Anxiety Disorders: Therapy

General measures

• Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day); if necessary, alcohol restriction (abstaining from alcohol) insofar as there was previous alcohol abuse
• Limited caffeine consumption (max. 240 mg caffeine per day; this corresponds to 2 to 3 cups of coffee or 4 to 6 cups of green / black tea).
• Aim for normal weight!Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program.
  • BMI ≥ 25 → participation in a medically supervised weight loss program.
• Reduction/avoidance of stressors/overload.
• Regular rest periods / adequate sleep
• Review of permanent medication due topossible effect on the existing disease.
• Exclusion of an organic anxiety disorder or substance-related disorder (see laboratory or medical device diagnostics).
• Avoidance of drug use

Nutritional medicine

• Nutritional counseling based on nutritional analysis
• Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
  • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
  • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
  • High-fiber diet (whole grains, vegetables).
• Observance of the following special dietary recommendations:
  • Diet rich in:
    • Vitamins (vitamin B6)
    • Minerals (magnesium)
• Selection of appropriate food based on the nutritional analysis
• See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
• Detailed information on nutritional medicine you will receive from us.

Sports Medicine

• Endurance training (cardio) – e.g., running 5 km three times a week; for therapy (exercise is anxiolytic (anxiety-relieving); can be used therapeutically in the short and long term; is very effective! ; meta-analysis across 8 meta-analyses with 306 randomized controlled trials and 10,755 participants).
• Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
• Detailed information on sports medicine you will receive from us.

Psychotherapy

• Psychosocial procedures/measures according to S3 guideline: psychosocial therapies for severe mental illness [for severe forms of anxiety disorders].
  • Self-management as part of coping with the illness; in this context also references to self-help contact points.
  • Individual interventions
    • Psychoeducational intervention: serves to increase knowledge of the disease, promotes self-responsible management of the disease and assists in coping with the disease.
    • Training of everyday and social skills.
    • Artistic therapies
    • Occupational therapy: work or occupational therapy.
    • Movement and sports therapies
    • Health promotion interventions
  • Ambulatory psychiatric care (APP) as an aid in times of crisis to establish self and disease history and to promote individual as well as recovery processes.
• The most important pillar of the therapy of anxiety disorder is psychotherapy. Among other things, the following procedures are available:
  • Cognitive behavioral therapy (CBT): the goal of therapy is to enable the patient to develop skills to independently recognize dysfunctional (faulty, one-sided) assumptions and thoughts. The patient then interrupts and corrects these and thus behaves more appropriately to the situation. [at most evidence level; proof of effect is given]
  • Psychodynamic methods – psychotherapy methods that deal with the conscious and unconscious forces of the psyche (if a KVT is not effective or not available).
  • Anxiety management
  • Social skills training
  • Relaxation techniques
    • Yoga
    • Kundalini yoga relieved generalized anxiety disorder more often than stress management lectures in a randomized trial; however, cognitive behavioral therapy (CBT) was more sustainable.
• Detailed information on psychosomatics (including stress management) can be obtained from us.

Complementary treatment methods

• Acupuncture – appears to be an appropriate intervention for treating patients with chronic anxiety symptoms when other forms of therapy have been unsuccessful