Anxiety neurosis: what is it and what symptoms is it linked to?

What is anxiety neurosis, as defined by psychoanalysts?

Throughout the last two centuries, psychology, and especially its clinical application, has been modifying several of its postulates and concepts used to establish subjects of study and scientific analysis.

Among them are the diagnostic systems, which have not only been adding and removing psychological disorders, but also renaming the existing ones in terms that one might think they are something else.

One of these disorders is that of anxiety neurosis, a term which today would be rare to find in the anamnesis of a patient.. Although outdated, its definition and coinage are very interesting, and tell us about the development of behavioral science (psychology) and psychiatry. If you want to know more about this, read on.

What is anxiety neurosis?

The term anxiety neurosis is an expression, nowadays in disuse, originally coined by Sigmund Freud.. With this term, the famous Austrian psychoanalyst referred to when a person suffered periods of deep anxiety and great bodily tension. When a person was diagnosed under this label, it meant that he or she suffered from a state of high excitability and, also, felt very worried about his or her future, especially seeing it as very dire (anxious expectation).

Although no psychologist today would give someone the diagnosis of anxiety neurosis, it is worth noting that it has been of vital importance in understanding anxiety disorders and the classifications that have been made of them. The current equivalent to this type of neurosis would be panic attack..

Neurosis in the history of Psychology

As we were already saying, before the current elaboration of the classification for anxiety disorders, the term neurosis was used with a definition very similar to the current definition of this type of disorder.

Freud devoted part of his work in developing a detailed description of disorders that shared the label of neurosis, such as phobic neurosis, obsessive-compulsive neurosis, depressive neurosis ... and, being the main subject of this article, anxiety neurosis. Today, all these neuroses have been renamed under different categories, especially within anxiety disorders.

However, who first used the term 'neurosis' was not the most famous psychoanalyst of all times, but a Scottish physician and chemist, William Cullen, who used the term for the first time in 1769. He used this word in reference to sensory and motor disorders that were caused by diseases of the nervous system.

Thus, the word neurosis referred in those times to any mental disorder that involved some kind of distortion in the rational thinking of the sufferer, in addition to reducing his or her functioning at the family, social and occupational levels.

Nowadays, the word neurosis the word neurosis has been practically forgotten in the academic world.. No clinical psychologist, no matter how much of a psychoanalyst he or she might be, would use this term when diagnosing someone.

However, this does not mean that the word has been totally forgotten in popular culture. Its use on a colloquial level is synonymous with obsession, nervousness and eccentricity, although it cannot be taken seriously as a relevant term in a clinical sense.

What are its symptoms?

As we saw, anxiety neurosis is no longer a current diagnostic label in clinical practice and, therefore, to say that it has some symptoms would not be entirely correct, since really, as it was conceived at the time, this pathology would not exist. However, it can half overlap with the concept we have today of what panic disorder is.

Thus, anxiety neurosis can be understood as a pathological condition in which the person presents episodes in which it feels a great fear and anxiety, appearing suddenly andThe crisis begins suddenly and without any previous warning. The crisis begins suddenly, without there being a clear factor that explains why the episode is beginning to occur.

These episodes typical of this type of neurosis coincide with panic attacks, which vary in duration from about 10 to 20 minutes to hours.. Their frequency of appearance also varies, being possible to manifest them every long time or, in the most worrying cases, several times every month.

The anxiety that the person suffers is very high, accelerating their heart and, usually, feeling chest pain, which makes them think that they are suffering a heart attack on many occasions.

Next we will see a list of symptoms that, although they are taken from the DSM-5 for the panic disorder; most of its symptomatology coincides with the original conception of anxiety neurosis..

• Excessive fear of losing control, going crazy or dying.
• Tremors all over the body.
• Sweating and chills.
• Rapid heartbeat and sensation that one is going to have a heart attack.
• Sensation of intense pain in the chest with no apparent Biological cause.
• Sensation of lack of air without apparent biological cause.
• Choking sensation without apparent biological cause.
• Nausea, hyperacidity, acid reflux and urge to vomit.
• Cramps.
• Dullness and sensation of loss of balance.
• Numbness of extremities.
• Dry mouth and throat.
• Sleep disturbances.
• Decreased sexual desire.

During the crisis not all the symptoms shown here are manifested, but an important number of them. The discomfort that the person suffers while having the panic attack is very high, which can even increase the panic attack itself.This can even increase the anxiety itself, which is already high. This is one of the factors that can make the episode last longer.

As the attacks are not predictable, the person lives in fear of experiencing them in situations in which, if something happens to him/her, his/her physical integrity may be endangered. People suffering from this anxiety neurosis would be on constant alert.

As already mentioned, many of the symptoms suffered during the crisis have no apparent biological cause. have no apparent biological cause. On many occasions, those who suffer from panic disorders, despite being told by their doctor that they have no health problems to explain the chest pain and shortness of breath, continue to fear that they may die from a heart attack or asphyxia.

Affect on daily life

Although, since the term anxiety neurosis is outdated, it is not possible to know statistics and studies that talk about how it interferes with the daily life of patients suffering from this disorder, it is possible, as we have done in the section on symptoms, to extrapolate it with how people with panic disorder live their daily life.

Panic attacks can occur uniquely, especially in high-stress situations. The person may be overwhelmed by the demands of day-to-day life, especially if there has been an event that has put him or her under particular stress.especially if there has been an event that has put him or her under particular stress.

However, the interference is very serious when panic attacks occur frequently and without warning. The person does not have the capacity to know what is going to activate all the aforementioned symptomatology, making him/her afraid of doing daily actions that, perhaps, will lead to such an unpleasant situation.

The person lives constantly in a state of hypervigilance and tension.. He is afraid that the future is going to be worse than how he is living in the present. He also fears that it will happen just when he is in a situation in which it will be difficult to help him, which causes him to develop agoraphobia as a collateral effect.

Agoraphobia, unlike the popular idea that it is the fear of leaving home, actually refers to the fear of finding oneself in a situation where one is in trouble and no one can help.

As a consequence of this, the person with panic disorder combined with agoraphobia begins to restrict his or her behavior, avoiding certain places or avoiding leaving his or her safe place, usually being at home, always with the person with panic disorder.usually being at home always with the company of someone.

Treatment

The treatment for anxiety neurosis would be the same for panic attacks. It would consist of helping the person who suffers these episodes of anxiety to develop and perform in a more functional way in their daily life, to be able to enjoy a family, social and work life as close to normal as possible. In order to achieve this it is necessary to combine psychopharmacology with psychotherapy..

First of all, the pharmacological route usually uses SSRI antidepressants, especially paroxetine, sertraline and fluoxetine, which selectively inhibit the reuptake of serotonin, elevating mood. SNRIs, specifically venlafaxine, would also be prescribed.

Other drugs prescribed are sedatives such as benzodiazepines, which are central nervous system depressants and induce a calm state. The most commonly used for this condition are alprazolam and clonazepamalthough their use would be limited in short-term treatment due to their high risk of addiction.

Secondly, there is psychotherapy, which would focus on working on the distortions in the person's mind that make him/her think that he/she is going to suffer an imminent panic attack that will end his/her life. It is also intended to make them see that there are not as many dangers as they think and that, if something were to happen to them, it is quite likely that someone would end up helping them if they were, for example, on the street or in a public space.

We teach stress management strategies, relaxation, breathing control and also work with ideas that can serve as triggers of anxiety. For this purpose, cognitive-behavioral therapy is often used, cognitive-behavioral therapy (CBT) is often used. (CBT), in which the person is encouraged to express their feelings and ideas regarding their problem and how it affects their daily life, in order to introduce changes in their way of thinking, feeling and behaving.

Thus, under the umbrella concept of anxiety neurosis there is a complex reality that can be embodied in many different types of problems that require a specific and personalized approach. That is why, as applied psychology evolves, there is an attempt to go beyond the old clinical categories and focus more on the symptoms linked to a given context, and from there to establish what type of psychotherapeutic intervention would work best.

Bibliographical references:

• American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
• Botella C. and Ballester, R, (1997). Panic disorder: Assessment and treatment. Barcelona, Spain: Martínez Roca.
• Calleo, J. & Stanley, M, (2008). Anxiety Disorders in Later Life: Differentiated Diagnosis and Treatment Strategies. Psychiatric Times. 26(8): pp. 24 - 27.