Anxiety (anxiety disorder)

What does fear mean?

Fear is a developmentally age-old emotion that protects us humans today from dangers and forces us to be careful. Virtually no one is free from it. Natural fear helps us to avoid accidents or illnesses and to avoid dangerous situations or to prepare accordingly. It is closely interwoven with physical processes and can be caused accordingly by organic disturbances. The interplay of disposition and life story determines our personal anxiety readiness, which however can be influenced, for example by psychological counseling or naturopathic measures.

contents

• What does fear mean?
• Anxiety Disorders - A Brief Overview
• Fear or fear - where is the difference?
• When does fear become a disease??
• Anxiety symptoms
• Possible causes of anxiety
• Physical illness can be associated with anxiety
• Anticipation fears - The fear of fear
• The different forms of anxiety disorder
• panic disorder
• Generalized anxiety disorder
• Social anxiety disorder
• Specific phobias
• diagnosis
• therapy
• Naturopathic treatment of anxiety

Anxiety Disorders - A Brief Overview

Diseases associated with a form of exaggerated anxiety are very common. Around 20 percent of all people in Germany develop at least one form of such disorder during their lifetime. In addition to depression, anxiety disorders are the most common mental illnesses. Here is a brief overview:

• definitionIn an anxiety disorder, the natural emotion of the anxiety is perceived to an abnormal extent and massively affects the daily lives of those affected.
• symptoms: Avoiding certain places, things or situations, isolation, dizziness, feelings of tightness, cold sweats, disturbances of consciousness, nausea, hot flashes, paleness, trembling hands, feeling of approaching catastrophe, fainting
• to form: In medicine, four common forms of pathological fears are described, but they can also be combined. These include panic disorders, generalized anxiety disorders, social anxiety disorders and specific phobias.
• panic disorder: This form is characterized by the regular occurrence of panic attacks, which vary in length and frequency. Between the attacks affected suffer from constant fear of the next attack.
• Generalized anxiety disorder: The complaints are based on strong long-term worries and fears, for which there is no reason in most cases. Concerned suffer from the constant feeling of approaching disaster, inner restlessness, nervousness, restlessness and sleep disorders.
• Social phobia: In this form, the fear of dealing with other people in the foreground. Conversations, exams, and all kinds of social interaction can trigger violent physical symptoms such as palpitations, tremors, nausea, and sudden urgency in those affected.
• Specific phobias: These disorders are dominated by the fear of certain objects, animals, situations or places. Animal phobias, fear of heights or the fear of spraying are typical examples of specific phobias.

Anxiety can become morbid and manifests itself in massive physical symptoms. (Image: studiostoks / fotolia.com)

Fear or fear - where is the difference?

Fear and fear are both emotions of humans and of many animals that are supposed to protect against danger. Fear is more predictive and omnipresent than fear. For example, one is afraid of what might lurk just around the corner or that a healthy, well-to-do person may suddenly get sick. Fear expresses itself against a perceived as real danger, which comes up, for example, if one sees poisonous animals such as spiders and snakes or by an emergency stop just such a car accident prevents. Fear triggers rather oppressive feelings of inner tension, whereas fear expresses itself more by sudden and violent reactions.

The lovely world of fear

We live in a world full of charms. These constantly influence our sense organs as image, word, writing, smell, stench, light, sound, color, taste, speed, volume, touch and crowding. While the one perceives these stimuli as a secure framework of modern life, another feels over-stressed, stressed, develops inner restlessness, tension and even anxiety. The interpretation of the situation as well as innate and learned personality structures cause us to perceive this arousal as fear or not. How our fear arises is still not understood as sufficient. The island cortex of the brain seems to play a central role.

When does fear become a disease??

So fear is normal and part of everyday life. If you are afraid of an exam, you are not automatically affected by morbid test anxiety and if you are disgusted with spiders and avoid them, you do not necessarily suffer from fear of spiders in the pathological sense. Where is the delimitation from which one speaks of an anxiety disorder? The German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) has published a number of questions to help anyone determine if they are suffering from abnormal anxiety. If the answer to one or more questions is "yes", medical or psychological counseling should be provided. The questions are:

• Think about fears about 80 percent of the day?
• Is significantly reduced by fears your quality of life?
• Cabinets Fear your freedom of movement?
• Become increasingly depressed by fears?
• Had you ever thought about suicide because of your fears??
• Tend to alcohol, tablet or drug use to soothe your fears?
• Is your partnership in danger because of the fears?
• Do you have problems with the job because of your fears or are you unemployed because of your fears??

Every person feels fear and anxiety as a normal protective function against possible dangers. But if these emotions take on dimensions that severely limit everyday life, it may be an anxiety disorder. (Image: ra2 studio / fotolia.com)

Anxiety symptoms

The process from the perception of an external stimulus to the perceived anxiety is complex. It passes through the sensory organs through various areas of the brain (especially the limbic system) and then triggers bodily processes via the autonomic nervous system and hormones. These manifest as arousal in the form of measurable physical changes that can increase up to a panic attack. Typical anxiety symptoms include:

• Blood pressure increase (blood pressure fluctuations),
• dizziness,
• difficulty breathing,
• excessive sweating,
• dizziness,
• Disturbances of consciousness,
• palpitations,
• Nausea and vomiting,
• hyperventilation,
• Hot flashes or cold sweats,
• pallor,
• Tremble,
• in some cases even unconsciousness or at least the feeling of fainting.

Possible causes of anxiety

Anxiety can also temporarily increase as a reaction, such as the unexpected loss of a loved one, a car accident or in the first few weeks with a suddenly needed pacemaker. For the most part, this is still to be understood as a normal adaptation process, which decreases with increasing acceptance of the situation or the fading of the memory. Only when everyday life is permanently restricted by specific or general feelings of anxiety, can an anxiety disorder be assumed. As a result of heart disease or a heart attack, for example, a cardiac neurosis manifest.

Physical illness can be associated with anxiety

There are a number of physical illnesses that can cause anxiety and panic attacks. These include thyroid dysfunction (hyperthyroidism, hypothyroidism), a heart attack, angina pectoris and cardiac arrhythmias. Diseases of the respiratory system, such as chronic bronchitis and asthma often lead to hyperventilation and can lead to (sometimes panic) anxiety. Anxiety can also occur with diabetes (hypoglycaemia) as well as with neurological conditions such as epilepsy or brain changes associated with dizziness.

Certain physical illnesses such as heart disease, cancer, thyroid disease, some neurological diseases or diabetes can lead to increased anxiety in everyday life. (Image: digitalskillet1 / fotolia.com)

An adrenal cortex tumor (pheochromocytoma), which produces excessive adrenaline, also causes anxiety and panic. Furthermore, anxiety disorders due to psychosis such as schizophrenia can be triggered. These diseases are sometimes associated with life-threatening consequences and should be treated and monitored by a doctor. Finally, drug or drug abuse and alcoholism as a possible trigger for anxiety disorders are mentioned. After a successful withdrawal, these fears often resolve themselves again.

Anticipation fears - The fear of fear

If an anxiety disorder remains untreated, it can become independent and take more and more influence on the lives of those affected. An anxiety disorder often develops a so-called anxiety anxiety as an additional burden. This fear of anxiety often causes sufferers to increasingly avoid and isolate certain areas of public life, which in turn can have a profound impact on work, family, relationships, and friends.

The different forms of anxiety disorder

In addition to depression, anxiety disorders are among the most common mental disorders. The anxiety disorders can be divided into four categories in most cases. These include panic disorders, generalized anxiety disorders, social anxiety disorder and specific phobias. These four areas are explained in more detail below.

panic disorder

This form of the disease focuses on panic attacks. These can be over after a few minutes or last for several hours. In most cases, such an attack lasts less than 30 minutes. Not only the length, but also the frequency of panic attacks varies greatly among those affected. In some cases, the attacks only appear once a month, others several times a day. The life of the patients is dominated by a constant fear of the next attack. Frequent visits to doctors or emergency rooms suggesting life-threatening conditions such as a heart attack indicate, among other things, a panic disorder.

Panic disorders often occur along with claustrophobia. A typical trigger of a panic attack, for example, is a stay in the elevator. (Image: andriano_cz / fotolia.com)

Spread and course of panic disorders

According to the DGPPN, about two to three percent of the German population is affected by panic disorder. Women are twice as likely to suffer from this mental illness as men. The first symptoms appear in the majority of those between 20 and 30 years of age. The strongest manifestation is between the ages of 30 and 40 years. Often the symptoms decrease afterwards.

Typical triggers of a panic attack

Panic attacks can occur suddenly and unexpectedly in all kinds of life situations. In about two-thirds of cases, panic disorders in combination with agoraphobia (claustrophobia) occur. In these cases, certain places or situations are considered triggers. Typical triggers are, for example, crowds or lines of people queuing up, public spaces, long distances from home, elevators, buses, airplanes or cars. Concerned people increasingly avoid such situations and places where panic attacks could develop. In severe cases, they almost never leave their house.

Generalized anxiety disorder

In generalized anxiety disorder, the focus is on long-lasting and pronounced worries and fears that can encompass all possible areas of life. The basis of anxiety is often a real danger, but disproportionately exaggerated. These include, for example, fear of robberies, burglaries, loneliness, car accidents, illnesses, the death of a loved one or his own death. Frequently sufferers suffer from the constant feeling of an approaching disaster, which can manifest itself through internal restlessness, nervousness, tense, muscle hardening, back pain and sleep disturbances. In contrast to the panic disorders, the symptoms do not show up in a sudden outbreak, but isolated sporadically throughout the day.

Frequency and course of generalized anxiety disorder

According to DGPPN, up to six percent of people in Germany are affected by such a disorder. Women are slightly more affected than men. The disease can take on a similar form to depression. Most of the time around the age of 30, the first symptoms appear, which, if left untreated, can persist into the later years of life.

Social phobias are often noticeable even in childhood and adolescence. Test anxiety, excessive shyness and avoidance of social interactions can be signs of such a disorder. (Image: andreaobzerova / fotolia.com)

Social anxiety disorder

In a social phobia, dealing with other people is the focus of the disease. In particular, situations in which one is potentially observed, evaluated, judged or criticized by other fellow human beings are a source of horror for those affected and trigger strong feelings of anxiety. One could consider the social anxiety disorder as a morbidly exacerbated form of timidity. Predominant symptoms in this form of the disorder are rapid flushing, palpitations, tremors, nausea, and sudden urge to toil. Typical situations that trigger such fears are for example:

• Talk in front of other people,
• be in the focus,
• take a job, exam or exam (fear of exams),
• Conduct disputes,
• talk to strangers,
• talk to the boss, superiors or authorities,
• Flirting, or talking to a person perceived as attractive.

Frequency and course of social phobia

The DGPPN states that around seven percent of the German population is affected by a social anxiety disorder. Often the first signs of this are already evident in childhood and youth. Between the ages of 20 and 35, social phobia in most cases reaches its peak and then decreases.

Specific phobias

In a specific phobia, the fear of individual objects, animals or situations in the foreground of the disease. Often the triggers are not real or at least no real danger. Animal phobias (e.g., dogs or mice) and fear of certain insects, such as fear of spiders, are common disorders in this area. An example of situational anxiety is fear of heights. Object-related fears include, for example, the fear of injections. Just the thought of the triggers puts those affected in discomfort. Actual confrontation with the triggers can sometimes lead to panic reactions.

Frequency and course of specific phobias

There is no precise information about the exact frequency of specific phobias. It is estimated that between five and 15 percent of the population develop a specific phobia during their lifetime. For the most part, those affected know about their exaggerated fears and are ashamed of it. Also in this type of anxiety disorder women are affected more often than men.

A disgust and a certain fear of spiders are normal. If only the thought already causes physical symptoms, visual contact leads to panic attacks and if this negatively influences everyday life, it can be a pathological spider phobia. (Image: Anatolii / fotoia.com)

diagnosis

To diagnose an anxiety disorder, it must first be determined in extensive discussions with the doctor, whether the anxiety in a normal frame moves or has assumed morbid features. Many anxiety disorders also combine with depression or are a hybrid of the above categories. Furthermore, it must be clarified whether any organic or physical causes of anxiety are underlying. For example, thyroid disorders, tumors or neurological diseases come into question. During diagnosis, various measurements are routinely performed by means of procedures such as ECG, EEG or MRI.

therapy

In conventional medicine, a cognitive behavioral therapy is often used in combination with a drug treatment. The cooperation and motivation of the patient decide to a great extent on the success of the therapy. In the course of treatment, sufferers have to face the anxiety-causing factors and learn to deal with them. Confrontational exercises are a fundamental part of cognitive behavioral therapy to resolve anxieties.

Medication

Medications include selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs). In generalized anxiety disorder, the drug pregabalin from the group of antiepileptic drugs is often prescribed. Other drugs used in anxiety disorders are:

• Tricyclic antidepressants,
• moclobemide,
• opipramol,
• buspirone,
• Benzodiazepines (Caution: dependency hazard).

Naturopathic treatment of anxiety

Naturally, the problem of increased inner tension and anxiety readiness can be addressed in a variety of ways. Traditionally, the goal of traditional medicine is to treat sufferers according to their constitution. Diagnosis is served by a conversation as well as facial and iris diagnosis, in which the individual, organically created weak points are determined on the basis of certain colors and signs. The recognized constitution should be adapted to lifestyle and eating habits in order to stay physically and mentally in balance. In addition, attempts are made to harmonize the constitution with suitable medicinal plants and herbal medicine.

In many cases, anxiety disorders can be well treated or at least alleviated with measures from natural medicine. (Image: heilpraxis.de/picture-waterfall/fotolia.com)

Strengthen the autonomic nervous system and promote relaxation

In practice, it is often irritable, people with strong vegetative reactions who are prone to anxiety and withdrawal. Here it is important to strengthen the autonomic nervous system and to promote relaxation. In other cases, it makes sense to use liver, bile and intestinal therapies to stimulate the digestive juices to maximize absorption of essential nutrients, minerals and vitamins. In Traditional Chinese Medicine (TCM), anxiety is an emotion associated with the kidneys. Accordingly, kidney-effective herbs are prescribed and acupuncture of the kidney meridian is performed.

homeopathy

Also including individual and mental aspects more strongly is the classical homeopathy, in which by discussions and observations ideally the constitutional remedy is found. For example, the homeopathic remedies Aconitum, Argentum nitricum, Coffea, Ignatia and Opium are used. Even a Bach flower therapy can restore the mental balance, especially if it goes along with consultative discussions. The choice of means and potency should always be left to experienced therapists.

medicinal plants

In naturopathic practice, various medicinal plants are used against panic attacks and other fears. Here are in particular the passionflower and the valerian name. Also other plants such as St. John's wort and hops have proven to be useful in this area for relief.

hypnosis

Hypnotherapy, through hypnosis and self-hypnosis, can help one to adapt to one's inner sensations and perceptions and, moreover, to gain more peace and serenity in dealing with the outside world.

Targeted stress reduction, for example through regular yoga, can help control anxiety better. (Image: fizkes / fotolia.com)

stress reduction

Breathing exercises for stress relief are easy to learn and very effective because they can be used anywhere without any aids. Various techniques can help to switch vegetatively to "rest", but also to increase well-being through better oxygenation. Coupled with the simplest meditation techniques, the effect can be increased even more. Breathing exercises and meditation are also part of holistic approaches like yoga, tai chi or qigong. Other relaxation techniques include autogenic training and progressive muscle relaxation.

Energetic treatment options

Likewise, psychological counseling, for example, systemic or client-centered, and energetic methods such as chakra, Auro-Soma, therapy with healing stones from stone healing or knock acupressure can help to react more relaxed to stimuli and demands.

Annotation: The literature often distinguishes between fear and anxiety. Fear refers to the legitimate response to a specific threat, while fear describes the same state without a "real" trigger. In this article, these terms are used interchangeably and in contrast to the anxiety disorder in the sense of common diagnostics according to ICD-10 / DSM-IV. (jvs, vb, updated on 28.06.2018)