NIKOLAOS A. KARAKATSANIS
PSYCHIATRIST – PSYCHOTHERAPIST
Are there many people suffering from psychological problems?
Every moment, about 10% of the general population suffers from depression, while more than 10% suffers from some disorder related to stress. At the same time, many other people face a variety of personal difficulties and psychological problems, which are related to their relationships with other people, their nutrition, their sexual life, the physical effects of stress or even with the total function of their own.
The frequency and extent of these difficulties is what makes the need of efficient interventions imperative.
Stress is a term used to describe the normal feeling of someone who faces a threat, a danger or when under psychological pressure. When someone is stressed, he usually feels agitation, discomfort and tension.
Feelings of stress can be caused by life experiences, such as job-loss, the ending of a relationship, a serious disease or accident, or the death of a close person. It is reasonable for someone to feel stressed under these circumstances and usually anxiety feelings last only for a limited amount of time.
Due to the fact that feelings of stress are something common, it is important to know the difference between normal stress feelings and symptoms of a stress disorder.
Stress disorders are not just a single condition, but a group of diseases which are characterized by persistent stress feelings of high degree, excessive discomfort and tension. A person can be diagnosed with a stress disorder if the level of anxiety is so high, that disturbs significantly his everyday life and does not allow him to do the things he wants to do.
Stress disorders are the most common psychic disease and affect 1 in 20 people at any given time. They often start at early adulthood, but they can also start during childhood or later in someone’s life.
Stress disorders are more likely to affect women rather than men. They often start abruptly without any profound reason. Generally, they are accompanied by intense physical symptoms such as dyspnea and rapid heartbeat. Other symptoms may include sweat, trembling, feeling of suffocation, nausea, stomach disorders, dizziness, tingling, feelings of control loss and/or feelings of imminent misfortune.
Stress disorders affect how an individual thinks, feels and behaves, and if they are not treated they can cause great mental tension and significantly disrupt his life. Fortunately, treatment for anxiety disorder is usually very effective.
Which are the main types of stress disorder?
There are several different types of stress disorder:
- Generalized stress disorder
Generalized stress disorder is characterized by excessive, uncontrolled and unrealistic worries for everyday things such as health, family, friends, money or profession.
People who suffer from this disorder are constantly and irrationally worrying about something that may happen to them or to their beloved ones and this worry is accompanied by a feeling of constant fear.
- Panic disorder with or without agoraphobia
Those who suffer from this disorder can have extreme panic attacks in situations with which most people wouldn’t feel fear. These crises are accompanied by unpleasant physical anxiety symptoms, such as the feeling that the person is having a heart attack. They are also afraid that they are going crazy or that this crisis will make them lose control.
These fears can lead some people to agoraphobia, which can severely disturb their life.
Agoraphobia is not a specific, separate disorder, but an element of the anxiety disorder which is featured by the fear of being found in a place or situation which will be difficult to escape from, or by fear they will get no help if they need it.
People who suffer from agoraphobia usually feel fear in a complex of situations such as super-markets and department stores, in crowded places, in restrained spaces, in public transport, in elevators and on highways.
People who suffer from agoraphobia may find relief when they are with an intimate person, such as their husband/wife, a friend, a pet or if they have with them a familiar object, such as some medicine.
- Specific/special phobias
We all have some unreasonable fears, but phobias are intense fears for specific objects or situations, that disrupt a person’s life. These fears may include fear of heights, water, dogs, κλειστούς χώρους, snakes or spiders. A person with a specific phobia can be calm when the object which causes him phobia is not around. But, when they face the object or the situation that causes them fear, they may feel excessive stress and have a panic attack. Individuals with phobias may do anything to avoid situations which would force them to confront the object or situation which frightens them.
- Social phobia
Social phobia is a strong and persistent fear for conditions of social gatherings or performance situations. The individual is afraid of getting carefully examined by other people and will be negatively judged. Social phobia can considerably disturb the individual’s life, because these people try to cope with this phobia by avoiding social affairs or by tolerating them with intense anxiety feelings.
They may even limit their actions in front of others, e.g. eating, talking, drinking or writing, or totally avoid contact with others.
- Obsessive-Compulsive Disorder (OCD)
This stress disorder consists of continuous unwanted thoughts and as a result, the individual performs complexed, standardized, repetitive actions in their effort to control or drive away the persistent thoughts.
These actions are usually time consuming and disturb significantly their everyday life. For example, some individuals feel the need to constantly wash their hands, check over and over again if they have locked the door or if they have turned the oven off or they follow rigid rules of order. The individuals who suffer from OCD usually feel intense shame and keep these repetitive actions secret even from the family.
- Post-traumatic stress disorder (PTSD)
People who have suffered a major traumatic experience, such as war, torture, car accident, fire or personal violence, can feel terrified even if there has been a long time since the traumatic event occurred. Not all people who have experienced something traumatic suffer by PTSD. People who do suffer from PTSD live over and over again the traumatic experience through uninvited and torturing memories, such as nightmares or images from the past (flashback). Flashbacks are often caused by occasions related to the traumatic experience, which the individual is trying to avoid. Also, a feature of PTSD is that the individual feels emotionally numb.
Coexisting mental health problems
Individuals who suffer from a specific stress disorder are likely to suffer from another disorder, or they may suffer from depression as well. For more information about depression you may read the newsletter “What is depressive disorder?”
Along with the stress disorder, harmful alcohol use and drug use also coexist. This makes treatment more complicated, and it is important to face effectively the alcohol and drug use.
- What causes stress disorders?
There are many factors related to each other, as far as stress disorders are concerned. The causes of a specific disorder vary and it is not always easy to distinguish a cause in each case.
- Hereditary factors
It is proven that the tendency to develop some stress disorder exists in some families. This is similar to predisposition for other diseases, such as diabetes and heart disease. People can also “learn” to correspond in an anxious way from their parents or other family members.
- Biochemical factors
Some stress disorders can be related in part to a chemical imbalance in the brain. The neurotransmitter that regulates emotions and body reactions may be involved.
Individuals with a certain temperament may be more prone to stress disorders. Individuals who are easily stimulated and upset and who are very sensitive and very emotional are more likely to develop some stress disorder. Individuals who were shy and timid as children may be more probe to develop some stress disorders, such as social phobia.
- Reaction by custom
Some individuals who have been exposed to situations, people or objects which cause anxiety or disturbance may develop a stress reaction. This reaction can be reactivated when the individual confronts again or thinks of this situation, person or object.
Stressful life experiences are related to the development of some stress disorders, especially to post-traumatic stress disorder.
What kinds of treatments exist?
Stress disorders can be treated very effectively. Although each disorder has its own specific features, most of them correspond well to psychological treatments or medication.
Treatments which combine psychological treatments with medication often have the best long-term results.
Effective treatments for stress disorders include the following:
- Psychological treatments such as cognitive-behavioral treatment (CBT), which aim to change the patterns of thinking, behavior and beliefs that may trigger anxiety. Part of the treatment may also be the progressive exposure of the individual to those situations that cause stress (desensitization).
- Ways of stress treatment and relaxation techniques.
- Antidepressants play a crucial role in therapy of some stress disorders, while at the same time they treat the coexisting depression.
- Anxiolytic drugs which affect specifically the neurotransmitters’ system in the brain may be useful sometimes. Medicines don’t treat stress disorders, but they can keep the symptoms under control while the individual undergoes psychological treatment.
- Family and friends of people who suffer from stress disorders may often feel confusion and mental tension. Support, education and better understanding of these issues by society are all a crucial part of the treatment.