Anxiety Disorders

Description

When the emotion of fear dominates everyday life, it is called an anxiety disorder.

There are the following criteria, according to which anxiety is classified as pathological:

• excessive anxiety
• increasing duration and frequency of the anxiety states
• inability to overcome the anxiety by oneself
• life circumstances are not sufficient to justify the anxiety

People who have been affected for a long time usually withdraw more and more from everyday life. Scary places and situations are avoided, and social isolation often follows from this.

About 5 out of 100 people suffer from an anxiety disorder, the extent of which requires treatment.

Learning theory explanatory model

A multistep process is thought to be the cause of an anxiety disorder.

Initially, a person "learns" that an originally normal situation triggers anxiety. This situation is then perceived as threatening, such as air turbulence.

If the person were to expose themselves to the same situation again, they may find that the fear was unfounded. However, because the fear is present, a repetition of the situation is avoided and the fear remains. Physical symptoms are perceived more intensely (e.g. heart palpitations), a fear-devil cycle occurs.

Neurobiological explanation model

The internal organs (e.g. heart and respiration) are controlled by the autonomic nervous system.

In people affected by anxiety disorders, this nervous system is probably over-sensitive and can be more easily irritated. As a result, anxiety symptoms develop more quickly. Studies show a possible inheritance of this predisposition, but it is not yet considered fully proven. In addition, the involvement of specific brain areas and neurotransmitters in the development of an anxiety disorder is suspected.

Psychoanalytical explanatory model

Normally, a person reacts to a conflict by trying to compromise. In this way, a psychological equilibrium is restored. If the solution of such a conflict fails, anxiety develops.

Another assumption is based on the possibility that those affected have not learned to deal with fear in their youth. They feel overwhelmed in conflictual situations and childish fears can erupt. Separation anxiety often manifests itself when the loss of a caregiver is imminent.

In anxiety disorders, experts distinguish two types and specific symptoms.

Directed fear

Certain situations or objects trigger fear, they are so-called phobias.

• Agoraphobia: fear of certain places
• Social phobia: fear of other people and dealing with them
• Specific phobia: confrontation with objects/situations e.g. spiders, syringes, blood, high altitude

Undirected fear

There is no specific trigger.

• Panic disorder: sudden episodic anxiety
• Generalised anxiety disorder: permanent anxiety

The most important tool for diagnosing an anxiety disorder is a detailed discussion between doctor and patient.

Affected people describe their fear and express assumptions about what could trigger it. Based on the severity and influence on social life, a doctor distinguishes between normal and pathological anxiety.

Anxiety disorders can also be the result of another illness, such as addiction:

• LSD
• Amphetamines
• Marijuana
• Caffeine

Any anxiety caused by another disorder is called secondary anxiety symptomatology. In this case, the underlying condition is treated first, and the symptom of anxiety is secondary.

• In order to rule out a physical cause, the following tests are necessary in individual cases:
• Blood sampling
• Ultrasound
• Computer tomography
• Magnetic resonance imaging of the skull

In contrast, true anxiety disorder is a primary anxiety disorder that cannot be explained medically.

Questionnaires can be particularly helpful in classifying the disorder more precisely. Self-assessment and peer-assessment questionnaires are available for this purpose, which are completed either by the patient or by the examining physician. Examples are the "State Trait Anxiety Inventory" and the "Hamilton Anxiety Scale".

For treatment offer medication and appropriate psychotherapy.

Medication

In the past, antidepressants have proved particularly effective. In particular, newer preparations with few side effects (selective serotonin reuptake inhibitors) are used successfully.

Sedatives such as benzodiazepines alleviate the symptoms of an anxiety disorder. Taking them requires a time limit and strict medical supervision, as these drugs are addictive.

Behavioral therapy

An anxiety situation is provoked by an expert by confronting the patient with his anxiety in a controlled way. The aim of this therapy is to let the affected person experience that the feared catastrophe does not occur. It is learned that one controls the fear oneself and not vice versa.

Sociophobic persons have forgotten how to behave properly in social situations. Role-playing in group therapies helps to train social skills and to use what has been forgotten correctly again.

Relaxation techniques such as autogenic training or progressive muscle relaxation according to Jakobson are also increasingly included in therapy.

It is crucial how quickly help is sought, the type of symptomatology is secondary. With appropriate behavioral therapy and medication, an anxiety disorder can usually be treated well.

Without adequate treatment, an anxiety disorder can persist and worsen for decades. The course varies and depends on how great the "fear of fear" is, i.e. the avoidance behaviour. Without self-control, there can be no sense of achievement.

The social isolation progresses and loneliness threatens.

You are not alone! 5 out of 100 people suffer from anxiety disorders.

You can be helped!

Seek professional help as soon as possible.The more time you let pass, the more difficult treatment will be.

Check with a trusted doctor about treatment options and support groups in your area. Don't settle for your situation, do something about it!

Don't try to avoid the trigger of your anxiety, as this will prevent resolution and entrench the anxiety.

Don't just treat the symptoms, e.g. with tranquilizers, as this makes therapy more difficult.

Avoid alcohol as an anxiety reliever. This helps at the most in the moment and worsens your situation by a possible dependence.

Alcohol is never a problem solver!