Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5572_Библиотеки_им_академика_М_И_Перельмана

Anxiety is one of the most common mental illnesses plagu­ing one-eighth of the total population and has become of great economic burden in most countries. It is a psychiatric problem that is not easily recognized and attended to. Anxiety is a persistent feeling of apprehension, dread, and impending disaster, or uneasiness and/or tension. It is a precise class of psychopathology that presents with future-oriented appre­hension and increased threat value associated with mental, physical, and social stimuli. Anxious people may commit crimes to cover up the source or cause of anxiety.

Anxiety, as presented in normal individuals, is character­ized by

(b) Physiological aspects of anxiety include autonomic

1. Trembling, sweating, feelings of choking, abdominal dis­tress, nausea, dizziness, pins and needles, feelings of impending doom, or losing control over minor issues.

Anxiety disorders encompass the following clinical conditions

1. Panic disorder

2. Social anxiety disorder and phobias

3. Generalized anxiety disorder

4. Post-traumatic stress disorder

Subjects with this disorder present with apprehension and brief attacks of intense terror, which is often characterized by shaking, confusion, trembling, dizziness, nausea, and some-

• Abdominal pain Other symptoms include:

The symptoms of anxiety are normal to every individual, and it is intended for the safety of the person. It is a series of events that alert the person to danger and proffer a solution to be safe. In most cases, it signals the person to run from the point of danger. A problem arises if these responses proceed beyond normal.

targets of sedating drugs. Action such as alteration of the inux of chloride ions within this receptor complex is associ­ated with the development of anxiety. All commonly used anti-anxiety agents (barbiturates, benzodiazepines, and etha­nol) selectively enhance only GABA-mediated transmission, exerting anti-anxiety, relaxing, and anti-convulsant effects.

The neurotransmitter released from adrenergic nerves in the brain, noradrenaline, is helpful in situations of emergen­cies or ght/ight response. Noradrenaline is elevated in these emergencies, but when its levels are elevated when there is no danger or emergencies, anxiety, fear, and irritabil­ity states are produced.

1. The main inhibitory neurotransmitter in the brain is the

2. GABA controls excitability states in areas of the brain.

2. Glutamate is the main excitatory neurotransmitter in the central nervous system (CNS).

5. The glutamatergic system plays a major role in the patho­genesis of fear conditioning and anxiety.

6. Glutamatergic neurotransmission in the limbic system plays a pivotal role in the pathogenesis of anxiety disorders.

1. The persistence of anxiety disorders and their develop-

ment is controlled by 5-HT and GABA

2. A decrease in central nervous system 5-HT concentration

increases anxiety symptoms, while an increase decreases anxiety symptoms

exercise, is benecial to subjects with phobias and panic dis­orders, and it diverts their attention from the causative factor of anxiety (phobia and fear).

Hydrotherapy: Promotes general relaxation of the ner­vous system. Exercise engages the subjects and diverts their focus of thought. Generally, exercise is a natural stress buster and anxiety reliever, and it strengthens the nerves and makes them more resilient. Relaxation techniques (Yoga) could be employed in the management of anxiety. These techniques include progressive muscle relaxation and controlled breath­ing which when practised regularly relieves anxiety. Sensors that measure physiological functions like heart rate, breath­ing, and muscle tension give feedback (biofeedback) that helps recognize the body’s anxiety response. The informa­tion generated helps stimulate subjects to use relaxation techniques. Sleep is an important endeavor of man and ani­mals. It helps to relax the brain and protect it from the out­side world. It refreshes and prepares animals for a new day and events. Most anxious subjects often present with insom­nia caused largely by their fears. Efforts are made through cognitive-behavioral therapy to make subjects sleep. Induction of sleep (Hypnotherapy) involves the application of different therapeutic approaches to help the subject sleep. Sleep often causes a state of deep relaxation (mind and mus­cle relaxation). Medicinal plants with hypnotic activity are benecial in the induction of sleep in anxious subjects. Chinese traditional medicine utilizes acupuncture to help alleviate anxiety. This works under the strong belief that it relaxes the mind and muscles and subsequently may induce sleep.

Plants are the major natural resource that are used in alterna­tive medicine. They are used solely or in combination with other natural substances. Plant parts consist of seeds, ow­ers, leaves, stems, and roots. All these parts contain varying concentrations of a particular biomolecule found in that plant. Some plants concentrate some bioactive agent prefer­entially in their leaves, stem, or root. Medicinal plants used for the management of anxiety utilize any of the parts for the treatment of anxiety.

Insomnia is a state of lack of sleep or inadequate sleep. It can occur if a subject is over stressed. Insomnia is the most com­mon sleep disorder, about one-third of the world population suffers from a long-term derangement of sleep and wakeful­ness [45]. Medicinal plants that have been reported to have hypnotic effects are listed in Table3.

Abnormality in various pathways in the brain has been credited for sleep disorders. Cortisol, GABA receptor and cytokines levels, circadian rhythm (melatonin secretion and adenosine receptors), and excitatory amino acid (glutamate and aspartate) are thought to have malfunctioned/altered to cause insomnia [46].