Treatment of neurotic disorders should be comprehensive, but in a significant range of these disorders, the treatment of choice is psychotherapy and psychoeducation. These interactions are aimed at changing the patient’s approach to the ailments and suffering experienced by him and changing the way he functions, which may result in improvement in the form of complete relief of symptoms or the ability to respond to their occurrence and deal with them in a way that is beneficial for the patient. In turn, pharmacotherapy in some cases of neurotic disorders is either not recommended or is only supplementary treatment in certain situations and conditions. But it can also be the basis of long-term treatment, such as for some anxiety disorders (panic disorder, generalized anxiety disorder, social phobia) or obsessive-compulsive disorder.
Anxiety disorders in the form of phobias
This group of disorders includes, among others, agoraphobia, social phobias or specific forms of phobias. Phobic fears are caused by some objectively harmless factor (an animal, object, phenomenon) (always the same and well identified by the patient) or an external event or situation that the patient perceives as threatening, tries to avoid them, and in their presence feels significant discomfort, fear and even suffering. Just thinking about these situations can cause anxiety – anticipatory anxiety.
Agoraphobia occurs when a patient feels a strong fear of crowds of people, public places or situations from which it is impossible to withdraw, run away, get quick help, e.g. traveling by means of transport (especially crowded ones), being in a church or shopping mall, standing in large queue. The increasing agoraphobic fear leads to avoiding such situations and increasing the patient’s difficulties with leaving home, to the point of being completely unable to leave the place of residence without the company of other people. Agoraphobia – when it is long-lasting and severe – may be accompanied by depressive symptoms. Agoraphobia and anxiety attacks are also common.
Social phobia (social anxiety disorder) is one of the most common mental disorders and affects approximately 5-10% of the population. In its course there is a growing anxiety, among others against evaluation and ridicule, humiliation, “fooling around” in front of other people in social situations in which, according to the patient, the attention of others is focused on him. The patient is afraid that in social situations he will be completely blank in his head, he will not be able to say anything or what he says will be inappropriate, funny, silly and unattractive. There is also often a fear of losing control of yourself in these situations.
In addition, anxiety is often accompanied by unpleasant somatic symptoms, such as palpitations, breathlessness, heat, sweating, reddening, trembling of hands and muscles. Just imagining such a situation can cause severe (anticipatory) anxiety. A person with social phobia is usually convinced that these symptoms are visible to everyone and they discredit and ridicule them. The patient is aware of the excessively experienced fear, but is unable to cope with it.
These people usually have no problem being in an “anonymous” crowd of people. On the other hand, they may feel anxious, for example, about being in a small specific group of people (except for the immediate family), about public speaking, eating meals in public places, using public toilets, and being in the presence of people of the opposite sex.