Andrés Quinteros: "Stress is also adaptive and necessary"

All of us, at some point in our lives, have experienced anxiety.. For example, before taking an exam in which we play a lot or when we have had to make an important decision. This psychological reaction is, in many cases, something normal, which appears in situations of stress or uncertainty.

• Related article: "Types of stress and their triggers"

Interview with Andrés Quinteros

Nowadays, anxiety disorders are talked about with some frequency. But what differentiates normal anxiety from pathological? In today's article we interview Andrés Quinteros, founder and director of the Cepsim Psychology Center in Madrid, to help us understand what are anxiety disorders and what can we do to prevent them.

Jonathan Garcia-Allen: Good morning, Andres. Anxiety and stress are often seen as similar states that are sometimes confused. But what is anxiety? Is anxiety the same as stress?

Andrés Quinteros: Well, to answer these questions I will begin by briefly describing what anxiety is and what stress is.

Anxiety is a normal emotional state that fulfills a very important function, since it warns us that there may be a danger or threat and works as an internal alarm system. Therefore, it is useful and adaptive. I emphasize this because sometimes there is the perception that anxiety is in itself something negative. This only happens when it is inadequate, that is, the alarm goes off when there is no danger, or when it is excessive, too intense, or also, when it lasts too long.

Stress can be defined as a psychophysiological process that begins to manifest itself at the moment in which we begin to perceive that a new or challenging situation can overwhelm us or that we believe difficult to solve, so we activate ourselves to find an answer to that situation. The new situation can be something positive, like preparing for a wedding, it can be a challenge, a new work project or it can be something unexpected, like facing the process of a disease.

Faced with any and each of these situations, our stress will be activated, tensing our body to the maximum to optimize its performance and prepare us for what is to come.

For this reason, stress is also adaptive and necessary, since it enables us to put ourselves into action to give answers to life's problems and situations. It becomes negative when that maximum tension does not cease and continues indefinitely over time, producing all the wear and tear of its own, such as sleep disorders, irritability and low tolerance for frustration.

However, sometimes it can be difficult to differentiate anxiety from stress, since anxiety can be a symptom of stress, it is say that in a stressful situation anxiety can arise, in addition to other emotions, such as frustration, sadness, anger.

Another difference is that in stress, the stressful object is in the present, triggered by a stimulus that appears: a task that I have to do or a problem that I have to solve. While in anxiety it can arise in anticipation of an event that may happen in the future in this case, it is anxiety anticipatory or even feel anxiety without knowing very well why it is, without being able to identify something external that shoot.

In this sense, stress has to do with the demands that the environment presents us, while anxiety can come from something more internal, it can be anticipatory, as I have already pointed out, and if it appears from the demands of the environment, then it can be a symptom of the stress. Following this thread, we can say that stress is caused by external factors that demand something of us, while anxiety can be caused by this, but also and mainly due to internal factors -psychological and emotional- that can anticipate a threat and can even appear without an apparent specific cause or threat real.

J.G.A: Is anxiety a disorder? When does it go from being a minor problem to generating a real problem that affects the normality of a person's life?

A.Q: Anxiety as an emotional state is not a disorder, I think it is important to differentiate between them, all emotions are useful and necessary. I don't like to differentiate between positive and negative emotions, but rather between those that produce a feeling of well-being or discomfort, pleasure or displeasure. All properly felt emotions are positive and all can turn negative.

It is inevitable in certain situations to feel fear, anxiety, sorrow and many times, and on the contrary, feeling joy or pleasure in some situations is negative. For example, for a person addicted to gambling, for example, at the moment of being in the gambling hall, express being well, with sensations that they identify as pleasant and if they gain these pleasant sensations increase. To feel the same way again, they seek to repeat it, they play again. In this sense, these emotions that produce well-being are dysfunctional in this situation because they support addictive behavior.

However, like any emotion, it becomes a problem when its intensity is very high or when it appears in certain situations, generating an unnecessary alarm, altering itself for no reason. For example, as I indicated earlier, we can feel anxiety, although nothing that happens in our lives explains or justifies it. There are even people who say they are fine with their lives, but do not know why anxiety does not leave them alone. In these two situations anxiety becomes a problem. It is also when for small things that can cause us low anxiety, this is disproportionate and overwhelms us.

• Related article: "Nerves and stress: what is anxiety for?"

J.G.A: Anxiety disorders are the most talked about mental illness, even ahead of depression. Are they disorders that only appear in developed countries?

A.Q: If so, there is a lot of talk, because it happens frequently, along with depression, these are the problems for which people consult us the most and there is also a knowledge of their symptoms is very widespread, so people now identify more if they are anxious or depressed and present themselves in the consultation like this: "I come because I have anxiety".

Studies indicate that in the past decade and in the current one, the consumption of anxiolytics has grown almost 60%, in 2016 data was indicated that Spain led figures in the consumption of certain anxiolytics. That is why there is a lot of talk about it. I also believe that today's society and its cultural, material and social demands cause an increase in anxiety and stress.

Regarding the second question, I can indicate that anxiety problems do not only occur in developed countries. I have lived and worked as a psychologist in 4 countries and in all of them anxiety disorders were present, even though people's life situations change. But what I would dare to say is that currently, and especially in developed countries, there is a tendency very strong hedonistic, which leads to denying the emotions that cause displeasure and to wanting to quickly get rid of them they.

The great demand is that we always have to feel good, and that this paradoxically exerts a pressure that generates stress and anxiety. This causes, and I see it a lot in consultations, what I would call a kind of phobia of negative emotions, as if it were forbidden. feel bad and as I pointed out before, all emotions are useful and we cannot do without fear, anxiety, anger, frustration etc And we already know that when we try to deny an emotion, it grows stronger and anxiety is no exception.

If we refuse to feel it, anxiety shoots up, I think we have to re-educate ourselves about the importance to be able to better cope with these emotions since they are sometimes signs of what is not going well for us. By trying to remove them without further ado, we lose a kind of compass that serves to guide us.

J.G.A: Anxiety disorders is a general term that covers different pathologies. What types are there?

AQ: Yes. The pathologies of anxiety are varied, we have panic attacks, generalized anxiety, phobias are also include, such as agoraphobia, social phobia or simple phobias, as well as obsessive-compulsive disorder and stress post traumatic

J.G.A: What are the main symptoms of a panic attack and how can we know if we are suffering from it? On the other hand, what kind of situations can cause it?

A.Q: A panic attack is a very intense and overflowing anxiety response, where the person has the feeling that they lose total control of the situation.

One of its main characteristics is the sensation of terror that the person feels because he believes that he is he is going to die or because he has the idea of ​​suffering a catastrophe, that he is going to die or that he is going crazy. This sensation is accompanied by other physical symptoms, such as tremors and sensations of suffocation or suffocation, dizziness, nausea, palpitations, sweating, agitation and also chest pain, which makes people think they may be suffering from a heart attack. These would be its main symptoms.

We cannot say that one situation or another can cause a panic attack, I think it is a combination of 2 factors, on the one hand, the internal processes in which we include the configuration of the personality that in some cases may be prone to anxiety, the internal locus of control of emotions, the attachment style, etc and on the other hand, the external situation that the person is going through.

If we only take into account the external, we cannot answer the question of why people can react in very different ways when faced with the same situation. This is due to his personal characteristics.

What it could mark is that there is a greater predisposition to suffer panic attacks, when the person is prone to anxiety and does not seek help to solve it. Another important point to understand this problem is that after a panic attack, the person is usually very afraid. to another attack occurring again and this is usually the cause of the second and subsequent panic attacks: the fear of fear.

J.G.A: Are cases of anxiety disorders increasing due to the crisis and the socioeconomic situation we are experiencing?

A.Q: Yes, of course, and not just anxiety, but many more psychological problems such as depression, difficulties in coping with changes, overcoming situations of loss of work, status, social conditions. Crisis situations cause uncertainty, feelings of danger and fear increase and are a breeding ground for increased anxiety, despair, and the burden of not being able to solve.

J.G.A: What causes anxiety disorders?

A.Q: It is a difficult question to answer today and it will depend on what psychological theory we are inserted in, there are currents of thoughts that indicate organic causes and others that indicate their cause in the problems of attachment, the bond and the experiences in the development. I personally believe that although we come with a biological basis that determines us, the attachment relationship, the bond affective and the experiences that we live in our development will mark us to be more vulnerable or more resilient before the anxiety.

**J.G.A: What should we do when faced with an anxiety crisis? **

A.Q: The psychoeducational part in the treatment of anxiety and panic attacks is very important, since it will help to prevent and/or minimize the magnitude of the attack. First of all, it is important to get the person to lose the fear of feeling anxiety, that they are not going to die or suffer a heart attack. It is only anxiety that his mind creates and that it is his own mind that can regulate it, this at first surprises the person, but then it is a thought that helps in moments when anxiety increases.

It is also important to indicate that anxiety is not an enemy, it is actually an emotion that warns us of that something is not going well and that perhaps there is some situation that you have to overcome, accept or leave behind.

In addition to the above, it is important to teach some bodily regulators of anxiety, such as the control of breathing, mindfulness is widely used today and it is also useful to teach them techniques to control their thought. Of course also if necessary, having the possibility of going to medication for anxiety, but always controlled by a specialist psychiatrist. And of course, if you want to properly regulate anxiety, a psychological treatment is the most appropriate.

J.G.A: What treatment is there for anxiety disorders? Is it good to use only drugs?

A.Q: Well, there are many procedures that are good and effective, I can tell you how I work with it, I think it has been more effective for me. carry out an integrative treatment, since I believe that each person has their particularities, so each treatment has to be specific. Even if 3 people come for a consultation with the same problem, for example panic attacks, I will surely carry out 3 different treatments, since the personality, the history, the ways of coping of each one are different.

For this reason, with some I will apply, for example, EMDR, sensorimotor therapy, Gestalt, hypnosis, cognitive, internal family, etc. or a combination of them. What is done in the sessions will depend on each case. I think it can be more effective that way.

Well, now to the question of whether it is good to use only medication, as I said before, it depends on each case. I believe that in a group of people, for example, therapy without medication works very well and there are cases in which it is necessary to work in combination with psychotropic drugs. It will also depend on what problem we are talking about, obsessive-compulsive disorder is not the same as a phobia, in the first case it is You probably need a combination of therapy and medication, in the second case it is likely that therapy alone will solve.

J.G.A: Is there really a cure for pathological anxiety or is it a problem that accompanies the person who suffers from it throughout their lives?

A.Q: Well, I think that in psychology we can't say that we're going to cure everything or forever, in our profession we use depends more. Once again I must say that it depends, for example, on the disorder that is suffered; phobias, panic attacks, generalized anxiety, usually have a good prognosis and in obsessive disorders, the treatments are longer and more complex.

If we say that anxiety and stress are adaptive mechanisms, they will not disappear, they will become more functional and it will be possible to regulate them better. What I would dare to say is that a good psychotherapy will help them to be better, being able to achieve the disorder disappears or the effects it produces decrease and that the person has a better quality of life.

J.G.A: Can anxiety disorders be avoided? What can we do to prevent them?

A.Q: As in everything, you can always do many things to avoid and prevent psychological discomfort, from the start, as a psychologist I recommend doing psychotherapy to help strengthen our personality and self-esteem, which is the best defense against these issues. You always think of going to the psychologist when there is a disorder already present, I recommend it as mental hygiene, you also have to go, to grow and develop personal resources.

Then, there are many other things that will help prevent anxiety, I would leave a small catalog:

• Learning to familiarize ourselves with and listen to our emotions, because they are telling us something, in this case anxiety tells us that something is not right, if we learn to listen to it, we can solve what causes it and thus improve our life
• Sharing time with people who enrich us internally
• Take advantage of our free time, doing pleasant things
• Develop sports activities, since it is not only good for the body, but also, exercise is a good emotional regulator
• A healthy diet is also important
• Accumulate positive experiences. It is also important to understand that we will feel better if we accumulate positive experiences rather than objects. The well-being of having something is momentary and less lasting than having lived a good experience that will last in our memory.

Of course there are many more things that help, but I would leave these 6 as important.