Anxiety

Up to 29 per cent of the population worldwide will experience an anxiety disorder at least once in their lifetime. Without treatment, this mental health condition often becomes chronic. The risk of developing this condition is increased if a family member has been or is currently affected.

However, with comprehensive therapy, an anxiety disorder is highly treatable. Our experienced doctors at avi are here to support you at all our locations.

The ICD-10 lists numerous criteria for the diagnosis of an anxiety disorder. For example, a phobic disorder requires specific physical alarm symptoms to be present. A generalised anxiety disorder, on the other hand, must persist for at least six months.

However, the presence of any of the following components generally leads to the immediate exclusion of an anxiety disorder diagnosis:

• physical causes — these include certain pulmonary conditions (asthma, COPD, pulmonary embolism) or cardiac conditions (arrhythmias) that are associated with severe breathing difficulties and, in turn, transient anxiety states
• neurological conditions such as Parkinson's disease or epilepsy
• electrolyte disturbances (deficiencies in minerals or blood sugar)
• side effects of medications (e.g. drugs for heart failure or depression) or the effects of toxic substances such as drugs and alcohol
• primary psychiatric conditions in which anxiety is a secondary symptom (e.g. depression, psychoses, obsessive-compulsive disorders)

The development of an anxiety disorder requires the interplay of three factors. These are:

• genetic theories, such as a congenital deficit in neurotransmitter receptors
• neurobiological theories, such as an overactive amygdala (the "fear centre" of the brain)
• learning theory, such as conditioning — meaning that over the course of their life, affected individuals learn to respond to a neutral stimulus with a physical reaction. An example is the sight of a harmless spider triggering a strong fear response

The accompanying features of an anxiety disorder are often diffuse and frequently occur simultaneously. Typical symptoms include:

• palpitations
• fear of death
• sweating, hot flushes, or a feeling of cold
• trembling, tingling, or numbness of the skin
• shortness of breath
• chest pain
• nausea and diarrhoea
• dizziness
• difficulties with concentration and sleep
• muscle tension
• nervousness
• in particular with social phobia, additional symptoms include: facial flushing, urge to urinate, and vomiting — symptoms that anxious patients inadvertently produce themselves, as if by a nocebo effect

Treatment of an anxiety disorder at avi begins with a comprehensive medical history. Together with our doctors, other underlying conditions are ruled out using medical examinations (laboratory tests, ECG for palpitations, assessment of lung function for breathlessness).

A specialist questionnaire is then used to determine the most appropriate course of action. Common measures include:

• psychiatric or psychological therapy (cognitive behavioural therapy, psychodynamic approaches, self-help groups — combined with exercise therapy or relaxation techniques)
• prescription of medications (e.g. antidepressants with an anxiolytic component but without sedating properties)