Anxiety Disorders

Dr Elisabetta Guida – Le Betulle Medical Center

Head of department

Dr. Elisabetta Guida

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Dr Francesco Somajni – Le Betulle Medical Center

Assistant Head

Dr. Francesco Somajni

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Dr. Massimo Del Vecchio

Clinical psychologist

Anxiety is a physiological symptom which alerts the individual to the presence of danger in order to activate a proper psychophysical response (i.e. cardiorespiratory activation in the face of imminent danger).

Anxiety becomes pathological when the same activated responses don’t find a specific external cause in reality, but rather are caused by subconscious reactions to facts related to the patient’s life experiences.

Anxiety is a clinical condition perceived by the subject as a distressing anticipation of imminent danger, experienced in a condition of constant alarm and helplessness.

Symptoms may be psychiatric:

  • fluctuating sense of anguish;
  • unjustified fears, such as inability to carry out school or work assignments; fear when confronted with closed spaces (cinema, supermarket, elevator, tunnel, underground parking) or open spaces (agoraphobia);
  • inability to concentrate, feeling of empty-headedness, uncertainty, fatigue;
  • in social contexts, the patient can feel unjustified fear, shame, sense of inadequacy.

Physical symptoms may be associated to mental symptoms::

  • tachycardia, breathlessness, breathing problems;
  • perspiration;
  • muscle stiffness, tremors;
  • difficulty sleeping, inability to relax;
  • cephalea;
  • skin diseases (eczema, psoriasis);
  • gastrointestinal ailments (nausea, vomit, spasms, diarrhoea);
  • abnormal diuresis;

The main anxiety disorders are:

  • Generalized anxiety disorder (being restless, feeling tense, prone to fatigability, difficulty in concentrating or memory losses, irritability, muscle tension, sleep changes);
  • Panic disorder (palpitations, cardiopalmus or tachycardia, perspiration, tremors, sense of suffocation, chest discomfort or pain, nausea or abdominal ailments; dizziness, feeling unsteady, lightheaded or faint; feelings of unreality or of being detached from oneself, fear of losing control, going mad, or dying);
  • Phobic disorders (i.e. phobia of open or closed spaces; social phobia and fear of speaking in public lest one should incur embarrassing or humiliating situations, be exposed to judgement; phobia of dirt, of animals and illnesses);
  • Obsessive-compulsive disorder (presence of intrusive, repetitive and pervasive ideas and behaviours; compulsions which are beyond the patient’s control: for example the fear of contamination, the obsessive need to continuously control gas faucets and the closing of doors and windows);
  • Post-traumatic stress disorder (mental and physical symptoms responding to a real or imaginary evocation of the traumatic event.)

Sometimes anxiety appears as a symptom which accompanies certain changes in some crucial stages of life: between childhood and adolescence, adolescence and adulthood, the end of a course of studies and starting employment, before getting married, during a divorce or separation, in the phase between work and retirement.

Moreover, anxiety can be present within relationships defined by:

  • strong emotional attachment;
  • fear of emotional distance, for instance leaving home (which represents a sort of external safety); or a relationship (bride-groom, girlfriend-boyfriend, parents-children);
  • sense of ‘constraint’ more or less conscious towards significant people or situations, often caused by an intense sense of duty or by the fear of judgement/failure.

Our Anxiety Disorder Clinic provides a multidisciplinary diagnostic and therapeutic approach. Initially, through medical consultation and all necessary exams, we exclude the presence of any primary somatic disorders independent from anxiety, such as heart disease, respiratory failure, gastrointestinal diseases, and endocrine diseases (for example thyroid diseases).

We then proceed to a diagnostic evaluation through one or more interviews, which will bring us to identify the proper course of treatment (psychotherapy, psychopharmacotherapy).

For the more severe and long-term clinical cases we provide hospitalization, which allows us to place the patient in peaceful surroundings, removed from possible stressful environmental factors, and to identify more swiftly the most appropriate pharmacological therapy.