Anxiety Health Article

Treatment

Meditation and mindfulness training can benefit patients with phobias and panic disorder. Hydrotherapy, massage therapy, and aromatherapy are useful to some anxious patients because they can promote general relaxation of the nervous system. Essential oils of lavender, chamomile, neroli, sweet marjoram, and ylang-ylang are commonly recommended by aromatherapists for stress relief and anxiety reduction.

Relaxation training, which is sometimes called anxiety management training, includes breathing exercises and similar techniques intended to help the patient prevent hyperventilation and relieve the muscle tension associated with the fight-or-flight reaction. Yoga, aikido, tai chi, and dance therapy help patients work with the physical, as well as the emotional, tensions that either promote anxiety or are created by the anxiety.

Homeopathy and traditional Chinese medicine (TCM) approach anxiety as a symptom of a holistic imbalance. Homeopathic practitioners select a remedy based on other associated symptoms and the patient's general constitution. Homeopathic remedies for anxiety include ignatia, gelsemium, aconite, pulsatilla, arsenicum album, and coffea cruda. These remedies should be prescribed by a homeopathic healthcare professional.

Chinese medicine regards anxiety as a disruption of qi, or energy flow, inside the patient's body. Acupuncture and/or herbal therapy are standard remedies for rebalancing the entire system. Reishi (Ganoderma lucidum or Ling-Zhi) is a medicinal mushroom prescribed in TCM to reduce anxiety and insomnia. However, because reishi can interact with other prescription drugs and is not recommended for patients with certain medical conditions, individuals should consult their healthcare practitioner before taking the remedy. Other TCM herbal remedies for anxiety include the cordyceps mushroom (also known as catepillar fungus) and Chinese green tea. In addition, there are numerous TCM formulas that combine multiple herbs for use as an anxiety treatment, depending on the individual problem.

Herbs known as adaptogens may also be prescribed by herbalists or holistic healthcare providers to treat anxiety. These herbs are thought to promote adaptability to stress, and include Siberian ginseng (Eleutherococcus senticosus), ginseng (Panax ginseng), wild yam (Dioscorea villosa), borage (Borago officinalis), licorice (Glycyrrhiza glabra), chamomile (Chamaemelum nobile), milk thistle (Silybum marianum), and nettles (Urtica dioica). Tonics of skullcap (Scutellaria lateriafolia), and oats (Avena sativa), may also be recommended to ease anxiety.

A 2002 preliminary study found that St. John's wort could be an effective treatment for generalized anxiety. Patients taking 900 mg a day and higher doses responded well in early trials. However, further research was needed, particularly at doses higher than 900 mg per day. The Ayurvedic herb gotu kola, long used by practitioners of India's holistic medical system to enhance memory and relieve varicose veins, may also help patients with anxiety by working against the startle response.

Allopathic treatment

Because anxiety often has more than one cause and is experienced in highly individual ways, its treatment often requires more than one type of therapy. In some cases, several types of treatment may need to be tried before the best combination is discovered. It usually takes about six to eight weeks to evaluate the effectiveness of a treatment regimen.

Medications

Medications are often prescribed to relieve the physical and psychological symptoms of anxiety. Most medications work by counteracting the biochemical and muscular changes involved in the fight-or-flight reaction. Some work directly on the brain chemicals that are thought to underlie the anxiety.

ANXIOLYTICS. Anxiolytics are sometimes called tranquilizers. Most anxiolytic drugs are either benzodiazepines or barbiturates. However, barbiturates, once commonly used, are now rarely used in clinical practice. Benzodiazepines work by relaxing the skeletal muscles and calming the limbic system. They include such drugs as chlordiazepoxide (Librium) and diazepam (Valium). Both barbiturates and benzodiazepines are potentially habit-forming and may cause withdrawal symptoms, but benzodiazepines are far less likely than barbiturates to cause physical dependency.

Two other types of anxiolytic medications include meprobamate (Equanil), which is now rarely used, and buspirone (BuSpar), a new type of anxiolytic that appears to work by increasing the efficiency of the body's own emotion-regulating brain chemicals. Unlike barbiturates and benzodiazepines, buspirone does not cause dependence problems, does not interact with alcohol, and does not affect the patient's ability to drive or operate machinery. However, buspirone is not effective against certain types of anxiety, such as panic disorder.

ANTIDEPRESSANTS AND BETA-BLOCKERS. The treatment of choice for obsessive-compulsive disorder, panic type anxiety, and other anxiety disorders is a group of antidepressants known as selective serotonin reuptake inhibitors (SSRIs), such as Prozac and Paxil. When anxiety occurs in tandem with depressive symptoms, tricyclic antidepressants such as imipramine (Tofranil) or monoamine oxidase inhibitors (MAO inhibitors) such as phenelzine (Nardil) are sometimes prescribed.

Beta-blockers are medications that work by blocking the body's reaction to the stress hormones that are released during the fight-or-flight reaction. They include drugs like propranolol (Inderal) or atenolol (Tenormin). Beta-blockers are sometimes given to patients with post-traumatic anxiety symptoms or social phobic anxiety.