Is it anxiety? Is it Panic?

-Ask the Expert-

Question:

Dear Doctors,

 I have a simple question to ask. As I was leaving the house today, I had one of those feelings that people can have when they are facing an exam or they are emotional and scared: tachycardia, agitation, and I am sure that my hands were trembling as well. I was very much agitated and anxious, as if I was afraid of something even though there is nothing that justified it. I tried to assure myself verbally and called a friend in order to talk about something else. I did calm down after a while.

I want to ask if this could be a type of mini-panic attacks or maybe only a bit of repressed anxiety. I don’t think that I currently have huge problems; it could be because the attitude of my father is rather anxious when he thinks about my future: he would like me to have clear ideas, big projects, and to follow his ideas. However, this period is not one of the worse regarding this. In fact, last year he gave me a lot of anxiety always accusing me of “not having time” or “make the wrong choices” .. and always pointing out that I have the wrong life and how it contradicts everything he knows.

I am in University with maximum grades possible and in addition, taking a course for a degree outside of the university related to my studies, but it is never enough.

Excuse me, at last I’ve dwelt more than I intended to!

Thank you very much for the time that will be dedicated to me.

 Answer:

Good day Bruna,

It seems like you have already done the diagnosis and timely intervention, with their own means. I give you my compliments. You were cautious before concluding it to be panic attack; even if the symptoms that you’ve had do not differ in quality, but rather in intensity.

 As for your question, I would not define it as a repressed anxiety, but an anxiety that suddenly became manifested, in which the cause can be found in the relationship with the family. The continuing requests from your father to “do the best and doing it better” can generate a conflict between the desires to achieving goals following a plan and the need to please your parents. 

 The conflict that I am talking about is not seen by the discussions that you have with your father, but from you inside. In the unconscious part of your mind, you cannot agree on how to act and on what to obtain. As an example, it is almost like, even though you are always staying ahead and obtaining good grades in your studies, there is always a little voice that says “you have not done enough and your father is not happy.”

 If your relationship with your family continues in this way, most of your energies will be dispersed with anxiety and with non-satisfactions. These energies instead can be used to clarify with your father what he is doing and the goals he has for the future. If the conversation within your family is not sufficient to make any changes, you may contact a specialist that can help negotiate between. It would also be useful to find an individualized approach to establish a consistency in your mind so that you can create a harmonic and equilibrium act to pursue your dreams with better results and waste less of your energy.

 To conclude this, in order to find calmness and harmony within yourself and prevent anxiety attacks, you should learn the technics of relaxation that are simple but with great therapeutic effects; it would need to be practiced constantly and would be best if it is learned from an expert.
I wish you the best.

Answer:
Giovanni Iustulin: Psychotherapist
Question:
Bruna, 22 years old
Publication Date: 09/14/2006

For other articles on the topic check out Scared of everything and What is Anxiety Disorder
Check out the original article here

Hypochondria: fake sickness?

-Ask the Expert-

Question: 

My wife, 68 years old, always had an unnatural inclination to magnify any pain she perceived. This thing worsened with aging and now, after 40 years of marriage, it has become a real problem for my daughter and me.

My wife absorbs illnesses like a sponge, she continuously visits doctors, but she does not trust any of them, especially if the diagnoses are good. Anyone that dares to say that her pains are not real, or at least are magnified, becomes her enemy. She constantly talks about her sicknesses, and she would like to be assisted as sick.

I tried to tell her that she should be checked for hypochondria, but she told me that I am selfish, self-centered, and that I am the one who need psychological cures. I do not know how to handle this anymore; my life is becoming really hard. Please help. 

Answer:

I will not tell you the definition of hypochondria, since in few lines you made a great description of this problem. Hypochondria come from a wrong interpretation of non-pathological physical sensations, and it persists even when the subjects affected are reassured that no sickness has been detected.

Obviously, a complete medical evaluation needs to exclude any organic condition that might explain the physical symptoms of your wife. Sadly we know that this evaluation will not be sufficient to reassure the subject, but it is necessary for a psychotherapist to begin a therapy.

The problems come now, as you already experimented, since the subject will almost never accept the diagnosis of hypochondria. Almost always the subject will get mad when someone tells him that “there is nothing wrong”, or that their symptoms do not have a serious cause, because this contradicts what the subject actually feels. It is often more useful to tell this patients that they have an increased level of sensitivity of their physical perceptions.

There is also the risk that these subjects, with a history of whining, sometimes in life receive a wrong or superficial medical evaluation for sicknesses that actually exist. It is always better to be careful.

Hypochondriacs are actually sincere, they do not try to fake their symptoms; they actually feel them. Two thirds of the hypochondriacs are affected by multiple coexistent psychological disorders: Major depression, panic attacks, Obsessive Compulsive Disorder, and Anxiety Disorder.

According to the psychoanalytical theory, the subject is scared to die because unconsciously wants to die. Hypochondriacs want to feel sick, because as long as they are sick, there will be someone out there that want them alive; as long as they are sick, they do not risk to die.

One of the most indicated therapies for hypochondria is the “behavioral cognitive therapy”. In this therapy, the patient learns new thinking paths and more functional behavioral modes, trying to get rid of the vicious circle that is hypochondria. Sadly, to cure hypochondria can be pretty difficult, since the subjects almost never fully believe that the origin of their pain is only psychological. Most of them do not want to start a therapy, since they feel accused of making up their symptoms, or because they believe that their doctor or family want to get rid of them.

In conclusion, hypochondriacs need their symptoms because they need attentions, so unconsciously they do not want to heal because they are worried that they will be abandoned when this will happen.

I do not know which are the deep, new and old, motivations that your wife has to feel sick. Of course, telling her that she is crazy is not going to help. It would be useful to try to make her understand that “some of her sicknesses” can be cured with the help of a psychotherapist. Not to cure the mind itself, but to help the mind to cure the body, and to be reassured that, even when she will feel better, she will not be alone.

Answer:

Giovanni Iustulin, Psychotherapist

Question: Joe, 69 years old

Publication Date: 06/26/2006

Check out the original article here