Anxiety Disorder Treatment

Anxiety disorders are treated with medication, psychotherapy, or both. According to the National Institute of Mental Health (NIMH), medication combined with psychotherapy is considered the best treatment approach for many people.

Most people who have an anxiety disorder can be helped with professional care. Each treatment is adjusted to the person's individual needs. Several different treatments or treatment combinations may be tried before finding one that works.

It's important to identify if people have any coexisting conditions that are contributing to their anxiety symptoms. A coexisting condition may be another anxiety disorder, depression, a medical condition, or substance abuse. It may be necessary to bring the coexisting condition under control before starting treatment for the anxiety disorder.

People who have been treated in the past for an anxiety disorder or depression should tell their doctor of any medications and psychotherapy treatments they've received, and whether or not the treatments were successful.

Common anxiety disorder treatments include:

• Psychotherapy
• Medications
• Lifestyle changes
• Complementary and alternative medicine

Psychotherapy

Psychotherapy (talk therapy or counseling) is the treatment of mental and emotional disorders in which people talk about their condition with a mental health professional. Psychotherapy helps people gain insight in to the causes of their depression, and learn how to improve their behavior and handle their problems.

Common types of psychotherapy for anxiety disorders include:

• Cognitive therapy
  Cognitive therapy helps people become aware of and change their unhealthy thinking patterns. The therapy uses guided self-discovery (personal analysis to understand oneself) and imaging (using thought to create mental experiences).
• Behavior therapy
  Behavior therapy uses basic learning techniques to help people change their undesirable behaviors. The therapy uses a system of rewards, reinforcements of positive behavior, and desensitization (confronting the cause of the problem).
• Cognitive-behavior therapy
  Cognitive-behavior therapy combines features of both cognitive and behavior therapies to help people identify and change their unhealthy thoughts, and develop healthier behaviors. Techniques used include journal keeping, homework assignments, role playing, and desensitization.
• Play therapy
  Play therapy is used with children who are not yet able to express their emotions or feelings in words. Children engage in activities, such as playing with dolls or toys.

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Medications

Anxiety disorder medications help control a person's anxiety symptoms while they receive psychotherapy. The principal medications used for anxiety disorders are:

• Antidepressants
• Antianxiety drugs
• Beta-blockers

It's important for people to be under medical supervision while taking anxiety disorder medications. People should ask their doctor or pharmacist in advance for possible drug side effects or interactions. A doctor should be notified if any severe reactions occur. When discontinuing some anxiety disorder medications, the dosage must be decreased gradually to avoid withdrawal symptoms.

The following list of medications isn't inclusive. Additional information, side effects, and drug interactions can be obtained by clicking the name of the highlighted medications.

Antidepressants

Antidepressants successfully treat the different types of anxiety disorders as well as treat depression. Most antidepressants work by making brain chemicals called neurotransmitters (serotonin, norepinephrine, and dopamine) more available to the brain. Scientists believe that higher levels of neurotransmitters improve the transmission of nerve impulses, which elevates a person's mood and behavior.

Antidepressants take from 4 to 6 weeks to start working fully. A doctor may have a person try more than one antidepressant before determining which antidepressant or combination of medications does the best job of relieving the person's symptoms with the fewest side effects. It's important for people to be under medical supervision while taking antidepressants. When discontinuing an antidepressant, the dosage must be decreased gradually to avoid withdrawal symptoms.

In 2007, the Food and Drug Administration (FDA) proposed that all antidepressant medicines should warn of the risk of suicidal behavior in young adults between 18 to 24 years old.

Selective serotonin reuptake inhibitors

SSRIs are used to treat:

• Generalized anxiety disorder
• Obsessive-compulsive disorder
• Panic disorder,
• Post-traumatic stress disorder
• Social phobia

Examples include:

• citalopram (brand name: Celexa)
• escitalopram (Lexapro)
• fluoxetine (Prozac)
• fluvoxamine (Luvox)
• paroxetine (Paxil, Pexeva)
• sertraline (Zoloft)

Tricyclic antidepressants

Tricyclic antidepressants are used to treat:

• Generalized anxiety disorder
• Obsessive-compulsive disorder (only Anafranil)
• Panic disorder
• Post-traumatic stress disorder

Examples include:

• amitriptyline (Elavil)
• amoxapine
• clomipramine (Anafranil)
• desipramine (Norpramin)
• doxepin (Adapin)
• imipramine (Tofranil)
• nortriptyline (Aventyl, Pamelor)
• protriptyline (Vivactil)
• trimipramine (Surmontil)

Monoamine oxidase inhibitors

MAOIs are used to treat

• Panic disorder
• Social phobia
• Post-traumatic stress disorder

Examples include:

• isocarboxazid (Marplan)
• phenelzine (Nardil)
• tranylcypromine (Parnate)

Serotonin and norepinephrine reuptake inhibitors

The following SNRIs are used to treat generalized anxiety disorder:

• duloxetine (Cymbalta)
• venlafaxine (Effexor)

Antianxiety Drugs

Antianxiety drugs (anxiolytics) help relieve anxiety symptoms for people with generalized anxiety disorder. They also are used for short-term control of social phobia or specific phobia. They are primarily used for people who need quick-acting relief of their anxiety symptoms.

Benzodiazepines

Benzodiazepines are used to treat:

• Generalized anxiety disorder
• Panic disorder
• Social phobia

Examples include:

• alprazolam (Xanax)
• chlordiazepoxide (Librium)
• clonazepam (Klonopin)
• clorazepate (Tranxene)
• diazepam (Valium)
• flurazepam (Dalmane)
• lorazepam (Ativan)
• oxazepam (Serax)
• temazepam (Restoril)
• triazolam (Halcion)

Azapirones

The following drug is used to treat generalized anxiety disorder and for the short-term treatment of anxiety symptoms:

• buspirone (BuSpar)

Beta-blockers

Beta-blockers, which typically are used to treat heart conditions, are also used to control some of the physical symptoms of anxiety disorders. Beta-blockers work by blocking the stimulating effect of the epinephrine (adrenaline), and reducing the physiological changes, such as increased heart rate, blood pressure, and shaking voice and limbs.

The following drugs are used to treat the physical symptoms of social phobia and are especially useful for performance anxiety:

• atenolol (Tenormin)
• propranolol (Inderal)

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Lifestyle Changes

In addition to psychotherapy and medications to treat anxiety disorders, the following lifestyle changes help people cope in their everyday lives:

• Visit the doctor or therapist regularly.
• Take medications as prescribed.
• Join an anxiety support group.
• Practice relaxation techniques.
• Avoid alcohol, caffeine and other stimulants, and illegal drugs.
• Eat well-balanced meals.
• Get regular exercise.
• Interact with family and friends.
• Maintain a regular sleeping routine.
• Participate in enjoyable activities.
• Set realistic goals and expectations.
• Try to maintain a positive outlook and self-image.

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Complementary and Alternative Medicine

Complementary and alternative medicine refers to those medical and healthcare treatments that are not part of traditional medicine. Whereas, complementary medicine is used with traditional medicine, alternative medicine is used in place of traditional medicine.

The following nontraditional therapies help treat anxiety disorders. Some of these therapies haven't been well studied, and little information is available about their effectiveness, side effects, and drug interactions. It's important to discuss any of these therapies with a doctor before trying them.

Relaxation techniques

• Acupuncture
  Acupuncture inserts sharp, thin needles into the body to adjust the body's energy flow into healthier patterns.
• Biofeedback
  Biofeedback uses special equipment to train people how to regulate their involuntary body functions related to stress, such as heart rate, blood pressure, or brain wave patterns.
• Deep breathing
  Deep breathing (diaphragmatic breathing) is a relaxation technique that involves breathing deeply into the lungs by flexing the diaphragm instead of the shallower flexing of the rib cage.
• Qi gong
  Qi gong is an ancient Chinese system of breathing techniques, exercises, meditations, and postures designed to improve and enhance the body's health and vitality.
• RESPeRATE Blood Pressure Lowering Device
  RESPeRATE is an FDA-approved portable electronic device that helps relieve stress naturally by helping people to master the technique of paced breathing.
• Yoga
  Yoga is a Hindu system that is believed to prevent diseases by a combination of breathing techniques, meditation, and physical exercises designed to strengthen the body and calm the nervous system.