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Treat anxiety disorders

You are not alone with your fears

The degree to which anxiety manifests itself varies greatly from person to person. Feeling a bit of fear
or having a queasy feeling is quite normal in unfamiliar situations, with strange animals, on the way home in the dark or even with a new challenge at work. The feeling becomes pathological when the fear arises without a real
threat, is unreasonably strong, lasts for a long time or occurs very often and affects our lives. In these cases, you should talk to
your family doctor or a specialist such as a psychiatrist about your anxiety.

Anxiety paves the way for other diseases

If left untreated, fear does not disappear; on the contrary. It often becomes stronger and other anxiety disorders, such as panic disorder, develop. But disorders such as depression or dependence on substances such as alcohol also occur more frequently in anxiety patients

Anxiety often manifests itself through physical symptoms such as racing heart, dizziness, or head and back pain
Those affected do not take these signs seriously or assume another illness is the cause. Therefore, on average, they do not receive a diagnosis of anxiety disorder until seven years after the onset of the illness.

How does fear arise?

Fear is a natural feeling, because it can protect us from real dangers. For a long time, this form of fear was an advantage for our ancestors: Those who were cautious, whether on unfamiliar terrain or in relation to poisonous or wild animals, simply survived longer. Therefore, there is a primal fear that urges us to be careful, but does not hinder life, but protects us

However, fear without a real threat or in an exaggerated degree is harmful and is considered a disease. Without treatment, it does not disappear in most cases; on the contrary, the fear gets worse over time. This can go so far that those affected can no longer leave the house and can no longer cope with their daily lives.

It doesn’t have to come to that. Anxiety disorders can be treated well today. Therefore, seek help early on if you feel that fear of certain things or situations, panic or even constant worry are determining your everyday life and limiting your quality of life. Your family doctor or a specialist such as a psychiatrist or psychotherapist, for example at LIMES Schlossklinik Fürstenhof, is the right person to contact to clarify whether an anxiety disorder is present. With the individually appropriate treatment, you will get your anxiety under
and regain quality of life

An anxiety disorder has many faces

There is no healthy person without anxiety. In the development of man, this feeling meant a decisive advantage. It called for caution when it was necessary to protect life and health. Therefore, it is only natural that we still feel fear in unknown situations, in strange places or at the sight of an apparently threatening animal. The body reacts with heart palpitations and accelerated breathing in order to be ready to deal with the threat – fight or flight. At the same time, certain fearful stimuli, such as snakes, spiders, heights, or darkness, are not only biological protective mechanisms, but are often
but are often also conditioned by upbringing or the cultural environment

Most people quickly succeed in assessing and coping with the situation. Often, fear even has positive effects: It increases performance and alertness. In an anxiety disorder, the body reacts in certain everyday situations as if there were real danger, but without reason or to an extent that is not appropriate for the given threat. A distinction is made between different forms of the disorder:


This term is often translated as claustrophobia. Triggers of agoraphobia are crowds or the need to go alone to a public place or store. Sufferers do not travel alone in cars, buses, trains, or trains, and some do not use elevators. They generally avoid places or situations that cause them fear. Often these are occasions when it would be difficult to summon a doctor or leave the place quickly if necessary, for example in the event of a panic attack

As a result of this avoidance behavior, sufferers are restricted in their daily lives. Some are unable to go to work or run their household. In extreme cases, people with agoraphobia no longer leave their house or apartment. The disorder usually begins in young adulthood and is often associated with panic attacks. If left untreated, it progresses and takes a chronic course

Social phobias

Fear and avoidance behavior in certain social situations are called social phobias. Put simply, they could be understood as an extreme form of shyness. Social phobias manifest themselves in situations in which the affected person feels that he or she is the center of attention, for example, when speaking in front of a group, attending events, or in exam situations

It limits social and professional life as well as performance, as sufferers find it difficult or impossible to attend family gatherings or business meetings, for example. But even everyday tasks such as visiting the doctor, going to the authorities, meeting or addressing other people lead to discomfort. Typical symptoms of social phobia are blushing, hand trembling, nausea or urination. The disorder usually begins before the age of 25 and often lasts a lifetime if untreated

Specific anxiety disorders

The persistent and unreasonable fear of certain creatures, objects, or situations is called specific anxiety disorder. Possible triggers may include:

– Animals such as snakes, spiders, dogs, cats, rats, mice,
– forces of nature such as thunderstorms,
– heights or traveling in airplanes,
– confined spaces,
– treatments at the dentist,
– blood, injuries, injections

Just thinking about the trigger of the fear can lead to mild discomfort and even a panic attack. Sufferers are aware that other people in the same situation do not feel fear, and they may feel ashamed of their behavior. Confrontation with the trigger of the fear immediately leads to a reaction. In this case, the affected person fears the danger emanating from the cause of their fear, for example an animal bite, lightning strike or a fall from a great height. In more than 80 percent of cases, the disorder begins before the age of 20 and affects women more frequently than men

Panic disorder

If panic attacks occur repeatedly, suddenly and unexpectedly, and seemingly for no reason, it is panic disorder. The anxiety comes on suddenly and lasts for a few minutes to a few hours. However, it usually passes in about half an hour. Typical symptoms include racing heart, shortness of breath, shortness of breath, chest pain, a feeling of suffocation, nausea, flushing or chills, and dizziness, as well as a sense of unreality. Sufferers fear going crazy, losing control, or having a breakdown. Some experience fear of death

The fear of the next panic attack is correspondingly great. Because of the symptoms, many sufferers think of a physical illness rather than a psychological trigger. Since no physical cause for the symptoms can be found at the family doctor’s or in the emergency room, panic disorders often remain undetected for a long time
The disorder usually begins in adolescence or early adulthood. Most of those affected also develop agoraphobia during its often chronic course (see p. 4). In addition, their risk of developing depression is increased

Generalized anxiety disorder

Worry, brooding and anxiety that affect almost all areas of life characterize generalized anxiety disorder. Affected individuals suffer from severe anxiety, worry and tension, or a sense of impending doom, for at least six months. These feelings relate to various life circumstances, everyday situations and common problems. If the fear applies to real threats, it is unrealistically exaggerated. Affected persons feel restless, nervous and tense and often suffer from sleep disorders and irritability

The typical symptoms, such as racing heart, trembling, restlessness, sweating, cold and clammy hands, dry mouth, nausea, tightness in the throat and muscle tension in the back, do not occur together in the form of an attack, but occur individually throughout the day. The disease usually begins slowly and insidiously between the ages of 15 and 50. If left untreated, it is usually chronic and worsens with exertion.

 chief physician
Dr. med. Kjell R. Brolund-Spaether chief physician

“Anxiety disorders affect many patients these days. To better educate sufferers, I’ve published a professional article on anxiety disorders.”

Facts and figures

  • 9.8 million adults in Germany suffer from an anxiety disorder within a year.
  • Twice as many women are affected as men.
  • Only just under half of people with an anxiety disorder receive proper treatment.

Fear has many causes

For an anxiety disorder to occur, various genetic, neurobiological, psychological, and environmental causes interact

Genetic causes
An anxiety disorder often occurs in multiple members of a family. Children of affected individuals have a three to five times higher risk of also developing a panic disorder than the general population. Generalized anxiety disorder and specific phobias also run in families
occur more frequently in families. In identical twins, whose genetic material is identical, both suffer more frequently from an anxiety disorder than in fraternal twins
These facts speak for a genetic involvement in the development of the disease. The proportion of genetic predisposition is between 30 and 67 percent. But a predisposition does not mean that the disease will also break out. Other factors must also be involved.

Environmental factors

Negative environmental factors can promote an anxiety disorder. These influences include:

– Abuse and neglect,
– experiences of violence,
– Traumatizing events,
– deaths,
– separation experiences,
– financial problems,
– chronic illnesses

However, family factors such as the overestimation of risks, an increased need for security or control, and a high sensitivity to embarrassment also have a promoting effect on the occurrence of an anxiety disorder. The opposite effect is exerted by positive environmental factors such as:

– good coping strategies,
– supportive learning experiences,
– secure attachments,
– and a good social network

They can help prevent the predisposition to an anxiety disorder from taking hold and developing into an illness

Neurobiological factors
Biochemical processes in the brain influence our feelings. In anxiety disorders, the balance of the neurotransmitters serotonin, norepinephrine and gamma aminobutyric acid is probably disturbed. The drugs that can be used for anxiety disorders intervene in this balance
can be used for anxiety disorders. Learning experiences Failures and negative learning experiences can promote the emergence and maintenance of anxiety. If the discomfort and physical symptoms occur repeatedly in response to certain triggers, such as being in an elevator or talking to co-workers, the fear becomes entrenched

The typical avoidance behavior, for example using the stairs instead of the elevator or not speaking up in meetings, prevents the important positive experiences in particular. In this way, those affected do not learn that their fears are unfounded and that they can master the situation.

Diagnosis and treatment

The first step in diagnosing an anxiety disorder is an open and trusting discussion with the family doctor or an expert, such as a psychiatrist or psychotherapist. The doctor can also use certain questionnaires as a guide, which have been shown in scientific studies to be helpful in identifying anxiety disorders. Since the fear often manifests itself in the form of physical symptoms, such as palpitations, racing heart, heart palpitations, dizziness, nausea, sweating or freezing, a physical examination must rule out any illnesses that could lead to these complaints

These include, for example, cardiovascular diseases, thyroid disorders or neurological causes. Therefore, the doctor will also order blood tests, an ECG (electrocardiogram, measurement of heart activity), possibly an EEG (electroencephalography, recording of brain waves) or even a magnetic resonance imaging (MRI).

Once the diagnosis of an anxiety disorder has been made through a detailed medical history and examination, with the corresponding more detailed definition of the
The next step is to determine the appropriate treatment for the individual. This can take place on an outpatient basis or in a clinic specializing in the treatment of anxiety disorders, such as the LIMES Schlosskliniken

How are anxiety disorders treated?

The treatment of anxiety disorders is the linchpin for a life without anxiety, because with the appropriate therapy, those affected can get their suffering under control. Without therapy, on the other hand, there is a risk that the disorder will become chronic and worsen. Depending on the course and severity of the disease, the doctor will suggest psychotherapy, drug treatment or a combination of both. This treatment can take place on an outpatient basis or in a specialized facility such as the LIMES Schlosskliniken

The goal is for the symptoms of the anxiety disorder to be alleviated to such an extent that the patient feels comfortable again and is not restricted in his or her daily private and professional life. In addition, the treatment should reduce the risk of a recurrence of the symptoms. It is important that you, as the patient, actively participate in the treatment. Therefore, the doctor will explain his therapy proposal to you in detail and advise you on the options. Then, together with your doctor, you will choose the treatment option that you are convinced of. For the treatment of anxiety disorders, psychotherapeutic and medicinal therapy methods have proven to be effective. These can be supplemented by supportive procedures such as sports and relaxation techniques

Psychotherapeutic treatments focus on cognitive behavioral therapy. The purpose of the therapy is for the patient to experience that his fear is unfounded and harmless. He learns to understand what thought processes underlie the fear or what reinforces this sensation. Anxiety patients thus learn to consciously correct the avoidant behaviors. This is best accomplished through exposure therapy, which is guided by the therapist. It is important that confrontation exercises and the possible reactions to the experience are discussed comprehensively in advance and that the patient is prepared to enter the anxiety-provoking situation step by step, accompanied by the therapist. This method is also promising for patients with strong fears

Drug treatment
Medications, especially antidepressants, can be used as an alternative or supplement to psychotherapy. It can take about two weeks for these drugs to take effect. During this time, nervousness, restlessness and anxiety may occur. Therefore, treatment is usually started with a low dosage, which is increased in the course of therapy until the final dose is reached. To avoid a relapse, the medication must continue to be taken according to the doctor’s instructions even when the symptoms of the anxiety disorder no longer occur. If treatment is discontinued, the physician will establish a regimen to slowly reduce the medication

The forms of therapy can be supplemented by other measures. These include:

Physical activity and sports can support psychotherapeutic or drug treatment. Exercise helps reduce stress. In addition, during sports, anxiety patients learn that heart palpitations, accelerated breathing or sweating are normal physical reactions that do not pose a threat. This can break the link between these physical adaptation reactions and anxiety-triggering stimuli

Relaxation techniques
With the help of relaxation techniques such as yoga, Qui Gong, autogenic training, mindfulness or breathing training, patients learn to better manage their symptoms. Certain yoga exercises, for example, can help patients become more aware of their bodies and reduce their overreactions

Healing Environment
A calm, relaxing and safe therapeutic environment has a positive impact on anxiety patients. LIMES Castle Clinics follow the Healing Environment approach and have created an environment for their patients tocalm down and recover in a sustainable way. The proximity to nature and the special architecture help to reduce stress. The use of calming materials in the clinic also has a positive effect on the mental state and supports the recovery process

A view of greenery, access to gardens, adapted lighting, pleasant acoustics and a good room climate – quiet zones promote recovery not only in the case of physical illnesses, but also in the case of psychological problems. Biologically, this can also be seen in the fact that the release of stress hormones decreases in this feel-good environment

How can I help myself?
If you believe that you are suffering from an anxiety disorder and if fear and worry dominate your everyday life, you should seek professional help as soon as possible. It is highly unlikely that the anxiety will go away on its own. It is also important that you do not avoid unpleasant situations or stimuli that trigger anxiety. The more often you show this avoidance behavior, the more power the fear gains over you. On your own, this is sometimes impossible

This is another reason to seek professional help. How can sufferers be supported? The way out of anxiety is not easy for affected people. The best way to support them is to encourage them to seek professional help. Find out about the particular form of anxiety and encourage the sufferer to face their fear. But also accept that the will alone is often not enough to get the fear under control.