Over the past two centuries, psychology, and in particular its clinical application, has altered many of its postulates and concepts used to establish subjects for scientific study and analysis.
Among them are diagnostic systems, which not only added and removed psychological disorders, but also renamed existing ones in terms that one might think are something else.
One of these disorders is anxiety neurosis, a term that would be rare to find in a patient’s medical history today. Although outdated, their definition and currency are very interesting and tell us about the development of behavioral science (psychology) and psychiatry. If you want to know more about it, keep reading.
What is anxiety neurosis?
The term anxiety neurosis is an expression, now obsolete, originally coined by Sigmund Freud. By this term, the famous Austrian psychoanalyst referred to a person who suffered from periods of deep anxiety and strong bodily tensions. When a person was diagnosed with this tag, it meant that they were suffering from a state of high excitability and also felt very worried about their future, especially seeing very disastrous (anxious waiting).
Although no psychologist today gives anyone the diagnosis of anxiety neurosis, it should be noted that it has been essential in understanding anxiety disorders and the classifications that have been made of them. The current equivalent of this type of neurosis would be a panic attack.
Neurosis in the history of psychology
As we have already said, before the current development of the classification of anxiety disorders, the term neurosis was used with a definition very similar to the current one for this type of disorder.
Freud devoted part of his work to developing a detailed description of disorders sharing the label of neurosis, such as phobic neurosis, obsessive-compulsive neurosis, depressive neurosis … and, being the main subject of this article, anxiety neurosis. Today, all of these neuroses have been renamed under different categories, especially in anxiety disorders.
However, who first used the term “neurosis” was not the most famous psychoanalyst of all time, but a Scottish physician and chemist, William Cullen, who first used the term in 1769. He used this word to refer to sensory and motor disturbances caused by diseases of the nervous system.
In this way, the word neurosis designated, at the time, any mental disorder which would cause a kind of distortion in the rational thought of those who suffered from it, as well as diminish its functioning at the family, social and professional level.
Nowadays the word neurosis has been practically forgotten in academia. No clinical psychologist, no matter how psychoanalyst, would use the term to diagnose someone.
However, that doesn’t mean the word has been completely forgotten in popular culture. Its use at the familiar level is synonymous with obsession, nervousness, and eccentricity, although it cannot be taken seriously as a clinically relevant term.
What are your symptoms?
As we have seen, anxiety neurosis is no longer a valid diagnostic label in clinical practice, and therefore to say that it presents symptoms would not be entirely correct, since really, as it has been. conceived at the time, this pathology would not exist. However, we can half overlap with the concept we have today of what panic disorder is.
Thus, anxiety neurosis can be understood as a pathological problem in which the person has episodes in which they feel great fear and anxiety, Appearing suddenly and without any warning. The seizure begins suddenly, without there being a clear factor as to why the episode begins to occur.
These episodes of this type of neurosis coincide with panic attacks, which vary in duration, about 10 to 20 minutes per hour. Its frequency of occurrence also varies, which can occur from time to time or, in the most worrying cases, several times a month.
The anxiety that the person suffers from is very high, makes their heart racing and usually experiences chest pain, which often makes them think they are having a heart attack.
Below is a list of symptoms which, although taken from DSM-5 for panic disorder; most of its symptomatology coincides with the original conception of anxiety neurosis.
- Excessive fear of losing control, going crazy or dying.
- Tremors all over the body.
- Sweating and chills.
- Increased heart rate and feeling like a heart attack.
- Sensation of severe chest pain with no apparent biological cause.
- Feeling short of breath with no apparent biological cause.
- Sensation of suffocation with no apparent biological cause.
- Nausea, hyperacidity, acid reflux and the urge to vomit.
- Mateos and feeling of loss of balance.
- Numbness of the limbs.
- Dry mouth and throat.
- Sleep disorders.
- Decreased sexual desire.
During the crisis, not all of the symptoms presented here are manifested, but a large part of them are. The discomfort experienced by the person during the panic attack is very highThis can even increase his anxiety which in itself is high. This is one of the factors that can prolong the duration of the episode.
The attacks being unpredictable, the person lives in fear of being able to live them in situations where, if something happens to him, his physical integrity could be endangered. People who suffer from this anxiety neurosis would be constantly on alert.
As already mentioned, many symptoms suffered during the crisis they have no apparent biological cause. Many times those who suffer from panic disorder, even though their doctor has told them that they do not have any health problems explaining the chest pain and shortness of breath, are still afraid of dying from a heart attack or suffocation.
Assignment in daily life
Although the term anxiety neurosis is outdated, it is not possible to know any statistics and studies that explain how it interferes with the daily life of patients suffering from this disorder, it is possible, as we have done in the section on symptoms, extrapolate to how people with panic disorder go about their daily lives.
Panic attacks can occur in unique ways, especially in high stress situations. The person may be overwhelmed by the demands of daily life, Especially if there were events that put you in particular tension.
However, the interference is very serious when the panic attacks occur frequently and without warning. The person does not have the capacity to know what will activate all of the symptoms mentioned above, which makes him afraid to take daily measures which can lead him to such an unpleasant situation.
The person is constantly living in a state of hypervigilance and tension. He fears that the future will get worse than the way the present lives. He is also afraid that this will happen to him just when he finds himself in a situation where they will barely be able to help him, which causes him to develop agoraphobia as a side effect.
With agoraphobia, contrary to the popular idea that it is the fear of leaving home, it really refers to the fear of being in a situation where you have a problem and no one can help us.
As a result, the person suffering from panic disorders associated with agoraphobia it begins to restrict behavior, by avoiding certain places or avoiding leaving your place of safetyUsually, always be at home with someone.
The treatment for anxiety neurosis would be the same for panic attacks. The aim would be to help the person suffering from these episodes of anxiety to develop and exercise more functionally in their daily life, in order to enjoy a family, social and work life as close as possible to the normal. for that psychopharmacology must be combined with psychotherapy.
First, the pharmacological route is typically used with SSRI antidepressants, especially paroxetine, sertraline, and fluoxetine, which selectively inhibit serotonin reuptake, which elevates mood. IRSN, in particular venlafaxine, would also be prescribed.
Other drugs that are prescribed sedatives such as benzodiazepines, which are central nervous system depressants and induce a state of calm. The most commonly used for this condition are alprazolam and clonazepam, Although its use is limited in short-term treatment due to its high risk of addiction.
The second is psychotherapy, which would focus on removing distortions in the person’s mind that make them think they are going to have an impending panic attack that will end their life. It also aims to make you understand that there are not as many dangers as you might think and that if something happens to you there is a good chance that someone will end up helping you if you were, for example, in on the street or in a public space.
Strategies for using stress, relaxation, breathing control are taught and also work with ideas that can serve as anxiety activators. For that, usually uses cognitive behavioral therapy (CBT), in which the person is encouraged to express their feelings and ideas about their problems and how it affects their daily life, to introduce changes in the way they think, feel and behave.
So, under the general concept of anxiety neurosis, there is a complex reality which can be embodied in many different types of problems and which require a specific and personalized approach. This is why, as applied psychology evolves, it tries to move beyond old clinical categories and focus more on symptoms related to a given context, starting from here to establish what type of intervention psychotherapy would work. better.
- American Psychiatric Association (APA). (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Ampolla C. and Ballester, R, (1997). Panic disorder: assessment and treatment. Barcelona, Spain: Martínez Roca.
- Calleo, J. and Stanley, M, (2008). Anxiety Disorders Later in Life: Differentiated Diagnosis and Treatment Strategies. Psychiatric time. 26 (8): pages 24 to 27.