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
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
- 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
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
- 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
- lorazepam (Ativan): used for
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
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:
(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.