Andrés Quinteros: "Stress is also adaptive and necessary"
Everyone, at some point in our lives, we have felt anxiety . For example, before performing an exam in which we played a lot or when we had to make an important decision. This psychological reaction is, in many cases, something normal, which appears in situations of stress or uncertainty.
- Related article: "Types of stress and its triggers"
Interview with Andrés Quinteros
Nowadays, anxiety disorders are spoken with a certain frequency. But what differentiates normal from pathological anxiety? In today's article we interview Andrés Quinteros, founder and director of the Cepsim Psychology Center in Madrid, to help us understand what anxiety disorders are and what we can do to prevent them.
Jonathan García-Allen: Good morning, Andrés. Anxiety and stress are often seen as similar states that are sometimes confused. But what is anxiety? Is anxiety the same as stress?
Andrés Quinteros: Well, to answer these questions I will begin by briefly describing what anxiety is and what stress is.
Anxiety is a normal emotional state that plays a very important role, since it warns us that there may be a danger or threat and functions as an internal alarm system. Therefore, it is useful and adaptive. I emphasize this because sometimes you have the perception that anxiety is in itself something negative. This only happens when it is inadequate, that is to say the alarm goes off when there is no danger, or when it is excessive, too intense, or also, when it is prolonged too much in time.
Stress can be defined as a psychophysiological process that begins to manifest itself when we begin to perceive that a new or challenging situation may overwhelm us or that we believe is difficult to resolve, so we activate ourselves to seek an answer to that situation. The new situation can be something positive, such as the preparation of a wedding, it can be a challenge, a new work project or it can be something unexpected, like facing the process of an illness.
With any and every one of these situations, our stress will be activated, tensing our body to the maximum to optimize its performance and prepare for what is coming.
For this reason, stress is also adaptive and necessary, since it enables us to take action to respond to problems and situations typical of life. It becomes negative, when that tension to the maximum does not cease and continues indefinitely in time producing all the wear and tear and own discomforts, such as sleep disorders, irritability and low tolerance to frustration.
However, sometimes it can be difficult to differentiate anxiety from stress, since anxiety can be a symptom of stress, that is, when faced with a stressful situation, anxiety can arise, as well as other emotions, such as frustration, sadness, anger.
Another difference is that in stress, the stressor object is in the present, triggered by a stimulus that appears: a task that I have to do or a problem that I have to solve. While anxiety may arise anticipating an event that may happen in the future in this case, it is anticipatory anxiety or even feeling the anxiety without knowing very well why it is, without being able to identify something external that triggers it.
In this sense, stress has to do with the demands that the environment presents to us, while anxiety can come from something more internal, can be anticipatory as I have already indicated and if it appears from the demands of the environment, then being a symptom of the stress. Following this thread we can say that stress is caused by external factors that demand something, while anxiety can be caused by this, but also and mainly by internal factors-psychological and emotional-that can anticipate a threat and can even appear without apparent cause specific or real threat.
J.G.A: Is anxiety a disorder? When does it go from being a minor problem to generating a real problem that affects normalcy in a person's life?
A.Q: Anxiety as an emotional state is not a disorder, I think it is important to differentiate them, all emotions are useful and necessary. I do not like to differentiate between positive and negative emotions, but between those that produce feelings of well-being or discomfort, pleasure or displeasure. All emotions felt properly are positive and all can become negative.
It is inevitable in certain situations to feel fear, anxiety, grief and many times and on the contrary, feeling joy or pleasure in some situations is negative.For example, for a person addicted to the game for example, at the time of being in the game room, they express being well, with sensations that they identify as pleasant and if they gain those pleasant sensations they increase. To return to feel the same way seek to repeat it, play again. In this sense, these emotions that produce well-being are dysfunctional in this situation because they are a support for the addictive behavior.
Now, like all emotion, it becomes a problem when its intensity is very high or when it appears in certain situations generating an unnecessary alarm, altering without reason. For example, as I indicated earlier, we can feel anxiety, although nothing that happens in our life explains or justifies it. There are even people who claim to be fine with their lives, but who do not know why anxiety does not leave them alone. In these two situations, anxiety becomes a problem. It is also when small things that can cause anxiety low, this is disproportionate and overflows.
- Related article: "Nerves and stress: what is anxiety for?"
J.G.A: Anxiety disorders are the mental illness most talked about, even ahead of depression. Are they disorders that only developed countries appear?
AQ: If so, we talk a lot, because it happens frequently, along with depression are the problems so people consult us more and there is also a very generalized knowledge of their symptoms, so people identify now more if he is anxious or depressed and shows up in the office as follows: "I am coming because I am anxious".
Studies indicate that in the past decade and in the current decade, the consumption of anxiolytics has grown by almost 60%, in 2016 data were indicated that Spain was leading figures in the consumption of certain anxiolytics. Therefore, much is said about it. I also believe that today's society and its cultural, material and social demands provoke an increase in anxiety and stress.
With regard to the second question, I can indicate that anxiety problems do not only occur in developed countries. I have lived and worked as a psychologist in 4 countries and in all of them, anxiety disorders were present, even if people's life situations changed. But what I would dare to say is that currently and especially in developed countries, there is a very strong hedonistic tendency, which leads to deny the emotions that produce displeasure and to want to quickly get rid of them.
The great demand is that we always have to feel good, and that this paradoxically exerts a pressure that generates stress and anxiety. This provokes, and I see a lot in consultation, what I would call a kind of phobia of negative emotions, as if it were forbidden to feel bad and as I pointed out before, all emotions are useful and we can not do without fear, anxiety, anger, frustration, etc. And we already know that when we try to deny an emotion, it grows stronger and anxiety is no exception.
If we refuse to feel it, anxiety is triggered, I think we have to re-educate ourselves on the importance of being able to cope better with these emotions since they sometimes constitute signs of what is not right for us. By trying to remove them without further ado, we lose a kind of compass that serves to guide us.
J.G.A: Anxiety disorders is a general term that covers different pathologies. What types are there?
A.Q: Yes. The pathologies of anxiety are varied we have panic attacks, generalized anxiety, phobias are also included, such as agoraphobia, social phobia or simple phobias, as well as obsessive-compulsive disorder and post-traumatic stress.
J.G.A: What are the main symptoms of a panic attack and how can we know if we are suffering? On the other hand, what kind of situations can cause it?
A.Q: A panic attack, is a very intense and overflowing anxiety response, where the person has the feeling that he loses total control of the situation.
One of its main characteristics is the sensation of terror that the person feels because he thinks he is going to die or because he has the idea of suffering a catastrophe, that he is going to die or to be going crazy. This sensation is accompanied by other physical symptoms, such as tremors and feelings of suffocation or suffocation, dizziness, nausea, palpitations, sweating, agitation and also chest pain, which makes people think that they may be suffering from a heart attack. These would be its main symptoms.
We can not say that one situation or another can cause a panic attack, I think it is a combination of 2 factors, on the one hand, the internal processes in which we include the configuration of the personality that in some cases may be prone to anxiety , the locus of internal control of emotions, the style of attachment, etc. and on the other hand, the external situation that the person is going through.
If we only take into account the external, we can not answer the question of why in the same situation people can react in very different ways.This is due to their personal characteristics.
What it could mark is that there is more predisposition to get to suffer from panic attacks, when the person is prone to anxiety and does not seek help to solve it. Another important point to understand this problem is that after a panic attack, the person is often very afraid that another attack will occur again and this is usually the cause of the second and subsequent panic attacks: the fear of fear.
J.G.A: Are the cases of anxiety disorders increasing due to the crisis and the socioeconomic situation we are experiencing?
A.Q: Yes, of course and not only of anxiety, but of many more psychological problems such as depression, the difficulties to face the changes, the overcoming of the situations of loss of work, of status, of social condition. Situations of crisis, cause uncertainty, the feelings of danger and fear increase and are a breeding ground for increased anxiety, despair and overwhelm for not being able to resolve.
J.G.A: What causes anxiety disorders?
A.Q: It is a difficult question to answer today and will depend on which psychological theory we are inserted, there are streams of thoughts that point to organic causes and others that indicate their cause in the problems of attachment, the link and experiences in development. I personally believe that although we come with a biological basis that determines us, the attachment relationship, the affective bond and the experiences that we live in our development will mark us to be more vulnerable or more resilient in the face of anxiety.
** J.G.A: What should we do in the face of an anxiety crisis? **
A.Q: The psychoeducational part in the treatments of anxiety and panic attacks is very important, since they will help to prevent and / or minimize the magnitude of the attack. First, it is important to get the person to lose the fear of feeling anxious, not going to die or going to suffer a heart attack. It is only anxiety that your mind creates and that it is your own mind that can regulate it, this at first surprises the person, but then it is a thought that helps in the moments when the anxiety increases.
It is also important to indicate that anxiety is not an enemy, it is really an emotion that warns us that something is not going well and that maybe there is a situation that you have to overcome, accept or leave behind.
In addition to the above, it is important to teach some body regulators of anxiety, such as breathing control, mindfulness is now widely used and it is also useful to teach them thought control techniques. Of course also if necessary, having the possibility of going to the medication for anxiety, but always controlled by a specialist psychiatrist. And of course if you want to properly regulate anxiety, a psychological treatment is the most appropriate.
J.G.A: What treatment exists for anxiety disorders? Is it good to use only drugs?
AQ: Well, there are many procedures that are good and effective, I can tell you how I work, I think it has been more effective to perform an integrative treatment, because I believe that each person has their particularities, so each treatment has to be specific . Even if 3 people with the same problem go to consultation, for example panic attacks, I will surely perform 3 different treatments, since the personality, the history, the coping modes of each one are different.
Therefore, with some I will apply for example EMDR, sensorimotor therapy, Gestalt, hypnosis, cognitive, internal family, etc. or a combination of them. What is done in the sessions will depend on each case. I think that can be more effective.
Well, now with the question of whether it is good to use only medication, as I said before, it depends on each case. I believe that in a group of people, for example, therapy without medication works very well and there are cases in which it is necessary to do a combined work with psychotropic drugs. It will also depend on what problem we speak, obsessive-compulsive disorder is not the same as a phobia, in the first case it is likely that you need a combination of therapy and medication, in the second case it is likely that the therapy alone will be solved.
J.G.A: Does the pathological anxiety really cure or is it a problem that accompanies the whole life of the sufferer?
A.Q: Well, I think that in psychology we can not talk about that we are going to cure everything forever, in our profession we use more depends. Again I must say that it depends, for example, on the disorder that is suffered; phobias, panic attacks, generalized anxiety, usually have a good prognosis and in obsessive disorders, the treatments are longer and more complex.
If we say that anxiety and stress are adaptive mechanisms, they will not disappear, they will become more functional and it will be possible to regulate them better. What I would dare to say that a good psychotherapy will help them to be better, being able to make the disorder disappear or diminish the effects that it produces and that the person has a better quality of life.
J.G.A: Can anxiety disorders be avoided? What can we do to prevent them?
A.Q: As in everything, you can always do many things to avoid and prevent psychological discomfort, starting, as a psychologist, I recommend a psychotherapy that helps strengthen our personality and self-esteem, which is the best defense against these problems. Always think about going to the psychologist when there is a disorder already present, I recommend it as mental hygiene, you also have to go, to grow and develop personal resources.
Then, there are many other things that will help prevent anxiety, it would leave a small catalog:
- Learning to familiarize ourselves and listen to our emotions, because something is telling us, in this case anxiety tells us something is not right, if we learn to listen to it, we can solve what causes it and thus improve our life
- Share time with people who enrich us internally
- Take advantage of our free time, doing pleasant things
- Develop sports activities, since not only is good for the body, but also, exercise is a good emotional regulator
- A healthy diet is also important
- Accumulate positive experiences. It is important to also understand that we will feel better if we accumulate positive experiences rather than objects. The well-being of having something is momentary and less lasting than having lived a good experience that will last in our memory.
Of course there are many more things that help, but I would leave these 6 as important.