2023-04-27 07:51:56
Does the “club of anxious people who treat themselves”, title of your book, exist?
It’s obviously an invention for comics! But I would point out that this type of club exists, it is also an ideal place to allow anxious people to meet and discuss the subject! Agoraphobes, panickers, big or small anxious people find themselves there. They see that they are not alone and look after themselves. The Mediagora association, for example, present in several large cities of the metropolis, was founded by people suffering or having suffered from anxiety. It is aimed at all French-speaking patients via a network of correspondents. [Note1]
What do we know today about the mechanisms involved in anxiety?
In anxiety, things are happening from a biological point of view at the level of the brain. We have known for 30 years that when people are in severe states of anxiety, the transmission of their serotonin is disrupted. Serotonin is the hormone of emotion. It is the neuromediator that regulates fear, therefore anxiety, but also depressed mood, impulsivity, compulsion phenomena… It is a central neuromediator: without it, the brain does not work well! Normally, like any neurotransmitter, serotonin migrates along the neurons, being transmitted from one to the other by crossing the synapses, which are the spaces between the terminals of the neurons… D n the brain of an anxious person, serotonin is captured, before being able to cross the synapses, by the serotonin receptors located at the level of the terminals of the presynaptic neurons: it cannot spread as it should. However, it is still unclear whether this is a cause or a consequence of anxiety… And besides, there is not only the biological, there is also the psychological! I detailed it quite extensively in the comics, anxiety is a disease of anticipation and rumination. The pathologically anxious person anticipates everything, he plans everything in advance because he is afraid of not being able to control what will happen to him. So he ruminates. In his head, it goes on a loop because he is afraid of not knowing how to solve problems. This has probably happened to him before in his life and he has lost confidence in himself and his abilities. And he develops a second psychological factor, which is the overestimation of the dangers. If you don’t know how to solve problems and you are afraid of not facing things, things will make you more and more afraid…
But as you explain in your book, anxiety is also a normal emotion, which everyone experiences in the face of stressors… When is it considered pathological?
Anxiety is part of life, and it is also a driving force. Provided you can tame it and can bear a small dose of anxiety. When anxiety lasts more than 50 minutes a day and is intense, there is a cognitive invasion, with negative thoughts that will act on our body. It is psychic and somatic. It is accompanied by major functional impairment (you can no longer work, you are unable to move normally)… There is also a social impact. The very anxious are handicapped in their daily life. Anxiety that is accompanied by avoidance of important situations for you (travelling, meetings, etc.) and that has major repercussions on your social, private and professional life is considered pathological. If it is not taken care of, not only will it not decrease, but it may be accompanied by complications such as addictions, depression and an association with another anxiety disorder…
How are these so-called severe anxieties treated?
The development of molecules resembling serotonin and capable of binding to serotonin receptors or “serotonin reuptake inhibitors” (IRS) has made it possible to develop basic drug therapy. SRIs allow natural serotonin to be transmitted from neuron to neuron without being “short-circuited” by the receptors. Behavioral and cognitive therapy is added in order to give the patient the means to manage his anxieties. The patient will learn body methods, such as muscle relaxation or cardiac coherence for example, and thought management methods through cognitive therapy. And, at the end of his therapy, when he will have become autonomous with regard to the management of his anxieties, he will not always need an external medicine, not even a plant for that matter, because he will know how to adopt anti-anxiety behaviors! At this time it will be time to gradually withdraw the drug for patients for whom it is possible.
Of course all cases are different because we work on individual cognitive schemes. But the idea is to learn to change behaviors, negative thoughts and manage emotions . For many patients, this is going to be enough. In some, more serious problems, such as childhood trauma for example, will require longer psychotherapy treatment. But on the whole, behavioral and cognitive therapies, which are validated by numerous studies in the treatment of anxiety, remain brief therapies which aim to make the patient autonomous — and not, as in psychoanalysis, to make him dependent on therapy!
Read also
Anxiety ? Tame your amygdala
What about “anxiolytics” or even plants known to be “soothing”?
Anxiolytics have no place in the long-term treatment of anxiety. These benzodiazepines do not act on serotonin, but on GABA, a braking system! Their calming effect is accompanied by undesirable effects and a risk of addiction. And then if you take an anxiolytic as soon as you are confronted with a distressing event, you feed the “all or nothing” functioning (“I only act if I have no fear”) that the therapy is trying to get you out of. ! Sleeping fear is counterproductive.
As for plants, it is very insufficient to relieve the severe type of anxieties that I deal with! And then what also bothers me is that it’s a bit like with anxiolytics, it gives the impression that the solution comes from outside. But what we are trying to do is to teach patients to manage their anxiety themselves, through behavioral, emotional and cognitive solutions. In the end, in a certain number of cases, people no longer need anything: they no longer need medicines, plants or anxiolytics, or drinking or taking drugs! It is very important here to emphasize thatthat the body and the spirit are linked! Several studies also show that behavioral and cognitive therapies given to patients who have phobias or obsessive-compulsive disorders modify their cerebral blood flow. It is observed in brain imaging: the psyche modifies the brain! It is a plastic organ open to the world…
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But by the way, what about the eco-anxiety that we talk about more and more with the ecological emergency… and that you don’t talk about at all in your book?
I think we should talk about ecostress rather than ecoanxiety! But it’s a somewhat delicate subject, quickly prone to controversy… Ecological problems, but also the war in Ukraine, a serious illness that you have just been diagnosed with, or the death of one of your relatives, generate anguish among Mr. and Mrs. everyone. However I refuse to say that ecological problems can be at the origin of “ecoanxiety”: what I simply see is that there are anxious people who polarize everything on ecology. It becomes an obsession for them and they no longer see the other anxiety factors: as soon as you zoom in on a theme, you no longer see what’s all around! I pqui pass in the background. I think that, probably, those who are called “ecoanxious” have a prior anxious ground. And Calling yourself “eco-anxious” is socially much more acceptable than recognizing that you actually have an anxiety disorder… Some of my colleagues say “eco-anxiety is not a disease, it’s a normal phenomenon, it’s a political problem. But I’m a psychologist, I’m not a politician, I can’t change the world… On the other hand, I can help you change your relationship to ecological problems. It’s the only thing I can do in therapy, help people adapt to the world they live in, but that’s already a lot…
Go further :
– Frédéric Fanget, Catherine Meyer, Pauline Aubry, The Club for anxious people who take care of themselves , editions Les Arènes, March 2023
– [Note 1] More details on this site, which offers an interactive map: ]
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