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Addictive disorders

Addictions come in different forms, and they relate to either a particular substances or behavior. They all have in common that strong feelings of happiness and reward are triggered in the brain by this substance or behavior. The so-called reward effect entices people to satisfy the addiction again, i.e., to take the addictive substance again or repeat the behavior. The desire for reward through this addiction is particularly strong when the affected person is not doing well at the moment – for example, when she or he is worried or anxious. Many affected persons feel they are losing control of the addiction. This means they can no longer control their behavior in relation to their addiction, and it becomes a kind of compulsion for them.

The following symptoms may indicate addiction – especially if they are constant:

  • a very strong desire to consume alcohol, pills or other drugs – even if this behavior is harmful
  • this desire may also relate to a specific behavior, such as gambling, online shopping or computer games
  • no more control over whether and how much alcohol, pills or other drugs are taken or when they are taken
  • more and more has to be consumed to achieve the same effect
  • physical complaints such as restlessness, shaking or pain when the addiction cannot be satisfied
  • thoughts constantly revolving around the addiction and difficulty focusing on anything else
  • no interest in things that previously gave pleasure, such as friendships or hobbies
  • secrecy about consumption or behavior

The ongoing state of being in an addiction has harmful consequences, but individuals suffering from addiction are unable to control their behavior, even though they are aware of these consequences.

What is an addictive substance?

An addictive substance is one that is highly likely to cause dependence. There are legal addictive substances such as alcohol, medication or cigarettes, and illegal addictive substances such as cannabis, speed, cocaine, ecstasy or heroin. Addictive substances also differ in their effects, in how harmful they are and how quickly they become addictive.

What are behavioral addictions?

Behavioral addictions refer to a specific behavior that can no longer be controlled and takes up so much space in the lives of those affected that it causes them great harm. As with addictive substances, there are certain behaviors that are more addictive than others. Gambling addiction and Internet addiction are common behavioral addictions, as are shopping addiction, sex addiction, or work addiction. They all have in common that the behavior triggers strong feelings of happiness and reward in the brain – for example, after buying something nice or winning money at a slot machine. This creates an urge in the affected person to repeat this behavior more and more often. The fact that we do things that make us feel good is basically great. But with behavioral addiction, this repetition becomes a kind of compulsion.

Some examples:

Addictions come in different forms, and they relate to either a particular substances or behavior. They all have in common that strong feelings of happiness and reward are triggered in the brain by this substance or behavior. The so-called reward effect entices people to satisfy the addiction again, i.e., to take the addictive substance again or repeat the behavior. The desire for reward through this addiction is particularly strong when the affected person is not doing well at the moment – for example, when she or he is worried or anxious. Many affected persons feel they are losing control of the addiction. This means they can no longer control their behavior in relation to their addiction, and it becomes a kind of compulsion for them.

The following symptoms may indicate addiction – especially if they are constant:

  • a very strong desire to consume alcohol, pills or other drugs – even if this behavior is harmful
  • this desire may also relate to a specific behavior, such as gambling, online shopping or computer games
  • no more control over whether and how much alcohol, pills or other drugs are taken or when they are taken
  • more and more has to be consumed to achieve the same effect
  • physical complaints such as restlessness, shaking or pain when the addiction cannot be satisfied
  • thoughts constantly revolving around the addiction and difficulty focusing on anything else
  • no interest in things that previously gave pleasure, such as friendships or hobbies
  • secrecy about consumption or behavior

The ongoing state of being in an addiction has harmful consequences, but individuals suffering from addiction are unable to control their behavior, even though they are aware of these consequences.

What is an addictive substance?

An addictive substance is one that is highly likely to cause dependence. There are legal addictive substances such as alcohol, medication or cigarettes, and illegal addictive substances such as cannabis, speed, cocaine, ecstasy or heroin. Addictive substances also differ in their effects, in how harmful they are and how quickly they become addictive.

What are behavioral addictions?

Behavioral addictions refer to a specific behavior that can no longer be controlled and takes up so much space in the lives of those affected that it causes them great harm. As with addictive substances, there are certain behaviors that are more addictive than others. Gambling addiction and Internet addiction are common behavioral addictions, as are shopping addiction, sex addiction, or work addiction. They all have in common that the behavior triggers strong feelings of happiness and reward in the brain – for example, after buying something nice or winning money at a slot machine. This creates an urge in the affected person to repeat this behavior more and more often. The fact that we do things that make us feel good is basically great. But with behavioral addiction, this repetition becomes a kind of compulsion.

Some examples:

 

Glücksspielsucht

Glücksspielsucht ist eine Krankheit, bei der die Betroffenen hohe Mengen an Geld verspielen – an Automaten in Spielotheken, in Online-Casinos, bei Online-Wetten oder in Wettbüros. Erst machen diese Spiele Spaß und lösen Glücksgefühle aus, aber dann wird der Weg in die Spielothek schnell zum Zwang: Betroffene werden unruhig und reizbar, wenn sie nicht spielen können. Sie spielen mit immer höheren Einsätzen, um Verluste auszugleichen, und spielen auch dann weiter, wenn sie ihr gesetztes Limit erreicht haben. Das hat sehr oft vor allem finanzielle Folgen im Leben der Betroffenen: Sie haben kein Geld mehr für Rechnungen, Reparaturen im Haushalt, für Essen, Strom oder die Miete. Oft verschulden Betroffene sich im Freundes- und Bekanntenkreis oder nehmen teure Kredite auf, um weiter spielen zu können. Gleichzeitig verlieren sie Beziehungen zu Menschen, die ihnen wichtig sind. Das kann daran liegen, dass die Betroffenen das Vertrauen der Menschen in ihrem Umfeld verlieren, oder auch daran, dass sie sich selbst aus ihrem gewohnten Umfeld zurück ziehen.

 

Wichtige Anzeichen für eine Spielsucht sind:

 

Starkes Verlangen: Bei Spielsüchtigen wird das Spielen zum wichtigsten Lebensinhalt. Das Denken und Handeln kreist immer mehr um die Fragen: „Wann kann ich wieder spielen? Ist genug Geld da, um Spielen zu können?“.

 

Kontrollverlust: Spielsüchtige können ihr Verhalten in Bezug auf das Spielen nicht mehr steuern. Sie spielen einfach weiter, solange es geht – auch bei großen Verlusten oder bis kein Geld mehr da ist. Das macht eine Spielsucht so gefährlich, denn daraus können hohe Verschuldungen entstehen.

 

Toleranzentwicklung: Bei vielen Spielsüchtigen stehen am Anfang große Gewinne, die einen großen Reiz ausüben und das Gefühl vermitteln, dass es immer so weiter geht. Das Gegenteil ist aber der Fall: Das Glück lässt schnell nach, und um verlorene Summen wieder zu bekommen, muss man weiter spielen. Das Glücksgefühl vom Anfang kommt erst dann wieder hoch, wenn höhere Summen gewonnen werden – schließlich müssen die Verluste wieder eingeholt werden.

 

Entzugssymptome: Wie bei anderen Süchten auch fühlen sich Spielsüchtige nervös, unruhig oder gereizt, wenn sie nicht spielen können.

 

Vernachlässigen von Freundschaften und Hobbies: Der Spieldruck führt dazu, dass Betroffene viel Zeit in Spielotheken oder mit dem Spielen verbringen. Auch die Geldbeschaffung, zum Beispiel durch den Verkauf von Einrichtungsgegenständen, nimmt zunehmend Zeit in Anspruch. Freundschaften und Hobbies geraten in den Hintergrund, auch, weil niemand etwas von dem schädlichen Verhalten mitbekommen soll.

 

Weiterspielen trotz schädlicher Folgen: Süchtige nehmen die schädlichen Folgen ihres Verhaltens oft sehr lange in Kauf. Der Drang zu spielen ist so stark, das auch hohe Verschuldungen, der Verlust von Freundschaften oder Probleme im Beruf daran nichts ändern.

 

Folgende Fragen können dir helfen zu erkennen, ob du bereits auf dem Weg zu einer Spielsucht bist:

  • Verspielst du mehr Geld, als du eigentlich möchtest?
  • Musst du auf andere wichtige Dinge – wie Essen, Kleidung oder Hobbies – verzichten, weil du dein Geld beim Spielen verlierst?
  • Verschuldest du dich bei deiner Familie, Freundinnen oder Freunden, um weiter spielen zu können?
  • Ist es dir unangenehm, darüber zu reden, wie viel oder wie oft du spielst?

 

Wenn du das Gefühl hast, von einer Spielsucht gefährdet zu sein, solltest du dir Hilfe und Unterstützung holen. Freundinnen, Freunde und die Familie können eine große Unterstützung sein, aber wenn du dich erstmal anonym austauschen oder professionelle Hilfe bekommen möchtest, gibt es viele Anlaufstellen, an die du dich wenden kannst. Die Bundeszentrale für gesundheitliche Aufklärung hat here  einige aufgelistet und bietet auch eine Telefonhotline an.

Alkoholsucht - wenn Alkohol dein Leben bestimmt

Neben Tabak- ist die Alkoholsucht die in Deutschland am weitesten verbreitete Suchterkrankung. Es gibt unterschiedliche Formen und Entwicklungsstufen der Alkoholsucht. Medizinisch wird zwischen Alkohol-Missbrauch und Alkohol-Abhängigkeit unterschieden, wobei die Übergänge fließend sind.
Von Alkoholmissbrauch spricht man dann, wenn der Alkohol bereits eine Funktion im Leben der Betroffenen übernimmt, wie sich zu entspannen oder sich zu belohnen. Wird diese Funktion für längere Zeit regelmäßig benutzt, kann es zur Abhängigkeit kommen. Dieser Prozess passiert oft unbemerkt, sodass weder die betroffene Person noch ihre Freundinnen, Freunde oder die Familie den Beginn einer Alkoholsucht bemerken. Deswegen ist es wichtig, auf sich und nahestehende Personen zu achten und erste Anzeichen ernst zu nehmen.

 

Wichtige Anzeichen für eine Alkoholsucht sind:

 

Starkes Verlangen: Sehr charakteristisch ist ein starkes Verlangen nach Alkohol. Das Verlangen wird umso stärker, je mehr die Betroffenen versuchen, nicht zu trinken. Frag dich selbst: Suchst du dir zunehmend Gelegenheiten, um Alkohol zu trinken?

 

Kontrollverlust: Betroffene haben keine Kontrolle mehr über ihr Trinkverhalten oder die Menge ihres Konsums. Während gesunde Menschen nach einem Glas wieder aufhören können, ist es bei Alkoholsüchtigen so, als würde ein Schalter in ihrem Kopf umgelegt werden, der dazu führt, dass sie immer weiter trinken, auch wenn sie beispielsweise am nächsten Tag früh aufstehen müssen oder einen wichtigen Termin haben.

 

Toleranzentwicklung: Betroffene müssen immer mehr Alkohol trinken, um die gleiche Wirkung zu erzielen. Das liegt daran, dass ihr Körper sich bereits an die Mengen gewöhnt hat. Menschen mit Suchterkrankung vertragen dann oft sehr viel mehr als nicht süchtige Menschen.

 

Entzugssymptome: Entzugssymptome wie Zittern, Schwitzen, Schlafstörungen, Angst und depressive Verstimmungen weisen bereits sehr stark auf eine Abhängigkeit hin. Sie zeigen an, dass Körper und Geist ohne den Alkohol nicht mehr richtig funktionieren, und verschwinden in der Regel, wenn wieder neuer Alkohol getrunken wird.

 

Vernachlässigen von Freundschaften und Hobbies: Da der Alkohol einen sehr großen Platz im Leben der Betroffenen einnimmt, rücken andere Interessen und auch Freundinnen, Freunde oder die Familie immer weiter in den Hintergrund. Auch Heimlichkeiten spielen hierbei eine große Rolle, denn viele Betroffene ziehen sich aus dem sozialen Leben zurück, damit niemand merkt, wie viel oder wie oft sie trinken.

 

Andauernder Konsum trotz schädlicher Folgen: Wer süchtig ist, nimmt die schädlichen Folgen seines Trinkens in Kauf. Das können körperliche Beschwerden sein – wie der Kater am nächsten Tag -, aber auch das Verpassen wichtiger Termine, schlechte Leistungen bei der Arbeit oder Probleme mit Freundinnen, Freunden und in der Familie aufgrund des Alkoholkonsums. Auf lange Sicht kann eine Alkoholsucht gravierende körperliche Folgen haben, zum Beispiel Erkrankungen der Leber, Entzündungen der Bauchspeicheldrüse oder der Magenschleimhaut.

 

Folgende Fragen können dir helfen zu erkennen, ob dein Umgang mit Alkohol bereits ungesund ist:

  • Trinkst du mehr, als du dir eigentlich vorgenommen hast?
  • Wirst du unruhig bei dem Gedanken, nicht trinken zu können?
  • Hast du manchmal Gedächtnislücken, weil du zu viel getrunken hast?

 

Wenn du diese Fragen mit Ja beantwortest, solltest du dir Hilfe holen und mit jemanden darüber sprechen. In frühen Stadien ist es noch einfacher, eine Suchterkrankung wieder in den Griff zu bekommen. Vertraue dich einem Familienmitglied, einer Freundin oder einem Freund an. Wenn du lieber mit jemandem sprechen möchtest, den du nicht kennst, kannst du jederzeit kostenlos und anonym die Telefonseelsorge (in Germany) anrufen, und auch das Deutsche Rote Kreuz nennt hier viele Kontaktmöglichkeiten für Unterstützung bei Suchterkrankungen. Wichtig ist, dass du ehrlich zu dir selbst bist und dich jemandem anvertraust.

Internetsucht - immer online

Wir leben im digitalen Zeitalter, sind ständig online, posten, streamen, liken, spielen. Bei manchen wird die digitale Welt aber zur Sucht: Sie verlieren die Kontrolle darüber, wie viel Zeit sie in sozialen Medien wie Facebook oder Instagram verbringen oder wie viel Platz im Alltag die Beschäftigung mit dem Computer oder Handy einnimmt. Auch hier wird das Belohnungssystem im Gehirn aktiviert: Wenn andere einen Post liken, teilen oder kommentieren, oder wenn wir erfolgreich in einem Computerspiel sind, schüttet unser Gehirn Glücksgefühle aus. Das weckt den Drang, das Verhalten zu wiederholen oder noch zu steigern, bis wir mehr in der digitalen als in der realen Welt leben. Problematisch wird es dann, wenn unsere Online-Aktivitäten für uns zum Ersatz für das richtige Leben werden, wenn wir wichtige Bedürfnisse – wie Anerkennung zu erfahren oder beliebt und erfolgreich zu sein – nur online ausleben oder negative Gefühle in der echten Welt dadurch verdrängen.

 

Wichtige Anzeichen für eine Internetsucht sind:

 

Ständiges Verlangen: Wer online-süchtig ist, verspürt ständig den Drang, online zu sein und seine Netzwerke auf neue Nachrichten zu prüfen. Betroffene checken ihre Apps und Messenger mehrmals stündlich und sogar dann, wenn schon klar ist, dass keine neuen Nachrichten eingegangen sind.

 

Kontrollverlust: Betroffene verlieren die Kontrolle darüber, wie oft und wie lange sie online sind oder am Computer spielen. Aus einer Stunde kann schnell eine Nacht werden. Sie werden unruhig bei dem Gedanken, keinen Zugang zu ihrem Handy, Computer oder sozialen Netzwerken haben.

 

Toleranzentwicklung: Damit die Sucht befriedigt wird, muss auch bei der Computersucht oft immer mehr konsumiert werden. Das kann bedeuten, dass die Sucht immer mehr Zeit in Anspruch nimmt, aber auch, dass die Ausprägung immer stärker wird – Spiele werden wichtiger als andere Dinge, die Frustration bei nicht ausreichenden Reaktionen auf einen Post wird größer oder die Aktivitäten im Internet werden extremer.

 

Entzugssymptome: Auch bei Online-Sucht gibt es Entzugssymptome: Dazu gehören insbesondere Unruhe und Gereiztheit, aber auch körperliche Symptome wie Zittern oder Schwitzen.

 

Vernachlässigen von Freundschaften und Hobbies: Das Spielen am Computer oder die Aktivitäten in sozialen Netzwerken nehmen einen sehr großen Platz im Leben der Betroffenen ein. Interessen im echten Leben und auch Freundschaften oder Familie rücken dadurch immer weiter in den Hintergrund. Besonders bei der Computerspielsucht findet ein Rückzug aus dem sozialen Leben statt. Das Tückische an sozialen Netzwerken ist, dass diese immer und überall genutzt werden können, also auch im Beisein von Freundinnen und Freunden.

 

Aufrechterhalten des Verhaltens trotz schädlicher Folgen: Betroffene merken oft selbst, dass ihre Computersucht negative Folgen auf ihr normales Leben hat, kommen aber trotzdem nicht von selbst aus ihrer Sucht heraus. Vielleicht haben sie auch schon Freundinnen oder Freunde verärgert und wurden von ihnen darauf hingewiesen, dass sie zu viel am Handy oder vor dem Computer hängen. Wie bei anderen Suchterkrankungen auch ist es aber meistens nicht möglich, ohne professionelle Hilfe und die Unterstützung von der Familie oder Freundinnen und Freunden die Sucht in den Griff zu bekommen.

 

Wenn du dir Sorgen um dein online-Verhalten oder das einer nahestehenden Person machst, kannst du dich an eine der vielen Hilfsangebote wenden – auch anonym, wenn dir das lieber ist. Ob du erstmal mit einer Freundin, einem Freund, oder einem Familienmitglied darüber sprechen möchtest, dein online-Verhalten besser verstehen, oder erstmal selbst versuchen möchtest, weniger online zu sein: Die Bundeszentrale für Gesundheitliche Aufklärung hat here viele Tipps dafür zusammengestellt, zeigt Anlaufstellen in deiner Nähe und bietet selbst eine Beratung an.

 

Auch, wenn sich eine Internetsucht vielleicht nicht wie eine „echte“ Sucht anfühlt, hat sie sehr großen Einfluss auf das Leben einer betroffenen Person und auf ihren Freundes- und Familienkreis. Beobachte deswegen deine eigene online-Nutzung und die deiner Freundinnen und Freunde, und zögere nicht, darüber zu sprechen oder Unterstützung zu suchen, wenn dir etwas Sorgen bereitet.

Addiction is a disease of the brain in which psychological, social and biological influences interact. Often there are problems in the lives of those affected; for example, they get little support from their families, have great worries and fears about the future, or have to cope with the loss of loved ones. Other mental illnesses, such as depression, borderline personality disorder or obsessive-compulsive disorder, can also promote an addictive disorder. Genetics and heredity also play a role: children of addicted parents are more prone to also develop an addictive disorder.

As with any mental illness, those affected by addiction cannot help the fact that they are ill. Many people think that people with addictions lack discipline or are to blame for their own illness – but that's not true! Each and every one of us can develop an addiction, and that's why it's important that we start talking openly about it when we're not feeling well, and that we're attentive and respectful to those around us about whom we're concerned.

Addictive disorders are very diverse and develop individually. Why an addictive disorder begins therefore varies from person to person. However, addictive disorders are based on the same process: the brain learns that the addictive substance or behavior makes us feel good, until affected persons can no longer feel good without it. A kind of compulsion to maintain the addiction develops.

Satisfying the addiction usually triggers positive feelings such as relaxation, joy, and exuberance – affected persons feel good and strong, and all problems fade away for a while. The body remembers this feeling and associates it with the addictive substance or behavior. When the effect wears off, the old problems are back. When the affected persons are feeling bad, the thought of the "liberating" effect of the addiction automatically arises. It is difficult for them to ignore this thought or to find something else that can help them out of the bad situation. It's like a compulsion for them to satisfy the addiction – to keep drinking or gambling, for example – because it's the only way they can feel good about themselves again. That's why people with addictions continue to drink or gamble even when it's already having bad consequences for them. The thought of a life without the addictive substance or the addictive behavior initially frightens many of those affected. Even if they themselves have the desire to no longer be addicted, it is very difficult for them to take the first steps on this path.

The most important thing is to be honest with yourself. Do you suspect that you are losing control, drinking too much, gambling, smoking pot, etc.? Or do you observe this behavior in a friend or family member? Then talk to someone about it! There are many contact pointswhere professionally trained people listen to you and help you. The services are free and you can remain anonymous. In addition, many clinics offer an addiction emergency hotline where you can call at any time. In larger cities, there are also special addiction counseling centers.
They offer a lot of information about the help available in your city, help you fill out applications, find the right clinic, or simply listen to you and advise you.

The addiction support network in Germany is very well developed and offers many help options for those affected. Basically, the step into therapy is recommended. This can take place on an outpatient, day-care or inpatient basis. If you would like to learn more about the topic of therapy, we have summarized everything important for you here .

Addictive disorders are difficult to cope with alone. That's why it's important to talk to other addicts and talk about your own problems and experiences. Self-help groups offer great support in this regard, because here those affected find understanding for their situation and can learn how to deal with the addictive disease through the experiences of the other participants. There are also self-help groups for relatives of people who have an addiction.

You have decided to seek help for yourself or someone close, and you ask yourself where to find support? Firstly: You should know that there are many different points of possible contact and various professionals to work with. It is important to first find out which path individually suits best.

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

It is also possible to turn directly to a psychotherapist. Here you get tips on how to get an appointment.

You want an impression of which contact points are the right ones for you or the person close to you? Here we explain, which professionals are best suited for which specific problem.

If you need further support on your way toward therapy, or if you want to keep anonymous while first talking to someone, here you will find links for points of contact in your area and trustworthy people to talk to.

What does an addictive disorder feel like?

Addictions come in different forms, and they relate to either a particular substances or behavior. They all have in common that strong feelings of happiness and reward are triggered in the brain by this substance or behavior. The so-called reward effect entices people to satisfy the addiction again, i.e., to take the addictive substance again or repeat the behavior. The desire for reward through this addiction is particularly strong when the affected person is not doing well at the moment – for example, when she or he is worried or anxious. Many affected persons feel they are losing control of the addiction. This means they can no longer control their behavior in relation to their addiction, and it becomes a kind of compulsion for them.

The following symptoms may indicate addiction – especially if they are constant:

  • a very strong desire to consume alcohol, pills or other drugs – even if this behavior is harmful
  • this desire may also relate to a specific behavior, such as gambling, online shopping or computer games
  • no more control over whether and how much alcohol, pills or other drugs are taken or when they are taken
  • more and more has to be consumed to achieve the same effect
  • physical complaints such as restlessness, shaking or pain when the addiction cannot be satisfied
  • thoughts constantly revolving around the addiction and difficulty focusing on anything else
  • no interest in things that previously gave pleasure, such as friendships or hobbies
  • secrecy about consumption or behavior

The ongoing state of being in an addiction has harmful consequences, but individuals suffering from addiction are unable to control their behavior, even though they are aware of these consequences.

What is an addictive substance?

An addictive substance is one that is highly likely to cause dependence. There are legal addictive substances such as alcohol, medication or cigarettes, and illegal addictive substances such as cannabis, speed, cocaine, ecstasy or heroin. Addictive substances also differ in their effects, in how harmful they are and how quickly they become addictive.

What are behavioral addictions?

Behavioral addictions refer to a specific behavior that can no longer be controlled and takes up so much space in the lives of those affected that it causes them great harm. As with addictive substances, there are certain behaviors that are more addictive than others. Gambling addiction and Internet addiction are common behavioral addictions, as are shopping addiction, sex addiction, or work addiction. They all have in common that the behavior triggers strong feelings of happiness and reward in the brain – for example, after buying something nice or winning money at a slot machine. This creates an urge in the affected person to repeat this behavior more and more often. The fact that we do things that make us feel good is basically great. But with behavioral addiction, this repetition becomes a kind of compulsion.

Some examples:

Addictions come in different forms, and they relate to either a particular substances or behavior. They all have in common that strong feelings of happiness and reward are triggered in the brain by this substance or behavior. The so-called reward effect entices people to satisfy the addiction again, i.e., to take the addictive substance again or repeat the behavior. The desire for reward through this addiction is particularly strong when the affected person is not doing well at the moment – for example, when she or he is worried or anxious. Many affected persons feel they are losing control of the addiction. This means they can no longer control their behavior in relation to their addiction, and it becomes a kind of compulsion for them.

The following symptoms may indicate addiction – especially if they are constant:

  • a very strong desire to consume alcohol, pills or other drugs – even if this behavior is harmful
  • this desire may also relate to a specific behavior, such as gambling, online shopping or computer games
  • no more control over whether and how much alcohol, pills or other drugs are taken or when they are taken
  • more and more has to be consumed to achieve the same effect
  • physical complaints such as restlessness, shaking or pain when the addiction cannot be satisfied
  • thoughts constantly revolving around the addiction and difficulty focusing on anything else
  • no interest in things that previously gave pleasure, such as friendships or hobbies
  • secrecy about consumption or behavior

The ongoing state of being in an addiction has harmful consequences, but individuals suffering from addiction are unable to control their behavior, even though they are aware of these consequences.

What is an addictive substance?

An addictive substance is one that is highly likely to cause dependence. There are legal addictive substances such as alcohol, medication or cigarettes, and illegal addictive substances such as cannabis, speed, cocaine, ecstasy or heroin. Addictive substances also differ in their effects, in how harmful they are and how quickly they become addictive.

What are behavioral addictions?

Behavioral addictions refer to a specific behavior that can no longer be controlled and takes up so much space in the lives of those affected that it causes them great harm. As with addictive substances, there are certain behaviors that are more addictive than others. Gambling addiction and Internet addiction are common behavioral addictions, as are shopping addiction, sex addiction, or work addiction. They all have in common that the behavior triggers strong feelings of happiness and reward in the brain – for example, after buying something nice or winning money at a slot machine. This creates an urge in the affected person to repeat this behavior more and more often. The fact that we do things that make us feel good is basically great. But with behavioral addiction, this repetition becomes a kind of compulsion.

Some examples:

 

Glücksspielsucht

Glücksspielsucht ist eine Krankheit, bei der die Betroffenen hohe Mengen an Geld verspielen – an Automaten in Spielotheken, in Online-Casinos, bei Online-Wetten oder in Wettbüros. Erst machen diese Spiele Spaß und lösen Glücksgefühle aus, aber dann wird der Weg in die Spielothek schnell zum Zwang: Betroffene werden unruhig und reizbar, wenn sie nicht spielen können. Sie spielen mit immer höheren Einsätzen, um Verluste auszugleichen, und spielen auch dann weiter, wenn sie ihr gesetztes Limit erreicht haben. Das hat sehr oft vor allem finanzielle Folgen im Leben der Betroffenen: Sie haben kein Geld mehr für Rechnungen, Reparaturen im Haushalt, für Essen, Strom oder die Miete. Oft verschulden Betroffene sich im Freundes- und Bekanntenkreis oder nehmen teure Kredite auf, um weiter spielen zu können. Gleichzeitig verlieren sie Beziehungen zu Menschen, die ihnen wichtig sind. Das kann daran liegen, dass die Betroffenen das Vertrauen der Menschen in ihrem Umfeld verlieren, oder auch daran, dass sie sich selbst aus ihrem gewohnten Umfeld zurück ziehen.

 

Wichtige Anzeichen für eine Spielsucht sind:

 

Starkes Verlangen: Bei Spielsüchtigen wird das Spielen zum wichtigsten Lebensinhalt. Das Denken und Handeln kreist immer mehr um die Fragen: „Wann kann ich wieder spielen? Ist genug Geld da, um Spielen zu können?“.

 

Kontrollverlust: Spielsüchtige können ihr Verhalten in Bezug auf das Spielen nicht mehr steuern. Sie spielen einfach weiter, solange es geht – auch bei großen Verlusten oder bis kein Geld mehr da ist. Das macht eine Spielsucht so gefährlich, denn daraus können hohe Verschuldungen entstehen.

 

Toleranzentwicklung: Bei vielen Spielsüchtigen stehen am Anfang große Gewinne, die einen großen Reiz ausüben und das Gefühl vermitteln, dass es immer so weiter geht. Das Gegenteil ist aber der Fall: Das Glück lässt schnell nach, und um verlorene Summen wieder zu bekommen, muss man weiter spielen. Das Glücksgefühl vom Anfang kommt erst dann wieder hoch, wenn höhere Summen gewonnen werden – schließlich müssen die Verluste wieder eingeholt werden.

 

Entzugssymptome: Wie bei anderen Süchten auch fühlen sich Spielsüchtige nervös, unruhig oder gereizt, wenn sie nicht spielen können.

 

Vernachlässigen von Freundschaften und Hobbies: Der Spieldruck führt dazu, dass Betroffene viel Zeit in Spielotheken oder mit dem Spielen verbringen. Auch die Geldbeschaffung, zum Beispiel durch den Verkauf von Einrichtungsgegenständen, nimmt zunehmend Zeit in Anspruch. Freundschaften und Hobbies geraten in den Hintergrund, auch, weil niemand etwas von dem schädlichen Verhalten mitbekommen soll.

 

Weiterspielen trotz schädlicher Folgen: Süchtige nehmen die schädlichen Folgen ihres Verhaltens oft sehr lange in Kauf. Der Drang zu spielen ist so stark, das auch hohe Verschuldungen, der Verlust von Freundschaften oder Probleme im Beruf daran nichts ändern.

 

Folgende Fragen können dir helfen zu erkennen, ob du bereits auf dem Weg zu einer Spielsucht bist:

  • Verspielst du mehr Geld, als du eigentlich möchtest?
  • Musst du auf andere wichtige Dinge – wie Essen, Kleidung oder Hobbies – verzichten, weil du dein Geld beim Spielen verlierst?
  • Verschuldest du dich bei deiner Familie, Freundinnen oder Freunden, um weiter spielen zu können?
  • Ist es dir unangenehm, darüber zu reden, wie viel oder wie oft du spielst?

 

Wenn du das Gefühl hast, von einer Spielsucht gefährdet zu sein, solltest du dir Hilfe und Unterstützung holen. Freundinnen, Freunde und die Familie können eine große Unterstützung sein, aber wenn du dich erstmal anonym austauschen oder professionelle Hilfe bekommen möchtest, gibt es viele Anlaufstellen, an die du dich wenden kannst. Die Bundeszentrale für gesundheitliche Aufklärung hat here  einige aufgelistet und bietet auch eine Telefonhotline an.

Alkoholsucht - wenn Alkohol dein Leben bestimmt

Neben Tabak- ist die Alkoholsucht die in Deutschland am weitesten verbreitete Suchterkrankung. Es gibt unterschiedliche Formen und Entwicklungsstufen der Alkoholsucht. Medizinisch wird zwischen Alkohol-Missbrauch und Alkohol-Abhängigkeit unterschieden, wobei die Übergänge fließend sind.
Von Alkoholmissbrauch spricht man dann, wenn der Alkohol bereits eine Funktion im Leben der Betroffenen übernimmt, wie sich zu entspannen oder sich zu belohnen. Wird diese Funktion für längere Zeit regelmäßig benutzt, kann es zur Abhängigkeit kommen. Dieser Prozess passiert oft unbemerkt, sodass weder die betroffene Person noch ihre Freundinnen, Freunde oder die Familie den Beginn einer Alkoholsucht bemerken. Deswegen ist es wichtig, auf sich und nahestehende Personen zu achten und erste Anzeichen ernst zu nehmen.

 

Wichtige Anzeichen für eine Alkoholsucht sind:

 

Starkes Verlangen: Sehr charakteristisch ist ein starkes Verlangen nach Alkohol. Das Verlangen wird umso stärker, je mehr die Betroffenen versuchen, nicht zu trinken. Frag dich selbst: Suchst du dir zunehmend Gelegenheiten, um Alkohol zu trinken?

 

Kontrollverlust: Betroffene haben keine Kontrolle mehr über ihr Trinkverhalten oder die Menge ihres Konsums. Während gesunde Menschen nach einem Glas wieder aufhören können, ist es bei Alkoholsüchtigen so, als würde ein Schalter in ihrem Kopf umgelegt werden, der dazu führt, dass sie immer weiter trinken, auch wenn sie beispielsweise am nächsten Tag früh aufstehen müssen oder einen wichtigen Termin haben.

 

Toleranzentwicklung: Betroffene müssen immer mehr Alkohol trinken, um die gleiche Wirkung zu erzielen. Das liegt daran, dass ihr Körper sich bereits an die Mengen gewöhnt hat. Menschen mit Suchterkrankung vertragen dann oft sehr viel mehr als nicht süchtige Menschen.

 

Entzugssymptome: Entzugssymptome wie Zittern, Schwitzen, Schlafstörungen, Angst und depressive Verstimmungen weisen bereits sehr stark auf eine Abhängigkeit hin. Sie zeigen an, dass Körper und Geist ohne den Alkohol nicht mehr richtig funktionieren, und verschwinden in der Regel, wenn wieder neuer Alkohol getrunken wird.

 

Vernachlässigen von Freundschaften und Hobbies: Da der Alkohol einen sehr großen Platz im Leben der Betroffenen einnimmt, rücken andere Interessen und auch Freundinnen, Freunde oder die Familie immer weiter in den Hintergrund. Auch Heimlichkeiten spielen hierbei eine große Rolle, denn viele Betroffene ziehen sich aus dem sozialen Leben zurück, damit niemand merkt, wie viel oder wie oft sie trinken.

 

Andauernder Konsum trotz schädlicher Folgen: Wer süchtig ist, nimmt die schädlichen Folgen seines Trinkens in Kauf. Das können körperliche Beschwerden sein – wie der Kater am nächsten Tag -, aber auch das Verpassen wichtiger Termine, schlechte Leistungen bei der Arbeit oder Probleme mit Freundinnen, Freunden und in der Familie aufgrund des Alkoholkonsums. Auf lange Sicht kann eine Alkoholsucht gravierende körperliche Folgen haben, zum Beispiel Erkrankungen der Leber, Entzündungen der Bauchspeicheldrüse oder der Magenschleimhaut.

 

Folgende Fragen können dir helfen zu erkennen, ob dein Umgang mit Alkohol bereits ungesund ist:

  • Trinkst du mehr, als du dir eigentlich vorgenommen hast?
  • Wirst du unruhig bei dem Gedanken, nicht trinken zu können?
  • Hast du manchmal Gedächtnislücken, weil du zu viel getrunken hast?

 

Wenn du diese Fragen mit Ja beantwortest, solltest du dir Hilfe holen und mit jemanden darüber sprechen. In frühen Stadien ist es noch einfacher, eine Suchterkrankung wieder in den Griff zu bekommen. Vertraue dich einem Familienmitglied, einer Freundin oder einem Freund an. Wenn du lieber mit jemandem sprechen möchtest, den du nicht kennst, kannst du jederzeit kostenlos und anonym die Telefonseelsorge (in Germany) anrufen, und auch das Deutsche Rote Kreuz nennt hier viele Kontaktmöglichkeiten für Unterstützung bei Suchterkrankungen. Wichtig ist, dass du ehrlich zu dir selbst bist und dich jemandem anvertraust.

Internetsucht - immer online

Wir leben im digitalen Zeitalter, sind ständig online, posten, streamen, liken, spielen. Bei manchen wird die digitale Welt aber zur Sucht: Sie verlieren die Kontrolle darüber, wie viel Zeit sie in sozialen Medien wie Facebook oder Instagram verbringen oder wie viel Platz im Alltag die Beschäftigung mit dem Computer oder Handy einnimmt. Auch hier wird das Belohnungssystem im Gehirn aktiviert: Wenn andere einen Post liken, teilen oder kommentieren, oder wenn wir erfolgreich in einem Computerspiel sind, schüttet unser Gehirn Glücksgefühle aus. Das weckt den Drang, das Verhalten zu wiederholen oder noch zu steigern, bis wir mehr in der digitalen als in der realen Welt leben. Problematisch wird es dann, wenn unsere Online-Aktivitäten für uns zum Ersatz für das richtige Leben werden, wenn wir wichtige Bedürfnisse – wie Anerkennung zu erfahren oder beliebt und erfolgreich zu sein – nur online ausleben oder negative Gefühle in der echten Welt dadurch verdrängen.

 

Wichtige Anzeichen für eine Internetsucht sind:

 

Ständiges Verlangen: Wer online-süchtig ist, verspürt ständig den Drang, online zu sein und seine Netzwerke auf neue Nachrichten zu prüfen. Betroffene checken ihre Apps und Messenger mehrmals stündlich und sogar dann, wenn schon klar ist, dass keine neuen Nachrichten eingegangen sind.

 

Kontrollverlust: Betroffene verlieren die Kontrolle darüber, wie oft und wie lange sie online sind oder am Computer spielen. Aus einer Stunde kann schnell eine Nacht werden. Sie werden unruhig bei dem Gedanken, keinen Zugang zu ihrem Handy, Computer oder sozialen Netzwerken haben.

 

Toleranzentwicklung: Damit die Sucht befriedigt wird, muss auch bei der Computersucht oft immer mehr konsumiert werden. Das kann bedeuten, dass die Sucht immer mehr Zeit in Anspruch nimmt, aber auch, dass die Ausprägung immer stärker wird – Spiele werden wichtiger als andere Dinge, die Frustration bei nicht ausreichenden Reaktionen auf einen Post wird größer oder die Aktivitäten im Internet werden extremer.

 

Entzugssymptome: Auch bei Online-Sucht gibt es Entzugssymptome: Dazu gehören insbesondere Unruhe und Gereiztheit, aber auch körperliche Symptome wie Zittern oder Schwitzen.

 

Vernachlässigen von Freundschaften und Hobbies: Das Spielen am Computer oder die Aktivitäten in sozialen Netzwerken nehmen einen sehr großen Platz im Leben der Betroffenen ein. Interessen im echten Leben und auch Freundschaften oder Familie rücken dadurch immer weiter in den Hintergrund. Besonders bei der Computerspielsucht findet ein Rückzug aus dem sozialen Leben statt. Das Tückische an sozialen Netzwerken ist, dass diese immer und überall genutzt werden können, also auch im Beisein von Freundinnen und Freunden.

 

Aufrechterhalten des Verhaltens trotz schädlicher Folgen: Betroffene merken oft selbst, dass ihre Computersucht negative Folgen auf ihr normales Leben hat, kommen aber trotzdem nicht von selbst aus ihrer Sucht heraus. Vielleicht haben sie auch schon Freundinnen oder Freunde verärgert und wurden von ihnen darauf hingewiesen, dass sie zu viel am Handy oder vor dem Computer hängen. Wie bei anderen Suchterkrankungen auch ist es aber meistens nicht möglich, ohne professionelle Hilfe und die Unterstützung von der Familie oder Freundinnen und Freunden die Sucht in den Griff zu bekommen.

 

Wenn du dir Sorgen um dein online-Verhalten oder das einer nahestehenden Person machst, kannst du dich an eine der vielen Hilfsangebote wenden – auch anonym, wenn dir das lieber ist. Ob du erstmal mit einer Freundin, einem Freund, oder einem Familienmitglied darüber sprechen möchtest, dein online-Verhalten besser verstehen, oder erstmal selbst versuchen möchtest, weniger online zu sein: Die Bundeszentrale für Gesundheitliche Aufklärung hat here viele Tipps dafür zusammengestellt, zeigt Anlaufstellen in deiner Nähe und bietet selbst eine Beratung an.

 

Auch, wenn sich eine Internetsucht vielleicht nicht wie eine „echte“ Sucht anfühlt, hat sie sehr großen Einfluss auf das Leben einer betroffenen Person und auf ihren Freundes- und Familienkreis. Beobachte deswegen deine eigene online-Nutzung und die deiner Freundinnen und Freunde, und zögere nicht, darüber zu sprechen oder Unterstützung zu suchen, wenn dir etwas Sorgen bereitet.

Where does an addictive disorder come from?

Addiction is a disease of the brain in which psychological, social and biological influences interact. Often there are problems in the lives of those affected; for example, they get little support from their families, have great worries and fears about the future, or have to cope with the loss of loved ones. Other mental illnesses, such as depression, borderline personality disorder or obsessive-compulsive disorder, can also promote an addictive disorder. Genetics and heredity also play a role: children of addicted parents are more prone to also develop an addictive disorder.

As with any mental illness, those affected by addiction cannot help the fact that they are ill. Many people think that people with addictions lack discipline or are to blame for their own illness – but that's not true! Each and every one of us can develop an addiction, and that's why it's important that we start talking openly about it when we're not feeling well, and that we're attentive and respectful to those around us about whom we're concerned.

Was passiert bei einer Suchterkrankung?

Addictive disorders are very diverse and develop individually. Why an addictive disorder begins therefore varies from person to person. However, addictive disorders are based on the same process: the brain learns that the addictive substance or behavior makes us feel good, until affected persons can no longer feel good without it. A kind of compulsion to maintain the addiction develops.

Satisfying the addiction usually triggers positive feelings such as relaxation, joy, and exuberance – affected persons feel good and strong, and all problems fade away for a while. The body remembers this feeling and associates it with the addictive substance or behavior. When the effect wears off, the old problems are back. When the affected persons are feeling bad, the thought of the "liberating" effect of the addiction automatically arises. It is difficult for them to ignore this thought or to find something else that can help them out of the bad situation. It's like a compulsion for them to satisfy the addiction – to keep drinking or gambling, for example – because it's the only way they can feel good about themselves again. That's why people with addictions continue to drink or gamble even when it's already having bad consequences for them. The thought of a life without the addictive substance or the addictive behavior initially frightens many of those affected. Even if they themselves have the desire to no longer be addicted, it is very difficult for them to take the first steps on this path.

Hilfe bei einer Suchterkankung

The most important thing is to be honest with yourself. Do you suspect that you are losing control, drinking too much, gambling, smoking pot, etc.? Or do you observe this behavior in a friend or family member? Then talk to someone about it! There are many contact pointswhere professionally trained people listen to you and help you. The services are free and you can remain anonymous. In addition, many clinics offer an addiction emergency hotline where you can call at any time. In larger cities, there are also special addiction counseling centers.
They offer a lot of information about the help available in your city, help you fill out applications, find the right clinic, or simply listen to you and advise you.

The addiction support network in Germany is very well developed and offers many help options for those affected. Basically, the step into therapy is recommended. This can take place on an outpatient, day-care or inpatient basis. If you would like to learn more about the topic of therapy, we have summarized everything important for you here .

Addictive disorders are difficult to cope with alone. That's why it's important to talk to other addicts and talk about your own problems and experiences. Self-help groups offer great support in this regard, because here those affected find understanding for their situation and can learn how to deal with the addictive disease through the experiences of the other participants. There are also self-help groups for relatives of people who have an addiction.

Who can i talk to?

You have decided to seek help for yourself or someone close, and you ask yourself where to find support? Firstly: You should know that there are many different points of possible contact and various professionals to work with. It is important to first find out which path individually suits best.

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

It is also possible to turn directly to a psychotherapist. Here you get tips on how to get an appointment.

You want an impression of which contact points are the right ones for you or the person close to you? Here we explain, which professionals are best suited for which specific problem.

If you need further support on your way toward therapy, or if you want to keep anonymous while first talking to someone, here you will find links for points of contact in your area and trustworthy people to talk to.

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Eating disorders

There are many different types of eating disorders. But all eating disorders have two things in common: the way people deal with food is just as disturbed as their perception of their own body. The thoughts of those affected very often revolve around their body and figure. Many of them do not feel comfortable with their appearance or even find themselves ugly. But the topic of "food" is also almost always at the center of attention. Affected persons restrict their eating behavior excessively, control it permanently or lose control over it.

The most common eating disorders are:

There are many different types of eating disorders. But all eating disorders have two things in common: the way people deal with food is just as disturbed as their perception of their own body. The thoughts of those affected very often revolve around their body and figure. Many of them do not feel comfortable with their appearance or even find themselves ugly. But the topic of "food" is also almost always at the center of attention. Affected persons restrict their eating behavior excessively, control it permanently or lose control over it.

The most common eating disorders are:

Anorexia

This eating disorder is characterized primarily by a greatly reduced food intake. Affected People have the goal of reducing their weight or at least not gaining weight. They are intensively concerned with their diet, design their own dietary rules and avoid foods with many calories, carbohydrates or fat. Often they also do an extremely large amount or intensive sport in order to get closer to their supposed body ideal. Because this behavior often leads to "success" – at least for a short time – and weight is lost quickly, the affected persons maintain this behavior. A disturbed perception of their own body in those affected leads to them not realizing how much they are losing weight and that this weight loss is no longer healthy – even if they are already underweight. The fact that they are getting closer to their ideal body image often gives affected persons a sense of pride. This behavior then often becomes a ritual for them, and at the same time they develop a strong compulsion to control or perfectionism, in which everything revolves around the topic of "food" and/or "sport". Gaining weight again would mean to them that their plan had failed and they had failed. That is why affected persons are usually very afraid of gaining weight again.

 

The heavy weight loss is very dangerous for our body and can lead to permanent damage. Many affected persons ignore this danger, as well as the fact that they have an eating disorder. Even when the risks of their behavior are explained to them, many sufferers stick to it.

Bulimia

In this eating disorder, too, affected persons aim to eat as few calories as possible to avoid gaining weight. The eating behavior and perception of one's own body is similar to that of anorexia: foods with few calories, carbohydrates and fat are eaten preferentially. However, sufferers of bulimia nervosa are unable to maintain this diet, and they experience regular eating attacks – also called "binge eating“ – in which they eat many times the usual amount within a short period of time. To prevent them from gaining weight, those affected often use medications such as laxatives or emetics following the binge, or cause themselves to vomit so that the ingested food can leave the body unprocessed. This is also intended to stop the resulting feelings of guilt that affected persons experience when they do not stick to their diet ideas. Sometimes bulimia develops from a previous bout of anorexia, but it can also develop from the beginning without the symptoms of anorexia.

 

Usually, these eating episodes take place secretly so that they are not noticed by any outside person. Affected persons often feel great shame and resolve not to give in to the eating attacks – but cannot prevent them from occurring again and again. That is why it often happens that relatives do not notice for a long time that a friend or family member has bulimia.

Binge-Eating

Affected individuals feed their bodies an excessive amount of food and thus calories, which sometimes leads to severe obesity. But the body's organs can also suffer from this excessive eating and become ill. One speaks of a binge-eating disorder when the binge eating episodes – in which significantly too much is eaten within a short period of time – occur at least once a week, and for at least three months. Often, those affected have the feeling of losing control and suffer greatly from the excess weight, which becomes increasingly severe with longer duration of the eating disorder. The habitual eating behavior cannot simply be discarded, for which the affected persons cannot do anything, since it is an eating addiction. Especially overweight people are often told that they have no discipline or that they themselves are to blame for their situation – but this is not true! Due to the pressure from outside and the pressure that the affected persons put on themselves, it seems to be the only possibility for them that they have to lose weight by starving themselves, which only aggravates the eating disorder. This pressure also means that affected individuals often feel ashamed and do not dare to talk to anyone about their disordered eating behavior. Without professional help and the support of friends and family, however, it is difficult to break out of this eating behavior.

The development of an eating disorder can have many reasons, but in most cases, several causes interact to lead to the disease. Therefore, the disease cannot always be traced back to a specific reason or event. An eating disorder often starts with the fact that we want to conform to a certain ideal of beauty – which usually has to do with being slim. Young people in particular often take their cues from people they admire on social media or other media, and whose lifestyles they are shown every day. The photos that show these personalities are heavily edited or staged and usually do not correspond to reality – yet they trigger an urge in us to compare ourselves to them and emulate their appearance. We want to optimize ourselves to be like the people we admire – and this often causes us to want to lose weight and start dieting.

Another trigger can be the loss of control in other areas of life. Affected persons then have the feeling of being at the mercy of everything and losing their grip. However, food intake is still something they can consciously control and manage – even if they no longer have control in other areas.

As with other mental disorders, biological or genetic causes can play a role in the development of eating disorders. In addition, there are many other individual aspects that can influence the development. These include, for example, problems within the family or among friends, or an experience that overwhelms us. Often it is also the pressure to perform that gives us the feeling that we have to constantly optimize ourselves – including our bodies. If we then have a false image of an "optimal" body, the desire for optimization can quickly turn into an eating disorder.

Many eating disorders start small. For example, many affected persons start with a normal diet to reduce their weight. When they have their first successes – what in this case means lose weight – a feeling of reward also sets in. So they remember: dieting leads to success. This success motivates them to continue in order to have even more success. Over time, the measures usually become more extreme: the amount of food is significantly reduced and, in addition, many affected persons begin to exercise to enhance the effect of weight loss. After some time, they become accustomed to the newly learned eating behavior and the new perception of their own body and can no longer discard these behavior patterns.
In binge-eating disorder, affected persons often no longer have a sense of when they are full. Feelings then fluctuate between feelings of happiness that eating as a reward is good for them and feelings of shame that they have eaten too much. The longer the disorder lasts, the more strongly they feel the desire to stop overeating – but this is usually not possible. People suffering from binge eating disorder often withdraw further and further, do less and meet less with the people who are important to them. As a result, sufferers spend more time alone, making binge eating episodes more frequent.

Eating disorders – if they last for a long time – can also have severe consequences for the body and the psyche.
Malnutrition leads to muscle atrophy, bouts of weakness, brittle bones and, in the worst cases, even death. Repeated vomiting can damage the esophagus and teeth. In addition, in both cases, the immune system is weakened because the body can no longer absorb enough nutrients. 
Obesity – which is often caused by binge eating disorder – can lead to problems with the heart or circulation. In addition, prolonged obesity can lead to diabetes, problems with bones and joints, and severe fatigue.
Often, eating disorders cause affected persons to withdraw from their friends, family and other social contacts. They also neglect hobbies and interests that were previously important to them. Affected persons may also develop other mental illnesses – such as depression, anxiety disorders or obsessive-compulsive disorders – that further impair and burden them.

Eating disorders are serious mental illnesses that can and must be treated. For outsiders, friends or family, however, eating disorders are difficult to recognize and often cannot be distinguished from "normal" dieting.

The most common type of treatment is psychotherapy. This aims to re-learn healthy eating behavior and to maintain it. However, the reasons for the disturbed eating behavior should also be treated, and sometimes the social environment or the family is also involved for this purpose. Such therapy can be carried out in a clinic (inpatient), day clinic (day patient) or in the home environment with regular treatment appointments (outpatient). However, it is often best if eating disorders are treated during a stay in a clinic. Here, the trained, unhealthy eating behavior can be best addressed, because those affected often find it very difficult to break away from it on their own. In the clinic, for example, in the case of anorexia, slow but controlled care is taken to ensure that the necessary calories are consumed so that an approximate normal weight and thus a better quality of life can be achieved. Medication can also be used to support the therapy and, for example, help to ensure that "extreme" sporting activities – through which the urge is felt to go on and on and achieve more and more – are approached somewhat more calmly and no longer in such a way that the person affected harms her or himself.

You have decided to seek help for yourself or someone close, and you ask yourself where to find support? Firstly: You should know that there are many different points of possible contact and various professionals to work with. It is important to first find out which path individually suits best.

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

It is also possible to turn directly to a psychotherapist. Here you get tips on how to get an appointment.

You want an impression of which contact points are the right ones for you or the person close to you? Here we explain, which professionals are best suited for which specific problem.

If you need further support on your way toward therapy, or if you want to keep anonymous while first talking to someone, here you will find links for points of contact in your area and trustworthy people to talk to.

What does an eating disorder feel like?

There are many different types of eating disorders. But all eating disorders have two things in common: the way people deal with food is just as disturbed as their perception of their own body. The thoughts of those affected very often revolve around their body and figure. Many of them do not feel comfortable with their appearance or even find themselves ugly. But the topic of "food" is also almost always at the center of attention. Affected persons restrict their eating behavior excessively, control it permanently or lose control over it.

The most common eating disorders are:

There are many different types of eating disorders. But all eating disorders have two things in common: the way people deal with food is just as disturbed as their perception of their own body. The thoughts of those affected very often revolve around their body and figure. Many of them do not feel comfortable with their appearance or even find themselves ugly. But the topic of "food" is also almost always at the center of attention. Affected persons restrict their eating behavior excessively, control it permanently or lose control over it.

The most common eating disorders are:

Anorexia

This eating disorder is characterized primarily by a greatly reduced food intake. Affected People have the goal of reducing their weight or at least not gaining weight. They are intensively concerned with their diet, design their own dietary rules and avoid foods with many calories, carbohydrates or fat. Often they also do an extremely large amount or intensive sport in order to get closer to their supposed body ideal. Because this behavior often leads to "success" – at least for a short time – and weight is lost quickly, the affected persons maintain this behavior. A disturbed perception of their own body in those affected leads to them not realizing how much they are losing weight and that this weight loss is no longer healthy – even if they are already underweight. The fact that they are getting closer to their ideal body image often gives affected persons a sense of pride. This behavior then often becomes a ritual for them, and at the same time they develop a strong compulsion to control or perfectionism, in which everything revolves around the topic of "food" and/or "sport". Gaining weight again would mean to them that their plan had failed and they had failed. That is why affected persons are usually very afraid of gaining weight again.

 

The heavy weight loss is very dangerous for our body and can lead to permanent damage. Many affected persons ignore this danger, as well as the fact that they have an eating disorder. Even when the risks of their behavior are explained to them, many sufferers stick to it.

Bulimia

In this eating disorder, too, affected persons aim to eat as few calories as possible to avoid gaining weight. The eating behavior and perception of one's own body is similar to that of anorexia: foods with few calories, carbohydrates and fat are eaten preferentially. However, sufferers of bulimia nervosa are unable to maintain this diet, and they experience regular eating attacks – also called "binge eating“ – in which they eat many times the usual amount within a short period of time. To prevent them from gaining weight, those affected often use medications such as laxatives or emetics following the binge, or cause themselves to vomit so that the ingested food can leave the body unprocessed. This is also intended to stop the resulting feelings of guilt that affected persons experience when they do not stick to their diet ideas. Sometimes bulimia develops from a previous bout of anorexia, but it can also develop from the beginning without the symptoms of anorexia.

 

Usually, these eating episodes take place secretly so that they are not noticed by any outside person. Affected persons often feel great shame and resolve not to give in to the eating attacks – but cannot prevent them from occurring again and again. That is why it often happens that relatives do not notice for a long time that a friend or family member has bulimia.

Binge-Eating

Affected individuals feed their bodies an excessive amount of food and thus calories, which sometimes leads to severe obesity. But the body's organs can also suffer from this excessive eating and become ill. One speaks of a binge-eating disorder when the binge eating episodes – in which significantly too much is eaten within a short period of time – occur at least once a week, and for at least three months. Often, those affected have the feeling of losing control and suffer greatly from the excess weight, which becomes increasingly severe with longer duration of the eating disorder. The habitual eating behavior cannot simply be discarded, for which the affected persons cannot do anything, since it is an eating addiction. Especially overweight people are often told that they have no discipline or that they themselves are to blame for their situation – but this is not true! Due to the pressure from outside and the pressure that the affected persons put on themselves, it seems to be the only possibility for them that they have to lose weight by starving themselves, which only aggravates the eating disorder. This pressure also means that affected individuals often feel ashamed and do not dare to talk to anyone about their disordered eating behavior. Without professional help and the support of friends and family, however, it is difficult to break out of this eating behavior.

Where does an eating disorder come from?

The development of an eating disorder can have many reasons, but in most cases, several causes interact to lead to the disease. Therefore, the disease cannot always be traced back to a specific reason or event. An eating disorder often starts with the fact that we want to conform to a certain ideal of beauty – which usually has to do with being slim. Young people in particular often take their cues from people they admire on social media or other media, and whose lifestyles they are shown every day. The photos that show these personalities are heavily edited or staged and usually do not correspond to reality – yet they trigger an urge in us to compare ourselves to them and emulate their appearance. We want to optimize ourselves to be like the people we admire – and this often causes us to want to lose weight and start dieting.

Another trigger can be the loss of control in other areas of life. Affected persons then have the feeling of being at the mercy of everything and losing their grip. However, food intake is still something they can consciously control and manage – even if they no longer have control in other areas.

As with other mental disorders, biological or genetic causes can play a role in the development of eating disorders. In addition, there are many other individual aspects that can influence the development. These include, for example, problems within the family or among friends, or an experience that overwhelms us. Often it is also the pressure to perform that gives us the feeling that we have to constantly optimize ourselves – including our bodies. If we then have a false image of an "optimal" body, the desire for optimization can quickly turn into an eating disorder.

What happens in eating disorders?

Many eating disorders start small. For example, many affected persons start with a normal diet to reduce their weight. When they have their first successes – what in this case means lose weight – a feeling of reward also sets in. So they remember: dieting leads to success. This success motivates them to continue in order to have even more success. Over time, the measures usually become more extreme: the amount of food is significantly reduced and, in addition, many affected persons begin to exercise to enhance the effect of weight loss. After some time, they become accustomed to the newly learned eating behavior and the new perception of their own body and can no longer discard these behavior patterns.
In binge-eating disorder, affected persons often no longer have a sense of when they are full. Feelings then fluctuate between feelings of happiness that eating as a reward is good for them and feelings of shame that they have eaten too much. The longer the disorder lasts, the more strongly they feel the desire to stop overeating – but this is usually not possible. People suffering from binge eating disorder often withdraw further and further, do less and meet less with the people who are important to them. As a result, sufferers spend more time alone, making binge eating episodes more frequent.

Eating disorders – if they last for a long time – can also have severe consequences for the body and the psyche.
Malnutrition leads to muscle atrophy, bouts of weakness, brittle bones and, in the worst cases, even death. Repeated vomiting can damage the esophagus and teeth. In addition, in both cases, the immune system is weakened because the body can no longer absorb enough nutrients. 
Obesity – which is often caused by binge eating disorder – can lead to problems with the heart or circulation. In addition, prolonged obesity can lead to diabetes, problems with bones and joints, and severe fatigue.
Often, eating disorders cause affected persons to withdraw from their friends, family and other social contacts. They also neglect hobbies and interests that were previously important to them. Affected persons may also develop other mental illnesses – such as depression, anxiety disorders or obsessive-compulsive disorders – that further impair and burden them.

Help with eating disorders

Eating disorders are serious mental illnesses that can and must be treated. For outsiders, friends or family, however, eating disorders are difficult to recognize and often cannot be distinguished from "normal" dieting.

The most common type of treatment is psychotherapy. This aims to re-learn healthy eating behavior and to maintain it. However, the reasons for the disturbed eating behavior should also be treated, and sometimes the social environment or the family is also involved for this purpose. Such therapy can be carried out in a clinic (inpatient), day clinic (day patient) or in the home environment with regular treatment appointments (outpatient). However, it is often best if eating disorders are treated during a stay in a clinic. Here, the trained, unhealthy eating behavior can be best addressed, because those affected often find it very difficult to break away from it on their own. In the clinic, for example, in the case of anorexia, slow but controlled care is taken to ensure that the necessary calories are consumed so that an approximate normal weight and thus a better quality of life can be achieved. Medication can also be used to support the therapy and, for example, help to ensure that "extreme" sporting activities – through which the urge is felt to go on and on and achieve more and more – are approached somewhat more calmly and no longer in such a way that the person affected harms her or himself.

Who can i talk to?

You have decided to seek help for yourself or someone close, and you ask yourself where to find support? Firstly: You should know that there are many different points of possible contact and various professionals to work with. It is important to first find out which path individually suits best.

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

It is also possible to turn directly to a psychotherapist. Here you get tips on how to get an appointment.

You want an impression of which contact points are the right ones for you or the person close to you? Here we explain, which professionals are best suited for which specific problem.

If you need further support on your way toward therapy, or if you want to keep anonymous while first talking to someone, here you will find links for points of contact in your area and trustworthy people to talk to.

Posted on

Obsessive-compulsive disorder

Obsessive-compulsive disorders can be very different, but they are all characterized by so-called obsessive thoughts or compulsive actions.

Obsessive thoughts are images, impulses or thoughts that repeatedly and very suddenly come to the mind of the affected person, and which he or she cannot easily ignore or suppress. These thoughts do not have to coincide with one's own opinion, but impose themselves on the affected person – often it even happens that the affected person her- or himself finds these thoughts repulsive or frightening.
Compulsive actions are images, impulses or thoughts that repeatedly and very suddenly come to the mind of the affected person, and which he or she cannot easily ignore or suppress. These thoughts do not have to coincide with one's own opinion, but impose themselves on the affected person – often it even happens that the affected person her- or himself finds these thoughts repulsive or frightening.

Basically, any thought or action can become compulsive. However, there are certain compulsions that occur in a wide range of people and are particularly common:

Obsessive-compulsive disorders can be very different, but they are all characterized by so-called obsessive thoughts or compulsive actions.
Obsessive thoughts are images, impulses or thoughts that repeatedly and very suddenly come to the mind of the affected person, and which he or she cannot easily ignore or suppress. These thoughts do not have to coincide with one's own opinion, but impose themselves on the affected person – often it even happens that the affected person her- or himself finds these thoughts repulsive or frightening.
Compulsive actions, on the other hand, are concrete behaviors or rituals that the affected persons "must" perform again and again. These actions are usually involuntary and, in retrospect, seem excessive or pointless to the affected person. In the moment itself, however, it feels to them as if they absolutely must perform these actions in order to prevent dire consequences or „disasters". When they suppress the compulsion, feelings of fear, disgust, emptiness, or guilt often surface in the sufferer.

 

Basically, any thought or action can become compulsive. However, there are certain compulsions that occur in a wide range of people and are particularly common:

Washing and cleaning compulsions

Affected persons feel fear or disgust of dirt and grime, of germs and other "sources of infection". Therefore, they wash their hands frequently and especially several times very thoroughly or take showers more often than usual. Sometimes they also clean certain things in the household in an exaggerated manner, even if no contamination is visible at all. These washing procedures – whether on their own body or in the environment – take up a lot of time and can lead to skin damage. In addition, they often give rise to conflicts, because those affected severely restrict themselves in their daily lives or, for example, occupy the bathroom for exceptionally long periods when living with others.

Control compulsions

In this case, affected persons repeatedly check certain things – such as electrical appliances and locks – even though they already know that everything is in order. They do this out of fear that something bad might happen: Someone might break into the home if all the locks aren't meticulously locked, or an electrical appliance might catch fire if it hasn't been checked before. People have a strong fear of making mistakes for which they could be blamed. That's why they try to avoid such mistakes through increased control.

Collection and storage compulsions

Affected people collect various things, usually without having a real use for them. The possession of these things brings them inner peace and satisfies the idea of collecting. Separation from these objects, on the other hand, is very difficult for those affected.

Aggressive, religious or sexual obsessive thoughts

These obsessive thoughts are a special kind, because in all cases they contradict the values of the affected person and yet impose themselves penetratingly. For example, malicious impulses and the desire to hurt other people may suddenly appear – thoughts that torment the affected persons because they do not want to and feel this desire to be morally wrong. However, the content of such thoughts can also be sexual or religious.

Other compulsions

There are many more compulsions, but compared to the other compulsions they occur less frequently. For example, the compulsion to arrange things in an exaggeratedly symmetrical and precise manner (order compulsion), to repeat actions several times and to perform them anew until something has "really succeeded" (repetition compulsion) or the compulsion to count certain things in everyday life - no matter how many there are (counting compulsion).

As you can see, obsessive-compulsive disorders are multifaceted, and there are many more than we have described. Therefore, it is important to take seriously actions or thoughts that occur against one's will and over and over again and are unpleasant for the person. Such obsessive-compulsive disorders can be well treated. However, for this, it is important to take the first step and talk about it instead of feeling ashamed. Talk to someone you trust. This can be a friend or family member. If you would rather talk first to someone you don't know who is a professional in the psychological field, you can go to one of the many possible drop-in centers. If you observe one or more of the following symptoms in yourself or a loved one, you should take them seriously and act directly:
  • Certain behaviors occur repeatedly at an increased rate – such as washing hands or checking locks. Sometimes these actions do not make sense in the situation – if the person in these cases already has freshly washed hands or the lock has already been checked twice. The affected person is afraid that something bad will happen if they do not perform these actions.
  • Frequent, exaggerated thoughts that are difficult or impossible to suppress and that are perceived as unpleasant.
  • The affected person's everyday life is severely restricted by obsessive-compulsive disorder: For example, she or he avoids events because she or he does not want to use a public toilet, or does not invite anyone to her or his home because of the compulsive collecting. These restrictions are often not recognizable at first glance, so one should be careful if the described actions or thoughts reduce a person's enjoyment of life and they suffer as a result.
As you can see, obsessive-compulsive disorders are multifaceted, and there are many more than we have described. Therefore, it is important to take seriously actions or thoughts that occur against one's will and over and over again and are unpleasant for the person. Such obsessive-compulsive disorders can be well treated. However, for this, it is important to take the first step and talk about it instead of feeling ashamed. Talk to someone you trust. This can be a friend or family member. If you would rather talk first to someone you don't know who is a professional in the psychological field, you can go to one of the many possible drop-in centers. If you observe one or more of the following symptoms in yourself or a loved one, you should take them seriously and act directly:
  • Certain behaviors occur repeatedly at an increased rate – such as washing hands or checking locks. Sometimes these actions do not make sense in the situation – if the person in these cases already has freshly washed hands or the lock has already been checked twice. The affected person is afraid that something bad will happen if they do not perform these actions.
  • Frequent, exaggerated thoughts that are difficult or impossible to suppress and that are perceived as unpleasant.
  • The affected person's everyday life is severely restricted by obsessive-compulsive disorder: For example, she or he avoids events because she or he does not want to use a public toilet, or does not invite anyone to her or his home because of the compulsive collecting. These restrictions are often not recognizable at first glance, so one should be careful if the described actions or thoughts reduce a person's enjoyment of life and they suffer as a result.

It is not yet clear why obsessive-compulsive disorder occurs. In any case, however, it is a psychological, means a mental illness, which can enormously restrict the lives of those affected. An obsessive-compulsive disorder is also not a trained behavior caused by "bad habits" or the like. Many different factors can play a role in the development of compulsions. In some cases, causes for the development can be found in particularly stressful or formative life events, or a connection with the circumstances of the person affected can be inferred.

In the brain, nerve cells communicate via so-called messenger substances, which are precisely coordinated to function so well. In obsessive-compulsive disorders, however, there is an imbalance of these messenger substances, and this alters the communication between the cells in the brain. Exactly which messenger substances are affected and in what way has not yet been clearly investigated. In addition, this connection can also be differently pronounced from compulsion to compulsion and vary from individual to individual.

The course of obsessive-compulsive disorder is also very diverse, which is why it is difficult to describe exactly what happens in obsessive-compulsive disorder. The symptoms can also change over time. For example, the symptoms may become weaker overall or new thoughts and actions may be added while others disappear. The content of the compulsions also varies greatly and can change over time. In general, however, it can be said that obsessive-compulsive disorders can interfere with the daily lives of those affected at an early stage: When compulsive actions or thoughts take precedence over other activities and lead, for example, to neglecting duties and needs in everyday social, professional or school life.

Es kann passieren, dass Betroffene ungerne über ihre Zwänge reden, da sie sich nicht verstanden fühlen und sich für ihr „abnormales“ Verhalten schämen. Als angehörige Person ist es dann wichtig, sehr einfühlsam und verständnisvoll zu sein. Es sollte ein sicherer Raum geschaffen werden, in dem die betroffene Person offen über ihre Gedanken und Handlungen sprechen kann, ohne verurteilt zu werden. Das kann dabei helfen, betroffenen Personen eine mögliche Psychotherapie näher zu bringen, da sie mehr und mehr dazu bereit sind, sich anderen anzuvertrauen und über ihre Erkrankung zu sprechen.

It can happen that affected persons are reluctant to talk about their compulsions because they do not feel understood and are ashamed of their "abnormal" behavior. As a carer, it is then important to be very empathetic and understanding. A safe space should be created where the affected person can talk openly about her our his thoughts and actions without being judged. This can help bring affected individuals closer to possible psychotherapy, as they become more willing to confide in others and talk about their condition.

You have decided to seek help for yourself or someone close, and you ask yourself where to find support? Firstly: You should know that there are many different points of possible contact and various professionals to work with. It is important to first find out which path individually suits best.

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

It is also possible to turn directly to a psychotherapist. Here you get tips on how to get an appointment.

You want an impression of which contact points are the right ones for you or the person close to you? Here we explain, which professionals are best suited for which specific problem.

If you need further support on your way toward therapy, or if you want to keep anonymous while first talking to someone, here you will find links for points of contact in your area and trustworthy people to talk to.

What does an obsessive-compulsive disorder feel like?

Obsessive-compulsive disorders can be very different, but they are all characterized by so-called obsessive thoughts or compulsive actions.

Obsessive thoughts are images, impulses or thoughts that repeatedly and very suddenly come to the mind of the affected person, and which he or she cannot easily ignore or suppress. These thoughts do not have to coincide with one's own opinion, but impose themselves on the affected person – often it even happens that the affected person her- or himself finds these thoughts repulsive or frightening.
Compulsive actions are images, impulses or thoughts that repeatedly and very suddenly come to the mind of the affected person, and which he or she cannot easily ignore or suppress. These thoughts do not have to coincide with one's own opinion, but impose themselves on the affected person – often it even happens that the affected person her- or himself finds these thoughts repulsive or frightening.

Basically, any thought or action can become compulsive. However, there are certain compulsions that occur in a wide range of people and are particularly common:

Obsessive-compulsive disorders can be very different, but they are all characterized by so-called obsessive thoughts or compulsive actions.
Obsessive thoughts are images, impulses or thoughts that repeatedly and very suddenly come to the mind of the affected person, and which he or she cannot easily ignore or suppress. These thoughts do not have to coincide with one's own opinion, but impose themselves on the affected person – often it even happens that the affected person her- or himself finds these thoughts repulsive or frightening.
Compulsive actions, on the other hand, are concrete behaviors or rituals that the affected persons "must" perform again and again. These actions are usually involuntary and, in retrospect, seem excessive or pointless to the affected person. In the moment itself, however, it feels to them as if they absolutely must perform these actions in order to prevent dire consequences or „disasters". When they suppress the compulsion, feelings of fear, disgust, emptiness, or guilt often surface in the sufferer.

 

Basically, any thought or action can become compulsive. However, there are certain compulsions that occur in a wide range of people and are particularly common:

Washing and cleaning compulsions

Affected persons feel fear or disgust of dirt and grime, of germs and other "sources of infection". Therefore, they wash their hands frequently and especially several times very thoroughly or take showers more often than usual. Sometimes they also clean certain things in the household in an exaggerated manner, even if no contamination is visible at all. These washing procedures – whether on their own body or in the environment – take up a lot of time and can lead to skin damage. In addition, they often give rise to conflicts, because those affected severely restrict themselves in their daily lives or, for example, occupy the bathroom for exceptionally long periods when living with others.

Control compulsions

In this case, affected persons repeatedly check certain things – such as electrical appliances and locks – even though they already know that everything is in order. They do this out of fear that something bad might happen: Someone might break into the home if all the locks aren't meticulously locked, or an electrical appliance might catch fire if it hasn't been checked before. People have a strong fear of making mistakes for which they could be blamed. That's why they try to avoid such mistakes through increased control.

Collection and storage compulsions

Affected people collect various things, usually without having a real use for them. The possession of these things brings them inner peace and satisfies the idea of collecting. Separation from these objects, on the other hand, is very difficult for those affected.

Aggressive, religious or sexual obsessive thoughts

These obsessive thoughts are a special kind, because in all cases they contradict the values of the affected person and yet impose themselves penetratingly. For example, malicious impulses and the desire to hurt other people may suddenly appear – thoughts that torment the affected persons because they do not want to and feel this desire to be morally wrong. However, the content of such thoughts can also be sexual or religious.

Other compulsions

There are many more compulsions, but compared to the other compulsions they occur less frequently. For example, the compulsion to arrange things in an exaggeratedly symmetrical and precise manner (order compulsion), to repeat actions several times and to perform them anew until something has "really succeeded" (repetition compulsion) or the compulsion to count certain things in everyday life - no matter how many there are (counting compulsion).

As you can see, obsessive-compulsive disorders are multifaceted, and there are many more than we have described. Therefore, it is important to take seriously actions or thoughts that occur against one's will and over and over again and are unpleasant for the person. Such obsessive-compulsive disorders can be well treated. However, for this, it is important to take the first step and talk about it instead of feeling ashamed. Talk to someone you trust. This can be a friend or family member. If you would rather talk first to someone you don't know who is a professional in the psychological field, you can go to one of the many possible drop-in centers. If you observe one or more of the following symptoms in yourself or a loved one, you should take them seriously and act directly:
  • Certain behaviors occur repeatedly at an increased rate – such as washing hands or checking locks. Sometimes these actions do not make sense in the situation – if the person in these cases already has freshly washed hands or the lock has already been checked twice. The affected person is afraid that something bad will happen if they do not perform these actions.
  • Frequent, exaggerated thoughts that are difficult or impossible to suppress and that are perceived as unpleasant.
  • The affected person's everyday life is severely restricted by obsessive-compulsive disorder: For example, she or he avoids events because she or he does not want to use a public toilet, or does not invite anyone to her or his home because of the compulsive collecting. These restrictions are often not recognizable at first glance, so one should be careful if the described actions or thoughts reduce a person's enjoyment of life and they suffer as a result.
As you can see, obsessive-compulsive disorders are multifaceted, and there are many more than we have described. Therefore, it is important to take seriously actions or thoughts that occur against one's will and over and over again and are unpleasant for the person. Such obsessive-compulsive disorders can be well treated. However, for this, it is important to take the first step and talk about it instead of feeling ashamed. Talk to someone you trust. This can be a friend or family member. If you would rather talk first to someone you don't know who is a professional in the psychological field, you can go to one of the many possible drop-in centers. If you observe one or more of the following symptoms in yourself or a loved one, you should take them seriously and act directly:
  • Certain behaviors occur repeatedly at an increased rate – such as washing hands or checking locks. Sometimes these actions do not make sense in the situation – if the person in these cases already has freshly washed hands or the lock has already been checked twice. The affected person is afraid that something bad will happen if they do not perform these actions.
  • Frequent, exaggerated thoughts that are difficult or impossible to suppress and that are perceived as unpleasant.
  • The affected person's everyday life is severely restricted by obsessive-compulsive disorder: For example, she or he avoids events because she or he does not want to use a public toilet, or does not invite anyone to her or his home because of the compulsive collecting. These restrictions are often not recognizable at first glance, so one should be careful if the described actions or thoughts reduce a person's enjoyment of life and they suffer as a result.
Where does an obsessive-compulsive disorder come from?

It is not yet clear why obsessive-compulsive disorder occurs. In any case, however, it is a psychological, means a mental illness, which can enormously restrict the lives of those affected. An obsessive-compulsive disorder is also not a trained behavior caused by "bad habits" or the like. Many different factors can play a role in the development of compulsions. In some cases, causes for the development can be found in particularly stressful or formative life events, or a connection with the circumstances of the person affected can be inferred.

What happens in obsessive-compulsive disorder?

In the brain, nerve cells communicate via so-called messenger substances, which are precisely coordinated to function so well. In obsessive-compulsive disorders, however, there is an imbalance of these messenger substances, and this alters the communication between the cells in the brain. Exactly which messenger substances are affected and in what way has not yet been clearly investigated. In addition, this connection can also be differently pronounced from compulsion to compulsion and vary from individual to individual.

 

The course of obsessive-compulsive disorder is also very diverse, which is why it is difficult to describe exactly what happens in obsessive-compulsive disorder. The symptoms can also change over time. For example, the symptoms may become weaker overall or new thoughts and actions may be added while others disappear. The content of the compulsions also varies greatly and can change over time. In general, however, it can be said that obsessive-compulsive disorders can interfere with the daily lives of those affected at an early stage: When compulsive actions or thoughts take precedence over other activities and lead, for example, to neglecting duties and needs in everyday social, professional or school life.

Help with obsessive-compulsive disorders

It can happen that affected persons are reluctant to talk about their compulsions because they do not feel understood and are ashamed of their "abnormal" behavior. As a carer, it is then important to be very empathetic and understanding. A safe space should be created where the affected person can talk openly about her our his thoughts and actions without being judged. This can help bring affected individuals closer to possible psychotherapy, as they become more willing to confide in others and talk about their condition.

 

It can happen that affected persons are reluctant to talk about their compulsions because they do not feel understood and are ashamed of their "abnormal" behavior. As a carer, it is then important to be very empathetic and understanding. A safe space should be created where the affected person can talk openly about her our his thoughts and actions without being judged. This can help bring affected individuals closer to possible psychotherapy, as they become more willing to confide in others and talk about their condition.

Who can I talk to?

You have decided to seek help for yourself or someone close, and you ask yourself where to find support? Firstly: You should know that there are many different points of possible contact and various professionals to work with. It is important to first find out which path individually suits best.

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

It is also possible to turn directly to a psychotherapist. Here you get tips on how to get an appointment.

You want an impression of which contact points are the right ones for you or the person close to you? Here we explain, which professionals are best suited for which specific problem.

If you need further support on your way toward therapy, or if you want to keep anonymous while first talking to someone, here you will find links for points of contact in your area and trustworthy people to talk to.

Posted on

Psychotic Disorders

In the beginning of a psychosis, the affected person will oftentimes realize later than others that they act differently than they would normally. This is due to the fact that a psychosis means an indistinguishable line between what is real and what is imagined. People who suffer from a psychosis might feel like they are being followed, or that nobody seems to want to understand them – even though what they experience is as real to them as day and night. Imagine how you would feel if you were reading this text, and someone comes along and tells you that what you are holding in your hand is not a mobile device or a laptop, but an empty piece of paper and that you are not reading anything and being crazy and imagining things. Yet here you are, knowing for a fact that you have just read all the information above and gotten to know a little bit about psychotic disorders – clear memories in your head from just a few moments ago. You would not believe the other person and probably be very suspicious of why they would want to make you believe things that you clearly know are not as they say they are. This is why people who suffer from a psychosis are sometimes quite difficult to reach and why they might resist talking about their actions and problems.

Psychotic disorders can take different shapes and forms and are therefore classified along a wide range of illnesses – like schizophrenia, or delusional disorders. However, the symptoms that point toward any such psychotic disorder are largely the same in the beginning:

Beim Beginn einer Psychose bemerken die betroffenen Personen meist erst später als ihre Angehörigen, dass sie sich anders verhalten als zuvor. Das liegt daran, dass für die betroffene Person Wirklichkeit und Einbildung oft nicht mehr zu unterscheiden sind. Menschen, die an einer Psychose erkrankt sind, haben auch häufig das Gefühl, dass sie verfolgt werden oder niemand sie versteht – sie sind schwieriger zu erreichen und wehren sich gegen Gespräche über ihr Verhalten.

 

Psychotic disorders can take different shapes and forms and are therefore classified along a wide range of illnesses – like schizophrenia, or delusional disorders. However, the symptoms that point toward any such psychotic disorder are largely the same in the beginning:

Hallucinations

The affected person perceives something that is not actually there. It could be hearing a voice, or music, without someone actually speaking, or without the radio being turned on. It could also be visual – meaning the person sees things or people that are also not there. Sometimes hallucinations can also be in the forms of smells and even touch – like feeling like insects are crawling over one’s skin.

Delusions

The affected person is deeply convinced of a fact that is factually not possible, or that can even be easily proven as wrong, or as only existing in the imagination of the person. It could be the thought that friends are constantly watching and wishing evil upon the affected person. It could also be the thought that something that is said on TV is directly intended towards the affected person and will lead to other people now chasing him or her.

Ego-disorder

The affected person loses touch with what is the self and what is the environment. This can lead to the feeling of being controlled by others, or that someone has planted thoughts into the mind of the affected person. Or it could be that the person is sure that reality and the self is something unrealistic and that others are able to read their minds.

Seemingly weird movements or speech

The affected person is moving differently to how she or he would normally move or is speaking in unfinished sentences that do not make sense.

Strong difficulties to concentrate

Quick to be distracted, jumping from one topic to the next.

These symptoms are called positive symptoms – Like in mathematics, positive as a quality means adding to something, rather than being good or feeling any special way.Plus“ in der Mathematik 

Positive symptoms are new behaviors or abnormalities that are not part of the person's previous nature, they are new additions.

Other symptoms can be:

    • Loss of interest in things and activity that used to be very important to the affected person.
    • Lack of motivation and a subsequent withdrawal from the social environment.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.

These symptoms are called negative symptoms – Like in mathematics, negative means something becomes less, rather than negative being an emotional quality of something.

Negative symptoms mean that normal characteristics and behavioural habits start to decline and become less.

Not everyone who seems or feels “weird” or distanced for a while is automatically subject to a psychotic disorder. But when the symptoms prevail and start to sincerely disturb daily life and social interactions it is important to look closer. Especially in the case of a psychotic disorder, the symptoms can seem very destructive and limiting. People who suffer from a psychotic disorder are easily be seen as “crazy” – this is why you should be sensitive when approaching someone you are worried about. Characteristically for a psychotic disorder, it might be very difficult to reach or talk to the affected person. If someone is convinced that even friends and family are conspiring against her or him, helping will probably be rejected and resisted. This is not to be taken personally but understood as part of the disorder and not to be worked against. Don’t be afraid to observe and recognize any changes in behaviour in yourself and people who are close to you. Take them seriously if they become significant. Talking and helping is always better than looking away! Feeling confused, or anxious, or losing grasp of what is real and what is not is not easy, nor particularly pleasant – whether this is due to an illness or not. There are ways to deal with these sorts of problems.

If you observe one or more of the following symptoms in your own behaviour or in someone around you, it is important to take them seriously and try to take action.

    • Occurrence of delusional thoughts that feel threatening or dangerous
    • Reluctance toward friends or family, maybe even in the form of anger or breaking contact completely
    • Threats to use violence against oneself or others (perhaps even strangers)
    • Recurring thoughts and talks about death and suicide

These symptoms are called positive symptoms – this means something is added to the person’s perception or the way she or he acts, which was not there before the psychotic disorder. Like in mathematics, positive as a quality means adding to something, rather than being good or feeling any special way. 

 

Positive symptoms are new behaviors or abnormalities that are not part of the person's previous nature, they are new additions.

 

Other symptoms can be:

    • Loss of interest in things and activity that used to be very important to the affected person.
    • Lack of motivation and a subsequent withdrawal from the social environment.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.

These symptoms are called negative symptoms – Like in mathematics, negative means something becomes less, rather than negative being an emotional quality of something.

 

Negative symptoms mean that normal characteristics and behavioural habits start to decline and become less.

 

Nicht bei jedem Menschen, der mal für eine Weile „seltsam“ wirkt oder sich zurückzieht, muss man sich Sorgen über eine psychotische Erkrankung machen. Allerdings sind besonders die Symptome einer psychotischen Erkrankung dadurch geprägt, dass sie die Lebensqualität, den Alltag und die sozialen Beziehungen der betroffenen Person stark einschränken. Menschen, die an einer Psychose leiden, werden schnell als „verrückt“ verurteilt – deswegen solltest du sensibel auf die Person zugehen, um die du dir Sorgen machst. Besonders bei Menschen mit einer psychotischen Erkrankung kann es schwierig sein, an sie heran zu kommen. Wenn eine dir nahestehende Person davon überzeugt ist, dass sich Freundinnen, Freunde und Familie gegen sie verschworen haben, dann wird sie sich wahrscheinlich nicht von euch helfen lassen wollen. Das solltest du nicht persönlich nehmen, sondern verstehen, dass diese Wahnvorstellung Teil der Krankheit ist. Beobachte dich selbst, deine Freundinnen, Freunde und Familienmitglieder, und nimm Verhaltensveränderungen ernst. Reden und helfen ist immer besser als wegschauen! Sich durcheinander zu fühlen, ängstlich zu sein oder sich in eingebildeten Realitäten zu verlieren, ist für niemanden schön – ob es nun mit einer Erkrankung zu tun hat oder nicht. Doch es gibt sicherlich eine Möglichkeit, das Problem anzugehen.

 

If you observe one or more of the following symptoms in your own behaviour or in someone around you, it is important to take them seriously and try to take action.

    • Occurrence of delusional thoughts that feel threatening or dangerous
    • Reluctance toward friends or family, maybe even in the form of anger or breaking contact completely
    • Threats to use violence against oneself or others (perhaps even strangers)
    • Recurring thoughts and talks about death and suicide

A psychosis is a mental illness. Just like with a bodily sickness, the affected person does not really have an influence on whether or not she or he suffers from a psychosis. Oftentimes, the occurrence of a psychosis can be linked to a traumatic experience, or a difficult phase in life. The misuse of drugs can also be the cause of a psychosis – sometimes the single use of a drug will cause it.

This could be due to increasingly high dosage of dangerous substances within drugs – also those that are said to be harmless.

Caution: As with any psychological disorder, people who suffer from a psychosis are never to blame for being ill – even if they, for example, misused drugs. It is never that easy. Some people are just predisposed to a psychosis by their genes and by people in their family having suffered from a psychosis. For others, the disorder comes “out of the blue”. A psychosis is subject to the transmitting and communicating substances in our brain – a complex interaction that we can’t see or influence from the outside. So, what can be said for sure is: There are different causes and influences for the occurrence of a psychosis, or that work against a psychosis; some of which we can work on, some of which we cannot. For many people, a psychosis starts with a phase that is often accompanied by a depression. Oftentimes, first signs of a psychosis are already visible in the teenage years, although this is often labelled as “just being teenagers”. This is why help often arrives late for the people who need it – although especially in the case of a psychosis, early treatment would be very helpful.

Dass wir täglichen Herausforderungen und Schwierigkeiten unterschiedlich begegnen, hängt von unserer persönlichen Widerstandskraft ab – der sogenannten Resilienz. Sie wird zum Beispiel dadurch gestärkt, dass wir ein Gefühl von Sicherheit und allgemeiner Zufriedenheit verspüren, unsere sozialen Kontakte pflegen und uns angemessen um uns selbst kümmern. Weitere Informationen findest du unter Psyche and resilience.

Experts often describe the onset of a psychosis as a vicious cycle. Especially people who often feel uncomfortable and do not get much support by friends and family are susceptible to psychoses. But exactly these vital things – social contacts and the well-being – are the first to break off in the beginning of a psychotic disorder. So, if a person who is susceptible to a psychotic disorder is exposed to a lot of stress, needs to tackle a difficult phase in life alone, or when social contacts start breaking away, the point can be reached where she or he just can’t deal with these challenges anymore – at least not alone. Sudden changes, like the loss of an important person or a loved one getting sick, can also become such a heavy burden to carry, that they trigger the first symptoms of a psychosis.

Experts often describe the onset of a psychosis as a vicious cycle. Especially people who often feel uncomfortable and do not get much support by friends and family are susceptible to psychoses. But exactly these vital things – social contacts and the well-being – are the first to break off in the beginning of a psychotic disorder. So, if a person who is susceptible to a psychotic disorder is exposed to a lot of stress, needs to tackle a difficult phase in life alone, or when social contacts start breaking away, the point can be reached where she or he just can’t deal with these challenges anymore – at least not alone. Sudden changes, like the loss of an important person or a loved one getting sick, can also become such a heavy burden to carry, that they trigger the first symptoms of a psychosis.

For example, there is the delusional disorder, in which the affected person experiences a new reality. She or he is absolutely certain that their subjective and imagined reality is the true reality. It could be paired with an understanding of others not seeing the same things and having a different reality – but such drastic misunderstandings can also lead to anger and aggression.
An example of delusions is a delusion of love, in which the affected person is certain that a specific person is in love with him or her – this goes so far that, even if the other person is in a relationship and told the affected person that she or he is not interested and happily married, the affected person will simply believe this to be a lie. Another widespread example is the delusion of prosecution, whereby the affected people feel watched and followed, even in their most private spaces.

Another form is schizophrenia, whereby affected people experience hallucinations and delusions over a longer period of time. Their speech and actions might seem blurred or disconnected. This may lead to them feeling uncomfortable or making others feel uncomfortable, often leading to unacceptance and distance in their usual social environment. A person with schizophrenia might experience fluctuations in the symptoms – sometimes weaker, sometimes stronger symptoms –, but in the long run schizophrenia will probably cause great changes in the affected person’s life: She or he is not able to keep up with the work of school or a job, the person falls behind with social contacts and family, and stops taking care of daily tasks and her or his own human needs - like eating, movement, and hygiene.

These two forms of psychotic disorders are just examples of the wide range of directions this illness can take. As with many other psychological disorders, a psychotic disorder can appear in combination or linked to another mental disorder – psychologists speak of a schizo-affective disorder.

Which type of psychotic disorder you or the person close to you deals with is impossible to simply say and poses a question to be answered with the help of a professional contact person. Such a professional can make a diagnosis and find out, in cooperation with you or the affected person, which therapy suits the individual needs and would lead to the regaining of the desired quality of daily life.

A person with a psychotic disorder will often feel like no one understands her or him. Oftentimes, she or he will not understand that there is a problem at all, since the perceived realities and convictions are unmistakably taken for the “right ones”, even if contradicting evidence exists. But it is important to take affected people and their views seriously, to treat them with respect, and support them as best as friends and family can to get the help that they might need.

Do you need help with the first step? Whether you are affected yourself and need to entrust your feelings to someone, or if you want to help a friend or a family member: here you will find tips on how to start a conversation about these difficult topics.

And then: Therapy? How a therapy looks like, how much time it needs, and what it does to help you or the person you are concerned about you will find here

You have decided to seek help for yourself or someone close, and you ask yourself where to find support? Firstly: You should know that there are many different points of possible contact and various professionals to work with. It is important to first find out which path individually suits best.

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

It is also possible to turn directly to a psychotherapist. Here you get tips on how to get an appointment.

You want an impression of which contact points are the right ones for you or the person close to you? Here we explain, which professionals are best suited for which specific problem.

If you need further support on your way toward therapy, or if you want to keep anonymous while first talking to someone, here you will find links for points of contact in your area and trustworthy people to talk to.

What does a psychosis feel like?

In the beginning of a psychosis, the affected person will oftentimes realize later than others that they act differently than they would normally. This is due to the fact that a psychosis means an indistinguishable line between what is real and what is imagined. People who suffer from a psychosis might feel like they are being followed, or that nobody seems to want to understand them – even though what they experience is as real to them as day and night. Imagine how you would feel if you were reading this text, and someone comes along and tells you that what you are holding in your hand is not a mobile device or a laptop, but an empty piece of paper and that you are not reading anything and being crazy and imagining things. Yet here you are, knowing for a fact that you have just read all the information above and gotten to know a little bit about psychotic disorders – clear memories in your head from just a few moments ago. You would not believe the other person and probably be very suspicious of why they would want to make you believe things that you clearly know are not as they say they are. This is why people who suffer from a psychosis are sometimes quite difficult to reach and why they might resist talking about their actions and problems.

Psychotic disorders can take different shapes and forms and are therefore classified along a wide range of illnesses – like schizophrenia, or delusional disorders. However, the symptoms that point toward any such psychotic disorder are largely the same in the beginning:

Beim Beginn einer Psychose bemerken die betroffenen Personen meist erst später als ihre Angehörigen, dass sie sich anders verhalten als zuvor. Das liegt daran, dass für die betroffene Person Wirklichkeit und Einbildung oft nicht mehr zu unterscheiden sind. Menschen, die an einer Psychose erkrankt sind, haben auch häufig das Gefühl, dass sie verfolgt werden oder niemand sie versteht – sie sind schwieriger zu erreichen und wehren sich gegen Gespräche über ihr Verhalten.

 

Psychotic disorders can take different shapes and forms and are therefore classified along a wide range of illnesses – like schizophrenia, or delusional disorders. However, the symptoms that point toward any such psychotic disorder are largely the same in the beginning:

Hallucinations

The affected person perceives something that is not actually there. It could be hearing a voice, or music, without someone actually speaking, or without the radio being turned on. It could also be visual – meaning the person sees things or people that are also not there. Sometimes hallucinations can also be in the forms of smells and even touch – like feeling like insects are crawling over one’s skin.

Delusions

The affected person is deeply convinced of a fact that is factually not possible, or that can even be easily proven as wrong, or as only existing in the imagination of the person. It could be the thought that friends are constantly watching and wishing evil upon the affected person. It could also be the thought that something that is said on TV is directly intended towards the affected person and will lead to other people now chasing him or her.

Ego-disorder

The affected person loses touch with what is the self and what is the environment. This can lead to the feeling of being controlled by others, or that someone has planted thoughts into the mind of the affected person. Or it could be that the person is sure that reality and the self is something unrealistic and that others are able to read their minds.

Seemingly weird movements or speech

The affected person is moving differently to how she or he would normally move or is speaking in unfinished sentences that do not make sense.

Strong difficulties to concentrate

Quick to be distracted, jumping from one topic to the next.

These symptoms are called positive symptoms – Like in mathematics, positive as a quality means adding to something, rather than being good or feeling any special way.Plus“ in der Mathematik 

Positive symptoms are new behaviors or abnormalities that are not part of the person's previous nature, they are new additions.

Other symptoms can be:

    • Loss of interest in things and activity that used to be very important to the affected person.
    • Lack of motivation and a subsequent withdrawal from the social environment.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.

These symptoms are called negative symptoms – Like in mathematics, negative means something becomes less, rather than negative being an emotional quality of something.

Negative symptoms mean that normal characteristics and behavioural habits start to decline and become less.

Not everyone who seems or feels “weird” or distanced for a while is automatically subject to a psychotic disorder. But when the symptoms prevail and start to sincerely disturb daily life and social interactions it is important to look closer. Especially in the case of a psychotic disorder, the symptoms can seem very destructive and limiting. People who suffer from a psychotic disorder are easily be seen as “crazy” – this is why you should be sensitive when approaching someone you are worried about. Characteristically for a psychotic disorder, it might be very difficult to reach or talk to the affected person. If someone is convinced that even friends and family are conspiring against her or him, helping will probably be rejected and resisted. This is not to be taken personally but understood as part of the disorder and not to be worked against. Don’t be afraid to observe and recognize any changes in behaviour in yourself and people who are close to you. Take them seriously if they become significant. Talking and helping is always better than looking away! Feeling confused, or anxious, or losing grasp of what is real and what is not is not easy, nor particularly pleasant – whether this is due to an illness or not. There are ways to deal with these sorts of problems.

If you observe one or more of the following symptoms in your own behaviour or in someone around you, it is important to take them seriously and try to take action.

    • Occurrence of delusional thoughts that feel threatening or dangerous
    • Reluctance toward friends or family, maybe even in the form of anger or breaking contact completely
    • Threats to use violence against oneself or others (perhaps even strangers)
    • Recurring thoughts and talks about death and suicide

These symptoms are called positive symptoms – this means something is added to the person’s perception or the way she or he acts, which was not there before the psychotic disorder. Like in mathematics, positive as a quality means adding to something, rather than being good or feeling any special way. 

 

Positive symptoms are new behaviors or abnormalities that are not part of the person's previous nature, they are new additions.

 

Other symptoms can be:

    • Loss of interest in things and activity that used to be very important to the affected person.
    • Lack of motivation and a subsequent withdrawal from the social environment.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.

These symptoms are called negative symptoms – Like in mathematics, negative means something becomes less, rather than negative being an emotional quality of something.

 

Negative symptoms mean that normal characteristics and behavioural habits start to decline and become less.

 

Nicht bei jedem Menschen, der mal für eine Weile „seltsam“ wirkt oder sich zurückzieht, muss man sich Sorgen über eine psychotische Erkrankung machen. Allerdings sind besonders die Symptome einer psychotischen Erkrankung dadurch geprägt, dass sie die Lebensqualität, den Alltag und die sozialen Beziehungen der betroffenen Person stark einschränken. Menschen, die an einer Psychose leiden, werden schnell als „verrückt“ verurteilt – deswegen solltest du sensibel auf die Person zugehen, um die du dir Sorgen machst. Besonders bei Menschen mit einer psychotischen Erkrankung kann es schwierig sein, an sie heran zu kommen. Wenn eine dir nahestehende Person davon überzeugt ist, dass sich Freundinnen, Freunde und Familie gegen sie verschworen haben, dann wird sie sich wahrscheinlich nicht von euch helfen lassen wollen. Das solltest du nicht persönlich nehmen, sondern verstehen, dass diese Wahnvorstellung Teil der Krankheit ist. Beobachte dich selbst, deine Freundinnen, Freunde und Familienmitglieder, und nimm Verhaltensveränderungen ernst. Reden und helfen ist immer besser als wegschauen! Sich durcheinander zu fühlen, ängstlich zu sein oder sich in eingebildeten Realitäten zu verlieren, ist für niemanden schön – ob es nun mit einer Erkrankung zu tun hat oder nicht. Doch es gibt sicherlich eine Möglichkeit, das Problem anzugehen.

 

If you observe one or more of the following symptoms in your own behaviour or in someone around you, it is important to take them seriously and try to take action.

    • Occurrence of delusional thoughts that feel threatening or dangerous
    • Reluctance toward friends or family, maybe even in the form of anger or breaking contact completely
    • Threats to use violence against oneself or others (perhaps even strangers)
    • Recurring thoughts and talks about death and suicide
Where does a psychosis come from?

Eine Psychose ist eine seelische, also psychische Krankheit. Wie bei einer körperlichen Krankheit haben wir keinen Einfluss darauf, ob wir an einer Psychose erkranken oder nicht. Oft hängt der Ausbruch einer psychotischen Krankheit mit einem besonders belastenden Ereignis oder einer schwierigen Lebensphase zusammen. Bei psychotischen Erkrankungen kann allerdings auch der Missbrauch von Drogen eine Rolle spielen – manchmal reicht der einmalige Konsum von Drogen aus, um eine Psychose auszulösen.

Das liegt zum Beispiel an immer stärkeren Dosen gefährlicher Stoffe in Drogen – auch in denen, die als „harmlos“ gelten. Einen Überblick darüber, welchen Einfluss Drogen auf unsere Psyche haben, bekommst du here.

Aber Vorsicht: Wie bei allen anderen psychischen Erkrankungen auch, hat eine an einer Psychose erkrankte Person nicht „selbst Schuld“ daran, dass sie erkrankt ist – auch nicht, wenn sie zum Beispiel Drogen konsumiert hat. Manche von uns sind vorbelastet, zum Beispiel dadurch, dass jemand in der Familie bereits an einer Psychose erkrankt ist. Für andere kommt die Erkrankung wie „aus dem Nichts“.

Auch eine Psychose hängt mit den Botenstoffen im Gehirn zusammen – ein komplexes Zusammenspiel, das wir von außen weder sehen oder steuern können.

Fest steht also: Es gibt einige Ursachen und Einflüsse, die den Ausbruch einer Psychose begünstigen oder ihm entgegenwirken, und an manchen können wir selbst arbeiten, während wir auf andere keinen Einfluss haben.

Bei vielen Menschen beginnt eine psychotische Krankheit mit einer Phase, die von Depressionen geprägt ist. Häufig sind erste Anzeichen einer Psychose bereits im Jugendalter erkennbar, werden dann aber als „typisches Teenagerverhalten“ abgestempelt. Deswegen suchen sich leider viele betroffene Personen erst sehr spät Hilfe – doch gerade bei einer Psychose sind die Erfolgschancen einer Therapie dann am größten, wenn diese frühzeitig begonnen wird.

Dass wir täglichen Herausforderungen und Schwierigkeiten unterschiedlich begegnen, hängt von unserer persönlichen Widerstandskraft ab – der sogenannten Resilienz. Sie wird zum Beispiel dadurch gestärkt, dass wir ein Gefühl von Sicherheit und allgemeiner Zufriedenheit verspüren, unsere sozialen Kontakte pflegen und uns angemessen um uns selbst kümmern. Weitere Informationen findest du unter Psyche and resilience.

What happens during a psychosis?

Experten vergleichen den Ausbruch einer Psychose häufig mit einem „Teufelskreis“. Denn besonders Menschen, die sich nicht wohl fühlen oder Unterstützung von der Familie, Freundinnen und Freunden bekommen, sind anfällig für Psychosen. Genau diese Dinge – das Wohlbefinden und die sozialen Kontakte – nehmen beim Ausbruch einer psychotischen Erkrankung meist als erstes ab. Wenn also ein Mensch, der anfällig für eine psychotische Krankheit ist, über einen längeren Zeitraum extremem Stress ausgesetzt ist, eine schwierige Phase durchstehen muss oder seine sozialen Kontakte wegbrechen, kann irgendwann der Punkt erreicht sein, an dem er nicht mehr aus eigener Kraft mit diesen Herausforderungen umgehen kann. Auch plötzliche Veränderungen können einen zu stark belasten, wie zum Beispiel der Verlust einer wichtigen Person oder wenn eine Freundin, ein Freund oder Familienmitglied erkrankt. Diese zu große Belastung kann der Auslöser für die ersten Symptome einer Psychose sein.

Es gibt unterschiedliche Formen psychotischer Erkrankungen, die zwar meist ähnlich beginnen, sich dann aber in unterschiedliche Richtungen entwickeln. Die Formen unterscheiden sich auch in der Dauer, die die Symptome anhalten. Manche Formen sind davon geprägt, dass die Symptome wiederholt und für kurze Zeiträume auftreten, andere davon, dass eine Person über einen langen Zeitraum hinweg immer stärker ausgeprägte Symptome aufzeigt.

For example, there is the delusional disorder, in which the affected person experiences a new reality. She or he is absolutely certain that their subjective and imagined reality is the true reality. It could be paired with an understanding of others not seeing the same things and having a different reality – but such drastic misunderstandings can also lead to anger and aggression.

Zu der Wahnhaften Störung gehört unter anderem der Liebeswahn, bei dem die betroffene Person davon überzeugt ist, dass eine bestimmte Person in sie verliebt ist. Oder der Verfolgungswahn: Hier ist die betroffene Person davon überzeugt, ständig beobachtet zu werden – zum Beispiel von den Nachbarn oder sogar im eigenen Badezimmer.

Another form is schizophrenia, whereby affected people experience hallucinations and delusions over a longer period of time. Their speech and actions might seem blurred or disconnected. This may lead to them feeling uncomfortable or making others feel uncomfortable, often leading to unacceptance and distance in their usual social environment. A person with schizophrenia might experience fluctuations in the symptoms – sometimes weaker, sometimes stronger symptoms –, but in the long run schizophrenia will probably cause great changes in the affected person’s life: She or he is not able to keep up with the work of school or a job, the person falls behind with social contacts and family, and stops taking care of daily tasks and her or his own human needs - like eating, movement, and hygiene.

These two forms of psychotic disorders are just examples of the wide range of directions this illness can take. As with many other psychological disorders, a psychotic disorder can appear in combination or linked to another mental disorder – psychologists speak of a schizo-affective disorder.

Um welche Form einer psychotischen Erkrankung es sich bei dir oder einer nahestehenden Person handelt, das ist eine Frage, mit der ihr am besten bei einer professionellen Ansprechperson aufgehoben seid. Neben der richtigen Diagnose kann sie mit euch zusammen herausfinden, welche Therapie am besten funktionieren kann, damit die Lebensqualität im Alltag zurückgewonnen wird.

Help with psychotic disorders

A person with a psychotic disorder will often feel like no one understands her or him. Oftentimes, she or he will not understand that there is a problem at all, since the perceived realities and convictions are unmistakably taken for the “right ones”, even if contradicting evidence exists. But it is important to take affected people and their views seriously, to treat them with respect, and support them as best as friends and family can to get the help that they might need.

Do you need help with the first step? Whether you are affected yourself and need to entrust your feelings to someone, or if you want to help a friend or a family member: here you will find tips on how to start a conversation about these difficult topics.

And then: Therapy? How a therapy looks like, how much time it needs, and what it does to help you or the person you are concerned about you will find here

Who can I talk to?

You have decided to seek help for yourself or someone close, and you ask yourself where to find support? Firstly: You should know that there are many different points of possible contact and various professionals to work with. It is important to first find out which path individually suits best.

 

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

 

It is also possible to turn directly to a psychotherapist. Here you get tips on how to get an appointment.

You want an impression of which contact points are the right ones for you or the person close to you? Here we explain, which professionals are best suited for which specific problem.

If you need further support on your way toward therapy, or if you want to keep anonymous while first talking to someone, here you will find links for points of contact in your area and trustworthy people to talk to.

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Anxiety Disorders

There are many kinds of anxiety disorders. However, what all of them have in common is that the affected person does not necessarily identify their experience as “fear”. Rather, an anxiety order feels more like a bodily sickness, as this is how it is expressed most of the times: Stomach aches, faintness, increased heart rates, and so on. Therefore, when trying to identify an anxiety disorder, it is especially important to check the affected person’s bodily health as much as the mental health.

Anxiety disorders are categorized into five main types that differ in their symptoms and their treatment:

There are many kinds of anxiety disorders. However, what all of them have in common is that the affected person does not necessarily identify their experience as “fear”. Rather, an anxiety order feels more like a bodily sickness, as this is how it is expressed most of the times: Stomach aches, faintness, increased heart rates, and so on. Therefore, when trying to identify an anxiety disorder, it is especially important to check the affected person’s bodily health as much as the mental health.

 

Anxiety disorders are categorized into five main types that differ in their symptoms and their treatment:

Panic Disorder – the fear of a panic attack

  • The affected person has experienced a panic attack in the past and knows how it feels: breaking into sweat, faintness, increased heart rates or the feeling of not being able to breathe properly. In most cases, a panic attack comes suddenly and lasts for a few minutes. Because it came suddenly, the lack of control about it makes the possibility of future panic attacks ever more threatening and unpredictable.
  • Since the affected person has already experienced a panic attack, she or he is extremely fearful of having to go through it again – whether the panic attack was related to a threatening place or situation is oftentimes irrelevant. Anything of the initial situation could be perceived as cause of the panic attack – this is why panic attacks are often quite broad and not tied to one specific fear or situation.
  • The affected person becomes very sensitive to anything that might indicate a panic attack. Normal bodily reactions are misinterpreted as being signs of a new panic attack, which makes the general fear of them even more present. This could be an increased pulse after walking up stairs, the slight feeling of faintness when riding a train, or a general feeling of discomfort in an unknown situation.

Agoraphobia – the fear of places or situations without quick exit

  • The affected person is afraid of places, from which it could be difficult to escape – like wide and crowded public places, waiting queues, closed rooms… – but also of “exitless” situations, like travelling somewhere far away from home on your own. It could also be the fear of a place where the person has once felt uncomfortable or helpless in the past.
  • Also possible is a fear of a particular place where the person has felt uncomfortable or helpless in the past.
  • Just in the case of finding oneself in an uncomfortable or even threatening situation, a person with agoraphobia wants to know that she or he could easily get away or at least have someone whom they trust by their side.
  • Because of this just-in-case-mentality, agoraphobia is often linked to a panic disorder, where the affected person is concerned with experiencing a panic attack and not being able to escape quickly. She or he fears that it would be uncomfortable to be surrounded by staring and witnessing people or that it would even be dangerous to be exposed to their panic in the first place.

Although claustrophobia may sound similar to agoraphobia with its general idea of fear of places, but a claustrophobic person is mainly afraid of closed rooms and tight spaces – unrelated to the number of people around them at that place.

General Anxiety Disorder – the permanent feeling of fear

  • The affected person feels a constant general fear and worry. She or he fears for her or himself and the people around them – but the fears are stronger than what most other people would feel and far from what would be a useful or adequate worry.
  • These uncontrollable fears span over many different aspects of life.
  • Sometimes the affected person might even be overwhelmed or sad that she or he experiences so many fears and worries.
  • Other signs of a general anxiety disorder could be restlessness, problems concerning sleep or difficulties to concentrate.

Social Anxiety Disorder – the fear of feeling humiliated

  • The affected person is afraid of social situations in which she or he could be judged by other people, as perhaps seeming dumb or weak, and therefore tries to avoid these situations.
  • This causes the person to avoid social situations.
  • People with such social phobias could have difficulties like speaking in front of people – even if it is very small number of people -, asking for directions or even eating in public.

Specific Phobia – the fear of a very specific thing

  • The affected person is disproportionately afraid of a specific thing or situation, like a specific animal, a specific action, or a very specific situation like being on a plane. This means the fear is way stronger than would be justified by the actual danger coming from that thing, and it is way bigger than most other people would feel.
  • The person starts to avoid any confrontation with the item of their fear, sometimes going to extreme ends to get around it – like driving extremely long distances because of their fear of planes or avoiding any doctors for their fear of injections or shots.
  • While these fears might be somewhat handleable in daily life, any hint of the item of their fear starts an incredibly strong and uncontrollable feeling of fear.

As you can see, an anxiety disorder can come in many forms and hide behind a variety of behaviours. This is why it is important to look out for any avoiding behaviour in oneself or others and see, whether it comes because of some persuasion (e.g. “I’m taking the stairs because it’s more healthy than an elevator”), or whether it is because of fear (like a disproportionate fear of elevators). It is important to take any fear seriously, even if you cannot understand them in your own experience. In truth, no one can really control what she or he is afraid of.

Talking and helping is always better than looking away! As normal and important fear is for all of us, it should never dictate what daily life looks like. No matter if the anxiety disorder is very faint or rather extreme, there is surely a way to deal with these issues.

If you observe one or more of the following symptoms in your own behaviour or in someone around you, it is important to take them seriously and try to take action.

    • Avoiding social activities to the point of distancing oneself from friends and family,
    • Getting through daily tasks seems very difficult or causes worry and anxiety,
    • One attempts to drown out these fears through drugs, alcohol, or meds, which are not intended to be used that way,
    • Self-harming behaviour, or behaviour that brings others in danger.

As you can see, an anxiety disorder can come in many forms and hide behind a variety of behaviours. This is why it is important to look out for any avoiding behaviour in oneself or others and see, whether it comes because of some persuasion (e.g. “I’m taking the stairs because it’s more healthy than an elevator”), or whether it is because of fear (like a disproportionate fear of elevators). It is important to take any fear seriously, even if you cannot understand them in your own experience. In truth, no one can really control what she or he is afraid of.

Talking and helping is always better than looking away! As normal and important fear is for all of us, it should never dictate what daily life looks like. No matter if the anxiety disorder is very faint or rather extreme, there is surely a way to deal with these issues.

If you observe one or more of the following symptoms in your own behaviour or in someone around you, it is important to take them seriously and try to take action.

    • Avoiding social activities to the point of distancing oneself from friends and family,
    • Getting through daily tasks seems very difficult or causes worry and anxiety,
    • One attempts to drown out these fears through drugs, alcohol, or meds, which are not intended to be used that way,
    • Self-harming behaviour, or behaviour that brings others in danger.

An anxiety disorder is a psychological issue which also has an effect on the body of the affected person.

There are several reasons to how an anxiety disorder can develop. Often, it is linked to the experience of a traumatic event. Sometimes the root lies at a neurological change in our brain that causes the communication within our brain to function differently than it did before – similar to a depression. In some cases, it is not really pinpointable where the disorder initially came from. In any way: as with a bodily disease, the affected person does not really have control over whether she or he will suffer from an anxiety disorder, or how well she or he will cope with the new situation. Generally open and brave people can just as easily suffer from an anxiety disorder as shy and introverted people. We can all do better when it comes to listening and to observing ourselves and the people around us, recognizing emotions and taking them serious enough to talk about them.

Fear is deeply ingrained in our bodies. It serves an important purpose of survival that has always been important for people and still is: Fear prepares us to react properly in a dangerous situation. In the end it comes down to fight or flight. Many processes in our body that are linked to fear helped our ancestors to navigate life and protected them from being eaten or hunted. Fear sharpens our senses – we are on the lookout for the danger and see, smell, and hear better. Fear puts our digestion system on hold, as well as other bodily workings that are of no advantage in the critical situation. The heart pumps quicker, our breath turns flat, and our whole body tenses up to be more efficient for a short period of time.

All these things are bodily reactions that help in fight or flight situations, but which are very exhausting too. If they help to get out of a dangerous situation, the body will recover rather quickly. But a person that suffers from an anxiety disorder keeps experiencing these extreme situations without a concrete danger and without the ability to control this reaction. Obviously, this will overwhelm the affected person, and motivate her or him to do her or his best to avoid such feelings and situations.

It can very well happen that a person with an anxiety disorder starts to draw away from the people close to her or him. The affected person might want to be left alone - or she or he fears to not be accepted any longer due to their issues and their seemingly chaotic feelings. That’s why it is important to not put any extra pressure on a person with an anxiety disorder, nor to try to make their fears seem small. What actually helps are people who listen – be it friends, family or any other close ones – who are there for them and who encourage and assist them to maybe get the help they need from a professional therapist.

Do you need help with the first step? Whether you are affected yourself and need to entrust your feelings to someone, or if you want to help a friend or a family member: here you will find tips on how to start a conversation about these difficult topics.

And then: Therapy? How a therapy looks like, how much time it needs, and what it does to help you or the person you are concerned about you will find here

You decided to seek out help for yourself or someone close to you? You ask yourself, where to get support or help? Firstly: You should know that there are many different possible contact points and professionals to talk to. It is important to first find out, which is the proper way for the individual case – this is especially the case with an anxiety disorder, seeing that there are many kinds of anxiety disorders.

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

It is also possible to turn directly to a psychotherapist. Here you get tips on how to get an appointment.

You want an impression of which contact points are the right ones for you or the person close to you? Here we explain, which professionals are best suited for which specific problem.

If you need further support on your way toward therapy, or if you want to keep anonymous while first talking to someone, here you will find links for points of contact in your area and trustworthy people to talk to.

What does a anxiety disorder feel like?

There are many kinds of anxiety disorders. However, what all of them have in common is that the affected person does not necessarily identify their experience as “fear”. Rather, an anxiety order feels more like a bodily sickness, as this is how it is expressed most of the times: Stomach aches, faintness, increased heart rates, and so on. Therefore, when trying to identify an anxiety disorder, it is especially important to check the affected person’s bodily health as much as the mental health.

Anxiety disorders are categorized into five main types that differ in their symptoms and their treatment:

There are many kinds of anxiety disorders. However, what all of them have in common is that the affected person does not necessarily identify their experience as “fear”. Rather, an anxiety order feels more like a bodily sickness, as this is how it is expressed most of the times: Stomach aches, faintness, increased heart rates, and so on. Therefore, when trying to identify an anxiety disorder, it is especially important to check the affected person’s bodily health as much as the mental health.

 

Anxiety disorders are categorized into five main types that differ in their symptoms and their treatment:

Panic Disorder – the fear of a panic attack

  • The affected person has experienced a panic attack in the past and knows how it feels: breaking into sweat, faintness, increased heart rates or the feeling of not being able to breathe properly. In most cases, a panic attack comes suddenly and lasts for a few minutes. Because it came suddenly, the lack of control about it makes the possibility of future panic attacks ever more threatening and unpredictable.
  • Since the affected person has already experienced a panic attack, she or he is extremely fearful of having to go through it again – whether the panic attack was related to a threatening place or situation is oftentimes irrelevant. Anything of the initial situation could be perceived as cause of the panic attack – this is why panic attacks are often quite broad and not tied to one specific fear or situation.
  • The affected person becomes very sensitive to anything that might indicate a panic attack. Normal bodily reactions are misinterpreted as being signs of a new panic attack, which makes the general fear of them even more present. This could be an increased pulse after walking up stairs, the slight feeling of faintness when riding a train, or a general feeling of discomfort in an unknown situation.

Agoraphobia – the fear of places or situations without quick exit

  • The affected person is afraid of places, from which it could be difficult to escape – like wide and crowded public places, waiting queues, closed rooms… – but also of “exitless” situations, like travelling somewhere far away from home on your own. It could also be the fear of a place where the person has once felt uncomfortable or helpless in the past.
  • Also possible is a fear of a particular place where the person has felt uncomfortable or helpless in the past.
  • Just in the case of finding oneself in an uncomfortable or even threatening situation, a person with agoraphobia wants to know that she or he could easily get away or at least have someone whom they trust by their side.
  • Because of this just-in-case-mentality, agoraphobia is often linked to a panic disorder, where the affected person is concerned with experiencing a panic attack and not being able to escape quickly. She or he fears that it would be uncomfortable to be surrounded by staring and witnessing people or that it would even be dangerous to be exposed to their panic in the first place.

Although claustrophobia may sound similar to agoraphobia with its general idea of fear of places, but a claustrophobic person is mainly afraid of closed rooms and tight spaces – unrelated to the number of people around them at that place.

General Anxiety Disorder – the permanent feeling of fear

  • The affected person feels a constant general fear and worry. She or he fears for her or himself and the people around them – but the fears are stronger than what most other people would feel and far from what would be a useful or adequate worry.
  • These uncontrollable fears span over many different aspects of life.
  • Sometimes the affected person might even be overwhelmed or sad that she or he experiences so many fears and worries.
  • Other signs of a general anxiety disorder could be restlessness, problems concerning sleep or difficulties to concentrate.

Social Anxiety Disorder – the fear of feeling humiliated

  • The affected person is afraid of social situations in which she or he could be judged by other people, as perhaps seeming dumb or weak, and therefore tries to avoid these situations.
  • This causes the person to avoid social situations.
  • People with such social phobias could have difficulties like speaking in front of people – even if it is very small number of people -, asking for directions or even eating in public.

Specific Phobia – the fear of a very specific thing

  • The affected person is disproportionately afraid of a specific thing or situation, like a specific animal, a specific action, or a very specific situation like being on a plane. This means the fear is way stronger than would be justified by the actual danger coming from that thing, and it is way bigger than most other people would feel.
  • The person starts to avoid any confrontation with the item of their fear, sometimes going to extreme ends to get around it – like driving extremely long distances because of their fear of planes or avoiding any doctors for their fear of injections or shots.
  • While these fears might be somewhat handleable in daily life, any hint of the item of their fear starts an incredibly strong and uncontrollable feeling of fear.

As you can see, an anxiety disorder can come in many forms and hide behind a variety of behaviours. This is why it is important to look out for any avoiding behaviour in oneself or others and see, whether it comes because of some persuasion (e.g. “I’m taking the stairs because it’s more healthy than an elevator”), or whether it is because of fear (like a disproportionate fear of elevators). It is important to take any fear seriously, even if you cannot understand them in your own experience. In truth, no one can really control what she or he is afraid of.

Talking and helping is always better than looking away! As normal and important fear is for all of us, it should never dictate what daily life looks like. No matter if the anxiety disorder is very faint or rather extreme, there is surely a way to deal with these issues.

If you observe one or more of the following symptoms in your own behaviour or in someone around you, it is important to take them seriously and try to take action.

    • Avoiding social activities to the point of distancing oneself from friends and family,
    • Getting through daily tasks seems very difficult or causes worry and anxiety,
    • One attempts to drown out these fears through drugs, alcohol, or meds, which are not intended to be used that way,
    • Self-harming behaviour, or behaviour that brings others in danger.

As you can see, an anxiety disorder can come in many forms and hide behind a variety of behaviours. This is why it is important to look out for any avoiding behaviour in oneself or others and see, whether it comes because of some persuasion (e.g. “I’m taking the stairs because it’s more healthy than an elevator”), or whether it is because of fear (like a disproportionate fear of elevators). It is important to take any fear seriously, even if you cannot understand them in your own experience. In truth, no one can really control what she or he is afraid of.

Talking and helping is always better than looking away! As normal and important fear is for all of us, it should never dictate what daily life looks like. No matter if the anxiety disorder is very faint or rather extreme, there is surely a way to deal with these issues.

If you observe one or more of the following symptoms in your own behaviour or in someone around you, it is important to take them seriously and try to take action.

    • Avoiding social activities to the point of distancing oneself from friends and family,
    • Getting through daily tasks seems very difficult or causes worry and anxiety,
    • One attempts to drown out these fears through drugs, alcohol, or meds, which are not intended to be used that way,
    • Self-harming behaviour, or behaviour that brings others in danger.
Where does an anxiety disorder come from?

An anxiety disorder is a psychological issue which also has an effect on the body of the affected person.

 

There are several reasons to how an anxiety disorder can develop. Often, it is linked to the experience of a traumatic event. Sometimes the root lies at a neurological change in our brain that causes the communication within our brain to function differently than it did before – similar to a depression. In some cases, it is not really pinpointable where the disorder initially came from. In any way: as with a bodily disease, the affected person does not really have control over whether she or he will suffer from an anxiety disorder, or how well she or he will cope with the new situation. Generally open and brave people can just as easily suffer from an anxiety disorder as shy and introverted people. We can all do better when it comes to listening and to observing ourselves and the people around us, recognizing emotions and taking them serious enough to talk about them.

What happens during an anxiety disorder?

Fear is deeply ingrained in our bodies. It serves an important purpose of survival that has always been important for people and still is: Fear prepares us to react properly in a dangerous situation. In the end it comes down to fight or flight. Many processes in our body that are linked to fear helped our ancestors to navigate life and protected them from being eaten or hunted. Fear sharpens our senses – we are on the lookout for the danger and see, smell, and hear better. Fear puts our digestion system on hold, as well as other bodily workings that are of no advantage in the critical situation. The heart pumps quicker, our breath turns flat, and our whole body tenses up to be more efficient for a short period of time.

 

All these things are bodily reactions that help in fight or flight situations, but which are very exhausting too. If they help to get out of a dangerous situation, the body will recover rather quickly. But a person that suffers from an anxiety disorder keeps experiencing these extreme situations without a concrete danger and without the ability to control this reaction. Obviously, this will overwhelm the affected person, and motivate her or him to do her or his best to avoid such feelings and situations.

Help and anxiety disorders

It can very well happen that a person with an anxiety disorder starts to draw away from the people close to her or him. The affected person might want to be left alone - or she or he fears to not be accepted any longer due to their issues and their seemingly chaotic feelings. That’s why it is important to not put any extra pressure on a person with an anxiety disorder, nor to try to make their fears seem small. What actually helps are people who listen – be it friends, family or any other close ones – who are there for them and who encourage and assist them to maybe get the help they need from a professional therapist.

Do you need help with the first step? Whether you are affected yourself and need to entrust your feelings to someone, or if you want to help a friend or a family member: here you will find tips on how to start a conversation about these difficult topics.

And then: Therapy? How a therapy looks like, how much time it needs, and what it does to help you or the person you are concerned about you will find here

Who can I talk to?

You decided to seek out help for yourself or someone close to you? You ask yourself, where to get support or help? Firstly: You should know that there are many different possible contact points and professionals to talk to. It is important to first find out, which is the proper way for the individual case – this is especially the case with an anxiety disorder, seeing that there are many kinds of anxiety disorders.

 

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

 

It is also possible to turn directly to a psychotherapist. Here you get tips on how to get an appointment.

You want an impression of which contact points are the right ones for you or the person close to you? Here we explain, which professionals are best suited for which specific problem.

If you need further support on your way toward therapy, or if you want to keep anonymous while first talking to someone, here you will find links for points of contact in your area and trustworthy people to talk to.

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Depression

Like any disorder or sickness, a depression feels different to everyone.

But the following symptoms can be signs of a depression – especially when they prevail for more than 2 weeks:

    • A gloomy mood, a permanent sadness, or even the feeling of not feeling anything – perhaps without a specific reason
    • A lack of interest for things that are normally important to you or the person you are concerned about – hobbies, friends, favourite music
    • A lack of energy or constant tiredness that make basic daily activities difficult to manage
    • Problems to concentrate
    • Being overwhelmed with things that are normally not much of a problem – be it tasks or social contacts; maybe going so far that one becomes anxious about these situations, or of the future in general
    • The feeling of being without worth or use to anyone
    • A lack of self confidence in general, but especially in areas where one would normally feel very secure, or even draw confidence from
    • A lack of appetite
    • Problems related to sleep – either not being able to fall asleep, or problems to sleep through

By the way, there are people who suffer from a depression who feel strong mood swings. This means there might be times where they seem “as always” and feel perfectly fine. Furthermore, it is quite common to, for example, feel better in the evenings. However, these mood swings do not make the bad phases any better or less intense.

Not everyone who experiences one or more of these symptoms is automatically depressed; and, as you can see, the symptoms vary drastically. But: it is important to keep an eye on the mental wellbeing of you, your friends, and your family – observe and recognize unusual changes in mood and behaviour and take changes which seem to last seriously. Talking about your feelings and trying to help is always better than looking away. Being tired, sad, or without appetite is never pleasant – whether this is due to a mental disorder or not. But there are ways to deal with these feelings.

Pay attention to the following symptoms in yourself or someone close, take them seriously and act immediately:

    • Distance from daily life and emotions, maybe a lack of energy to leave bed at all, or to manage daily life
    • Strong feelings of guilt or maybe even self-loathing
    • Recurring thoughts and talks about death and suicide

A depression is a psychological – which means mental – illness. But it affects the body too, or, more specifically: the brain

Just what happens in the brain you'll get to read very soon!

Just as with bodily diseases, the affected person can’t really influence whether she or he will “get sick”, and how she or he will cope with the new situation. Oftentimes, either a traumatic event or just a very difficult phase of life is the initial cause to a depression. A lot of stress is also a very common cause for a depression – especially when it is constant, and one does not feel any relief or knows how to cope with it. Some people suffer from a depression without a specific cause – sometimes it seems to happen “just like that”. In the end, all of us can do better to care about our own and other’s mental health; and all of us can improve in talking about mental health.

Our perception and interpretation of the world around us is highly influenced by the communication between cells within our brain. For this communication, nature has developed so called neurotransmitters: chemicals that bridge the signals coming from one cell and going to another. During a depression, neurobiological changes happen in the brain that make this communication work differently, or malfunction. This has the direct effect of turning the affected persons´ emotional world upside down, and they perceive the world differently. An affected person feels an immense inner chaos that overwhelms her or him. Of course, this affects their reactions to the outer world and the people close to them: they might be very distanced or rejecting, have no patience, or seem constantly sad and unhappy.

With the help of a professional therapy, a proper way to deal with these symptoms can be learnt, or the functioning of the body and the brain can be supported by meds:

    1. The depression appears just once, and the affected person will be free of it after therapy
    2. After the depression was treated in therapy, it is weaker but never truly gone
    3. The depression comes back just as strongly as the first time after therapy
    4. The person is always slightly depressed but does not suffer from a full-blown depression
    5. The person is always slightly depressed and experiences a depression – therapy will bring back the earlier permanent state of slight depression
    6. A chronic depression that never goes away

Understanding the different routes a depression can take might help to understand one’s own situation and needs in order to find the most suitable therapy. In any case, it is important to see a depression as similar to any other illness. This means it needs time, patience, and support – and fall backs are just as much part of it as any little achievement.

It can very well happen that a person suffering from a depression starts to draw away from the people close to her or him. The affected person might want to be left alone – or she or he fears to not be accepted any longer due to their issues and their seemingly chaotic feelings. That’s why it is important to not put any extra pressure on someone with a depression; nor to try to make their fears seem small. What actually helps are people who listen – be it friends, family or any other close ones – who are there for them and who encourage and assist them to maybe get the help they need from a professional therapist.

Do you need help with the first step? Whether you are affected yourself and need to entrust your feelings to someone, or if you want to help a friend or a family member: here you will find tips on how to start a conversation about these difficult topics.

And then: Therapy? How a therapy looks like, how much time it needs, and what it does to help you or the person you are concerned about you will find here

You have decided to seek help for yourself or someone close, and you ask yourself where to find support? Firstly: You should know that there are many different points of possible contact and various professionals to work with. It is important to first find out which path individually suits best.

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

It is also possible to turn directly to a psychotherapist. Here you get tips on how to get an appointment.

You want an impression of which contact points are the right ones for you or the person close to you? Here we explain, which professionals are best suited for which specific problem.

If you need further support on your way toward therapy, or if you want to keep anonymous while first talking to someone, here you will find links for points of contact in your area and trustworthy people to talk to.

How does a depression feel?

Like any disorder or sickness, a depression feels different to everyone.

But the following symptoms can be signs of a depression – especially when they prevail for more than 2 weeks:

    • A gloomy mood, a permanent sadness, or even the feeling of not feeling anything – perhaps without a specific reason
    • A lack of interest for things that are normally important to you or the person you are concerned about – hobbies, friends, favourite music
    • A lack of energy or constant tiredness that make basic daily activities difficult to manage
    • Problems to concentrate
    • Being overwhelmed with things that are normally not much of a problem – be it tasks or social contacts; maybe going so far that one becomes anxious about these situations, or of the future in general
    • The feeling of being without worth or use to anyone
    • A lack of self confidence in general, but especially in areas where one would normally feel very secure, or even draw confidence from
    • A lack of appetite
    • Problems related to sleep – either not being able to fall asleep, or problems to sleep through

By the way, there are people who suffer from a depression who feel strong mood swings. This means there might be times where they seem “as always” and feel perfectly fine. Furthermore, it is quite common to, for example, feel better in the evenings. However, these mood swings do not make the bad phases any better or less intense.

Not everyone who experiences one or more of these symptoms is automatically depressed; and, as you can see, the symptoms vary drastically. But: it is important to keep an eye on the mental wellbeing of you, your friends, and your family – observe and recognize unusual changes in mood and behaviour and take changes which seem to last seriously. Talking about your feelings and trying to help is always better than looking away. Being tired, sad, or without appetite is never pleasant – whether this is due to a mental disorder or not. But there are ways to deal with these feelings.

Pay attention to the following symptoms in yourself or someone close, take them seriously and act immediately:

    • Distance from daily life and emotions, maybe a lack of energy to leave bed at all, or to manage daily life
    • Strong feelings of guilt or maybe even self-loathing
    • Recurring thoughts and talks about death and suicide

Where does a depression come from?

A depression is a psychological – which means mental – illness. But it affects the body too, or, more specifically: the brain

Just what happens in the brain you'll get to read very soon!

Just as with bodily diseases, the affected person can’t really influence whether she or he will “get sick”, and how she or he will cope with the new situation. Oftentimes, either a traumatic event or just a very difficult phase of life is the initial cause to a depression. A lot of stress is also a very common cause for a depression – especially when it is constant, and one does not feel any relief or knows how to cope with it. Some people suffer from a depression without a specific cause – sometimes it seems to happen “just like that”. In the end, all of us can do better to care about our own and other’s mental health; and all of us can improve in talking about mental health.

What happens during a depression?

Our perception and interpretation of the world around us is highly influenced by the communication between cells within our brain. For this communication, nature has developed so called neurotransmitters: chemicals that bridge the signals coming from one cell and going to another. During a depression, neurobiological changes happen in the brain that make this communication work differently, or malfunction. This has the direct effect of turning the affected persons´ emotional world upside down, and they perceive the world differently. An affected person feels an immense inner chaos that overwhelms her or him. Of course, this affects their reactions to the outer world and the people close to them: they might be very distanced or rejecting, have no patience, or seem constantly sad and unhappy.

Mithilfe einer professionellen Therapie kann ein richtiger Umgang mit den Symptomen erlernt oder mithilfe von Medikamenten die Funktionen im Körper und Gehirn unterstützt werden. Trotzdem gibt es unterschiedliche Formen der Depression, die sich besonders in ihrem Verlauf

unterscheiden:

    1. The depression appears just once, and the affected person will be free of it after therapy
    2. After the depression was treated in therapy, it is weaker but never truly gone
    3. The depression comes back just as strongly as the first time after therapy
    4. The person is always slightly depressed but does not suffer from a full-blown depression
    5. The person is always slightly depressed and experiences a depression – therapy will bring back the earlier permanent state of slight depression
    6. A chronic depression that never goes away

Understanding the different routes a depression can take might help to understand one’s own situation and needs in order to find the most suitable therapy. In any case, it is important to see a depression as similar to any other illness. This means it needs time, patience, and support – and fall backs are just as much part of it as any little achievement.

Depressions and help

It can very well happen that a person suffering from a depression starts to draw away from the people close to her or him. The affected person might want to be left alone – or she or he fears to not be accepted any longer due to their issues and their seemingly chaotic feelings. That’s why it is important to not put any extra pressure on someone with a depression; nor to try to make their fears seem small. What actually helps are people who listen – be it friends, family or any other close ones – who are there for them and who encourage and assist them to maybe get the help they need from a professional therapist.

Do you need help with the first step? Whether you are affected yourself and need to entrust your feelings to someone, or if you want to help a friend or a family member: here you will find tips on how to start a conversation about these difficult topics.

And then: Therapy? How a therapy looks like, how much time it needs, and what it does to help you or the person you are concerned about you will find here

Who can I talk to?

You have decided to seek help for yourself or someone close, and you ask yourself where to find support? Firstly: You should know that there are many different points of possible contact and various professionals to work with. It is important to first find out which path individually suits best.

 

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

 

It is also possible to turn directly to a psychotherapist. Here you get tips on how to get an appointment.

You want an impression of which contact points are the right ones for you or the person close to you? Here we explain, which professionals are best suited for which specific problem.

If you need further support on your way toward therapy, or if you want to keep anonymous while first talking to someone, here you will find links for points of contact in your area and trustworthy people to talk to.

Further information:

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