Everyone is afraid of something

Generalized anxiety disorder

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

Leading complaints

  • Constantly increased fear level, which is expressed physically by nervousness, tremors, muscle tension, sweating, palpitations, dizziness or abdominal pain - these are all physiological consequences of fear or the stress experienced.
  • Constant fear that something bad could happen to you or to important people you care about, even though there is no real risk.
  • Real dangers - such as in traffic or sports - are extremely overestimated and give rise to considerations as to what could happen.
  • Sleep disorders, as patients cannot switch off from brooding, worries and fears.
  • Fear of existence and life, fear of the future, especially social and financial security. Constant fear of not being up to the demands of everyday life and work, of failing, of embarrassing yourself or causing damage.

When to the doctor

In the next few days if the complaints last longer than 14 days.

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

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 about themselves seem more likely to develop generalized anxiety disorder.

Cognitive factors. An attitude acquired as a child that important events cannot be controlled, foreseen or influenced and that you are therefore not in control of your life. In addition, external dangers are overestimated and one's own coping options are underestimated.

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

Chronic anxiety, permanent apprehension, apprehensions and negative premonitions represent the attitude towards life that is characteristic for long phases. This disorder is therefore also called "worry sickness". Affected people can no longer control their fearful thoughts. Attempts to think of something else fail and seem to make the problem even worse. In addition to the constant circling of thoughts, the physical symptoms are particularly stressful. The feeling of always having to be “on the go” and the sleepless nights lead to exhaustion, easy fatigue, nervousness and a wide variety of functional complaints such as muscle tension, abdominal complaints and cardiovascular disorders. These can become so acute that they lead to a panic attack.

That's what the doctor does

If the anxiety disorder is correctly diagnosed, treatment is carried out with behavioral or psychoanalytic psychotherapy and / or with 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 take the patient's preference into account.

Psychiatric drugs.Antidepressants of the SSRI or SNRI type such as citalopram, escitalopram or venlafaxine are now the first choice for generalized anxiety disorders. In individual cases, however, other antidepressants can work best. The slow onset of action is disadvantageous. The benzodiazepines used routinely in the past are experienced by those affected as being quick and highly effective at first, but because of the high potential for dependence and other side effects such as severe fatigue, they are only indicated for a short period of time for acute states of excitement or thoughts of suicide.

Psychotherapy. The aim of psychotherapy is to normalize the disturbed perception of the sick. Anxiety management programs that have emerged from cognitive behavioral therapy initially reduce the physical symptoms of anxiety through relaxation techniques and make them more manageable. Together with the patient, it is then worked out which central assumptions they have about themselves and the world. Often those affected believe that they will only be loved if they always please everyone. Sick people also tend to always accept the more negative variant of two possible alternatives. The therapist helps the patient replace such beliefs with other thoughts.

The therapy also discusses what the sick person may avoid through their permanent worries. For example, anxious patients often shy away from tackling things independently and taking their lives into their own hands. Anxiety therapy is often supplemented by training in social skills and self-confidence training.

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

Your pharmacy recommends

Sufferers should do two things: on the one hand, seek professional help, on the other hand, try to cope with everyday life as well as possible until the anxiety management programs work. So it helps z. B. to reflect on your own strengths and to make sure that you do something every day that distracts and is good for you. This is most likely to keep brooding and worries at bay. Exercise breaks down stress hormones that are constantly released in the body due to fear

Many people affected also find it helpful to write down their 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.


Gisela Finke, Dr. med. Arne Schäffler in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update: Dr. med. Sonja Kempinski | last changed on at 15:44

Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.