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Colloquially, the term "anxiety" is mostly used to describe a relatively unspecific complaint and usually refers to an impairment of psychological well-being. From a medical point of view, the term is also used, for example, to describe a physically perceptible tightness in the chest (feelings of oppression).
Anxiety describes an inner feeling of tightness, which can occur in connection with both mental and physical impairments. The Latin name for anxiety is angina, although the term also generally describes a narrowing or narrowing in the organism. This is expressed in the medical names of various clinical pictures, such as tonsillitis (angina tonsillaris), which is characterized by swelling of the tonsils and a corresponding tightness in the throat (see thick neck). However, tonsillitis is not associated with a feeling of anxiety. This is different with angina pectoris, which describes tightness in the chest and is actually perceived as oppressive by those affected.
The anxiety itself describes a feeling of inner narrowness or constriction, in principle a purely psychological complaint. However, the feeling of oppression is usually accompanied by physical symptoms, which can be both the result (for example, due to a classic attack or flight reaction when anxiety arises) and the cause of the oppression (for example, angina pectoris). Physical complaints frequently observed in connection with anxiety include shortness of breath, rapid heartbeat, stumbling in the heart, sweating, trembling, nausea and vomiting. Muscle spasms are also not uncommon with oppressions.
Causes of anxiety
The psychological causes of anxiety are just as multifaceted as the possible triggers of anxiety and can vary greatly from person to person. They can be observed increasingly under extreme emotional stress when people feel they can no longer cope with them. Most phobias, such as fear of confined spaces or fear of heights, can also cause anxiety. Feelings of oppression are also possible complaints with depression.
In addition to the psychological factors, various heart problems such as coronary artery disease, myocarditis or a heart attack cause feelings of tightness, which are manifested in the chest. In general, the temporary tightness in the chest with accompanying symptoms such as heart pain, stinging in the chest and radiating pain in the back or upper abdomen is summarized under the name angina pectoris, which, despite similar symptoms in the medical sense, must be differentiated from heart diseases such as a heart attack or cardiac muscle inflammation. The angina pectoris is caused by a temporary poor circulation in the heart. Functional heart problems can also cause anxiety, but they are not due to an organic impairment of the heart. What the chest pressures have in common is that the affected patients often experience severe panic attacks and fear of death.
A tightness in the chest and corresponding anxiety can also occasionally be observed in the context of respiratory diseases such as pulmonary embolism or pleurisy.
Diagnosis of anxiety
When diagnosing, the possible physical cause of the feelings of anxiety should be ruled out first. If the patient suffers from the accompanying cardiac symptoms mentioned above and if there is a suspicion of a heart attack or a chronic heart disease, a physical examination is required, in which the heart function is checked using a so-called electrocardiogram (EKG). An initial ultrasound examination can also be carried out in acute emergencies. In the case of blood tests, special biomarkers can often be identified, which provide information about possible heart problems. In case of doubt, there is the possibility of a so-called angiography of the coronary arteries (X-ray examination with prior injection of a contrast agent), which, however, represents a significant burden on the body and should therefore only be used if the other diagnostic methods fail.
Pulmonary embolism and pleurisy must be considered as further possible physical causes of the anxiety if chest pain is present. A pulmonary embolism is often visible when an EKG is created. In case of doubt, the final proof is a contrast-enhanced computed tomography of the lungs. In the best case scenario, chest pleurisy can be determined by listening to the chest, the typical pain symptoms and a blood test in the laboratory, but their diagnosis can also be considerably more difficult. In such cases, an ultrasound examination often provides important additional diagnostic information.
If all possible physical triggers of the anxiety are excluded, a psychological cause of the complaints can be assumed and an in-depth medical examination is recommended in order to uncover possible previously unknown phobias, depression, cardiac neurosis or other psychological complaints of those affected and to subsequently be able to provide targeted therapy.
If the anxiety is caused by a respiratory or heart condition, the first step is therapy based solely on the physical complaints. It is not uncommon to act quickly here, since, for example, both pulmonary embolism and a heart attack are potentially life-threatening events that should urgently be treated by an emergency doctor.
If the anxiety is due to chronic heart disease such as coronary artery disease, long-term treatment based on the prescription of medicines to inhibit blood clotting and to lower cholesterol and blood pressure is usually provided. This is intended to avoid further arterial calcifications in the area of the coronary arteries and acute heart problems. In case of doubt, surgical intervention, for example in the form of a bypass operation or the placement of a stent, may also be required. With the normalization of cardiac function to a large extent, a feeling of oppression can also be achieved.
For anxiety that is based on a psychological cause such as phobia, psychotherapeutic treatment is available, which in addition to rectifying the direct causes of the feelings of anxiety can also include learning strategies for dealing with the anxiety. For example, special breathing techniques and autogenic training are known for their positive effects in acute anxiety. So-called cognitive behavior therapy also offers a promising treatment option for phobias. If the anxiety is due to depression, psychotherapeutic treatment can sometimes be much more difficult. Psychopharmaceuticals are also increasingly being used here to successfully overcome depression.
Naturopathy for feelings of anxiety
Naturopathy offers promising approaches in particular to relieve the psychological anxiety, but also in connection with functional heart problems. For example, aconite, mistletoe, lemon balm, valerian and St. John's wort are used to combat acute feelings of anxiety. Another use of naturopathic treatment for anxiety is the use of Bach flowers. On a homeopathic basis, Aconitum is mainly used against the psychologically related complaints, Tabacum has proven itself against angina pectoris. In the field of Schüssler salt therapy, the Schüssler salts No. 6 (Kalium sulfuricum) and No. 7 (Magnesium phosphoricum) are mainly used to combat anxiety in the context of functional heart problems. Medical massages and acupuncture should also have a positive effect here.
All in all, the various naturopathic procedures offer good opportunities for accompanying use in the context of psychotherapy or the treatment of the physical causes of anxiety. In many cases, however, they cannot replace them, but rather form a helpful addition. (fp)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch
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