If you have been diagnosed with anxiety disorder, you will need treatment. Anxiety is a medical condition and does not go away on its own. You cannot will it away any more than you can will away appendicitis or a broken arm.
There are many forms of anxiety disorder and each case is different. You will need the help of a medical doctor or mental health professional to determine the best course of treatment for you. You may have other conditions that need to be treated before or along with your anxiety disorder. This can only be determined by your doctor.
Most anxiety disorder patients are treated with a combination of psychotherapy and medication. The goal is to help you manage your anxiety so you can function and feel better in your day-to-day life.
Psychotherapy involves talking with a trained mental health professional. Also known as talk therapy, it helps you discover the cause of your anxiety and learn how to manage its symptoms. The form of psychotherapy used most often in treating anxiety disorders is cognitive behavioral therapy (CBT). CBT helps you change both your thought patterns and the way you react to situations that cause anxiety.
CBT is usually a short-term therapy involving 10 to 20 visits with a therapist over a number of weeks. During these visits you will learn:
- to understand your distorted view of life and gain control of your thoughts
- to recognize and replace the thoughts that cause anxiety and panic
- to manage your stress and relax when symptoms occur
- to avoid thinking that minor problems are going to become major problems
When you are ready, you may be taught exposure techniques to make you less sensitive to the things you fear. The therapist will help you discover that there’s no danger. For example, if you are obsessed with germs you might be encouraged to get your hands dirty and not wash them immediately. Gradually, as you begin to see that nothing bad happens, you will be able to go for longer and longer periods without washing your hands, and your anxiety will diminish. If you fear a specific place or situation, the therapist may accompany you there and help you cope with your anxiety until you feel more comfortable.
CBT typically lasts for about 12 weeks. You may see the therapist alone or in a group. If you have social phobia, individual therapy will probably be the most beneficial.
The effects of CBT are usually long-lasting. If the anxiety returns at a later date, the same therapy can be used again.
There are several drugs available to treat anxiety. The main difference between the various anxiety drugs is the way they affect brain function. Each person is different, so finding the right medication for you may involve trial and error. Drugs do not cure anxiety, but they can help you manage your symptoms while you receive psychotherapy.
The following are some of the drugs approved to treat anxiety:
Usually reserved for short-term treatment of anxiety, benzodiazepines are known for their sedative qualities. They can also be habit-forming, increase drowsiness, and affect balance and memory.
There is an increasing epidemic of benzodiazepine abuse, and it is very important that these drugs be considered only as a short-term option for anxiety treatment until more effective, more useful therapies are initiated. There is one exception: in the case of panic disorder, benzodiazepines can be used for up to a year without harm.
Benzodiazepines used to treat anxiety include:
- alprazolam (Xanax): used for panic disorder and generalized anxiety disorder (GAD)
- chlordiazepoxide (Librium): used for short-term relief of anxiety
- clonazepam (Klonopin): used for social phobia and GAD
- diazepam (Valium): used for GAD and social anxiety disorder
- lorazepam (Ativan): used for panic disorder
This medication is used to treat both short-term anxiety and chronic anxiety disorders. It can take up to several weeks to become fully effective, but can be used on an ongoing basis. Side effects include dizziness, headaches, and nausea.
It is sold under the brand names Buspar and Vanspar.
Antidepressant medications affect neurotransmitters (brain chemicals that relay messages) and can be used to treat anxiety symptoms. Antidepressants do not relieve symptoms instantly. They usually take four to six weeks to produce noticeable effects.
One class of antidepressants used to treat anxiety is known as selective serotonin reuptake inhibitors (SSRIs). They act by interacting with serotonin, a neurotransmitter that affects mood, sexual desire, appetite, sleep, and memory. SSRIs have very few side effects. They are usually started at low doses and gradually increased until they begin to have a beneficial effect.
SSRIs used to treat anxiety include:
- escitalopram (Lexapro)
- fluoxetine (Prozac)
- paroxetine (Paxil)
- sertraline (Zoloft)
- venlafaxine (Effexor)
Tricyclics work as well as SSRIs for treating anxiety disorders, with the exception of obsessive-compulsive disorder (OCD). Like SSRIs, tricyclics are started at a low dose and then increased gradually. Side effects include dizziness, drowsiness, dry mouth, and weight gain. These can usually be controlled by changing the dose or switching to another tricyclic.
Tricyclics used for anxiety include:
- imipramine (Tofranil): for panic disorder and GAD
- clomiprimine (Anafranil): the only tricyclic used to treat OCD
Monoamine oxidase inhibitors (MAOIs) are used to treat panic disorder and social phobia. If you take MAOIs, you cannot eat certain foods, such as cheese and red wine. You also cannot take certain medications, including some birth control pills, pain relievers (Tylenol, Motrin, and Advil), cold and allergy medications, and herbal supplements. Doing so may cause a dangerous increase in your blood pressure.
MAOIs approved by the FDA to treat depression are:
- isocarboxazid (Marplan)
- phenelzine (Nardil)
- selegiline (Emsam)
- tranylcypromine (Parnate)
You also cannot take SSRIs when taking MAOIs. The two together can cause confusion, hallucinations, increased sweating, muscle stiffness, seizures, changes in blood pressure and heart rhythm, and other potentially life-threatening side-effects.
These drugs are used to treat heart conditions, but are also useful in relieving the physical symptoms of anxiety, especially in cases of social anxiety disorder. If you know you are going to be in a fearful situation, such as attending a party or giving a speech, your doctor may prescribe a beta-blocker to help reduce your symptoms.
Be sure to follow your doctor’s instructions when taking these medications. Let your doctor know about any side effects you experience. Drugs can help relieve the symptoms of anxiety, but should be used along with psychotherapy. Anxiety disorder is a medical condition. With the help of your doctor, it can be treated and controlled.