How do psychiatrists diagnose anxiety

Psychiatry, Psychosomatics & Psychotherapy

Patients with an anxiety disorder often do not come to the doctor until they have been ill for years. The earlier this is treated, the better the prospects for improvement.

Significant progress has been made in the treatment of anxiety disorders in recent years. The most convincing evidence of effectiveness is available for cognitive behavioral therapy, drug therapy (SSRI, SNRI, pregabalin and others) and the combination of cognitive behavioral therapy and these drugs. For a promising treatment, the patient's motivation and comprehensive information about the clinical picture are crucial. It is important that the patient learns to recognize his symptoms as an expression of fear and also to stand by his illness.

What can i do on my own?

The most important rule is never to escape from fearful situations. This means that if you have agoraphobia, for example, you don't “pinch” in front of an elevator and instead use the stairs, avoid shopping in a supermarket and instead go to an expensive small shop or take a taxi because you are afraid of a bus ride. The more often and the more you expose yourself to these fear-inducing situations, the sooner you can reduce your fear. It certainly takes a lot of effort to get into such situations after years of avoiding them.

If you have generalized anxiety disorder, you shouldn't avoid or postpone things like traveling. If you have social anxiety, you should practice speaking to strangers, making speeches, looking the other person in the eye, or asserting yourself in an argument. In the case of panic disorder, it is important that when a panic attack occurs, it is important to realize again and again that the symptoms of anxiety such as a panic attack cannot lead to any harmful consequences such as fainting, heart attack, etc.


The most effective psychotherapy for treating anxiety disorders is cognitive behavioral therapy. In this, the patient learns to understand which thought processes underlie or intensify his fear. Avoidant behaviors can be consciously corrected on this basis. In the case of overstimulation, the patient - accompanied by the therapist - is confronted with the fear-inducing situation for a long time. The patient experiences the fear very strongly at first, but then notices that it subsides on its own. Such confrontation exercises are always well discussed in advance and the patient decides for himself whether he is confident of an exercise or whether a less frightening exercise is to be used. In this way, patients with very strong fears can usually be treated successfully.

Medical therapy

Antidepressants are used today for drug treatment of an anxiety disorder. For example, selective serotonin reuptake inhibitors (SSRI) and serotonin norepinephrine reuptake inhibitors (SNRI) are used. Another drug that is used for generalized anxiety disorder is pregabalin, a drug from the group of anticonvulsants (anti-epileptic drugs). Other effective drugs are tricyclic antidepressants, moclobemide, opipramol, or buspirone. Benzodiazepines, which are effective in treating anxiety disorders, pose a risk of addiction and considerably increase the risk of falling in older patients. They should only be used temporarily in the event of severe anxiety in exceptional cases. As a rule, a careful medication setting by the doctor can keep the therapy low in side effects.

Drug therapy should be continued for at least six to twelve months after the improvement has occurred. Additional cognitive behavioral therapy can reduce relapse rates after stopping medication.