Are psychiatrists ever afraid of their patients?

Psychiatry, Psychosomatics & Psychotherapy


Morbid anxiety or panic can be easily treated

If people have the impression that they are developing an anxiety disorder, their family doctor can be the first point of contact. Agoraphobia and panic disorders can be treated very well with psychotherapy.

Panic attacks can appear out of nowhere. A panic attack is a clearly defined episode of intense fear and discomfort that can usually last a few minutes to half an hour. The occurrence of such anxiety attacks is not limited to a specific situation or special circumstances - they are therefore also not predictable for those affected. Isolated panic attacks in life do not in themselves constitute a disease. Only when several attacks occur per month and everyday life is impaired, one speaks of a panic disorder. "Typical symptoms of a panic attack are sudden shortness of breath, chest pain and anxiety, as well as dizziness and feelings of powerlessness," explains Prof. Arno Deister from the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) based in Berlin. "In another part of those affected, physical symptoms dominate less, but thoughts of fear and alienation or the impression of standing completely beside themselves." What both groups have in common is that they may be afraid of losing control, or of becoming "insane" dying and that symptoms are often not recognized as the result of panic. While it can stick to a single overwhelming panic attack, some people develop a chronic course that requires treatment.

In agoraphobia, fear occurs in specific situations

Some people experience severe fear or even panic in certain places or in certain situations. This anxiety disorder is also known as agoraphobia, it can be present with or without panic attacks. “In agoraphobia, fear typically occurs when people are in large, wide open spaces and in public places. Narrow, overcrowded rooms can also be problematic for those affected, such as public transport or narrow supermarkets, ”adds Prof. Deister. "Those affected experience great inner tension and a strong emotional burden, which can escalate into panic." At the center of their fear is often the worry that they will not be able to get help quickly enough in the event of an incident, that they will get into an embarrassing situation or not being able to escape in the event of a threat. The variety of symptoms in agoraphobia is great. The places or situations in which those affected experience fears can also be very different from one individual to the next. In some people, agoraphobia can become so severe that in the long term they will no longer be able to leave their home.

Eliminate physical causes and seek professional help

If people have the impression that they are developing an anxiety disorder, their family doctor can be the first point of contact. Fears are to be regarded as pathological if they do not serve any protective function and no longer appear appropriately. First of all, physical causes such as cardiac arrhythmias, hyperthyroidism, asthma, COPD or epilepsy, which can cause panic-like conditions, must be ruled out. If no physical cause for the seizure can be determined, psychotherapeutic help is important. “The earlier psychotherapy to treat anxiety attacks begins, the higher the chances that the anxiety cycle will not become too chronic and that it will not be able to be overcome promptly,” emphasizes Prof. Deister. "With anxiety disorders, there is also an increased risk of developing other anxiety disorders as well as depression or addictions, which is why early treatment is fundamentally very important." Agoraphobia and panic disorders can be treated very well with psychotherapy. Panic attacks or fears can also occur in the context of other mental illnesses, such as depression, which is why an accurate diagnosis is of great importance.

People often develop anxiety disorders when their living conditions change negatively and are associated with stress. This could be a breakup, a diagnosis of another serious illness, the sudden death of a close relative or the loss of a job. If those affected are not able to cope with such stressful situations in a favorable way, the body can react with corresponding fearful attacks. Around 12 million people in Germany suffer from anxiety disorders, with women being affected significantly more often than men.

Additional Information:
AWMF patient guidelines "Anxiety Disorders"

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