By contacting a psychologist, those who suffer from an anxiety disorder can take the first step on the road to recovery. Different psychologists use different approaches to the treatment of anxiety and, as mentioned above, it may take some time before the most appropriate treatment or combination of treatments is found for the individual.
Cognitive-Behavioral Therapy (CBT): Cognitive-behavioral therapy (CBT) helps in changing the behaviors and thought processes of people with anxiety disorders. The cognitive part of CBT involves changing the thinking patterns that keep the person from overcoming the fear. Someone with panic disorder can learn to understand that they are not having a heart attack when they are having heart palpitations. People are taught to identify the thoughts and situations that stimulate their anxiety, and to view them more realistically. Over time, the individual is helped to change maladaptive thought patterns which contribute to the feelings of anxiety. The behavioral part is meant to change the person's behavior by exposing that person to very thing they fear in manageable, gradual stages until they are desensitized to it. For instance, someone with obsessive compulsive disorder with a fear of germs may be encouraged by a therapist to go a certain amount of time without washing. Doing this repeatedly along with counseling from the therapist eventually helps decrease the anxiety. Sometimes behavioral therapy is used without the component of cognitive therapy. This involves exposing the person to the object or situation that is feared. For these approaches to work, the patient must be ready. (A therapist can help them decide if they are.)
- Psychotherapy: Most people with anxiety disorders will be given some form of psychotherapy, sometimes accompanied by medication. Many people benefit from insight-oriented therapies, which are designed to help them uncover unconscious battles in order to understand how their symptoms developed in the first place. People who are extremely anxious may benefit from supportive psychotherapy, which aims at reducing the symptoms. It centers on the developmental aspects of anxiety disorders solely through talk therapy
- Behavioral Therapies: Behavioral therapies focus on using techniques such as guided imagery, relaxation training, progressive desensitization or flooding as means to reduce anxiety responses or eliminate specific phobias.
- Relaxation training, 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. The person may also be given a CD to continue the relaxation training at home. Both CBT and relaxation training can be used in group therapy as well as individual treatment. In addition to CBT, support groups are often helpful to anxious patients, because they provide a social network and lessen the embarrassment that often accompanies anxiety symptoms.
- Psychopharmacological Treatments: Medications are often prescribed to relieve the physical and psychological symptoms of anxiety. Most drugs work by counteracting the biochemical and muscular changes involved in the fight-or-flight reaction. Some work directly on the chemicals in the brain that are thought to underlie the anxiety.
- Benzodiazepines: (e.g. Klonopin, Ativan, Valium, Librium, Serax) can help to reduce the symptoms of an anxiety disorder. However, if used long term, dependency may develop, along with tolerance to the drug. With some benzodiazepines, dependency can develop very quickly – even after two or three weeks of use. Because of the development of tolerance to the drug, dosage might have to be increased over time in order to achieve the same effect. Once the person has become dependent on benzodiazepines, it can be difficult for them to stop taking it due to severe withdrawal symptoms. Benzodiazepine dependency is a major problem in the Western World and the use of benzodiazepines for more than a week or two should be considered as a last resort only – after all other interventions have failed. Remember that these drugs also increase the effects of alcohol and the two should never be taken in combination.
- Serotonergic Agents: newer antidepressants act as anti-anxiety agents as well. Unlike benzodiazepines which are faster acting, these drugs can take 4 to 6 weeks for full response. Examples are Luvox, Prozac, Zoloft and Paxil. Although manufacturers claim that they are not dependency forming, withdrawal symptoms when discontinuing these medications are widely reported, along with other side effects like weight gain and loss of libido.
- Tricyclic Antidepressants (TCAs): These are older antidepressants with more side effects typically than the serotonergic agents. They may also take 4 to 6 weeks for full response. Examples include Tofranil, Elavil, Pamelor and Sinequan.
- Combination Serotonin/Norepinephrine Agents: These include medications such as Effexor, Serzone, and Remeron. Response time is also 4 to 6 weeks.
- Antihistamines: Antihistamines, usually prescribed for allergies, were also used for mild to moderate anxiety for many years. These, like the benzodiazepines, work fairly quickly (Atarax, Vistaril), but may also cause drowsiness and other side effects.
- Buspirone (BuSpar): A new serotonergic combination agonist/antagonist. This medication claims to be non-addicting, but may take 2 to 4 weeks for full effect.
- Major Tranquilizers (also called neuroleptics): These are medications that act on a variety of neurotransmitter systems (acetylcholine, dopamine, histamine, adrenergic). Most are somewhat sedating, and have been used in situations where anxiety is severe enough to cause disorganization of thoughts and abnormal physical and mental sensations, such as the sense that things around you aren't real or that you are disconnected with your body (derealization). Commonly used neuroleptics include: Zyprexa, Risperdal, Seroquel, Mellaril, Thorazine, Stelazine, Moban, Navane, Prolixin, and Haldol.
If you have been diagnosed with an anxiety disorder, your healthcare professional may give you a beta-blocker for going into a situation where an attack may happen. The beta-blocker can keep your heart from pounding, your hands from shaking and other physical symptoms from developing.
Before taking medication for an anxiety disorder:
- Ask your healthcare professional to tell you about the effects and side effects, as well as the risk of dependency. Do not allow yourself to be brushed off with simple reassurances that there will be no problems. If you do not receive the information you need from your doctor, seek a second opinion, do your own research on the internet, or ask your pharmacist for a package insert. While drug therapy can be helpful, especially in the short term, many people later regret that they ever started it, finding themselves dependent on their medication as well as having to use a range of drugs to cope with the side effects that may develop.
- Tell your healthcare professional about any alternative therapies or over-the-counter medications you are using.
- Ask your healthcare professional when and how the medication will be stopped. Some drugs have to be tapered slowly under a doctor's care.
In today’s modern world, daily stresses and a fast-paced lifestyle can take its toll. Alternative treatments offer a natural alternative to prescription drugs (that often have serious side effects and that may prove very costly). Natural remedies for anxiety can include a variety of approaches.
Natural remedies for anxiety often provide the public with services not available from conventional medicine such as:
- Patient empowerment
- Alternative methods of pain management
- Treatment methods that support the systemic model of health
- Stress reduction services
- Other preventive health services that are not typically a part of conventional medicine
In alternative medicine, a holistic approach to healing recognizes that the emotional, mental, spiritual and physical elements of each person comprise a system that is greater than its individual parts. This approach attempts to treat the whole person, concentrating on the cause of the illness as well as symptoms.
Examples of such holistic therapies include Acupuncture, Ayurveda, Chinese medicine, Homeopathy, Indian Head Massage, Naturopathic medicine, Qi Gong, Reiki, and Reflexology. They usually do not originate from the western allopathic medical-scientific tradition.
Holistic Living may be defined as simple, spiritual, purposeful, peaceful and productive living with moderation in food intake, adequate exercise and positive thinking and attitude to life. Holistic Living is an art of living in harmony with nature and concern to the whole universe - using all that nature has to offer as a natural medicine chest!
Rather than treating problems in isolation, Naturopaths prefer to take a holistic look at the individual and encompass a variety of factors to include diet, lifestyle, personality type, surroundings and emotional elements – thereby supporting the health of the individual as a whole.
Natural remedies have been used in traditional medicine for thousands of years to support the healthy functioning of the body, helping to encourage normal and efficient functioning of all the body systems. In more recent times, research has confirmed this traditional wisdom. Natural remedies for anxiety can include herbs such as St John’s Wort. Clinical studies have demonstrated that this herb can be just as effective as prescription drugs, without the side effects.
Most conventional doctors are not trained in the use of alternative medicine and therefore do not encourage their patients to give it a trial. This means that the only option for the patient remains drug therapy. However, some conventional doctors, recognising the benefits to their patients, have begun to inform themselves about natural remedies and many are now helping their patients to seek alternatives to the prescription drugs.
Traditional Chinese medicine is a branch of naturopathy that originated in the East and has a long and esteemed history. Anxiety is seen as a symptom of a systemic disorder and Chinese medicine regards anxiety as a blockage of qi, or vital force, inside the patient's body. The practitioner of Chinese medicine chooses acupuncture point locations and/or herbal therapy to move the qi and rebalance the entire system in relation to the lung and large intestine.
Although malpractices on the part of some unscrupulous individuals has resulted in Chinese medicine falling into disrepute in some quarters, it is important to note that this ancient system of medicine has a long and reputable history and can be very helpful when correctly applied. Make sure that you buy Chinese medicinal herbs from reputable sources and companies and you should have no problems.
Homeopathic practitioners select a remedy based on other associated symptoms and the patient's general constitution and personality type. Homeopathy is a medical approach which operates on the principle of ‘Like treats Like’, using minute amounts of certain substances, prepared in a very unique way, to stimulate the body’s own healing forces.
Homeopathy can be very helpful in the treatment of anxiety disorders. Because the medicines used in homeopathy are present in such small quantities and because of the special methods of manufacturing these medications, side effects are almost unheard of and there is no risk of dependency.
Herbalists may use medicinal herbs from a range of countries, drawing on the natural medicine knowledge of indigenous people from India (Ayurvedic medicine), America, Africa, Australia and Europe. Many of these remedies come with thousands of years of traditional use. Once again, it is always important to source natural remedies from reputable companies who also offer backup and support to their customers.
Other holistic interventions may often be useful along with either conventional drugs or natural remedies. For example, meditation and mindfulness training have been found to be beneficial to individuals with phobias and panic disorder. Hydrotherapy is useful to some anxious patients because it promotes general relaxation of the nervous system. Yoga, aikido, t'ai chi, and dance therapy help people work with the physical, as well as the emotional, tensions that either promote anxiety or are created by the anxiety.
Talking with friends or someone from your religious or spiritual community also can help, although this is not a substitute for mental health care. The family is very important in the recovery of an anxiety disorder. Families should be supportive. If family members tend to trivialize the disorder or demand improvement without treatment, individuals suffering from anxiety and the related disorders may experience worse anxiety attack symptoms.
Managing stress and practicing meditation may help calm you and enhance treatment. Early research says heart-pumping exercise such as brisk walking or running may help. Caffeine, illegal drugs and even some over-the-counter cold medications can worsen an anxiety disorder.
Recovery depends on a number of factors such as:
• The specific disorder
• The severity of anxiety attack symptoms
• The specific causes of the anxiety
• The person's degree of control over these causes
• The patient's age, sex, general health, living situation, belief system, social support network, and responses to different medications and forms of therapy
Remember! According to the National Institutes of Mental Health, 90 percent of people with emotional illnesses will improve or recover if they get adequate treatment.
A number of techniques may help manage anxiety attack symptoms, such as:
- Relaxation techniques (meditation, listening to soothing music or having a hot aromatherapy foam bath)
- Breathing exercises
- Distraction (putting the anxiety out of one's mind by focusing thoughts on something else)
As humans, we have significant control over thoughts, and therefore, we can try to re-program our minds and learn ways of preventing anxiety by changing irrational ideas and beliefs.
- Picture yourself confronting your fears. Figure out what scares you and learn to respond differently.
- Change your attitude. Remind yourself that you are in control.
- Learn calming techniques.
- Practice. Place yourself in smaller, more manageable social situations.
- Tell people that you're nervous. This can help put you and others at ease.
- Read as much as you can about anxiety and ways of helping yourself. There are many excellent books written by professionals containing a wealth of information that can help you. Knowledge is power!