Anxiety

anxiety is a subjective phenomenon which occurs in certain people. In general, patients come to the clinic of internal medicine with somatic complaints. Anxiety disorder is one of the mental disorder that is often found in patients who visited the mental health section. Symptoms are also very similar to a heart attack made ​​in the first patient used to come frequently to the emergency room or a heart specialist / internal medicine. This disorder is diagnosed when in the past month there have been more than 3 (three) times the panic attacks. The attack came suddenly, and in between the attacks the patient was worried if he was experiencing the situation again (anticipatory anxiety). The attacks also have disrupted the function of both personal and social patient. Anxiety can be decreased when has the desire to heal with medication alone or join the community of sharing that had the same anxiety disorder.

DIAGNOSIS
1. Excessive feelings of anxiety, subjective, unrealistic
2. There are complaints and symptoms as follows:
    • Tension motor: muscle twitching, stiffness, aches, chest pain, joint pain
    • Hyperactivity autonomous: shortness of breath, palpitations, wet palms, dry mouth, nausea, mules, diarrhea and other
    • If found organic abnormalities are generally complaint is not comparable with organ abnormalities were found
   • Vigilance excessive catching capacity is reduced: easily startled, irritable difficulty concentrating, difficulty sleeping, etc.
3. Impaired activities of daily living: decreased work ability, impaired social relationships, lack of self care, etc.

Deff DIAGNOSIS
Mixed anxiety and depressive disorders, depression, somatization disorder, organ abnormalities were found (coincidence)

Examination support
• Hb, hematocrit, leukocytes, urea, creatinine, blood sugar, liver function tests, complete urine
• Analysis of blood gases, K, Na, Ca, T3, T4, TSH, as indicated
• Chest X-ray, if necessary
• ECG, electromyogram, electroencephalogram, if necessary
• Endoscopy, colonoscopy, ultrasound, if necessary

THERAPY
Nonpharmacologic: education, reassurance, psychotherapy, hypnotherapy,

pharmacologic:
• Benzodiazepines: Diazepam, alprazolam, clobazam
• Non benzodiazepim: Buspiron, beta blockers if symptoms of autonomic hyperactivity prominent
• Symptomatic, as indicated

COMPLICATIONS
Less / not able to perform daily activities (work).

Conclusion
Anxiety disorder is one of the mental disorder that is often found in patients who visited the mental health section or clinic of interna. In these patients obtained a major symptom anxiety syndrome. The main symptoms of excessive anxiety arises especially when alone at home, difficulty concentrating, multiorgan found physical complaints such as palpitations, shortness of breath at times choked up, trembling.