Generalized anxiety disorder


Generalized anxiety disorder (GAS, anxiety neurosis, generalized anxiety disorder): persistent feeling of diffuse anxiety for which there is no real, concrete reason (free-floating anxiety). Generalized anxiety disorder is a common disorder, especially in women, typically between the ages of 20. and the 35. Year of life. In about 70% of those affected, it occurs in conjunction with depression or other anxiety disorders.

Leading complaints

  • Constantly elevated levels of anxiety that manifest physically as nervousness, trembling, muscle tension, sweating, palpitations, dizziness, or abdominal pain – these are all physiological consequences of anxiety or. of the experienced stress.
  • Permanent feeling of fear that something bad could happen to yourself or important caregivers, although there is no real danger.
  • Real dangers – such as in traffic or sports – are extremely overestimated and give rise to thoughts of what could happen.
  • Sleep disturbances, as patients are unable to switch off from ruminations, worries and fears.
  • Fear of existence and life, fear of the future, especially of social and financial security. Constant fear of not being able to cope with the demands of everyday life and work, of failing, of embarrassing oneself or of causing harm in the process.

When to see a doctor

In the next few days, when the symptoms last longer than 14 days.

Generalized anxiety disorder is often not recognized as a mental illness because of the pronounced physical accompanying symptoms. Since the affected persons usually do not associate these symptoms with their anxiety, they do not tell the doctor about their constant great worries and fears. The consequence: The doctor often only recognizes very late what the real trigger for the physical complaints is.

Show background information

The illness

The causes of generalized anxiety disorder are still unclear – only the risk factors are clear:

Personality. Shy, more introverted people who think more about others than themselves seem more likely to develop generalized anxiety disorder.

Cognitive factors. An attitude acquired as a child that important events are not controllable, predictable and influenceable and that one therefore does not have one’s life in one’s own hands. In addition, external dangers are overestimated and one’s own coping abilities are underestimated.

Social insecurity. In times of social and political uncertainty (unemployment, terrorism), generalized anxiety disorders seem to increase.

Chronic anxiety, permanent worry, apprehension, and negative forebodings represent the life experience that characterizes long periods of time. This disorder is therefore also called "worry sickness". Affected persons can no longer control their anxious thoughts. Attempts to think of something else fail and even seem to exacerbate the problem. In addition to the constant mental circles, the physical symptoms are particularly stressful. The feeling of always having to be "on the go" and the sleepless nights lead to exhaustion, easy fatigability, nervousness and a wide variety of functional complaints such as muscle tension, abdominal discomfort and cardiovascular disorders. These can become acute enough to lead to the onset of a panic attack.

This is what the doctor does

If the anxiety disorder is correctly diagnosed, treatment is by behavioral or psychoanalytic psychotherapies and/or by psychotropic drugs and beta blockers. According to studies, both forms of therapy are equivalent – but not equally suitable for every patient, which is why the doctor should consider the patient’s preference.

Psychotropic drugs. SSRI- or SNRI-type antidepressants such as citalopram, escitalopram or venlafaxine are now the first choice for generalized anxiety disorders. In individual cases, however, other antidepressants may work best. The slow onset of action is a disadvantage. Benzodiazepines, which used to be routinely used, are experienced by sufferers as fast-acting and also highly effective in the early stages, but they are now only indicated for acute states of agitation or suicidal thoughts for a short time because of the high potential for dependence and other side effects such as severe fatigue.

Psychotherapy. The aim of psychotherapy is to normalize the disturbed perception of the ill person. Anxiety management programs, which originated in cognitive behavioral therapy, first use relaxation techniques to reduce the physical symptoms of anxiety and make it more manageable. Together with the patient, it is then worked out which central assumptions they have about themselves and the world. Sufferers often believe that they are only loved if they always please everyone. Sick people also tend to always take the more negative option when given two possible alternatives. The therapist helps the patient replace such beliefs with other thoughts.

During therapy, the patient also discusses what he or she may be avoiding by worrying all the time. Anxiety patients are often reluctant to take responsibility for their own actions and to take their lives into their own hands. Often, anxiety therapy is also supplemented by social skills training and self-confidence training.

Unfortunately, waiting times for psychotherapy in many places are 4-12 months. If psychotherapy is successful, about half of those affected benefit from it. If treatment proves difficult, it is usually because the patient has other conditions such as z. B. suffer from depression.

Your pharmacy recommends

Patients should do two things: seek professional help and try to cope with everyday life as well as possible until the anxiety management programs take effect. How it helps z. B., Focusing on one’s strengths and making sure to do something every day that is distracting and good for you. This is most likely to keep brooding and worry at bay. Exercise reduces stress hormones that are constantly released in the body due to anxiety

Many sufferers also find it helpful to write the worries on a piece of paper and symbolically throw them away, or to distract themselves with a book or by listening to music or other calming activities in order to tackle problem solving the next day.

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