problems, or to send greetings and comfort when you are worried, or it may be to directly solve problems and give substantial help by giving money, doing work on your behalf, etc., and in some cases, just accompanying people is enough to provide support to anxious people.
Therefore, in the future, it may be possible to further understand the therapeutic significance of various types of social support to help improve the treatment of anxiety disorders. In addition to the social support provided by the outside world, self-help is equally important.
The World Health Organization (WHO) has included generalized anxiety disorder and panic disorder in its mental health disparities action programme, primarily to address treatment disparities faced by people everywhere, especially in low- and middle-income countries. In February 2024, researchers from the World Health Organization's Department of Mental Health and Substance Use published the organization's recommendations for the management of these two types of anxiety disorders in the journal World Psychiatry, which not only recommended treatment modalities based on cognitive behavioral therapy and selective serotonin reuptake inhibitors, but also believed that guided self-help and improved stress management skills are also useful for treatment.
For example, you can participate in more physical exercise, develop regular eating and rest habits, avoid smoking, drinking and other ways to relieve anxiety, and instead reduce anxiety by relaxing the body and improving brain concentration. If you notice that you are always overly worried and unable to do anything, you should still seek help from your doctor. More importantly, we should first realize that such long-lasting anxiety symptoms are not just a knot caused by temporary inability to think about it, but are likely to be a mental illness caused by the comprehensive effects of biology, psychiatry, psychology, social environment and social relations, which deserves attention.
Southern Weekly reporter Wang Jiangtao
Editor-in-charge: Zhu Liyuan