Brief overview
- What is fear? Basically a normal reaction to threatening situations. Anxiety is pathological when it occurs without a specific cause, becomes a frequent/permanent companion and impairs the quality of life.
- Forms of pathological anxiety: generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, phobias (such as claustrophobia, arachnophobia, social phobia), post-traumatic stress disorder, cardiac neurosis, hypochondria, anxiety in schizophrenia and depression.
- Causes of pathological anxiety: various explanatory approaches (psychoanalytical, behavioral and neurobiological). Factors that trigger anxiety are stress, trauma, alcohol and drug use, certain medications, thyroid dysfunction, heart and brain diseases.
- When to see a doctor? In the case of excessive anxiety, anxiety that becomes more frequent or more severe and cannot be overcome on its own, anxiety without objective cause and/or severely reduced quality of life due to the anxiety.
- Diagnosis: Detailed interview, questionnaires, possibly further examinations.
- Therapy: Cognitive behavioral therapy, depth psychological methods, medication.
- Self-help and prophylaxis:Relaxation methods, medicinal plants, healthy lifestyle with plenty of exercise and healthy diet.
Anxiety: Description
Fear, like joy, pleasure and anger, is one of the basic human emotions. It is crucial for survival: those who are afraid act particularly cautiously and attentively in critical situations – or do not put themselves in danger in the first place. In addition, fear causes the body to mobilize all the reserves it needs for fight or flight.
Anxiety: Symptoms
Anxiety is accompanied by various physical symptoms. These include:
- Palpitations
- accelerated pulse
- @ sweating
- tremors
- difficulty breathing
- dizziness
In cases of severe anxiety, chest pain, vomiting, diarrhea, feelings of anxiety, and even loss of consciousness may also occur. Sufferers feel like they are beside themselves or losing their minds. During panic attacks, sufferers often fear death. General anxiety, in turn, is often associated with pain.
Anxiety: What is normal, what is pathological?
One speaks of pathological anxiety when the anxiety occurs without a concrete reason or even becomes a constant companion. It can then considerably restrict the quality of life of the person affected. Such fears are not a normal reaction to a concrete threat, but an independent clinical picture that should be treated psychotherapeutically.
Forms of anxiety disorders
The term anxiety disorder refers to a group of mental disorders in which anxiety symptoms occur without external threat. These anxiety symptoms can be physical (racing heart, sweating, etc.) and psychological (catastrophic thinking, avoidance behaviors such as refusal to go outside the door, etc.). An anxiety disorder can manifest itself in different forms:
Generalized Anxiety Disorder.
For people with generalized anxiety disorder, worries and fears are constant companions. Often, these fears have no concrete cause (diffuse worries, anxieties and general nervousness).
However, they can also relate to real threats (possibility of a car accident or illness of close relatives, etc.), although in this case the anxiety symptoms are exaggerated.
Obsessive Compulsive Disorder
Obsessive-compulsive disorder is characterized by obsessive thoughts and/or actions. For example, sufferers react tensely and anxiously when they are prevented from performing certain rituals. These include, for example, compulsions to wash, count objects, or repeatedly check that windows are locked.
Obsessive thoughts may have aggressive, offensive, or frightening content, for example.
Phobia
People with a phobia are excessively afraid of certain situations or objects. Yet most sufferers know that their fears are actually unfounded. Nevertheless, the corresponding key stimuli trigger sometimes violent fear reactions.
Such key stimuli can be certain situations (air travel, high altitude, elevator ride, etc.), natural phenomena (thunderstorms, open water, etc.) or certain animals (such as spiders, cats). Sometimes things associated with illness and injury (blood, injections, etc.) also trigger a phobia.
Experts distinguish three main types of phobia:
Agoraphobia (“claustrophobia”).
In the medium term, sufferers often withdraw completely out of fear and no longer leave their homes.
Social phobia
People with social phobia fear being the center of attention, getting into an embarrassing situation or failing. Therefore, they withdraw more and more from social life.
Specific phobia
Here, the phobia has a narrowly defined trigger. This is the case, for example, with arachnophobia, syringe phobia, fear of flying, claustrophobia (fear of confined spaces) and fear of heights (vertigo).
Not every phobia needs to be treated. But if your anxiety disorder is limiting your quality of life, you should have therapy.
Post-traumatic stress disorder (PTSD).
Post-traumatic stress disorder (PTSD) occurs as a result of an extremely stressful or threatening experience (trauma). This can be, for example, an experience of war, a natural disaster, a serious accident, the death of a close relative, sexual abuse or other experiences of violence.
So-called flashbacks are typical of PTSD. These are sudden, extremely stressful memory fragments in which the affected person relives the traumatic experience over and over again. Flashbacks are triggered, for example, by sounds, smells or certain words that are closely linked to the traumatic experience.
To avoid these stimuli, many traumatized people withdraw. They are highly nervous and irritable, suffer from sleep and concentration disorders, but at the same time appear increasingly emotionless.
Panic disorder
Panic disorder is more common in women than in men. Those affected have repeated massive anxiety attacks with severe physical and psychological symptoms. These include shortness of breath, racing heart, tightness in the throat or feelings of suffocation, sweating, nausea, fear of dying or losing control, and feelings of unreality.
Usually, a panic attack lasts less than half an hour. It can occur quite unexpectedly or can be triggered by certain situations.
Other types of pathological anxiety
People with hypochondria (new term: hypochondriacal disorder) live in permanent fear of suffering from a serious or even fatal disease. In doing so, they misinterpret harmless physical symptoms. Even doctors’ assurances that they are healthy cannot convince or reassure them.
Hypochondria belongs to the so-called somatoform disorders – just like cardiac neurosis: Here, those affected suffer from palpitations and shortness of breath and fear a heart attack, without an organic cause for the complaints being found.
Sometimes anxiety occurs as a symptom of other illnesses. For example, people with schizophrenia often suffer from massive anxiety. They perceive their external world as threatening, have hallucinations or a persecutory delusion. Depression is also often accompanied by objectively unfounded fears.
Anxiety: Causes
There are various theories on the origin of pathological anxiety or anxiety disorders:
- Behavioral therapy approaches, on the other hand, view fears as learned. An example is fear of flying. It can develop when the person concerned has experienced a threatening situation (e.g. strong turbulences) on board. Accordingly, fears can develop through mere observation – for example, when a child experiences that his mother is afraid of a spider.
- Neurobiological approaches, on the other hand, assume that the autonomic nervous system in anxiety patients is more unstable than in healthy people and therefore reacts particularly quickly and violently to stimuli.
Factors that can trigger anxiety
- Stress: Severe mental stress can lead to permanent feelings of anxiety or panic attacks.
- Trauma: Traumatic experiences such as war, accidents, abuse, or natural disasters can trigger recurrent anxiety.
- Alcohol and drug use: use of drugs such as alcohol, LSD, amphetamines, cocaine, or marijuana can also cause anxiety or panic.
- Thyroid function disorders: both hyperthyroidism and hypothyroidism can lead to anxiety and panic attacks.
- Diseases of the heart: Organic heart complaints such as cardiac arrhythmias or heart stenosis (angina pectoris) can also trigger massive anxiety.
- Diseases of the brain: In rare cases, an organic disease of the brain, for example an inflammation or a brain tumor, is behind anxiety.
Anxiety: When should you see a doctor?
If one or more of the following applies to you, you should see a doctor about your anxiety:
- Your anxiety is excessive.
- Your anxiety is becoming more frequent and more intense each time.
- You are unable to overcome your anxiety on your own.
- Your current life circumstances cannot explain the severity of your anxiety.
- Your quality of life is severely limited because of your anxiety.
- You withdraw from social life because of your anxiety.
Even fears that have an understandable cause may require treatment. For example, when a life-threatening disease such as cancer is accompanied by massive anxiety.
Anxiety: What does the doctor do?
The doctor makes the diagnosis after a detailed interview, in which possible causes and triggers of the fears are also discussed (anamnesis). Specialized questionnaires help in this process. They allow an assessment of how strong your anxiety is and what it is directed against.
In some cases, further examinations (such as blood tests, ECG) are necessary to exclude organic causes of the anxiety symptoms.
Once your anxiety has been clarified in more detail, the doctor can suggest appropriate treatment.
Cognitive behavioral therapy
Cognitive behavioral therapy has proven particularly effective in treating anxiety. It can be used to discover and question anxiety-triggering behavior patterns, thoughts and feelings. Targeted exercises help to change these anxiety-triggering patterns.
Patients with social phobia can use role-playing to try out scary situations in a protected space. In this way, they gain self-confidence and social skills. This helps them to overcome their fears.
Depth psychological methods
Sometimes depth psychological therapy (e.g. psychoanalysis) can also be useful. This can reveal and work on deeper-lying psychological problems as the root of the anxiety.
Medication
In addition to psychotherapeutic measures, medication can help to control anxiety. Antidepressants, among others, have proven effective. Tranquilizers such as benzodiazepines can also relieve anxiety. However, since they can be addictive, they should only be taken under medical supervision and for a limited period of time.
Treatment of causative diseases
If other illnesses (such as schizophrenia) are the cause of pathological anxiety, they should be treated professionally.
Anxiety: What you can do yourself
Even with “normal” (not pathological) anxiety and tension, you should become active.
Relaxation methods
In any case, it makes sense to learn a relaxation method. The reason: relaxation and anxiety are two emotional states that are mutually exclusive. So if you master a relaxation technique, you can use it to get a grip on anxiety and even panic attacks. Examples include special breathing exercises, yoga, autogenic training and Jacobson’s progressive muscle relaxation.
Medicinal plants
The following medicinal plants are particularly helpful for symptoms such as anxiety, nervousness, inner tension and restlessness:
They can be used individually or in combination.
Ready-made preparations from the pharmacy
Various ready-to-use preparations based on the above-mentioned medicinal plants are available in pharmacies, for example as capsules, dragées or drops. Herbal medicines have a controlled content of active ingredients and are officially approved as medicines. Consult your pharmacist for advice on selection and use.
Medicinal plants as tea
If your anxiety does not improve or even worsens despite treatment, you should consult a health care professional. If you need to take other medications in addition, you should talk to a doctor or pharmacist before using medicinal plant preparations. This will help you avoid unwanted interactions.
Lifestyle
In addition, a healthier lifestyle can also have a positive effect on anxiety symptoms. For example, exercise reduces stress and increases fitness. In addition, exercise improves sleep, which is significantly disturbed in many anxiety patients.
A healthy diet provides additional energy. All this also has an effect on mental stability – those who feel more alert and fit are better able to deal with problems, conflicts and anxiety.
