ANXIETY DISORDERS
>> Understanding of Anxiety:
Basically, anxiety is a natural thing that every human being has ever experienced. Anxiety is considered a part of everyday life. Anxiety is a general feeling, where a person feels fear or loss of confidence that is not clear in origin or form (Sutardjo Wiramihardja, 2005)
Anxiety is something that happens to almost everyone at a certain time in his life. Anxiety is a normal reaction to situations that suppress a person's life. Kcemas can appear alone or join other symptoms of various emotional disorders (Savitri, 2003).
Anxiety is a response to certain situations that threaten, and is a normal thing that happens accompanying developments, changes, new experiences or those that have never been done, as well as in finding self-identity and meaning of life. Anxiety is a reaction that can be experienced by anyone, but excessive anxiety especially those that have become a disorder will hamper a person's function in his life (Kaplan, et al, 2007).
Anxiety is a subjective feeling about mental tension which is disturbing as a general reaction from the inability to overcome a problem or lack of security. These erratic feelings are generally unpleasant, which in turn will lead to physiological and psychological changes (Kholil Rochman, 2004).
According to Namora Lumongga Lubis (2009), anxiety is a response from a real or imaginary threat. Individuals experience anxiety because of uncertainty in the future. Anxiety is experienced when thinking about something unpleasant that happens. Meanwhile, according to Siti Sundari (2004), anxiety is a shocking situation because of the threat to health.
Anxiety is a feeling of worry, fear that is not clear why. Anxiety is also a great force in driving behavior, both deviant and disturbed behavior. Both are statements, appearances, incarnations of defense against anxiety (Gunarsa, 2008).
The conclusion that can be drawn from several opinions above is that anxiety is fear or worry about a very threatening situation that can cause anxiety because of uncertainty in the future and fear that something bad will happen.
>> Symptoms of Anxiety
Anxiety is a shocking condition because of the threat to health. Individuals who are classified as normal sometimes experience the anxiety that appears so that it can be witnessed in the appearance of physical and mental symptoms. These symptoms are more pronounced in individuals who experience mental disorders. More clearly for individuals who have severe mental illness.
Physical symptoms include cold fingers, fast heartbeat, cold sweating, dizziness, decreased appetite, sleeplessness, tightness of chest. While mental symptoms, namely fear of being overtaken by danger, unable to focus attention, are not peaceful, want to run away from reality (Sundari, 2004).
According to Kaplan et al (2007), anxiety also has characteristics in the form of the emergence of feelings of fear and caution or alert that are not clear and unpleasant. The symptoms of anxiety that arise can be different for each individual. Fear and anxiety are two emotions that function as a sign of a danger. Fear arises if there is a clear or real threat, comes from the environment, and does not cause conflict for individuals. While anxiety arises if the danger comes from within yourself, is unclear, or causes conflict for individuals.
Anxiety comes from an unconscious feeling that is in the personality itself, and does not relate to real objects or circumstances that really exist. Kholil Lur Rochman, (2010) suggested several symptoms of anxiety include:
1. There are just things that are very worrying, almost every incident causes fear and anxiety. This anxiety is a form of unwillingness towards things that are not clear.
2. There are strong and very unstable emotions. Angry and often exited (excited) that peaked, very irritable, but often also suffered depression.
3. Followed by various fantasies, delusions, illusions, and delusion of persecution (delusions being chased).
4. Frequent nausea and vomiting, the body feels very tired, sweats a lot, trembles, and often suffers from diarrhea.
5. Chronic tension and fear that causes heart pressure to become very fast or high blood pressure.
Nevid Jeffrey S, Spencer A, & Greene Beverly (2005: 164) classify the symptoms of anxiety in three types of symptoms, including:
1. Physical symptoms of anxiety are: anxiety, vibrating limbs, sweating a lot, difficulty breathing, heart beating fast, feeling weak, cold, irritable or irritable.
2. Behavioral symptoms of anxiety are: avoiding, shaking, inherent and dependent behavior.
3. Cognitive symptoms of anxiety are: worry about something, feeling disturbed by fear of something that happens in the future, belief that something frightening will happen soon, fear of inability to overcome the problem, the mind feels mixed or confused, difficult to concentrate.
>> Factors That Cause Anxiety
Anxiety often develops over a period of time and is largely dependent on one's life experience. Special events or situations can accelerate the appearance of anxiety attacks. According Savitri Ramaiah (2003: 11) there are several factors that show anxiety reactions, including:
a. Environment: The environment or around the place of residence affects the way individuals think about themselves and others. This is due to an unpleasant experience in individuals with family, friends, or with colleagues. So that the individual feels insecure about his environment.
b. Suppressed emotions: Anxiety can occur if an individual is unable to find a way out of his own feelings in this personal relationship, especially if he suppresses anger or frustration in a very long period of time
c. Physical causes: The mind and body constantly interact and can cause anxiety. This is seen in conditions such as pregnancy, during adolescence and when recovering from an illness. As long as these conditions are overwritten, changes in feelings commonly arise, and this can cause anxiety.
a. Environment: The environment or around the place of residence affects the way individuals think about themselves and others. This is due to an unpleasant experience in individuals with family, friends, or with colleagues. So that the individual feels insecure about his environment.
b. Suppressed emotions: Anxiety can occur if an individual is unable to find a way out of his own feelings in this personal relationship, especially if he suppresses anger or frustration in a very long period of time
c. Physical causes: The mind and body constantly interact and can cause anxiety. This is seen in conditions such as pregnancy, during adolescence and when recovering from an illness. As long as these conditions are overwritten, changes in feelings commonly arise, and this can cause anxiety.
Zakiah Daradjat (Kholil Lur Rochman, 2010: 167) suggests several causes of anxiety are:
a. Anxiety that arises from seeing the danger that threatens him. This anxiety is closer to fear, because the source is clearly visible in the mind
b. Anxious because they feel guilty or guilty, because they do things that are contrary to their beliefs or conscience. This anxiety often accompanies the symptoms of mental disorders, which sometimes appear in a general form.
c. Anxiety in the form of disease and seen in several forms. This anxiety is caused by things that are not clear and not related to anything that is sometimes accompanied by fear that affects the overall personality of the sufferer.
Anxiety is present because of an excessive emotion. In addition, both are able to attend because of the environment that accompanies it, both the family, the school and its causes. Musfir Az-Zahrani (2005), mentions the factors that influence the existence of anxiety are:
1. Family environment: The state of the house with conditions that are full of quarrels or full of misunderstandings and the indifference of parents to their children, can cause discomfort and anxiety in children while inside the house.
2. Social Environment: The social environment is one of the factors that can affect individual anxiety. If the individual is in an environment that is not good, and the individual creates a bad behavior, it will lead to a variety of bad judgments in the eyes of society. So that it can cause anxiety.
Anxiety arises because of a threat or danger that is not real and at any time happens to the individual and the refusal of the community causes anxiety to be in the new environment (Patotisuro Lumban Gaol, 2004: 24). While Page (Elina Raharisti Rufaidah, 2009), stated that the factors that influence anxiety are:
1. Physical factors: Physical weakness can weaken an individual's mental condition so as to facilitate anxiety.
2. Trauma or conflict: The appearance of anxiety symptoms is very dependent on individual conditions, in the sense that emotional experiences or mental conflicts that occur in individuals will facilitate the onset of anxiety symptoms.
3. The initial environment is not good: Environment is the main factors that can affect individual anxiety, if these factors are not good it will prevent the formation of personality so that anxiety symptoms arise.
>> Types of anxiety
Anxiety is a change in mood, a change in itself arising from the inside without external stimuli. Mustamir Pedak (2009) divides anxiety into three types of anxiety, namely:
1. Rational Anxiety: It is a fear due to objects that are indeed threatening, for example when waiting for the results of examinations. This fear is considered as a normal constituent of our basic defense mechanism.
2. Irrational Anxiety: Which means that they experience these emotions under specific circumstances that are not usually considered threatening.
3. Fundamental Anxiety: Fundamental anxiety is a question about who he is, what his life is for, and where his life will continue. This anxiety is called existential anxiety which has a fundamental role for human life.
1. Rational Anxiety: It is a fear due to objects that are indeed threatening, for example when waiting for the results of examinations. This fear is considered as a normal constituent of our basic defense mechanism.
2. Irrational Anxiety: Which means that they experience these emotions under specific circumstances that are not usually considered threatening.
3. Fundamental Anxiety: Fundamental anxiety is a question about who he is, what his life is for, and where his life will continue. This anxiety is called existential anxiety which has a fundamental role for human life.
While Kartono Kartini (2006: 45) divides anxiety into two types of anxiety, namely:
1. Mild Anxiety: Mild anxiety is divided into two categories: mild for a while and light for long. This anxiety is very beneficial for the development of a person's personality, because this anxiety can be a challenge for an individual to overcome it. Mild anxiety that appears briefly is a reasonable anxiety that occurs in individuals due threatening situations and the individual cannot overcome it, so anxiety arises. This anxiety will be beneficial for individuals to be more careful in dealing with similar situations in the future. Long mild anxiety is anxiety that can be overcome but because the individual does not immediately overcome the cause of anxiety, the anxiety will settle long in the individual.
2. Heavy Anxiety: Severe anxiety is an anxiety that is too heavy and deeply rooted in someone's body. If a person experiences this kind of anxiety then he usually cannot overcome it. This anxiety has the effect of inhibiting or detrimental development of one's personality. This anxiety is divided into two, namely short and long-term anxiety. Severe anxiety but the appearance of a moment can be traumatic in individuals if faced with the same situation as the situation that causes anxiety. There is heavy anxiety but the old appearance will damage the individual's personality. This will last for years and can be an individual cognition process. Severe and long-standing anxiety will cause various types of disease such as high blood pressure, tachycardia (accelerating blood), excited (excited, uproar)
>> Anxiety Disorders
Anxiety disorder is a disorder that has characteristics anxiety or fear that is unrealistic, also irrational, and cannot intensively displayed in clear ways. Fitri Fauziah & Julianty Widuri (2007) divides anxiety disorders in several types, namely:
a. Specific phobia is an unwanted fear due to the presence or anticipation of a specific object or situation
b. Social phobia is an irrational and persistent fear, usually associated with the presence of others. The individual avoids situations where he is evaluated or criticized, which makes him feel insulted or humiliated, and shows signs of anxiety or other embarrassing behavior.
c. Panic Disorders, Panic disorder has the characteristics of spontaneous and unexpected panic attacks. Some symptoms that can appear in panic disorder include; difficulty breathing, heart beat, nausea, chest pain, cold sweating and trembling. Another important thing in diagnosing panic disorder is that individuals feel every panic attack is a sign of death or disability.
a. Specific phobia is an unwanted fear due to the presence or anticipation of a specific object or situation
b. Social phobia is an irrational and persistent fear, usually associated with the presence of others. The individual avoids situations where he is evaluated or criticized, which makes him feel insulted or humiliated, and shows signs of anxiety or other embarrassing behavior.
c. Panic Disorders, Panic disorder has the characteristics of spontaneous and unexpected panic attacks. Some symptoms that can appear in panic disorder include; difficulty breathing, heart beat, nausea, chest pain, cold sweating and trembling. Another important thing in diagnosing panic disorder is that individuals feel every panic attack is a sign of death or disability.
d. Generalized Anxiety Disorder Generalized Anxiety Disorder (GAD) is excessive and pervasive concern, accompanied by various somatic symptoms, which cause significant disruption in social life or work in the sufferer, or cause real stress.
While Sutardjo Wiramihardja (2005) divides disturbances anxiety which consists of:
a. Panic Disorder: Panic Disorder is characterized by the appearance of one or two unexpected panic attacks, which are not triggered by things that are not an extraordinary problem for others. There are several symptoms that indicate the panic condition, namely shortness of breath, palpilation (dry mouth) or even the throat cannot swallow, fear of death, or even fear of being insane.
b. Agrophobia: that is a fear of being in a place or situation where he feels that he cannot or is difficult to be physically and psychologically to escape. People who have agrophobia are afraid of crowds and crowded places.
a. Panic Disorder: Panic Disorder is characterized by the appearance of one or two unexpected panic attacks, which are not triggered by things that are not an extraordinary problem for others. There are several symptoms that indicate the panic condition, namely shortness of breath, palpilation (dry mouth) or even the throat cannot swallow, fear of death, or even fear of being insane.
b. Agrophobia: that is a fear of being in a place or situation where he feels that he cannot or is difficult to be physically and psychologically to escape. People who have agrophobia are afraid of crowds and crowded places.
>> Impact of Anxiety
Fear and anxiety can persist even increase despite the situation who really threatens nothing, and when these emotions grow excessive compared to the real danger, this emotion become not adaptive. Excessive anxiety can have an impact which is harmful to the mind and body can even cause diseases physical (Cutler, 2004).
Yustinus Semiun (2006: 321) divides some of the impacts from anxiety into several symptoms, including:
a. Symptom of mood: Individuals who experience anxiety have feelings of threatening punishment and disaster from a certain unknown source. People who experience anxiety cannot sleep, and thus can cause irritability.
b. Cognitive symptoms: Anxiety can cause anxiety and concern for individuals about unpleasant things that might happen. The individual does not pay attention to the real problems that exist, so that the individual often does not work or study effectively, and finally he will become more anxious.
c. Motor symptom: People who experience anxiety often feel uneasy, nervous, motor activities become meaningless and purposeless, such as toes tapping, and are very shocked at the sudden noise. Motor symptom is a high picture of cognitive stimulation in individuals and is an attempt to protect itself from anything that feels threatening. Anxiety will be felt by everyone, especially if there is feeling pressure or mental stress.
Yustinus Semiun (2006: 321) divides some of the impacts from anxiety into several symptoms, including:
a. Symptom of mood: Individuals who experience anxiety have feelings of threatening punishment and disaster from a certain unknown source. People who experience anxiety cannot sleep, and thus can cause irritability.
b. Cognitive symptoms: Anxiety can cause anxiety and concern for individuals about unpleasant things that might happen. The individual does not pay attention to the real problems that exist, so that the individual often does not work or study effectively, and finally he will become more anxious.
c. Motor symptom: People who experience anxiety often feel uneasy, nervous, motor activities become meaningless and purposeless, such as toes tapping, and are very shocked at the sudden noise. Motor symptom is a high picture of cognitive stimulation in individuals and is an attempt to protect itself from anything that feels threatening. Anxiety will be felt by everyone, especially if there is feeling pressure or mental stress.
According to Savitri Ramaiah (2005) anxiety can usually cause two consequences, namely:
1. Very panic and therefore fail to function normally or adjust to the situation. Failed to know in advance the dangers and take adequate precautions.
From some of the opinions above, it can be concluded that anxiety is fear or worry about a very threatening situation because of uncertainty in the future and fear that something bad will happen. This anxiety is characterized by several symptoms that arise such as anxiety, fear of something that happens in the future, feeling uneasy, difficult to concentrate, and feeling unable to overcome the problem. This is caused by several factors including, anxiety arises because the individual sees the danger that threatens him, anxiety also occurs because individuals feel guilty or guilty of doing things that are contrary to belief or conscience. Of the several symptoms, factors, and definitions above, this anxiety is included in the type of rational anxiety, because rational anxiety is a fear due to objects that are indeed threatening. The existence of various kinds of anxiety experienced by individuals can cause anxiety disorders such as specific anxiety disorders, namely an unwanted fear due to the presence or anticipation of a specific object or situation.
So that it can cause the impact of anxiety in the form of cognitive symptoms, namely anxiety can cause concern and concern for individuals about unpleasant things that might happen. The individual does not pay attention to the real problems that exist, so that the individual often does not work or study effectively, and finally he will become more anxious.
>> Treatment
If there is a mild form Gad is applied therapy, which teaches, How to get rid of anxious thoughts. Therapy includes:
1. Cognitive behavioral therapy: The occupational therapist is to, to change the mindset of the patient, which allows you to more easily respond to the situation, which is worrying. This can reduce anxiety symptoms.
2. Behavioral therapy: The therapist teaches patient relaxation techniques, including your glubok breathing, muscle relaxation and visualization. Exploring how rasslableniâââ can help patients control anxiety. Instead, react with anxiety and tension, patients who learn to stay calm. Doctors can also expose patients to small effects, which causes anxiety and tension. This will make it possible to do therapy and directly observe the patient in an environment that is not beneficial.
1. Cognitive behavioral therapy: The occupational therapist is to, to change the mindset of the patient, which allows you to more easily respond to the situation, which is worrying. This can reduce anxiety symptoms.
2. Behavioral therapy: The therapist teaches patient relaxation techniques, including your glubok breathing, muscle relaxation and visualization. Exploring how rasslableniâââ can help patients control anxiety. Instead, react with anxiety and tension, patients who learn to stay calm. Doctors can also expose patients to small effects, which causes anxiety and tension. This will make it possible to do therapy and directly observe the patient in an environment that is not beneficial.
Support group: Joining this self-help group or support is often very useful. This form of support allows you to share experiences and learning, how others have been overcome with GAD.
Biofeedback:
Biofeedback works by attaching sensors to the body. Therapists who try to capture signals from the body, stimulation, and determine treatment, to reduce anxiety.
1. Drug Therapy
Medications can be prescribed for symptoms, which are severe and interfere with work. Medication can help relieve symptoms. It is important to note, that taking a lot of drugs cannot suddenly be stopped, their removal must be gradual. You should consult with your doctor before you stop taking any medication. Medications can include:
• Benzodiazepines - to relax the body and interfere with stress in response to disturbing thoughts. These medications must be taken under control, because they can cause addiction; Medications to reduce anxiety:
• Buspirone - a sedative, based on;
• Alprazolam - can be appointed for a short period of time;
• Antidepressants (most often serotonin reuptake inhibitors [SSRI'S]) - to control restless thoughts. Some antidepressants can cause damage to changes in mood and behavior, including thoughts of suicide in some patients (rare);
• Beta blockers - can be used, to reduce physical symptoms of anxiety
1. Drug Therapy
Medications can be prescribed for symptoms, which are severe and interfere with work. Medication can help relieve symptoms. It is important to note, that taking a lot of drugs cannot suddenly be stopped, their removal must be gradual. You should consult with your doctor before you stop taking any medication. Medications can include:
• Benzodiazepines - to relax the body and interfere with stress in response to disturbing thoughts. These medications must be taken under control, because they can cause addiction; Medications to reduce anxiety:
• Buspirone - a sedative, based on;
• Alprazolam - can be appointed for a short period of time;
• Antidepressants (most often serotonin reuptake inhibitors [SSRI'S]) - to control restless thoughts. Some antidepressants can cause damage to changes in mood and behavior, including thoughts of suicide in some patients (rare);
• Beta blockers - can be used, to reduce physical symptoms of anxiety
>> Prevention
At present, methods for the prevention of generalized anxiety disorder are unknown. Early detection and treatment can reduce the risk of severe psychological complications. Some evidence suggests that exercise can reduce symptoms of generalized anxiety disorder. To further reduce anxiety symptoms, it is necessary to avoid caffeine, nicotine, and excessive use of drugs for colds.