What Is the Connection Between Anxiety and Chest Pain?

Anxiety is a state between anxiety and anxiety. It is heavier than anxiety and lighter than anxiety. Anxiety has obvious anxiety, irritability, irritability, irritability, nervousness, restlessness, and sleep. Disorders and some symptoms of autonomic nervous disorders, such as palpitation, palpitations, chest tightness, fatigue, cold sweats, but these symptoms are generally short in time, can have certain incentives, and are sometimes good and bad, and can be alleviated through self-regulation.

Anxiety

Anxiety state is between anxiety and

Anxiety is the most

Anxiety is very common. The incidence rate in the general population reported abroad is about 4%, accounting for 6-27% of psychiatric clinics. The United States estimates that the lifetime prevalence rate in normal population is 5%, and the domestic incidence is low, with an average of 7 . Wartime anxiety accounts for 1% of wartime neurosis. It usually starts in adolescence and the ratio of male to female is 2: 3.

Anxiety is the anticipation of future threats. Unlike fear, the latter is a response to a specific threat that exists objectively. Normal people's anxiety is a kind of adaptive response or biological defense phenomenon when people expect a certain danger or painful situation is about to happen. It is a complex comprehensive emotion. Anxiety can also be a symptom of all mental illness. Pathological anxiety is a kind of fear that cannot be controlled, without clear object or content, and its threat is not consistent with the degree of anxiety.

First, the etiology and pathogenesis

The cause is unknown, and different schools have different interpretations.

1. Genetic factors: It plays an important role in the occurrence of anxiety disorders. The same disease rate among blood relatives is 15%, which is much higher than that of normal residents. The same disease rate of twins twins is 2.5%, while single twins are 50%. Some people think that anxiety disorder is the result of environmental factors acting together through susceptibility, which is determined by heredity.

2. Pre-illness personality characteristics: low self-esteem, lack of self-confidence, timidity and fear, be cautious, easy to be nervous about slight setbacks or physical discomfort, anxiety or mood swings.

3. Psychological factors: Mindful setbacks and dissatisfaction can be induced factors.

4. Biological factors: The physiological basis of anxiety reaction is the general hyperactivity of sympathetic and parasympathetic nervous system activities, and there is often excessive release of adrenaline and norepinephrine. The manifestation of physical changes depends on the characteristics of the patient's sympathetic and parasympathetic nerves.

There are also different opinions on the pathogenesis. Some scholars emphasized that the amygdala and hypothalamus and other "emotion centers and anxiety disorders, the discovery of benzodiazepine receptors in the limbic system and neocortex, put forward the" central theory of anxiety disorders "; Some people also believe that -adrenergic blockers can effectively improve physical symptoms, relieve anxiety, and support the "surrounding theory" of anxiety. The psychoanalytic school believes that anxiety is the result of self-threatening due to the internal conflict of progress. Based on "Learning theory" scholars believe that anxiety is a habitual behavior. The conditional connection between anxiety-stimulating stimuli and neutral stimuli generalizes conditional stimuli and forms widespread anxiety. Lader proposed that genetic qualities are an important psychology of the disease. And physiological basis, once a strong anxiety reaction occurs, anxiety is formed through environmental strengthening or self-reinforcing.

Clinical manifestations

It can start at any age, and is more common before the age of 40. Onset can be acute or slow, and there are often psychological or physical incentives before the illness.

1. Acute anxiety disorder, also known as panicattack. Suddenly there is a strong fear, with autonomic dysfunction as the main manifestation. Suddenly the patient is afraid, as if the experience is "coming soon" or "coming to death", "losing self-control", and screaming to escape, hide or call for help. May be accompanied by dyspnea, palpitations, chest pain or discomfort, dizziness, vomiting, sweating, pale, and tremors. Each episode lasts for several hours, with several episodes per month, and there may be no obvious symptoms during the intermittent period.

2. Chronic anxiety disorder, also known as generalized anxiety or generalized anxiety, is a kind of fear that you can't control. There is no clear object or content, and you feel that some kind of non-existent threat is coming. Uneasy, fearful and painful experience. It is also accompanied by motor disturbances such as tremors, local discomfort such as chest compressions, and symptoms of autonomic nervous system such as palpitation, rapid breathing, pale, sweating, frequent urination, and urgency.

There may be panic attacks on the basis of chronic anxiety.

Third, the course and prognosis

The duration of the disease varies, and some patients have a longer duration. Female patients, short duration, good personality before illness, little change in symptoms, the prognosis is good; those with obvious physical symptoms, the prognosis is poor. However, with proper treatment, most patients have a good prognosis.

4. Diagnosis basis and differential diagnosis

(I) Diagnosis basis

1. Recurring emotional experiences with no clear cause, fear or nervousness of the subject or content, accompanied by physical symptoms such as motor restlessness and hyperautonomic nervous system

2. Self-knowledge is complete and requires treatment.

3. The course of disease lasts for more than 1 month.

4. Pre-morbid personality traits, mental factors, and similar authors in the family all contribute to the diagnosis.

5. Has affected the patient's work, study and life.

6. Exclude anxiety associated with snoring, depression, schizophrenia, heart disease and other physical and mental diseases.

(Two) differential diagnosis

1. Heart disease: chest pain, palpitations, sweating, etc. that occur during panic attacks are easily misdiagnosed as acute myocardial infarction, which can be identified by physical examination, time of attack, predisposing factors, and ECG examination. It is worth noting that mitral valve prolapse can be accompanied by panic attacks.

2. Hyperthyroidism: Anxiety symptoms associated with hyperthyroidism. After treatment, anxiety symptoms improve with the recovery of thyroid function. Persistent anxiety should be considered chronic anxiety.

3. Hysteria: Hysteria is easy to confuse with panic attacks. The former has a strong emotional color, cries and smiles, and mood changes; the latter is characterized by strong anxiety and tension that cannot be controlled.

4, depression: often accompanied by anxiety. Depression is dominated by depressed mood, uninterested feelings, poor self-sensation, low self-evaluation, reduced ability, and negative perceptions; anxiety disorders are predicated on the prospect of unfortunate or non-existent threats in the future.

Five, treatment

1. Psychotherapy means that the clinician establishes a good doctor-patient relationship with the patient through verbal or non-verbal conversations, and uses psychological and medical knowledge to guide and help patients overcome and correct poor lifestyle, behavioral habits, emotional disorders, Cognitive prejudice and adaptation issues. Medication and psychotherapy are the two legs that help patients with anxiety recover. Medication is essential in the snow. Psychotherapy is the icing on the cake, and it will be very important for patients to recover further.

So, who is the most suitable person for psychotherapy?

(1) Part of the psychiatrist's specialty is psychotherapy. Finding this part of the psychiatrist is most suitable for psychotherapy, because this is the most competent psychiatrist. Other psychiatrists may not specialize in psychotherapy, but they can also do psychotherapy, such as supportive therapy, cognitive therapy, etc .;

(2) Clinical psychologists such as hospital psychotherapists and others who have knowledge of clinical psychology.

Psychological treatments suitable for anxiety disorders include: supportive therapy, behavioral therapy, cognitive therapy, biofeedback therapy, and so on.

Wenqu psychological network introduces a relaxation treatment to everyone:

Relaxation training is to achieve psychological relaxation through physical relaxation. It is relatively simple such as deep breathing: when anxious, close your eyes, slowly inhale with your nose, exhale through your nose and mouth, and repeat three to five times. You can also use meditative thoughts: consciously thinking of something happy, as realistic and specific as possible. When you are overly nervous or anxious, close your eyes lightly, relax your body, and take a few deep, even, rhythmic deep breaths. Repeatedly suggest yourself: "Don't worry," "Relax, relax." After a few minutes, your mood will be stable. [

2. Drug treatment: Chinese and Western drug anxiety can both stabilize the mood of patients and improve the state of the body.

3. The damage is great-patients in this state cannot or barely fulfill their social functions, lack a relaxed and enjoyable experience, and have a strong sense of pain. "It is not comfortable anywhere" and "It is better to die than to live" are their true inner experiences.

4. Psychologist's treatment is needed-Patients in this state cannot generally recover through self-adjustment and treatment by a non-psychologist. Psychologists generally use a combination of psychotherapy and medication to treat such patients. In the early stage of treatment, emotions are adjusted quickly through mood-adjusting drugs, and in the middle and late stages, psychological therapy is used to remove psychological obstacles and to achieve social function recovery and improve their mental health through psychological training.