Treatments for anxiety disorders

Contents

What Treatment Options are Available?

Like other anxiety disorders, medications and therapy are the most common treatment options if you are suffering from Generalized Anxiety Disorder.

Psychotherapy – often referred to as “talk” therapy is one treatment option. Cognitive behavioral therapy is a very common method of psychotherapy that has shown great results for people living with Generalized Anxiety Disorder. This form of therapy is geared toward helping you recognize and understand your thoughts and the pattern of any negative thoughts you may experience. Cognitive behavioral therapy focuses on teaching you coping skills or mechanisms you can use to help you return to normal functioning and ease your feelings of anxiety. It is normally a short-term therapy and people who undergo this type of psychotherapy have found great results.

Medications are also a common form of treatment for Generalized Anxiety Disorder. The most common types of medications prescribed to individuals living with this form of anxiety include anti-depressants, anti-anxiety drugs, and in some cases, sedatives. Antidepressants are used to treat depression but have been found effective in the treatment of anxiety as well. They commonly take a couple of weeks to start taking effect and may cause some mild side effects, including headache, nausea, or difficulty sleeping. Most of the side effects are mild and tend to subside within a few weeks. Anti-anxiety medication is also often prescribed to help individuals cope with Generalized Anxiety Disorder. These types of drugs are powerful in their treatment of this type of anxiety; one of the most commonly prescribed types is a drug called buspirone often under the brand name Buspar.

During acute attacks of anxiety, your doctor may prescribe a sedative to ease your anxiety symptoms – though these should be used as needed and on a short-term basis.

Some people find that medication alone can be helpful in the treatment of Generalized Anxiety Disorder, while others are more likely to benefit from psychotherapy. Some find that the combination of psychotherapy and medication is the best course of action. Engaging in certain behaviors may also ease your anxiety and promote a healthier lifestyle. These include:

  • Daily exercise
  • Limiting or stopping the use of caffeine
  • Eating a healthy, well-balanced diet
  • Stress management techniques – such as yoga or meditation

To decrease the occurrence of your anxiety in general, don’t miss your medication or any counseling sessions – even if you don’t feel like talking or feel “fine” and make sure you attend your regularly scheduled doctor’s appointments.

Last Updated: Oct 21, 2019

Anxiety Disorder Treatment Program Options

Anxiety is a normal reaction to various stress factors, helping an individual cope with dangerous or demanding situations; however, when this reaction gets out of control, it may turn into an anxiety disorder. Anxiety disorder is a condition that causes the sufferer to experience uneasiness at things that usually seem ordinary to other people but can negatively affect an individual’s ability to function normally in everyday situations. According to the National Institutes of Health (NIH), yearly, about 40 million Americans ages 18 or older suffer from various anxiety disorders, which is roughly 18 percent of the US adult population. If you suspect that you or someone you know may have an anxiety problem, call to find out how you can get treatment.

What Causes Anxiety Disorders?

Anxiety disorder can be linked to a person’s neurotransmitters being out of balance. This neurological state is usually accompanied by a general worsening of the person’s sense of well-being. The condition may also impede upon the sufferer’s ability to relax, exacerbating the symptoms of anxiety. Although anxiety disorder cannot be traced back to a single cause, several physical and mental conditions can be linked to it. An anxiety disorder could be the result of one or more of the following factors:

  • Stress
  • Phobias
  • Drug use
  • Financial problems
  • Panic disorder
  • Relationship issues
  • Physical conditions such as heart attack or heat stroke

Sometimes, an anxiety problem could be a symptom of a broader medical condition. For example, someone with emphysema may go through periods where they suffer from a lack of oxygen. The body responds to this lack of oxygen with panic, which could ultimately lead to a full-blown anxiety disorder.

Is There a Cure for Anxiety?

No actual cure for anxiety exists, but a study of university students showed that preventive measures could help avert depression and anxiety disorders in students who are at risk for these two conditions. A control group was put on a cognitive behavioral therapy program, while another group underwent no therapy. Both groups had their progress followed for a full three years. At the end of the experiment, the first group showed significantly fewer anxiety symptoms than the second group.

Therapies for Anxiety Disorders

Abnormal anxiety affects a significant portion of the population, but the good news is that many treatments are available to help. Depending on the specific cause of the anxiety disorder as well as on the patient’s preferences, the treatment method may include behavioral therapy, physical therapy, counseling and medications. As a rule, the treatment is aimed at reducing the symptoms related to anxiety and assisting patients in getting back to normal life.

According to the Anxiety and Depression Association of America, one in eight children is affected by an anxiety disorder. Your child doesn’t need to suffer alone anymore. If you think your son or daughter has an anxiety disorder, find out more about treatment options by calling .

Cognitive Behavioral Therapy Treatment for Anxiety Disorders

Cognitive behavioral therapy (CBT) is one of the most common therapies available for those who suffer from anxiety disorders. During CBT, the patient learns about what exactly triggers anxiety and how to avoid or respond to those triggers. Emphasis is put on how a patient thinks about anxiety and how to avoid or cope with anxiety-triggering situations through various behavior-modifying techniques. Statistics indicate that it is a highly effective therapy, with some patients seeing results in as little as 12 to 16 weeks.

Exposure Therapy for Treating Anxiety Disorders

Exposure therapy involves a controlled environment in which patients are gradually exposed to situations that would normally cause anxiety in them. The purpose is to slowly desensitize them to those triggering situations until those triggers become manageable, or completely eliminated. As a result, the patient has less panic or fewer anxiety attacks over time.

Other Therapeutic Methods

Though CBT and exposure therapy are fairly common, other methods of treatment aimed at lessening the symptoms of anxiety are also available. In some cases, a doctor may use more than one type of therapy, which may also depend on the patient’s age.

Relaxation techniques are often used to treat anxiety disorder. These may include such methods as breathing techniques and acupuncture. They can alleviate or even eliminate the symptoms by either controlling the anxiety or stopping it before it happens.

Residential Inpatient Anxiety Disorder Treatment Centers

Though some patients with an anxiety disorder seek outpatient treatment, while others prefer to get treated in an inpatient center. Treatment in a residential center has many advantages, including a stable environment in which patients can fully focus on their recovery without any distractions from the outside world getting in their way. The emotional stability and safety that an inpatient treatment center provides can be crucial to the success of the overall treatment.

The Benefits of Residential Anxiety Treatments

A residential treatment center can provide a patient with multiple therapy types all in one place, instead of forcing the patient to seek treatment in a variety of places. For example, patients can receive CBT, psychotherapy and exposure treatment all in the same treatment facility. This makes receiving all their treatments faster and easier than receiving them on an outpatient basis.

Patients who go to a center for treatment may also get other benefits. In a residential center, a dietitian can help you become healthier physically if your anxiety disorder is accompanied by physical symptoms such stomach problems. You may also get to meet others who have the same emotional concerns as you, and these people can provide advice and friendship. Many facilities also provide recreational activities that you may find enjoyable. When treatment is over, many facilities provide a plan to help you transition from inpatient to outpatient treatment, which may help you avoid anxiety over leaving the facility.

Luxury Anxiety Disorder Facilities

Not all anxiety disorder treatment facilities are created equal. While some have very basic amenities, others are quite luxurious. If you are used to having high-end amenities at your disposal, you won’t have to give them up in order to check into a treatment center. Some amenities at these luxury facilities include gourmet chefs, private rooms, access to private facilities for family counseling, spa treatments and more. Some facilities have both basic facilities and special rooms set aside for patients in their luxury programs. To find out which treatment facilities near you have luxury rooms, call .

Executive Anxiety Disorder Programs

The business world can be brutal, so anxiety often runs high among executives, particularly those from large companies. If an executive is in need of inpatient anxiety treatment, they can enroll in a special executive treatment center. There, they can receive treatment together with likeminded individuals who know how tough it is to be an executive in the stressful workplace environment. The program is often tailored to the specific stresses an executive faces, which may trigger their anxiety disorder.

Outpatient Anxiety Rehab and Treatment Programs

An outpatient program will include treatment options similar to those offered in an inpatient facility, except the patient will not stay overnight. As a rule, you will go to the treatment facility and meet with your doctors and other medical professionals early in the morning. You will go to your therapy appointments during the day and then return home in the afternoon or evening.

Prescription and Over-the-Counter Medications

It is estimated that anxiety disorders cost a whopping $42 billion per year in healthcare expenses in the United States alone, with a significant portion of this money being used for therapy and drugs. Several drugs may be used individually or in combination with other drugs or therapies to help combat the symptoms of an anxiety disorder.

Antidepressants may be used if the patient has an anxiety disorder but also shows symptoms of depression. These medications can help the patient achieve an overall sense of well-being, which can also help alleviate some anxiety symptoms. Anti-anxiety drugs, which are also sometimes called anxiolytics, may also be prescribed. These work to help balance the neurotransmitters in the brain that may be off balance and that are usually responsible for triggering an anxiety episode.

Beta-blockers are another type of drug commonly used for the treatment of anxiety. Unlike antidepressants or anti-anxiety drugs, these work primarily on the physical symptoms that often accompany anxiety, such as headaches, chest pain or muscle pain. They are sometimes prescribed in conjunction with other drugs, so the patient can get help for both the mental and physical symptoms.

It’s important to note that none of these medications, taken either alone or in conjunction with one another, will cure an anxiety disorder. However, they can help you successfully control your anxiety and have a normal life when used in conjunction with therapy. If you believe someone you love suffers from an anxiety disorder, call to find out how to help.

How to Find the Best Anxiety Disorder Treatment Facility

No facility for anxiety treatment will be right for everyone. Some individuals require basic facilities, while others desire more luxurious settings. Some patients want to go to a center located near their homes, while others would prefer to travel further away in order to get the help they need. To ascertain which facility is best for you, it is good to sit down and evaluate your exact needs. Start by making a list of everything you may want and need in a treatment facility. For example, consider whether you have a food allergy or are following a special diet. Some facilities may not be able to provide a peanut-free or vegan menu for you, while others will be able to address these specific requirements.

Once you have made a list, you can simply call to find out which residential treatment center can cover all your needs. Talking about your anxiety disorder with someone else may not be easy, because of the very nature of this condition, but suffering in silence shouldn’t go on. Our friendly operators are here to help you put your fears aside and reach out for help. You’ll have all your questions answered, so you’ll know what to expect before you check into your chosen center, giving you the confidence needed to conquer your fears and get your anxiety under control.

Anxiety Treatments: Know Your Options

Anxiety disorders can have multiple potential causes and co-existing conditions, so there is no single remedy that works for all of them. Anxiety treatment must be tailored specifically for each individual; what works well for one person may not work for another. Understand your options – and then work with your doctor or therapist to determine the course of action that is best for you.

Professional Therapy

The treatment options listed below require the assistance of mental health or medical providers or other licensed professionals.

  • Cognitive behavioral therapy: CBT focuses on identifying, understanding, and changing thinking and behavior patterns related to anxiety in regular meetings with a licensed, CBT-trained therapist. Therapists who practice CBT may use interpersonal therapy (IPT) to help their clients develop coping skills, encourage them to record their thoughts throughout the week as they occur, and attempt exposure therapy if appropriate for their disorder (read more below).
  • Dialectical behavioral therapy: DBT is a specific type of CBT. The term “dialectics” refers to a philosophical practice of examining multiple or often contradictory ideas, combining acceptance and change simultaneously. For example, a patient can accept where she is in her life and also feel motivated to improve it. DBT places an emphasis on mindfulness, enabling people to recognize and attempt to understand thoughts as they occur.
  • Exposure Therapy: As this term suggests, exposure therapy gradually exposes an individual to the feared situation in a safe, controlled environment. Eliminating the actual fear is the ultimate goal. Practitioners begin by having the patient repeatedly imagine the feared situation or object and potential responses to it. Often used in treating OCD, phobias, and PTSD, this therapy may incorporate virtual reality or computer simulations to create a more realistic yet completely safe method of exposure.
  • Group Therapy: The phrase “group therapy” describes a few therapeutic environments6 with participants beyond a single patient and provider. In addition to normalizing an individual’s experience by relating to others, group therapy may offer an alternative for those who are unable to afford one-on-one therapy. Peer support groups offer an opportunity to share experiences and offer advice. In addition to fostering relationships between people with similar struggles, participating in a support group validates the shared experience of anxiety. A process group may be a good fit for people with social anxiety or generalized anxiety disorder (GAD). The theory behind these groups is that, as you develop friendships with others in the group, over time the sources of anxiety will emerge and can be addressed.
  • Hypnosis: Hypnotherapists may be doctors, therapists, psychologists, social workers, nurses, or other licensed professionals. Hypnosis 7 helps people achieve a very relaxed state through breathing, guided imagery, or muscle-relaxing techniques and make them more amenable to suggestions. The hypnotherapist may use imagery or simple verbal suggestions to reduce the severity of anxiety symptoms. Some people may see positive results after one or two sessions. If hypnosis shows promising results, a hypnotherapist may also teach ways to practice self-hypnosis.

Prescription Medications

The medications described below can be obtained only with a prescription. Primary care physicians can diagnose and treat anxiety, but they may recommend that you consult a psychiatrist for severe or treatment-resistant anxiety disorders.

What is most commonly prescribed for anxiety?

  • SSRIs and SNRIs: These two classes were initially prescribed as antidepressants but, more recently, research has found that they might help with anxiety as well. They were named based on how they work in the brain: selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). To understand these, some terms need to be defined. First, a neurotransmitter is like a messenger or a runner in a relay race; when an impulse affects a nerve fiber, that fiber then releases a substance (i.e., the neurotransmitter) that will transfer the message to the next stop along the path, which ultimately leads to a muscle, gland, or other target cells.
    Serotonin is a chemical that acts as a neurotransmitter, carrying signals along and between nerves—and it also plays a role in mood regulation, which is helpful for someone with anxiety. SSRIs block certain nerve cells in the brain from reabsorption, or reuptake, which leaves more serotonin available. SSRIs include fluoxetine, fluvoxamine, sertraline, citalopram, paroxetine, and escitalopram. Brand names associated with SSRIs include Paxil, Prozac, and Zoloft. SSRIs may be used to treat post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder, social anxiety disorder (SAD), and obsessive-compulsive disorder (OCD).
    SNRIs increase the levels of serotonin and norepinephrine (a chemical also known as a stress hormone) by inhibiting their reabsorption into brain cells. SNRIs include venlafaxine, milnacipran, desvenlafaxine, levomilnacipran, and duloxetine. Cymbalta and Effexor are examples of SNRI brand names. A physician may prescribe SNRIs for patients with GAD, SAD, or panic disorder.
  • Benzodiazepines: These drugs work on the GABA (gamma-aminobutyric acid) neurotransmitter, which plays numerous roles related to sleep, relaxation, anxiety, mood changes, and memory. Although benzodiazepines are typically fast-acting, they also tend to be habit-forming, so doctors usually try other medications first, especially in their patients with a history of addiction. Among the benzodiazepines that may be prescribed for the treatment of anxiety are lorazepam, clonazepam, and diazepam. Some of the brand names are Xanax, Librium, Valium, and Ativan. Individuals who suffer from panic disorder, SAD, or GAD may be prescribed benzodiazepines as part of their treatment plan.
  • Beta Blockers: This class of drugs blocks the binding of epinephrine (also known as the hormone adrenaline) and norepinephrine to nerve receptors. Typically used to treat cardiac conditions, beta-blockers like atenolol and propranolol1 may be prescribed to a patient with social anxiety disorder specifically in performance situations, such as speaking in public, rather than as a long-term treatment. Brand name beta-blockers include Inderal, Tenormin, and Lopressor. Beta-blockers are usually only used to treat infrequent, performance-related episodes of social anxiety.
  • Off-Label and Other Drugs: A physician may prescribe other types of medications, such as a tricyclic antidepressant (imipramine); a monoamine oxidase inhibitor, or MAO inhibitor; an anxiolytic (buspirone); or others that work via different mechanisms, such as mirtazapine. Currently, ketamine2 is receiving increased scholarly interest as a potential treatment for depression3 and anxiety; the FDA gave it priority status4 as a treatment for depression, and some physicians have been using it as an off-label5 treatment for anxiety.
    A doctor may also consider an off-label use of a drug specified by the Food and Drug Administration (FDA) as effective for a condition other than an anxiety disorder or one that is approved outside the United States.

Brain Stimulation Therapies

These procedures target the regions of the brain that influence stress, anxiety, mood, and fear response.

How do you treat anxiety without medication?

  • DBS: Deep brain stimulation is a procedure8 that involves implanting an electrode in the brain. In the same way that a pacemaker delivers an electrical current to the heart to keep it beating as it should, the electrode helps regulate the patient’s mood. Because it is an invasive procedure, DBS has typically been reserved for severe, treatment-resistant obsessive-compulsive disorder (OCD). Although still in the initial stages of research, DBS may also be an effective treatment for PTSD9.
  • rTMS: Most researched for OCD, repetitive transcranial magnetic stimulation delivers magnetic field pulses to the brain via an electrode10 placed on the patient’s scalp. rTMS is increasingly being considered and studied11 as a treatment for other anxiety disorders including panic disorder, PTSD, and social anxiety disorder.
  • Vagus Nerve Stimulation: Because the vagus nerve is connected to many areas of the brain, it has been studied as a way to indirectly deliver impulses to deeper areas without being as invasive as brain surgery. Although in an early stage of research, vagus nerve stimulation shows promise for refractory cases of PTSD, panic disorder, and OCD12.
  • Other Brain Stimulation Therapies: Additional therapies include transcranial direct current stimulation (tDCS), transcranial electrical stimulation (tES), and electroconvulsive therapy (ECT). Because anxiety-specific studies on these procedures are scarce, they are not considered first-line treatments for anxiety disorders; however, ongoing research suggests that these may provide further options for treating generalized anxiety disorder, OCD, PTSD, and social anxiety disorder.

Self-Help

For those who seek alternatives to traditional medicine or would like to supplement their treatment, self-help and complementary and alternative medicine (CAM) may be useful.

How can I treat anxiety naturally?

  • Self-Help: Many self-help books and materials (DVDs, CDs) are available. Before investing in these, consider the background and credentials of the author or producer, as well as the credibility of the publisher. Ask your mental health care or primary care provider for recommendations, check reputable websites13, or consult trusted family and friends.
  • Exercise: When you pick up the pace physically, your body releases endorphins, which are hormones that can improve your mood. Activities that require concentration, such as catching a ball or following an aerobics routine, also keep your brain occupied. Replacing negative thoughts with neutral or positive ones can help calm you down. And exercise may increase confidence and personal satisfaction as you begin to accomplish your goals and overcome challenges.
  • Diet and Nutrition: Some research suggests an association between nutrient deficiencies and different manifestations of anxiety. For example, zinc deficiency may have a relationship to panic disorder14 and OCD. Other deficiencies that may contribute to anxiety are magnesium15 and vitamins D, B6, and B12. Your doctor will likely order a blood test if a deficiency is suspected.
    The nutrients L-theanine16 and tryptophan may help decrease anxiety if added to your diet. What vitamin is good for anxiety? Ongoing research seeks to determine whether vitamin E, omega 3 polyunsaturated fatty acids, glycine, and inositol supplements could have protective or other anti-anxiety benefits.
    Using diet to manage anxiety may also require avoiding or moderating some foods and beverages. A study in 2005 found that the preservative sodium benzoate, found in jelly, soda, and other products, contributes to anxiety. There is also some evidence that links age and high-cholesterol to anxiety. Because of their stimulating effects — which can increase anxiety— sugar and caffeine should be consumed in moderation. In addition to all of the anxiety-exacerbating problems that can come with drinking too much, alcohol is a diuretic that can speed up the loss of valuable nutrients17.
  • Meditation and Mindfulness: Although separate concepts, meditation and mindfulness are often practiced together, especially for the treatment of anxiety. Both focus on thoughts that drive anxiety for many people. Meditation is a conscious practice of focusing your thoughts in one specific direction, redirecting them when they begin to wander. It is usually best practiced in an environment without sensory distractions such as crying babies, barking dogs, cold temperatures, pungent odors, or uncomfortable furniture. Many consider mindfulness a subcategory of meditation. It keeps your thoughts focused on the present moment, even if they wander. For example, you might notice muscle tension in your shoulders, then the sound of the clock ticking and the pattern of your breathing. In practicing mindfulness, it’s important that you recognize your own experiences without casting judgment.
  • Relaxation Techniques: Many methods help people relax, including guided imagery (listening to a script to visualize calm environments) and breathing exercises for slowing the heart rate and focusing thoughts. Another method, progressive muscle relaxation, involves tensing and releasing different muscle groups throughout the body. During this process, note positive sensations and decreased stress with every release. Other relaxation techniques include massage, tai chi, yoga, reiki18 or other healing touch therapies, and music and art therapy or similar creative outlets.
  • Herbal Supplements: Scientific research on herbal supplements as anxiety treatments have been limited and inconclusive. Using supplements as a complementary or alternative treatment must be done with great caution. Before taking any herbal supplement, discuss it with your doctor to minimize the chance of an adverse drug interaction or side effect. Read more about Natural supplements for anxiety.
    Of supplements marketed for anxiety, chamomile19 and kava20 have shown some promise. Studies of passionflower21 have shown mixed results or were tested only in small groups of people. No studies have reported benefits of using St. John’s Wort to treat anxiety. In fact, if you have been prescribed an SSRI or SNRI, adding St. John’s Wort can cause a potentially life-threatening condition known as serotonin syndrome. The research on lavender oil, lemongrass, bacopa monnieri, and other herbs is ongoing; there simply is not enough information to know whether they can treat anxiety, work better than a placebo, and most importantly if they are safe to use at all.

Unless you experience adverse side effects, don’t be too quick to abandon treatment because it doesn’t provide instantaneous results. Weeks may pass before you detect improvement. Discuss all side effects with your mental health provider; it’s often worth sticking with treatment and seeking out ways to reduce or eliminate any negative side effects. Importantly, never stop taking medication without consulting your doctor first because an abrupt stop may cause other health problems.

Beyond Worry:

Everyone worries or feels nervous from time to time. Anxiety is a normal human reaction to stressful situations. But for people with anxiety disorders, those fears and worries aren’t temporary. Their anxiety persists, and can even get worse over time.

Anxiety disorders can severely impair a person’s ability to function at work, school and in social situations. Anxiety can also interfere with a person’s relationships with family members and friends. Fortunately, though, there are effective treatments for anxiety.

In some cases, medications have a role in treating anxiety disorders. Yet research shows behavioral treatment, alone or in combination with medication, is a highly effective treatment for most people with an anxiety disorder.

Understanding Anxiety

Anxiety disorders are common in both adults and children. About 18 percent of U.S. adults and 25 percent of adolescents age 13 to 18 will experience anxiety, according to the National Institute of Mental Health. About 4 percent of adults, and nearly 6 percent of teens, have anxiety disorders classified as severe.

There are several major types of anxiety disorders:

  • Generalized anxiety disorder is characterized by persistent worry or anxious feelings. People with this disorder worry about a number of concerns, such as health problems or finances, and may have a general sense that something bad is going to happen. Symptoms include restlessness, irritability, muscle tension, difficulty concentrating, sleep problems and generally feeling on edge.
  • Panic disorder is marked by recurrent panic attacks that include symptoms such as sweating, trembling, shortness of breath or a feeling of choking, a pounding heart or rapid heart rate, and feelings of dread. Such attacks often happen suddenly, without warning. People who experience panic attacks often become fearful about when the next episode will occur, which can cause them to change or restrict their normal activities.
  • Phobias are intense fears about certain objects (spiders or snakes, for instance) or situations (such as flying in airplanes) that are distressing or intrusive.
  • Social anxiety disorder is also known as social phobia. People with this disorder are fearful of social situations in which they might feel embarrassed or judged. They typically feel nervous spending time in social settings, feel self-conscious in front of others, and worry about being rejected by or offending others. Other common symptoms include having a hard time making friends, avoiding social situations, worrying for days before a social event and feeling shaky, sweaty or nauseous when spending time in a social setting.
  • Obsessive-compulsive disorder is characterized by persistent, uncontrollable feelings and thoughts (obsessions) and routines or rituals (compulsions). Some common examples include compulsive hand washing in response to a fear of germs, or repeatedly checking work for errors.
  • Post-traumatic stress disorder (PTSD) can develop after a severe physical or emotional trauma such as a natural disaster, serious accident or crime. Symptoms include flashbacks of the trauma, nightmares and frightening thoughts that interfere with a person’s everyday routine for months or years after the traumatic experience.

Seeing a Psychologist About Anxiety Disorders

Though many types of anxiety disorders exist, research suggests that most are driven by similar underlying processes. People with anxiety disorders tend to become easily overwhelmed by their emotions, and they tend to have particularly negative reactions to those unpleasant feelings and situations.

Often, people try to cope with those negative reactions by avoiding situations or experiences that make them anxious. Unfortunately, avoidance can backfire and actually feed the anxiety.

Psychologists are trained in diagnosing anxiety disorders and teaching patients healthier, more effective ways to cope. A form of psychotherapy known as cognitive-behavioral therapy (CBT) is highly effective at treating anxiety disorders. Through CBT, psychologists help patients learn to identify and manage the factors that contribute to their anxiety.

Through the cognitive component of therapy, patients learn to understand how their thoughts contribute to their anxiety symptoms. By learning to change those thought patterns, they can reduce the likelihood and intensity of anxiety symptoms.

With the behavioral component, patients learn techniques to reduce undesired behaviors associated with anxiety disorders. Specifically, patients are encouraged to approach activities and situations that provoke anxiety (such as public speaking or being in an enclosed space) to learn that their feared outcomes (such as losing their train of thought or having a panic attack) are unlikely.

Psychotherapy for Anxiety Disorders: What to Expect

Psychotherapy is a collaborative process, where psychologists and patients work together to identify specific concerns and develop concrete skills and techniques for coping with anxiety. Patients can expect to practice their new skills outside of sessions to manage anxiety in situations that might make them uncomfortable. However, psychologists won’t push patients into such scenarios until they’re sure they have the skills they need to effectively confront their fears.

Psychologists sometimes use other approaches to treat anxiety disorders in addition to CBT. Group psychotherapy, which typically involves several people who all have anxiety disorders, can be effective for both treating anxiety and providing patients with support. Family psychotherapy can help family members understand their loved one’s anxiety, and help them learn ways to interact that do not reinforce anxious habits. Family therapy can be particularly helpful for children and adolescents suffering from anxiety disorders.

Anxiety disorders are very treatable. The majority of patients who suffer from anxiety are able to reduce or eliminate symptoms after several (or fewer) months of psychotherapy, and many patients notice improvement after just a few sessions.

Psychologists are highly trained and will tailor a treatment plan to address the unique needs of each patient. To find a licensed psychologist in your area, visit Psychologist Locator.

The American Psychological Association gratefully acknowledges Shannon Sauer-Zavala, PhD, Lynn Bufka, PhD, and C. Vaile Wright, PhD, for contributing to this fact sheet.

Published October 2016

Treating anxiety without medication

Image: iStock

If you suffer from anxiety, the constant, nagging feelings of worry can be troubling and hard to control. These feelings are usually intense and out of proportion to the actual troubles and dangers in your everyday life. They can make it hard to function at home, at work, or in social situations.

Anxiety can be treated with medication, but several mind-body approaches may also be effective.

Hypnosis is sometimes used along with cognitive behavioral therapy to treat anxiety. It can help people focus their attention, rethink problems, relax, and respond to helpful suggestions. Hypnosis relies mainly on your ability to concentrate and on the trust you have in the therapist. If you are interested in hypnosis, discuss it first with your psychiatrist or psychologist. She or he can help you find a qualified practitioner.

Biofeedback measures specific body functions, such as heartbeat or breathing, and feeds this information back to you in the form of sounds or lights. This can help you become aware of your body’s responses and learn to control them using relaxation and cognitive techniques. You can practice different relaxation techniques while attached to biofeedback equipment and get immediate sensory input about which techniques produce the desired results, such as slowing the heart rate or relaxing tense muscles. The hope is that this extra feedback helps people find — and refine — techniques that can calm the body and reduce anxiety.

Other relaxation techniques that may ease anxiety include deep (diaphragmatic) breathing, visualization, and body scanning.

Deep breathing

To practice this technique, begin by finding a comfortable, quiet place to sit or lie down. Start by observing your breath. First, take a normal breath. Now try taking a slow, deep breath. The air coming in through your nose should feel as though it moves downward into your lower belly. Let your abdomen expand fully. Now breathe out through your mouth (or your nose, if that feels more natural). Alternate normal and deep breaths several times. Pay attention to how you feel when you inhale and exhale normally and when you breathe deeply. Shallow breathing often feels tense and constricted, while deep breathing produces relaxation.

Continue this for several minutes. Put one hand on your abdomen, just below your belly button. Feel your hand rise about an inch each time you inhale and fall about an inch each time you exhale. Your chest will rise slightly, too, in concert with your abdomen. Remember to relax your belly so that each inhalation expands it fully.

Try to practice this breathing technique for 15 to 20 minutes every day. You might also try shorter bouts lasting a few minutes when anxiety begins to build, to see if this feels calming.

To learn more about how to keep anxiety and phobias from interfering in your life, buy Coping with Anxiety and Stress Disorders, a Special Health Report from Harvard Medical School.

Disclaimer:
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Therapy for Anxiety Disorders

Want to control your anxiety, stop worrisome thoughts, and conquer your fears? Here’s how therapy can help.

Whether you’re suffering from panic attacks, obsessive thoughts, unrelenting worries, or an incapacitating phobia, it’s important to know that you don’t have to live with anxiety and fear. Treatment can help, and for many anxiety problems, therapy is often the most effective option. That’s because anxiety therapy—unlike anxiety medication—treats more than just the symptoms of the problem. Therapy can help you uncover the underlying causes of your worries and fears; learn how to relax; look at situations in new, less frightening ways; and develop better coping and problem-solving skills. Therapy gives you the tools to overcome anxiety and teaches you how to use them.

Anxiety disorders differ considerably, so therapy should be tailored to your specific symptoms and diagnosis. If you have obsessive-compulsive disorder (OCD), for example, your treatment will be different from someone who needs help for anxiety attacks. The length of therapy will also depend on the type and severity of your anxiety disorder. However, many anxiety therapies are relatively short-term. According to the American Psychological Association, many people improve significantly within 8 to 10 therapy sessions.

While many different types of therapy are used to treat anxiety, the leading approaches are cognitive behavioral therapy (CBT) and exposure therapy. Each anxiety therapy may be used alone, or combined with other types of therapy. Anxiety therapy may be conducted individually, or it may take place in a group of people with similar anxiety problems. But the goal is the same: to lower your anxiety levels, calm your mind, and overcome your fears.

Cognitive behavioral therapy (CBT) for anxiety

Cognitive behavioral therapy (CBT) is the most widely-used therapy for anxiety disorders. Research has shown it to be effective in the treatment of panic disorder, phobias, social anxiety disorder, and generalized anxiety disorder, among many other conditions.

CBT addresses negative patterns and distortions in the way we look at the world and ourselves. As the name suggests, this involves two main components:

Cognitive therapy examines how negative thoughts, or cognitions, contribute to anxiety.

Behavior therapy examines how you behave and react in situations that trigger anxiety.

The basic premise of CBT is that our thoughts—not external events—affect the way we feel. In other words, it’s not the situation you’re in that determines how you feel, but your perception of the situation. For example, imagine that you’ve just been invited to a big party. Consider three different ways of thinking about the invitation, and how those thoughts would affect your emotions.

Situation: A friend invites you to a big party

Thought #1: The party sounds like a lot of fun. I love going out and meeting new people!

Emotions: Happy, excited

Thought #2: Parties aren’t my thing. I’d much rather stay in and watch a movie.

Emotions: Neutral

Thought #3: I never know what to say or do at parties. I’ll make a fool of myself if I go.

Emotions: Anxious, sad

As you can see, the same event can lead to completely different emotions in different people. It all depends on our individual expectations, attitudes, and beliefs. For people with anxiety disorders, negative ways of thinking fuel the negative emotions of anxiety and fear. The goal of cognitive behavioral therapy for anxiety is to identify and correct these negative thoughts and beliefs. The idea is that if you change the way you think, you can change the way you feel.

Thought challenging in CBT for anxiety

Thought challenging—also known as cognitive restructuring—is a process in which you challenge the negative thinking patterns that contribute to your anxiety, replacing them with more positive, realistic thoughts. This involves three steps:

  1. Identifying your negative thoughts. With anxiety disorders, situations are perceived as more dangerous than they really are. To someone with a germ phobia, for example, shaking another person’s hand can seem life threatening. Although you may easily see that this is an irrational fear, identifying your own irrational, scary thoughts can be very difficult. One strategy is to ask yourself what you were thinking when you started feeling anxious. Your therapist will help you with this step.
  2. Challenging your negative thoughts. In the second step, your therapist will teach you how to evaluate your anxiety-provoking thoughts. This involves questioning the evidence for your frightening thoughts, analyzing unhelpful beliefs, and testing out the reality of negative predictions. Strategies for challenging negative thoughts include conducting experiments, weighing the pros and cons of worrying or avoiding the thing you fear, and determining the realistic chances that what you’re anxious about will actually happen.
  3. Replacing negative thoughts with realistic thoughts. Once you’ve identified
    the irrational predictions and negative distortions in your anxious thoughts, you can replace them with new thoughts that are more accurate and positive. Your therapist may also help you come up with realistic, calming statements you can say to yourself when you’re facing or anticipating a situation that normally sends your anxiety levels soaring.

To understand how thought challenging works in cognitive behavioral therapy, consider the following example: Maria won’t take the subway because she’s afraid she’ll pass out, and then everyone will think she’s crazy. Her therapist has asked her to write down her negative thoughts, identify the errors—or cognitive distortions—in her thinking, and come up with a more rational interpretation. The results are below.

Challenging Negative Thoughts

Negative thought #1: What if I pass out on the subway?

Cognitive distortion: Predicting the worst

More realistic thought: I’ve never passed out before, so it’s unlikely that I will on the subway.

Negative thought #2: If I pass out, it will be terrible!

Cognitive distortion: Blowing things out of proportion

More realistic thought: If I faint, I’ll come to in a few moments. That’s not so terrible.

Negative thought #3: People will think I’m crazy.

Cognitive distortion: Jumping to conclusions

More realistic thought: People are more likely to be concerned if I’m okay.

Replacing negative thoughts with more realistic ones is easier said than done. Often, negative thoughts are part of a lifelong pattern of thinking. It takes practice to break the habit. That’s why cognitive behavioral therapy includes practicing on your own at home as well. CBT may also include:

Learning to recognize when you’re anxious and what that feels like in the body

Learning coping skills and relaxation techniques to counteract anxiety and panic

Confronting your fears (either in your imagination or in real life)

Exposure therapy for anxiety

Anxiety isn’t a pleasant sensation, so it’s only natural to avoid it if you can. One of the ways that people do this is by steering clear of the situations that make them anxious. If you have a fear of heights, you might drive three hours out of your way to avoid crossing a tall bridge. Or if the prospect of public speaking leaves your stomach in knots, you might skip your best friend’s wedding in order to avoid giving a toast. Aside from the inconvenience factor, the problem with avoiding your fears is that you never have the chance to overcome them. In fact, avoiding your fears often makes them stronger.

Exposure therapy, as the name suggests, exposes you to the situations or objects you fear. The idea is that through repeated exposures, you’ll feel an increasing sense of control over the situation and your anxiety will diminish. The exposure is done in one of two ways: Your therapist may ask you to imagine the scary situation, or you may confront it in real life. Exposure therapy may be used alone, or it may be conducted as part of cognitive behavioral therapy.

Systematic desensitization

Rather than facing your biggest fear right away, which can be traumatizing, exposure therapy usually starts with a situation that’s only mildly threatening and works up from there. This step-by-step approach is called systematic desensitization. Systematic desensitization allows you to gradually challenge your fears, build confidence, and master skills for controlling panic.

Facing a fear of flying

Step 1: Look at photos of planes.

Step 2: Watch a video of a plane in flight.

Step 3: Watch real planes take off.

Step 4: Book a plane ticket.

Step 5: Pack for your flight.

Step 6: Drive to the airport.

Step 7: Check in for your flight.

Step 8: Wait for boarding.

Step 9: Get on the plane.

Step 10: Take the flight.

Systematic desensitization involves three parts:

Learning relaxation skills. First, your therapist will teach you a relaxation technique, such as progressive muscle relaxation or deep breathing. You’ll practice in therapy and on your own at home. Once you start confronting your fears, you’ll use this relaxation technique to reduce your physical anxiety response (such as trembling and hyperventilating) and encourage relaxation.

Creating a step-by-step list. Next, you’ll create a list of 10 to 20 scary situations that progress toward your final goal. For example, if your final goal is to overcome your fear of flying, you might start by looking at photos of planes and end with taking an actual flight. Each step should be as specific as possible, with a clear, measurable objective.

Working through the steps. Under the guidance of your therapist, you’ll then begin to work through the list. The goal is to stay in each scary situation until your fears subside. That way, you’ll learn that the feelings won’t hurt you and they do go away. Every time the anxiety gets too intense, you will switch to the relaxation technique you learned. Once you’re relaxed again, you can turn your attention back to the situation. In this way, you will work through the steps until you’re able to complete each one without feeling overly distressed.

Complementary therapies for anxiety disorders

As you explore your anxiety disorder in therapy, you may also want to experiment with complementary therapies designed to bring your overall stress levels down and help you achieve emotional balance.

Exercise is a natural stress buster and anxiety reliever. Research shows that as little as 30 minutes of exercise three to five times a week can provide significant anxiety relief. To achieve the maximum benefit, aim for at least an hour of aerobic exercise on most days.

Relaxation techniques such as mindfulness meditation and progressive muscle relaxation, when practiced regularly, can reduce anxiety and increase feelings of emotional well-being.

Biofeedback uses sensors that measure specific physiological functions—such as heart rate, breathing, and muscle tension—to teach you to recognize your body’s anxiety response and learn how to control it using relaxation techniques.

Hypnosis is sometimes used in combination with CBT for anxiety. While you’re in a state of deep relaxation, the hypnotherapist uses different therapeutic techniques to help you face your fears and look at them in new ways.

Making anxiety therapy work for you

There is no quick fix for anxiety. Overcoming an anxiety disorder takes time and commitment. Therapy involves facing your fears rather than avoiding them, so sometimes you’ll feel worse before you get better. The important thing is to stick with treatment and follow your therapist’s advice. If you’re feeling discouraged with the pace of recovery, remember that therapy for anxiety is very effective in the long run. You’ll reap the benefits if you see it through.

You can also support your own anxiety therapy by making positive choices. Everything from your activity level to your social life affects anxiety. Set the stage for success by making a conscious decision to promote relaxation, vitality, and a positive mental outlook in your everyday life.

Learn about anxiety. In order to overcome anxiety, it’s important to understand the problem. That’s where education comes in. Education alone won’t cure an anxiety disorder, but it
will help you get the most out of therapy.

Cultivate your connections with other people. Loneliness and isolation set the stage for anxiety. Decrease your vulnerability by reaching out to others. Make it a point to see friends; join a self-help or support group; share your worries and concerns with a trusted loved one.

Adopt healthy lifestyle habits. Physical activity relieves tension and anxiety, so make time for regular exercise. Don’t use alcohol and drugs to cope with your symptoms, and try to avoid stimulants such as caffeine and nicotine, which can make anxiety worse.

Reduce stress in your life. Examine your life for stress, and look for ways to minimize it. Avoid people who make you anxious, say no to extra responsibilities, and make time for fun and relaxation in your daily schedule.

Then there are other issues that are closely related to anxiety, like obsessive-compulsive disorder, which involves intrusive thoughts and urges, and posttraumatic stress disorder, which happens when people have a prolonged stress response to harrowing situations.

These are just some of the various anxiety and anxiety-adjacent disorders out there. That these issues can present in myriad ways can make it even harder to know if what you’re experiencing is anxiety that could benefit from outside help.

“Some people feel they can control their anxiety, some feel it’s something they ‘should’ be able to manage, some feel shame, some fear they might be ‘crazy,’ and others downplay how much their anxiety is impacting them,” Reynolds says.

If anxiety interferes with your daily life—whatever that might look like to you—that’s reason enough to see a mental health professional.

“When your world starts to become limited because of anxiety, that is a good signal that it’s time to seek treatment,” Reynolds says. “What is it doing to your life, your relationships, your sleep, health, work, and ability to learn and pursue things that are important to you?”

This “functional impairment,” as Reynolds calls it, can show up in different ways in different people. Is anxiety making you avoid doing things with loved ones because you’re too nervous to go outside? Do you skip school or work out of fear of what people may think of you? Can you not get enough sleep because you’re up all night worrying about the next day? Is your anxiety over certain tasks, like paying bills, leading to procrastination so extreme it comes with consequences, like getting your lights turned off?

Keep tabs on whether you’re blowing up at people, too. Anger and irritability can sometimes be a sign of anxiety. “We often forget that fight or flight includes ‘fight,’” Reynolds says. “If you have a shorter fuse or are always on edge for triggers, it could be related to anxiety.”

So, too, could physical issues. “We think of ourselves as these disembodied heads floating around,” Reynolds says. “We forget that there is a big feedback loop between the nervous system and the body.” Every part of you, from your head to your stomach to your feet, has nerves to regulate important processes, which is why your sympathetic nervous system’s stress response can be so far-reaching. You even have an entire nervous system reserved for gastrointestinal function, known as your enteric nervous system, which may help explain why there’s such a between issues like irritable bowel syndrome and anxiety.

Constant fatigue can also kick in if your anxiety is in overdrive. “The physical reaction to anxiety, by nature, is supposed to be short-term. The body is supposed to come back down to baseline,” Duff says. “But a prolonged period of anxiety depletes your resources and exhausts you.”

“If your anxiety is bothering you and you are suffering, you deserve to get help,” Duff says. That’s true whether or not you think your anxiety is serious, whether or not you think you meet diagnostic criteria you read online, and whether or not your friends and family treat your anxiety with the weight it deserves. And if your anxiety is getting to the point where you’re worried for your safety, call 9-1-1 or the National Suicide Prevention Lifeline (it’s available 24 hours a day, seven days a week at 1-800-273-8255), or go to the emergency room, Reynolds says.

Seeing a therapist can be anxiety-inducing on its own, but it’s worth it. Here are a few ways to make it easier.

Knowing what to expect at your first therapy session may make the experience less scary. Although every professional is different, you’re likely to get a lot of questions at the first visit. Ultimately, your psychologist or therapist’s goal is to learn what troubles you’re having so that they can create a plan to help you build the skills you need to address your anxiety.

While it is true that there are some personality types more prone to being anxious, it’s absolutely not true that you have to always suffer from anxiety or that anxiety is a life sentence.

Support in the form of psychological talk therapies is now evidence-based (proven by research) to help reduce or even resolve your anxiety completely.

But how does therapy help anxiety? What does it really involve?

How does therapy help anxiety, exactly?

How can going to therapy (the very thought of which might leave you feeling even more anxious) actually make your anxiety any better?

It can help in the following ways:

1. You can finally admit the full extent of your anxiety.

By: Alfy

Anxiety, because of it’s illogical nature, can leave us feeling ashamed of what we are going through, meaning we can hide our suffering from friends and family – and even from ourselves.

Just speaking out loud the true extent of all that you’ve been suffering can feel a huge relief.

2. You can be fully understood.

A therapist will not make you feel silly or judge you for being anxious. To the contrary, they will take your anxiety very seriously, and know exactly what you are talking about.

And nothing you tell an experienced therapist will surprise them – they will have dealt with many similar cases before.

3. You get clarity on why you suffer anxiety.

Anxiety often feels so unconnected to what’s really going on around you it can be impossible to see how it all began and ‘why you’, so to speak.

A therapist is trained and skilled at helping you sift through your life experiences to understand just how you might have developed anxiety as a coping mechanism.

4. You gain fresh insight into your triggers.

Anxiety can be connected to certain triggers, especially when it comes to anxiety disorders such as social anxiety and obsessive compulsive disorder (OCD). A therapist can help you get really clear on what those triggers are.

You might find that you can catch and circumvent your anxiety faster than you realise if you learn to really pay attention to things like the subtle bodily sensations that come before an anxiety attack.

5. You find new and effective ways of handling your anxiety.

Anxiety is an awful, uncomfortable feeling for most people.

So when anxiety hits, we develop ways of trying to not feel it, which might provide short-term relief. Of course these exact ways of coping might be prolonging your anxiety, not helping it!

Therapy helps you see this, then helps you find other ways of managing your anxieties that are more adaptive and healthy and lead to you feeling better about yourself and your life.

6. You learn techniques to bring instant relief when anxiety hits.

By: Michael Pravin

Therapists are trained at teaching a range of techniques that combat anxiety, which can include things like:

  • body relaxation techniques
  • breathing techniques
  • visualisation techniques
  • mindfulness.

Cognitive behavioural therapy, the most common sort of therapy offered for anxiety, can also teach you ways to challenge your thoughts and test your behaviour.

But where’s the proof that therapy will help my anxiety?

There is a huge field of research around the effects of therapy on anxiety, with several dedicated charities working to further knowledge and evidence, such as Anxiety Research UK.

Cognitive behavioural therapy (CBT) in particular has been researched for its effects on anxiety and various anxiety disorders. One large scale overview of research on the affects of CBT on anxiety and anxiety orders looked at studies covering almost 1500 subjects and found CBT therapy consistently created an improvement for anxiety sufferers compared to placebo conditions.

Another form of therapy currently being researched for its affect on anxiety sufferers and showing positive results is mindfulness-based therapy. For example, a study at the University of Oxford found that out of 273 subjects there was a reported 58% reduction in anxiety levels.

What if I don’t seek help for my anxiety?

The decision is up for you.

It’s important, though, to not brush off your anxiety as no big deal. Yes, we all get anxious when life is challenging. But ongoing feelings of dread and panic that take over your life are serious.

Left untreated, persistent anxiety is a leading cause of serious depression, as well as a contributor to addictions like alcoholism and drug use.

If you are avoiding people, places or situations that make you anxious, or if anxiety is affecting your relationships and career, is it really worth ignoring it when help is readily available?

Do you have an experience of therapy for anxiety you’d like to share? Or a question you want answered? Use the comment box below.

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