Francisco Atienza Martín, family doctor at the ‘El Porvenir’ health center (Seville).
Francisco Atienza Martín, family doctor at the ‘El Porvenir’ health center (Seville), explained, at the 46th National Congress of the Spanish Society of Primary Care (Semergen), that the mixed anxious-depressive disorder “is important because Its evolution is slower than that of anxiety and depression. “The patient spends more time with symptoms and has a more chronic course.”.
Francisco Atienza Martín, family doctor at the ‘El Porvenir’ health center (Seville). |
Patients with this pathology “They suffer from depression and anxiety at the same time”indicated the member of the Semergen Mental Health Working Group. “They have aspects of depression but, in addition, are associated with classic anxiety disorders,” he added.
Regarding this, Atienza Martín has pointed out that “We don’t really know if it’s anxiety or depression.” since both pathologies “have a very similar physiology.”
Anxiety and depression in Spain
The family doctor explained that “the prevalence of anxiety disorders in Spain is highmore in women than in men and more in the middle ages of life.
For his part, he added that “Depressive disorders occur at ages 65 and olderhaving its peak at 75-80 years”, that is, at a more advanced stage of life.
The symptoms of anxiety and depression begin, according to the same source, “when a threat is presented and the situation is evaluated“. “If we evaluate that we are not capable of overcoming that obstacle, we become active, we are afraid and worried. In short, anxiety appears,” he said.
Francisco Atienza Martín, family doctor at the ‘El Porvenir’ health center (Seville). |
The health professional has pointed out, in this regard, that it is the cognitive system, “distorting reality”which causes the first symptoms of these mental health pathologies to appear.
“There are two clues to think that there is cognitive distortion: totalitarianism of everything, nothing, always, never, black or white and paralysis, in which the patient assures that everything is going wrong and does nothing to solve it.
As a result of this, Atienza Martín has stated that “Cognitive distortion leads to the most toxic behavior that there is psychologically, which are avoidance behaviors, the fact of stopping doing things.
The therapeutic options
“The therapeutic options for mixed anxiety and depression disorders are the active listening; the cognitive behavioral therapythat is, send the patient to the psychologist; recommend relaxation techniques and medication“, commented Atienza Martín.
In this sense, the priority of family doctors is to assess “if there is a suicidal risk” and, subsequently, “treat the most frequent symptoms.” “You have to choose treatment and go little by little, in a phased manner”the doctor has pointed out.
Along these lines, Atienza Martín has highlighted that “The problem is when there is a focus of mixed anxiety-depressive disorder that is not very intense.which are the most frequent” since the patients “do not improve” with the treatment.
In these cases there is “difficulty implementing non-pharmacological therapies and the pharmacological therapies in low intensity frames they don’t work“in the right way.
Appearance of the room during the presentation. |
Psychotropic drugs in autolytic cases
Virginia Vesga, a fourth-year resident of Family and Community Medicine in Valladolid, has focused on “autolytic attempts, psychotropic drugs and young patients, between 14 and 35 years old” in his presentation at the 46th National Congress of Semergen.
If anxiety occurs, above all, at middle ages and depression occurs after the age of 65, self-harm attempts “They start at 14 years old and it is very common”Vesga has indicated.
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Virginia Vesga, R4 resident of Family Medicine |
Along these lines, the resident has pointed out that “of Primary Care consultations, more assistance is requestedboth by psychologists, by psychiatrists and, furthermore, with drugs”.
Regarding psychotropic drugs, Vesga has commented “that they have their advantages” but from Family Medicine they always try to “do a medical treatment”. “We give them a series of guidelines, we do group work, we use different tools with psychologists and, many times, also among family members” before starting treatment.
On the other hand, the doctor has pointed out that Primary Care “has a super important role” because they know the patients and have “a fairly close relationship with them.” “When there is a relationship of trust, in the end it is like a friendship or like a family,” he said.
Virginia Vesga, R4 resident of Family and Community Medicine in Valladolid. |
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