Anxiety Disorder:
Symptoms, Types and Modern Treatment

At a glance

FrequencyOne of the most common mental health conditions - many adults are affected at some point in their lives
TypesGeneralized anxiety disorder, panic disorder, social anxiety disorder, specific phobias, agoraphobia
TreatableVery treatable - psychotherapy and/or medications markedly improve the symptoms in most of those affected
Treatment of choiceCognitive behavioral therapy (CBT) with exposure - the best-studied form of treatment
MedicationsSSRIs / SNRIs as first line; pregabalin for generalized anxiety; benzodiazepines only short-term
ICD-10F40 (phobic disorders), F41 (other anxiety disorders)

Table of contents

  1. What is an anxiety disorder?
  2. Types
  3. Symptoms
  4. Causes
  5. Diagnosis
  6. Treatment: psychotherapy
  7. Treatment: medications
  8. Everyday life with an anxiety disorder
  9. How brite helps you
  10. FAQ
  11. Related topics

1. What is an anxiety disorder?

Anxiety is a normal and vital feeling. It warns of danger and prepares the body for fight or flight. We only speak of an anxiety disorder when the anxiety occurs disproportionately strongly, frequently, or for a long time, has no real cause, and considerably affects everyday life.1

Anxiety disorders are among the most common mental health conditions of all. Nevertheless, many of those affected only seek help after years - out of shame, because they cannot make sense of the symptoms, or because they believe they simply have to endure the anxiety.1,2

The good news: anxiety disorders are very treatable Psychotherapy - above all cognitive behavioral therapy (CBT) with exposure - is highly effective and is recommended by the guideline as a first-line treatment. In many of those affected, the symptoms can be markedly improved or completely overcome.1

2. Types

Generalized anxiety disorder (GAD)
Persistent, exaggerated worrying about various areas of life (health, work, family, finances) - on most days over at least six months. The worries cannot be controlled. Often accompanied by muscle tension, restlessness, sleep disorders, and irritability.
Panic disorder
Recurring, unexpected panic attacks - sudden attacks of intense anxiety with physical symptoms (a racing heart, shortness of breath, sweating, dizziness, fear of dying). Between the attacks, there is often a fear of the next attack (anticipatory anxiety).
Agoraphobia
Fear of situations from which escape would be difficult or in which no help would be available - public places, crowds, public transport, department stores. Can occur with or without panic disorder and often leads to avoidance behavior.
Social anxiety disorder (social phobia)
Marked fear of social situations in which one might be observed, judged, or embarrassed - e.g. public speaking, eating in front of others, conversations with strangers. Goes beyond normal shyness.
Specific phobias
Intense, disproportionate fear of certain objects or situations - e.g. heights, flying, spiders, injections, blood, enclosed spaces. Usually leads to avoidance.

3. Symptoms

Psychological symptoms

  • Intense, disproportionate anxiety or worry
  • A feeling of threat with no real cause
  • Avoidance behavior - anxiety-triggering situations are avoided, which reinforces the anxiety over the long term
  • Difficulty concentrating
  • Irritability, inner restlessness
  • Catastrophizing - the worst is expected

Physical symptoms

Often the GP, cardiology, or emergency department first Because of the physical symptoms, many of those affected first go to their GP practice, cardiology, or the emergency department - without knowing that an anxiety disorder is the cause. An open conversation about possible psychological triggers can shorten the path to the right treatment.

4. Causes

Anxiety disorders usually arise through an interplay of several factors.1

  • Genetics: a family predisposition plays a role - anxiety disorders occur more frequently in families.
  • Neurobiology: changes in the balance of neurotransmitters (above all serotonin, noradrenaline, GABA) and in brain regions that process fear (the amygdala, the prefrontal cortex).
  • Learning history: negative experiences, traumatic events, learned avoidance behavior, overprotective upbringing.
  • Stress: chronic stress, stressful life events, transitional phases (a job change, separation, loss).
  • Comorbidities: anxiety disorders often occur together with depression, ADHD, addictions, or physical illnesses.

5. Diagnosis

  • Clinical interview: the basis of the diagnosis. Capturing the symptoms, the duration, the impairment, and the avoidance behavior.
  • Standardized questionnaires: e.g. the GAD-7 (generalized anxiety), the PHQ (anxiety and depression) - help with screening and assessing severity.
  • Physical workup: an overactive thyroid, heart rhythm disturbances, substance misuse, and other physical causes usually have to be ruled out.
  • Differentiation: anxiety disorders have to be distinguished from normal anxiety, adjustment disorders, post-traumatic stress disorder, and other mental health conditions.

More: preparing for a doctor's appointment.

6. Treatment: psychotherapy

Psychotherapy is the first-line treatment for anxiety disorders - in particular cognitive behavioral therapy (CBT) with exposure.1

First line Cognitive behavioral therapy (CBT)
The two core elements of CBT
1. Cognitive restructuring: recognizing and changing anxiety-reinforcing thoughts.
2. Exposure: deliberately and gradually facing anxiety-triggering situations instead of avoiding them. This makes the anxiety weaker over the long term.1
Exposure - the heart of CBT
Can be done in vivo (in the real situation), in sensu (in the imagination), or via VR (virtual reality). Unpleasant at first, but highly effective. Experience shows: the feared catastrophe does not happen - and the brain learns to reappraise.
Alternative Psychodynamic therapy

Can be used as an alternative when CBT is not available or not wanted.

Waiting times - what you can do Waiting times for a psychotherapy place can often be long. A psychotherapy consultation (without a waiting list) can be the first step. Online programs - e.g. internet-based CBT - can also help to bridge the gap.

7. Treatment: medications

Medications are usually used when psychotherapy alone is not enough, with a severe course, or when no psychotherapy is available promptly. They are often combined with psychotherapy.1

SSRIs - the first-line medication
Active ingredients: escitalopram, sertraline, paroxetine, and others.
Selective serotonin reuptake inhibitors. Usually take effect after a few weeks. Common initial side effects (nausea, restlessness, sleep disorders) mostly subside. No addiction risk.
SNRIs
Active ingredients: venlafaxine, duloxetine
Serotonin-noradrenaline reuptake inhibitors. An alternative to SSRIs with a similar effect profile.
Pregabalin
Approved for generalized anxiety disorder. Works faster than SSRIs/SNRIs. Can have a certain potential for dependence.
Buspirone
An alternative for generalized anxiety disorder. No addiction risk. Takes effect after weeks.
Benzodiazepines - only short-term, because of the addiction risk Benzodiazepines (e.g. lorazepam, diazepam) work quickly and strongly to relieve anxiety. Because of the high addiction risk, however, they are usually used only short-term and as emergency medication. The guideline does not recommend them as a long-term treatment for anxiety disorders.1

More: discontinuing medication - antidepressants and pregabalin should usually not be stopped abruptly (withdrawal phenomena). Also: drug interactions.

8. Everyday life with an anxiety disorder

  • Don't avoid: avoidance behavior is the strongest thing that keeps anxiety going. Facing anxiety-triggering situations step by step is more effective over the long term than avoiding them - even if it is hard in the short term.
  • Exercise: regular physical activity can measurably reduce anxiety symptoms and is recommended as a supplementary measure.
  • Sleep: sleep disorders and anxiety reinforce each other. Good sleep hygiene is important.
  • Caffeine and alcohol: caffeine can intensify anxiety symptoms. Alcohol relieves anxiety in the short term but worsens it over the long term and carries an addiction risk.
  • Self-help: self-help groups, anxiety guides, and structured online programs (e.g. internet-based CBT) can support the treatment.

How brite helps you with an anxiety disorder

Escitalopram in the morning, pregabalin in the evening, maybe an emergency lorazepam in your bag - and the CBT appointment in the calendar. brite holds the treatment together.

  • Intake reminders - SSRIs take weeks to work, and only regular intake brings the effect. brite reminds you reliably, even during crisis phases when concentration is hard. Set up a reminder
  • Interaction check - SSRIs plus triptans (migraine)? Plus St. John's wort? brite warns you about risky combinations before they become a problem. Check now
  • Health journal - document anxiety symptoms, avoidance behavior, panic attacks, and treatment progress over time. Helps in the CBT conversation and with the treatment plan. Track your progress
  • Digital medication plan - all your medications clearly laid out for psychiatry, psychotherapy, and your GP - also helpful when several practitioners are involved. Go to the medication plan
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FAQ: common questions about anxiety disorders

Yes - anxiety is a normal and vital feeling. We only speak of an anxiety disorder when the anxiety is disproportionately strong, has no real cause, and considerably affects everyday life.
A sudden attack of intense anxiety with physical symptoms (a racing heart, shortness of breath, dizziness, fear of dying). Panic attacks are extremely unpleasant but not dangerous. They usually last a few minutes and subside on their own.
Yes - in many people the symptoms can be markedly improved or completely overcome through psychotherapy (CBT) and/or medications. The earlier treatment begins, the better the prognosis.1
Deliberately and gradually seeking out anxiety-triggering situations under therapeutic guidance. The anxiety becomes weaker over the long term because the brain learns: the feared catastrophe does not happen. Exposure is the most effective element of CBT for anxiety disorders.1
No - SSRIs have no addiction risk in the narrower sense. With abrupt discontinuation, however, withdrawal phenomena can occur (dizziness, tingling, irritability). SSRIs should therefore usually be tapered off gradually under medical supervision. More: discontinuing medication.
Benzodiazepines work quickly and strongly to relieve anxiety, but they become addictive with longer use. They are therefore usually used only short-term as emergency medication. The guideline does not recommend them as a long-term treatment for anxiety disorders.1
Usually a few months (CBT typically 12 to 25 sessions, depending on the form and severity). First improvements can appear after just a few sessions - especially when exposure is worked on actively.
A psychotherapy consultation, your GP practice, and a psychiatric emergency department in an acute crisis. Online programs (internet-based CBT) can bridge the waiting time. In an acute crisis, contact your local emergency services or a local crisis helpline. In the US you can call or text 988 (Suicide & Crisis Lifeline); in the UK call 111 or the Samaritans on 116 123; across the EU the general emergency number is 112.
Depression ADHD in adults Sleep disorders Discontinuing medication Drug interactions Preparing for a doctor's appointment

Sources

  1. S3 Guideline Treatment of Anxiety Disorders (DGPPN, AWMF reg. no. 051-028, V2, 2021), Germany. awmf.org
  2. gesundheitsinformation.de (IQWiG): Anxiety Disorders. gesundheitsinformation.de
  3. German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN). dgppn.de
  4. German Depression Aid Foundation: Anxiety. deutsche-depressionshilfe.de
Medical disclaimer: This article is for general information and does not replace medical or psychotherapeutic advice, diagnosis, or treatment. Anxiety medications - in particular SSRIs, SNRIs, and pregabalin - should not be stopped on your own. Benzodiazepines carry an addiction risk and should only be used short-term. In an acute crisis or with suicidal thoughts: contact your local emergency services or a local crisis helpline right away. In the US you can call or text 988 (Suicide & Crisis Lifeline); in the UK call 111 or the Samaritans on 116 123; across the EU the general emergency number is 112. Last updated: April 2026.