PATHOLOGICAL ANXIETY


In the intense anxiety condition of pathological anxiety, it is natural therefore that both the time and space sense become stretched when nothing interests the patient. The disease may come to a standstill at this stage and after a few weeks or months, a gradual adjustment of the mind begins to take place as a result of treatment and the patient shows signs of improvement. If left to itself, the disease may develop further and may show certain extraordinary changes in its development.


Then there may be “anxiety attacks” during this stage. This

on is somewhat like a fit. The patient suddenly becomes extremely anxious without any cause and feels as if he is going to die. His face becomes pale, pupils dilate and limbs tremble and there is a haunted fear of death in his eyes. The respiration quickens, the heart flutters and there is a cold sweat coming out of his body. He feels a sinking death-like sensation and clutches hold of somebody in fear. The condition lasts for a few minutes only and then passes off and the patient may fall into an exhausted and disturbed sleep afterwards.

During this anxiety condition of the mind, the patient looses interest in most things; he is too busy with his own condition. His hobbies disappear, he cannot concentrate on his daily work; in fact he may even neglect his toilette.

In addition he may become hypersensitive to ordinary stimuli. He hates strong light and wants to stay in a darkened room. Ordinary noise, even the ticking of a clock, disturbs him. The skin of his body may become sensitive also, so that even in hot weather he does not like a cool breeze.

He has no peace in his mind. He does not like amusements, does not like work, does not like to lie down and does not like to get up. He tries everything but finds no relief. He wails “I do not know what I like. I find no rest–not even in sleep.” He gets up exhausted in the morning with a frontal headache after disturbed snatches of drowsiness at night.

He passes his waking period in the day in roaming about from place to place in search of distraction–places of amusement mostly, but finds that they dont interest him.

He falls into a mood of depression, “the slough of despondency.” Everything appears futile to him. His work, his play, his whole existence has no meaning, because none gives him any satisfaction which he craves. He does not like company and does not like to stay alone. People whom he loved before appear to recede away from his mind and he feels as if he is not interested in them.

He describes his symptom vividly by saying “I have lost all feeling,” meaning that he does not feel love and hate as strongly as he used to feel before. There is never really an absence of feeling, because if it were so, he wouldnt have complained of “absence of feeling.” There is an inner want of adjustment resulting in restlessness and anxiety which engage his mind so overwhelmingly that normal emotions are displaced overshadowed to some extent in his conscious mind.

In a normal man, the mental energy is expended in work and pleasure both of which give him satisfaction and when done, a feeling of rest. In this diseased state, the same energy which ought to have been expended outside, is utilised to create the diseased condition, so that all work become impossible and the person suffers. This may be called the “disease-energy.” It is not a new thing and does not come from outside. It is the product of ones own mind which is being misused.

It is like the kitchen- fire which cooks your food and if mismanaged, may burn your house. The same coal-energy which feeds you may make you destitute. It is a condition of maladjustment of various mental factors, mostly unconscious, which come into clash with one another and cause disturbance like a civil war in a country.

Thus the disease progresses and smites the hitherto healthy and bright man to a painful condition, a man without interest, without hobby, without rest, no sleep, no satisfaction, no happiness, no future, a painful present, a condition worse than even death. He wonders how other people are living, how they can derive pleasure out of work which he cannot, how anything may have any worth.

This feeling of misery may be so profound that he may be thrown into a dazed condition for weeks, suffering intense agonies and finding no means to relieve them.

During this condition, disturbances of space and time sense appear about which I spoke earlier. This is an interesting and a new condition about which practically nothing has been written so far.

Normally everybody has a certain sense about time and space. During this anxiety condition both these senses are stretched.

A small distance, say 100 yards, appears to the patient as if it is a long one. He preserves the memory of his previous space-sense and compares with it his present one and says “small distances appear too big for me.”.

The same stretching occurs with his time-sense too. Five minutes appear to him to be equivalent to more than five hours. A few days seem to him as long as a few months.

A peculiar condition, but not a new one. The stretching and contraction of space and time sense occur, to some extent, in normal individuals too. When one is interested in anything, time and space sense become contracted. A lover does not feel the distance he has to travel to meet his girl, even when there are obstacles in the way which he overcomes easily in the eagerness of his pursuit. But when there is nothing to interest you, when you are bored and unhappy, a little distance, crossing an open field for instance, may appear to you as laborious and exhausting.

Time-sense shows the same peculiarities. When you like to do anything, you do not mind the time it takes you to do it. People say how time flies !Juliet wanted Romeo to stay with her because she thought that the night was not yet over. A foot-ball enthusiast feels that the game is over too soon. A busy man suddenly realizes one day that he is getting old. A faded beauty tries to stop the passage of time with powders, paints and dresses. Stays are used by women to preserve the curves of the female figure when they are sagging. The word “stay” seems to be a request to time to stay its cruel course.

Time drags with leaden feet when you have to face an un- pleasant situation. The patient with a toothache has to wait for ages in the waiting room before the dentist calls him. The criminal feels that he passes years when he has to wait for a few minutes before the hangman who arranges the gallows that will hang him.

We have two types of interest in us. Primary-when our interest is involuntarily directed towards something whether we like it or not, such as an earthquake or a fire and secondary- when we free our interest voluntarily towards something out of social considerations, e.g. attending to an uninteresting lecture. It appears that primary interest contracts time and space sense and secondary interest stretches them.

Certain drugs produce a similar disturbance in space and time sense in normal individuals. Cannabis Indica, alcohol and opium are some of them. De Quincey, the opium-addict, says “Some- times I seem to have lived for seventy or a hundred years in one night !” What a difference between clock-time and imagined time !.

In the intense anxiety condition of pathological anxiety, it is natural therefore that both the time and space sense become stretched when nothing interests the patient.

The disease may come to a standstill at this stage and after a few weeks or months, a gradual adjustment of the mind begins to take place as a result of treatment and the patient shows signs of improvement. If left to itself, the disease may develop further and may show certain extraordinary changes in its development.

It is the natural law of every disease, either of the body or the mind that it tries to adjust itself by whatever means at its disposal and however faultily. An attempt at cure is always sought by nature, which may or may not succeed. Let us take an example from the body and apply it to the mind to understand the changes better.

Suppose there is an inflammation somewhere in the body which, if severe, is associated with general malaise, leucocytosis, high temperature, headache, constipation, etc. At this stage, nature, to relieve the body from these generalised condition of fever and pain, attempts to localise the inflammation and produce an abscess. If it succeeds, the generalised condition is replaced by a local condition, or in other words, the patient is relieved of many of his painful symptoms and the chances of his cure increase.

We may at once say that the development of a localised abscess is an attempt on the part of nature at cure, although faultily, from the generalised inflammatory condition. Most of the changes which occur in the body or in the mind as a result of disease and which we notice as signs and symptoms, are just outward manifestations on the part of nature to fight and adjust itself to the causative factor which has created the diseased condition.

Similar attempts may be made by the mind to relieve the suffering caused by the excessive anxiety which nearly kills the patient. He may suddenly or gradually develop a phobia. Drawing the analogy from the body, if you consider the pathological anxiety as an inflammation of the mind, a phobia may be regarded as a sort of mental abscess.

S. C. Laha
S. C. Laha, M. B. (Cal. Univ.)