How Do I Use Fluoxetine for Anxiety?

Pre-competitive anxiety (or PCA), also known as competition anxiety, is a state of anxiety related to competition.

Pre-match anxiety

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Pre-competitive anxiety (or PCA), also known as competition anxiety, is anxiety related to competition

In modern sports competitions, athletes pre-match anxiety is getting more and more attention, mainly because with the refinement and rapid development of high-end material selection technology and material selection theory, the technical level of participating athletes is getting closer, the transparency of training methods is increasing, The congenital gap in quality has gradually narrowed. In a fierce, evenly matched match, how the players' mental state before and during the match is particularly important to defeat their opponents and give play to their due level. At the 1984 Olympic Scientific Conference, Mr. Gruber of the United States pointed out that for low-level events, the biomechanical factors of the winning and losing athletes account for 80%; for high-level events, the psychological factors affecting the winning and losing athletes of the competition account for 80%. This shows that the psychological factors of athletes in high-level competitions, how to control pre-match anxiety plays a decisive role.

Pre-match anxiety includes mental and physical symptoms. The latter is mainly related to changes in autonomic nerve activity, which are manifested as increased heart rate, increased blood pressure, accelerated breathing, muscle tension, pale skin, insomnia, frequent urination, diarrhea, and so on. Psychiatric symptoms can cause good players to behave abnormally. These symptoms usually occur 24 hours before the game. Increased heart rate may be the main manifestation at the beginning. Long-term tension and anxiety will affect many systems such as nervous, endocrine, immune, digestive, respiratory, cardiovascular and urinary, and induce psychosomatic diseases such as migraine, functional hypertension, peptic ulcer and hyperthyroidism. Among severely anxious athletes, the incidence of irregular heart rate, digestive disorders, obesity, headaches, irregular menstruation, and bad breath is particularly high. ^[1]

From the perspective of the quaternary model, the main causes of anxiety are: (1) physical and biological factors, such as their own life attributes, genetic influences and physiological factors; (2) idea and psychological factors, such as cognition, emotion, etc. (3) Space-time ecological and social factors, such as changing seasons, overly dense cities, crowded living spaces, environmental pollution, stress, and excessive work pressure. ^[1]

The famous psychologist Spielberg believes that anxiety is divided into two types: state anxiety and trait anxiety. State anxiety generally refers to anxiety that is directly expressed by an individual in a specific situation and at a specific time and has obvious explicit behavior. It is a temporarily fluctuating emotional state. Trait anxiety refers to the more stable personality traits shown in the anxiety tendency. It is an individual's personality characteristics. Trait anxiety is that individuals will show a higher level of anxiety in almost every situation they face. It has a motivational role. It is the behavioral tendency acquired the day after tomorrow, that is, a person's tendency to treat things with a special emotional reflection method and degree no matter in which situation.

According to Yerkes and Dodson's law, the level of psychological tension and the effect of the activity have an inverted U-shaped curve. Too low and high levels of tension will affect performance. When the level of tension is low, thinking sensitivity slows down and movements are accurate Reduced rates, muscle relaxation, and inattention; high levels of tension, emotional confusion, excessive psychological tension, excessive excitement, muscular tension, and too narrow attention, causing the brain to lose control of the body and easily cause sports injuries.

The human heart rate is generally constant, but in fact there are slight fluctuations in the length of each pulse, which are not exactly the same. The average heart rate of healthy people is 72 beats / minute, the average heartbeat interval is 833 ms, and the standard deviation is about 40 ms. The standard deviation of this heartbeat interval is HRV (Heart Rate Variability), which is the heart rate variability. It originates from the modulation of the cardiac sinus node by the autonomic nervous system, and represents the coordination function of the autonomic nervous system. Multiple studies have shown that HRV is reduced in anxious athletes. Testing HRV can understand the level of anxiety, stress status and stress resistance of athletes. The HeartMath Institute of the United States and the World Academy of Natural Medicine through HRV testing and a series of studies have found that when athletes are in a "psychophysiological coherence" state, various physiological systems, such as the heart rhythm model, the autonomic nervous system, and brain function , Breathing and changes in blood pressure are in an orderly operation and physiological resonance state; psychological aspects of human emotions are also in a stable and positive state; in terms of cognitive function, memory is enhanced, concentration is focused, and responsiveness is improved. At this time, the HRV waveform is smooth and orderly, and a very high and narrow peak (harmonic peak) appears in the low frequency band (LF), concentrated at 0.1 Hz. Therefore, "psychosomatic harmony" is a state of psychological and physical harmony and a state of maximum overall function, which helps to efficiently study, work and cope with stress and challenges. The technologies and equipment that facilitated this state were used in astronaut, pilot, athlete training, and student education.

Diet adjustment is one of the important means of decompression. For example, avoid drinking caffeinated beverages, because caffeine can stimulate the central nervous system; nicotine in smoke is also irritating; alcoholic beverages may make people relax deeply , But will produce a rebounding irritating effect later; avoid edible ginseng, which contains stimulants; acanthopanax helps to keep the mind awake, and can relieve stress at the same time. Stress can lead to a lack of VC, VE, B vitamins and magnesium in the body, so it is beneficial to supplement these vitamins and minerals properly; drink plenty of water; avoid foods with high sugar content, such as juice, dried fruits, etc. The scientific diet plan should be formulated according to the different life attributes of the athletes. Some emerging energy and information medical instruments, such as the Tisconcord quaternary system, can formulate targeted diet plans based on the life attributes of different individuals, and can also relieve pre-race anxiety by taking peace of mind Symptoms.

Aroma can reduce anxiety and improve competitive state by activating emotional brain. In ancient Greece, students wore rosemary woven wreaths at the test room to enhance memory and increase responsiveness. Several studies have found that newly emerged chana made with fermentation technology, such as Ecolo, uses a "two-way regulation" energy balance formula. By smelling and sucking before the game, sympathetic and parasympathetic nerves can enter a cooperative state and improve mind-body harmony Degree, has a balance effect on a variety of bad emotional states such as tension, anxiety, depression, irritability, and helps improve the state of competition. Shana Shuhe helps improve insomnia and dreaminess caused by high tension.

Music is a certain frequency of sound wave vibration, carrying different physical energy. The effect of music on the human body should include two major aspects, psychological and physical. Athletes should listen to beautiful melodies and melodious tunes, which can transfer and resolve psychological anxiety and produce a pleasant feeling. Music can further regulate human body functions through the neuroendocrine system, such as promoting blood circulation, promoting gastrointestinal motility and saliva secretion, and strengthening metabolism, thereby energizing people. The latest TIS crystal bowl therapy is made of high-purity silica sand and has been used to ease test tension. The crystal bowl should be used according to the life attributes of different individuals, and selected different frequency bowls, and compiled a supporting method of use, which has a good help for pre-match tension and decompression.

Respiration regulation is a common psychological adjustment method for athletes to deal with emotional fluctuations on the spot, that is, to help athletes stabilize their emotions by slow breathing. Slow breathing can control anxiety, deceive the body and brain, and mistake us for quietness. The World Academy of Natural Medicine found that abdominal breathing is the most ideal method, and focusing on breathing can keep the brain away from negative emotions. The breathing regulation method can be combined with the Shanna therapy. For example, when Ecolew smells and breaths, using the breathing regulation method can better relieve the pre-match tension and improve the competitive state.

Benzodiazepines (also known as diazepam)

1) Advantages: Quick effect, more effective in 30-60 minutes

Positive anti-anxiety effect

The price is generally cheaper

2) Disadvantages: short duration of effect, not suitable for long-term use

Dependence may occur. Stabilizers are anxiolytic, like driving too fast, using the brakes on your feet, which works but is not suitable for common use.

3) Commonly used drugs: Laurazepam (Rolla): The commonly used dose is 2-3 times a day, 0.5-1.0mg each time; Jiajinganding (also known as alprazolam): The commonly used dose is 2-3 times a day, 0.4mg each time; oxazepam tablets (also known as Youfei): the usual dose is 2-3 times a day, 15mg each time. These three drugs are short- and medium-acting tranquilizers, which have good anti-anxiety and sedative effects. It is relatively weak and has less impact on daytime work. In fact, all antipsychotic drugs can be anti-anxiety, but the side effects and effects are different. The above three drugs are more commonly used.

Little common sense: Any drug that is followed by zixiong or zozolan is a stable drug.

4) How to use diazepam:

Intermittent medication principle: Take it temporarily when you are anxious, and do not take it for a long time.

Low-dose principle: small doses do not require large doses

The principle of regular drug change: If the condition requires taking antipsychotic drugs for a long period of time, changing to another antipsychotic drugs in 3-4 weeks can effectively avoid dependence. Note that when changing the medicine, the original medicine is gradually reduced, and the newly added medicine is slowly added. After the two drugs are taken for a period of time, the original medicine is withdrawn, and the newly added medicine is added to the treatment amount. If the patient is too old, the dosage is not large, and the effect is good, it is not necessary to change the drug. As long as the dose of the stable drugs is not increased, the effect is not weakened within the normal range, it can be considered that there is no dependence.

Experts remind:

In the early treatment of anxiety disorders, a sufficient amount of antipsychotic drugs should be used as soon as possible in order to control anxiety as soon as possible, because antidepressants exert anti-anxiety effects, it usually takes 2-3 weeks. Adverse effects on recovery. After taking valium for 4-6 weeks, you can slowly reduce it to stop taking it.

If diazepam is discontinued, slowly reduce the dose to discontinuation of the drug, do not stop it suddenly, otherwise it will easily cause a discontinuation reaction and aggravate the condition.

2. Antidepressants

If you use an excessive speed to compare anxiety, then the antidepressant is pine throttle, which can fundamentally improve anxiety, because the cause of anxiety is closely related to the imbalance of neurotransmitters in the brain, and antidepressants can improve neurotransmitters in the brain. Imbalances, thereby relieving anxiety and radically treating anxiety. The United States and China guidelines for the treatment of anxiety disorders clearly state:

1) General anxiety: The first-line treatment drugs are: paroxetine (Seletax), escitalopram (Raspor), venlafaxine (Bolexin, Yinuosi). Dulosi Ting.

2) Panic attacks: The first-line drug is paroxetine (Silot), escitalopram, and the second-line drug is clomipramine.

3) Social anxiety (social horror): The first-line drugs are paroxetine (Silex), buspirone, and the second-line drugs are escitalopram, sertraline, and venlafaxine.

The first-line drug means the first-selected drug with clear curative effect; the second-line drug refers to the second-selected drug if the first-line drug does not respond well. Through the treatment guide, you can see that Celeste is a first-line drug for all kinds of anxiety, and it is the first choice for all kinds of anxiety. Followed by escitalopram, duloxetine, and venlafaxine, with good results.

These drugs are characterized by:

1) Advantages: The anti-anxiety effect is certain

radically improve anxiety

No addiction, suitable for long-term use.

2) Disadvantages: The anti-anxiety effect is slow, and it takes effect after 2-3 weeks. It is often necessary to use a combination of stable drugs at the same time.

The price is too expensive.

Which medicine is used, the doctor will generally consider the patient's condition, physical condition, economic situation and other factors.

Experts remind:

1) Anxiety may be aggravated at the beginning of taking the drug, which is related to the side effects of the drug, and usually disappears after 2 weeks. Note that at the beginning of the medication, the dose is smaller, and the dose is gradually increased. If the anxiety is obvious, add anxiolytic drugs in time to relieve the anxiety.

2) After the symptoms are relieved, it is recommended to take the medicine for about 1-2 years. Please consult your doctor before stopping and increasing the dosage. Do not adjust the medication plan yourself.

3) There will be side effects during taking the medicine. Don't panic, pay attention to consult your doctor in time. In general, most of the side effects disappear after 2 weeks, because the body has already adapted. If the side effect is intolerable, ask your doctor to help adjust the treatment plan.

4) Individualized differences in psychiatric drugs refer to different patients with the same diagnosis, same age and sex, and similar physiques, but there are obvious differences in the effect of drug treatment. The effective dose of the drug and the side effects of the drug can also vary widely. When taking the medicine, patients should pay attention to keep in touch with the doctor and solve the problem in time. Don't be afraid of the side effects of the medicine, you can think of ways to solve it together.

Combining clinical medication experience, comment on these drugs:

1) Paroxetine tablets: trade names Celeste, Leyou, etc., belong to the SSRI class of drugs, acting on the 5-HT system, the commonly used dose is 20-60mg / day, can be taken in a single time, the anxiolytic effect is outstanding, it is a treatment The drug of choice for all types of anxiety disorders, because it is really effective, especially in the treatment of anxiety disorders is more prominent, when other drugs are not effective, switching to Xelote can still be effective. Therefore, in the guidelines for the treatment of anxiety disorders, it is clearly stated that it is the drug of choice for various anxiety disorders. A bit of experience: When you start taking Xelote, take half a tablet first, then add one tablet a few days later. If you discontinue the drug, slowly reduce it. Individual patients have a certain sedative effect after taking the medicine, which can be taken at night, usually in the morning; individual patients will have transient hypertension, and hypertension patients need to monitor blood pressure.

2) Escitalopram: Trade names are Lyspolide and Perot, which are also SSRI drugs. They act on the 5-HT system. The commonly used dose is 10-20mg / day. The anti-anxiety effect is good, and its side effects are small. It is especially suitable for the elderly and patients with cardiovascular disease. The price is relatively expensive.

3) Venlafaxine: trade names are Yinuosi and Bolexin, there are slow-release preparations and immediate-release preparations. The drug is a dual-receptor drug, which acts on 5-HT and NE neurotransmitters. The commonly used dose is 75-225mg / day. It has good antidepressant and anxiolytic effects. Note that anxiety may increase at the beginning of taking the drug, and you need to add antipsychotic drugs, which usually disappear for two weeks.

4) Duloxetine: the trade names are Xinbaida and Osparin. They are available in slow-release preparations and immediate-release preparations. They are also dual-receptor drugs. They act on 5-HT and NE neurotransmitters. The dosage is 60mg / day. The biggest feature of this drug is that it has its advantages in the degree of action of dual receptors, and has better antidepressant and anxiolytic effects.

Drugs such as sertraline, Lanshi, Xipu Miao, fluoxetine, clomipramine and other drugs are often used as second-tier drugs.

3. Buspirone, Tandospirone

It is a 5-HT-1A receptor agonist, which has a good effect on social anxiety and has no dependence. The disadvantage is that the effect is slow and it is effective in 2-3 weeks. If the patient has previously taken a tranquilizer drug, then take buspirone. The effect is not ideal, and it can be used in combination with antidepressants.

4. Chinese medicine treatment

TCM has many years of clinical certification for the treatment of diseases, which can be differentiated and treated according to the symptoms of the patient. Therefore, experts in treating anxiety disorders recommend TCM and traditional Chinese medicine for treatment. Significant effects. As to which drug is appropriate for each patient, the patient's condition, previous medication experience, efficacy after taking the drug, patient's tolerance to the drug and side effects, and the patient's economic situation must be considered. A decision is made after comprehensive consideration. At the same time, patients need to be closely followed up, and the treatment plan can be adjusted at any time so that the patient can gradually recover. ^[1]

Many anxieties originate from conditioned reflexes. That is to say, we used to be anxious or nervous about a certain stimulus or thing, and then we will feel anxious or nervous when we encounter a similar stimulus or thing. During the operation, first let the athletes in a relaxed state, and then start imagining the competition situation from the lowest level. When the athlete experiences anxiety, immediately adopt relaxation techniques to suppress the anxiety caused; after the effect is consolidated, imagine the higher level anxiety situation; When anxiety reappears, the relaxation technique is used to adjust and suppress the emerging anxiety phenomenon. This cycle continues uninterrupted until the anxiety of all levels of the athlete disappears.

Positive emotions can reverse negative states, including situations where success can be imagined, and not allow emotions to drift. According to research from South Dakota State University's Department of Psychology, one of the best ways is to think about things you can control in your life, not the weather and your teammates. For athletes who are nervous before the game, we encourage them to develop a positive attitude. For example, using Tisconcord and thought therapy, it is easy to clear the accumulation of negative emotions, make the heart evoke a heartfelt positive emotion, and cause favorable changes in the neuro-endocrine-immune system. , Improve the physical and mental harmony, reduce tension before the game, improve the state of competition.