Germain, 30: « You shouldn’t hesitate to get help »
“I suffer from generalized anxiety with agoraphobia which expresses itself in a fear of being away from my home. It started in 2015, at the time of the Paris attacks. I was going through a difficult time. One Sunday evening, I had a major panic attack, with heart palpitations, a feeling of loss of control and impending death. My mother took me to the HUG psychiatric emergency room. Since then, there have been ups and downs. In times of crisis, I am in constant control and constantly prepare for the worst. I ruminate a lot, it never stops. My condition deteriorated again with the pandemic. At first it was very oppressive, I didn’t dare to go out anymore because I was afraid of seeing people and getting sick. Today, I am better thanks to the follow-up of the Anxiety Disorders Program. The objective of my therapy with the psychologist is to resume a normal life and decisions without my anxiety dictating my choices. I also take medication to ease the symptoms. When you suffer from anxiety, you tend to belittle yourself, but you shouldn’t feel guilty and don’t hesitate to get help. »
CBTs aim to reduce the symptoms of anxiety, or even eliminate them completely. This begins with a better understanding of its mechanisms (therapeutic education), then with desensitization thanks in particular to therapies of exposure to the feared situation. The approach is collaborative and personalized. The objectives of the therapy are defined by mutual agreement with the therapist (psychiatrist, psychologist, nurse or psychiatric nurse) and updated as the follow-up progresses. For one person, the goal will be to participate in evenings with friends, for another, to be able to go alone to the supermarket or climb to the tenth floor of a tower, for example. “Each person has their own problem. We are trying to understand how it works, why its alert system is triggered so easily and what the maintenance factors are,” explains Paolo Cordera, psychologist in the anxiety disorders program of the University Hospitals of Geneva (HUG).
Thanks to benevolent accompaniment, the person will be able, through a progressive exposure, to bring back their fears, continues Frédérique Tettamanti, nurse specialized in psychiatry at the HUG: “In the field, we help them to become aware of their thoughts. , his emotions, his bodily feelings and his level of anxiety. And to assume the discomfort in which the confrontation places it. Indeed, rather than wanting to extinguish the unpleasant symptoms at all costs, it is a question of increasing one’s tolerance to bear them. Through positive experiences, the person sees that he is capable of coping with situations that put him on alert and gradually regains self-confidence. « The goal is for her to eventually become her own therapist, » comments Paolo Cordera. Although pragmatic, CBTs do not evade the question of meaning, underlines the psychologist: “It is easier to express your anxiety than your sadness. It is important to look at what is behind it, its meaning and its function in the person’s life.
Drugs: with or without
CBTs may or may not be associated with taking medication depending on the wishes of patients and scientific recommendations. “For panic disorder and agoraphobia, studies show that it is more effective to combine the two”, illustrates Professor Guido Bondolfi, chief physician of the Liaison Psychiatry and Crisis Intervention Service and the Disorders Program. anxious about the HUG. Antidepressants act on symptoms and ruminations. As for benzodiazepines, which are often prescribed, they are certainly very effective in the short term, but lead to an addiction from which it can be difficult to get out. « They are not a treatment of choice against anxiety and their prescription must be limited », insists the psychiatrist.
Prevent relapses with meditation
Difficult life events can reactivate anxiety. To prevent relapse, the University Hospitals of Geneva (HUG) offers a program to learn how to better recognize anxiety.
“Even after treatment, there may be residual anxiety and a tendency to worry. Thanks to mindfulness meditation, people learn not to get caught up in the mechanisms of illness, such as avoidance,” says Paolo Cordera, psychologist in the anxiety disorders program at HUG. Through nine sessions, integrating elements of cognitive psychotherapy, psychoeducation and meditation, participants learn to recognize anxious attitudes and return to the serenity of the present moment, without judgement. But also not to overreact when the alert system is triggered. “Thoughts influence our feelings. Anxiety feeds on fantasies. The proposed approach consists in becoming aware of it and coming back to reality”, explains Frédérique Tettamanti, nurse specialized in psychiatry and instructor of the HUG program. Over the course of different experiences, everyone is invited to assess their level of anxiety, their physical and psychological effects and their resources to deal with them. It is, basically, to get out of automatic thoughts to be more present and present to oneself and to the emotions that cross us in order to manage moments of anxiety in a different way. A program at the end of which people manage to better recognize anxiety and its workings, and to make their personal mapping.
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#Anxiety #facing #free
