An anxiety disorder, anxiety neurosis is a psychosomatic disease in which sufferers are mainly affected by anxiety attacks or panic attacks. Most often, physical symptoms accompany an anxiety disorder without actually having a physical illness.
What are anxiety disorders?
Anxiety is a natural sense of danger. Once the threat is over, the anxiety also disappears. The condition is not called a disorder until the person shows an excessive fear reaction without having an objective reason for it, which is almost always accompanied by physical symptoms. Formerly also called anxiety neurosis, there are different forms of anxiety disorder. The best known are so-called phobias, which relate to specific objects or situations. Furthermore, there is panic disorder, which manifests itself in sudden anxiety and panic attacks, for no apparent reason. In generalized anxiety disorder, the focus is more on the feeling of constant threat. Sufferers cannot localize where the anxiety is coming from.
Causes
The causes of anxiety disorder are still not clearly understood. Many factors come together, which only together and in interaction trigger the disease. It is assumed that one of the causes is inner conflict. Psychoanalysis in particular focuses on this. The person affected has not learned to deal with normal anxiety. Experts from different disciplines look for and research other causes. Anxiety disorders and depression can promote each other. A depressed person who worries about everything will quickly suffer from anxiety about the future. On the other hand, impairment of quality of life can lead to an anxiety disorder. Other causes may be certain diseases, such as thyroid dysfunction. It is also assumed that certain messenger substances, so-called neurotransmitters, are out of balance in the brain. Anxiety disorders often occur after extreme stress or after consuming certain substances, such as drugs, caffeine or alcohol.
Symptoms, complaints, and signs
In anxiety disorder, the sufferer is dealing with a variety of fears. Very often, an anxiety disorder begins as a so-called generalized anxiety disorder. Here, fears occur that affect all areas of daily life. The sufferer is afraid of situations that are basically not threatening, but are suddenly perceived as threatening. The fears also relate to the possible effects of the situation in question. Another form of anxiety disorder brings to light fears that are related to previously experienced situations, which then act as so-called triggers. For example, after a traffic accident, an anxiety disorder may occur regarding driving. The symptoms of an anxiety disorder are the typical occurrence of fear, intense anxiety and apprehension and all thoughts that revolve around these complexes of issues. In the advanced stage, panic attacks can be added, and the transitions are fluid. The anxiety is associated with a release of adrenaline, a feeling of heat is perceived. The head feels numb, the affected person fears a near fainting. The pulse rate is greatly accelerated and is perceived physically, the blood pressure also rises. An anxiety or panic attack is evaluated as very exhausting and stressful, usually followed by a decrease in tension. Many sufferers develop an increasing fear of the anxiety and fear that the anxiety will occur again. This affects the quality of life.
Course
The course of the disease depends on what form of anxiety disorder it is. If left untreated, the disorder often persists for years or decades, with phases of severe and less severe symptoms alternating. Only in rare cases does a “spontaneous cure” of the anxiety disorder occur (in the case of panic disorders, this affects about 10 – 30% of those affected). Where possible, the affected person avoids the anxiety-provoking situation. In generalized anxiety disorder, this is of course not possible. Such patients often develop concomitant disorders that are psychosomatic in nature. Gastrointestinal disorders are often among them. Many anxiety disorders are accompanied by avoidance behavior. This can result in social complications that may feedback to the worsening of the anxiety disorder. Examples include ridicule, bullying, lack of understanding, and lack of patience from close family members.In the course of an anxiety disorder, agoraphobia can develop. Affected persons then avoid places and situations in which it would be difficult for them to access help in an emergency. The fear can also cause sufferers to withdraw into their homes and not leave the house – or they only travel short distances, for example to the nearest supermarket or bank. Depending on the type of anxiety disorder, avoidance can extend to many areas of life. Occupational restrictions are also possible. In the context of psychotherapy, it is necessary to discuss the fears and worries and to expose oneself to them in a protected setting. This confrontation is a burden for many patients and can impair motivation for therapy.
Complications
In addition, anxiety disorders may be associated with various other psychological complaints. Many people who suffer from generalized anxiety disorder (GAS) seek help late in life. As a result, the majority of GAS patients develop another mental illness. Various mental disorders come into question for this. For example, other anxiety disorders, depression and sleep disorders are common. Further complications can arise from self-medication, drugs, alcohol, problematic eating behaviors, and other attempts to manage anxiety independently.
When should you see a doctor?
Because an anxiety disorder can seriously worsen a patient’s quality of life, a visit to the doctor is recommended, especially if it is severe. Especially if anxiety-triggering situations in everyday life can no longer be avoided, the visit to the doctor should be completed without fail. The typical symptoms of an anxiety disorder, such as shortness of breath, rapid heartbeat and inner tension, put the patient’s body on alert and thus also endanger physical health. If, in addition to the stressful mental states, such as helplessness and anxiety, physical pain and other physical symptoms also become noticeable, the doctor should conduct a comprehensive examination of the patient. In this way, it is possible to get to the bottom of a physical cause that may lie behind the symptoms. If the anxiety disorder is only mild and is not associated with any restrictions on everyday life, the patient must decide for himself whether he considers a visit to the doctor to be useful. The first port of call for an anxiety disorder may be the family doctor, who can then write a referral to specialists. For treatment of an anxiety disorder, a visit to a psychiatrist is recommended, who can also prescribe medication if necessary. In a milder course, treatment by means of talk therapy alone is recommended, which is usually carried out by a psychologist.
Treatment and therapy
The treatment of anxiety disorder is based on two pillars. First, medications are used to provide immediate relief. These can be antidepressants, which are designed to rebalance the neurotransmitters in the brain and have an anxiety-relieving effect. Benzodiazepines are psychotropic drugs used for tension and anxiety. They have a depressant, relaxant and anticonvulsant effect and work much faster than antidepressants. However, dependence can develop quickly, so they are prescribed cautiously. Other medications for treating anxiety disorders may include St. John’s wort preparations, neuroleptics, or beta blockers. Psychotherapeutic measures are carried out to achieve a longer-term improvement, as the anxiety disorder often has psychological causes. For specific phobias, confrontation therapy is an option, in which the affected person learns to endure the situation with the help of the therapist. For generalized anxiety disorder, cognitive therapy is often used. The patient should learn to recognize and correct his thinking patterns that lead to the anxiety disorder. This still includes learning relaxation techniques to help the patient help himself.
Outlook and prognosis
An anxiety disorder can usually be successfully tackled with the help of behavioral therapy and medication. The prognosis is better the earlier treatment begins: Anxieties that have already existed for a very long time require a much greater amount of therapy and cannot always be completely resolved. In principle, individual phobias can be better treated than generalized anxiety disorder, which almost always requires protracted treatment.Even after successful therapy, it often happens that persistent stress or a life crisis bring the old fears back to the surface after a longer anxiety-free phase. If the affected person tries to cope with the anxiety disorder without help, the prognosis is worse: In many cases, the fear of anxiety leads to avoidance behavior, which can massively restrict everyday life. Social withdrawal often brings isolation, which is not infrequently accompanied by depression and suicidal thoughts. Anxiety patients often take refuge in addictions, which can lead to alcohol or drug dependence with all the negative physical and psychosocial consequences. Anxiety disorders should be viewed as chronic illnesses that can flare up again and again even after successful therapy. A largely normal life is nevertheless possible if anxiety patients live in a stable social environment and are open to treatment.
Prevention
Anxiety disorders cannot be prevented directly. However, relaxation techniques, such as autogenic training, help people cope better with many everyday problems and thus develop less anxiety about situations. Herbal extracts, such as St. John’s wort, valerian and lemon balm, also help. Mild anxiety disorders rarely require follow-up care. They occur preferentially in crisis situations and subsequently disappear. More complex anxiety disorders, however, need to be treated. Often this happens years after the first occurrence, when the suffering pressure has become unbearable.
Aftercare
Depending on whether a clinical stay became necessary or prolonged psychotheraopeutic treatment occurred, aftercare may or may not be common. Some clinics that treat anxiety disorders actively ensure that their patients receive follow-up care after their clinic stay. For example, they refer them to support groups close to home. Others recommend psychotherapy or behavioral therapy as an aftercare measure. In this case, the clinic sends the treating therapist documentation on the nature of the anxiety disorder. If the anxiety disorder was associated with depression, follow-up may consist of medication monitoring. Exercise is an important part of aftercare. Relaxation classes or therapeutic painting can also be helpful aftercare. The pension insurance company also offers aftercare options. Aftercare absolutely includes a person taking steps on their own after an anxiety disorder to avoid falling back into their fears. Aftercare may include, for example, seeking a lower-stress job or changing something about one’s life. Without follow-up care, it is difficult to keep the good resolutions made during a psychosomatic cure.
Here’s what you can do yourself
An anxiety disorder is one of those conditions in which sufferers can actively work to improve or even eliminate symptoms. This is possible within the framework of participation in a self-help group, but also alone. In anxiety disorder, physical symptoms such as rapid heartbeat or dizzy spells are often in the foreground, which make patients think they are seriously ill. After a medical clarification, it is important to trust the diagnosis of anxiety disorder and not to constantly search for other organic causes. Often the anxiety disorder leads to avoidance behavior with regard to situations in which the unpleasant symptoms occurred. It is important to re-learn, via conscious confrontation with these anxiety-provoking situations, that the anxiety is unfounded and that nothing bad will happen. Those affected can practice this on their own, for example by starting with confrontations that are rather easy for them and gradually regaining self-confidence. In addition, patients with an anxiety disorder can work on their inner balance by regularly practicing endurance sports or learning one of the many forms of relaxation such as progressive muscle relaxation or autogenic training. Regular yoga can also make a valuable contribution here, because it helps to regulate the flow of breath and to ensure greater calm and composure through meditation and deep relaxation.