Health and Medical

When fear becomes a problem – depression and anxiety

Alongside depression, anxiety disorders are among the most common mental illnesses in Germany. About every seventh German suffers from an anxiety disorder that requires treatment in the course of his life. The good news: Anxiety disorders are now well researched and known. There are promising treatment options

Fear as a constant companion?

There is no life without fear. It warns and protects you from dangers and is therefore vital for survival. So to be afraid is no reason to worry at first. An anxiety disorder is only involved when fear becomes a constant companion, stresses and restricts you in the long term. And there are several of them. The following five anxiety disorders are currently distinguished in psychotherapy:

Panic disorder

With a panic disorder we are overwhelmed by strong fears out of the blue. And that several times a month. We experience various very strong physical symptoms such as sweating, rapid heartbeat, shortness of breath or dizziness.


If we suffer from agoraphobia, we are afraid of crowds, public places or traveling. This usually means that we start to avoid these situations and experience significant restrictions in our lives.

Specific phobia

Fears of other situations such as certain animals, bad weather, spraying are also possible. If the fears relate exclusively to these special things or situations, we speak of a specific phobia.

Social phobia

If the fear only occurs in social situations (e.g. speaking in front of a group or contact with the opposite sex) in which we are evaluated by other people or could be embarrassing, we speak of a social phobia.

Generalized anxiety

The so-called generalized anxiety disorder plays a special role among anxiety disorders. The fears here do not relate to special situations and are less intense on a physical level than with the other disorders. However, uncontrollable and strong concerns about everyday issues are part of the game, such as financial security, health, or family well-being. Generalized anxiety disorder is often difficult to distinguish from depression, which also includes worrying thoughts. If we suspect such a disorder, we should carefully rule out the existence of depression.

What distinguishes depression from anxiety disorder

While feelings of anxiety and physical tension dominate in anxiety disorders, but we can also be in a good mood and have fun doing things, we are depressed in depressive phases, feel little joy and can hardly pull ourselves together. In addition, symptoms such as self-doubt, guilt, poor concentration, thoughts about death and negative thoughts about the future occur. Besides, a change in appetite and sleep is typical.

And now it gets complicated: Even during depressive phases, fears can arise and anxiety disorders can lead to depression.

When fears and depression overlap

Fears are also an important topic in the everyday life of many people with depression. During depressive phases, many sufferers increasingly suffer from fear of the future, panic attacks, fear of failure or rejection. Everyday fears like the fear of going shopping or taking the subway can also occur. Often these are not independent anxiety disorders, but rather the consequences of depression. It is therefore important to treat depression first, then your fears will decrease again. For instance, you can get yourself engaged in some activities, such as residential addition or renovation.

In condition of fear, we can no longer do things that are important to us, withdraw from our social environment, no longer travel, no longer go to concerts. Sooner or later, this affects the mood and, in the worst case, triggers depression. Here it is important to treat the cause, i.e. the anxiety disorder. If we can better deal with fears and make our lives more active again, it is very likely that the mood will improve again.

Anxiety and depression is also a mixed disorder where both of the conditions occur at the same time. Besides, some depressive symptoms such as self-doubt, listlessness and sleep disorders mix with fears such as panic feelings, worries or fears in contact with other people. In contrast to the other two cases, neither of the two disorders is completely present. There are only a few aspects at a time, so that neither “depression” nor “anxiety disorder” can be spoken of. Instead, there is a disease called “anxiety and depressive disorder mixed”. Treatment should relate to both problem areas.

One lies dejected in bed – the other is afraid of spiders

Even if you won’t get 100% clear answers to the question “why” in the field of mental illness, a look behind the scenes can help you to better understand and accept your own difficulties. By nature, everyone is particularly vulnerable to certain mental illnesses. It is very similar to physical illnesses. Here too, some people are often plagued by gastrointestinal problems, while others regularly suffer from migraines.

If you come from a family in which anxiety disorders are common, you are more likely to develop an anxiety disorder.

All are vulnerable – but in different means

Environment is a very important factor where we all grow up. Often, parents feed in our minds that the world around us is full of dangers and that we have to be constantly on guard, we tend to develop fears. Studies show that we can even learn from fears. If we observe, for example, how our mother is afraid of dogs and avoids them, we can develop fear of dogs ourselves. The tendency towards depressive thoughts and behaviors can also be encouraged by our environment. For example, we can take our parents’ negative view of ourselves and the world, or learn from them that we cannot treat ourselves to pleasure.

Vulnerability plus stress leads to illness. Each of us has such vulnerabilities that we can deal with under normal circumstances.  

Treatment: what we can do about anxiety and depression

The type of disorder has important consequences for the treatment. In the case of a depressive disorder, psychotherapy, in which you learn to build an active life with beautiful and relaxing moments, knowledge of technology, question problematic thinking patterns and gain security in contact with other people, is helpful. Depending on the severity of the depression, drug treatment may also be useful.

In contrast, anxiety disorders are usually treated purely psychotherapeutically. Typically, you will learn with your therapist to better understand your fears, find strategies to deal with fear, and revisit anxious situations.

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