Treatments for Anxiety Disorders

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Treatments for Anxiety Disorders Making Anxiety Treatment Work for You

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Mental health disorders don’t lend themselves to quick fixes, and anxiety is

no exception. Although some treatments, especially the fast-acting

benzodiazepines, can make you feel better almost overnight, this improvement

shouldn’t be mistaken for a cure. Anxiety is a chronic condition, which means

that symptoms tend to wax and wane. Often, when people seem to have recovered

from an anxiety disorder, the symptoms recur or another anxiety disorder

develops. This doesn’t mean that treatment or the individual has failed. It

simply means that you need to resume treatment (if you’ve stopped the one you

were on) or try a different one (if your current treatment has stopped working).

The nature of anxiety disorders can be frustrating, but there are several things

you can do to get the most from your treatment and reduce the chances of a

relapse. (For advice on helping a family member or friend with anxiety, see When

a Loved One Has Anxiety.)

Persisting with treatment

The most important thing you can do is to stay with your treatment for as long

as your doctor recommends. People often stop taking medication or attending

therapy sessions too soon. Some halt treatment because they start to feel better

and think they no longer need it. When symptoms return, they assume that the

treatment was ineffective. Others stop taking medication when they develop side

effects.

Whatever the reason, stopping medication or therapy too early reduces its

effectiveness and increases the chances of a recurrence. Ask beforehand how long

your treatment will last. If you experience unpleasant side effects, tell your

doctor at once. He or she can often minimize the side effects by prescribing a

different medication or offering other advice.

Treatments for Anxiety Disorders

3 Ways to Reduce Your Anxiety

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Learn to cope with stress: Reducing stress can help control symptoms of

anxiety. The National Institute of Mental Health reports that stress-management

techniques may even boost the effectiveness of therapy. There are many ways to

reduce stress, including meditation, massage, and muscle relaxation. Listening

to music and exercising are also effective stress-busters. Different methods

work well for different people. What’s important is that you find the method or

combination of methods that works for you—and that you use it regularly.

When anxiety is related to a traumatic event in the news, one of the most

important things you can do is tune it out. In the weeks following the terrorist

attacks on September 11, 2001, the media was saturated with replays and updates

of the tragedies. While the events naturally caused feelings of anxiety in many

people, dwelling on the news made some people feel helpless and extremely

fearful about the future. If an event dominates your thoughts or causes extreme

upset or panic, it’s time to turn off the TV and put down the newspaper.

Limiting exposure to traumatic news is especially important for children, who

have less experience with putting problems into perspective.

Avoid coffee and cigarettes: Smoking and caffeine can promote anxiety.

Research suggests that heavy cigarette smoking during adolescence increases the

risk for generalized anxiety disorder and panic disorder in early adulthood. The

mechanism may have less to do with nicotine’s effect on the nervous system than

with the damage done to the respiratory system. Smoking causes breathing

problems, which research suggests may play a role in anxiety. The theory is that

the brain misinterprets the smoker’s labored breathing and resulting lack of

oxygen as a threat of suffocation. The automatic physiological response is

heavier breathing and faster pumping by the heart. In people who are susceptible

to anxiety, the brain mistakes these responses as signs of panic.

With caffeine, on the other hand, it’s the stimulant effect that promotes

anxiety. Caffeine can set off a panic attack in someone prone to anxiety by

activating the sympathetic nervous system, which launches the body’s response to

stress or danger. Many psychiatrists recommend that their anxiety patients

eliminate, or at least minimize, their consumption of coffee and other

caffeinated beverages and foods. Also be aware that many over-the-counter

medications, including weight-loss aids and " daytime " cold medications, contain

caffeine.

Seek social support: Support from family members and from others with anxiety

disorders can improve the results of treatment. The National Institute of Mental

Health reports that many people with anxiety benefit from sharing their problems

and triumphs with others. Joining a support group can help by giving you a

regular opportunity to talk with people who understand. Talking with trusted

relatives, friends, and members of the clergy can be helpful, too. Chat groups

on the Internet also provide a forum in which to share concerns and decrease the

feelings of isolation that are common among people with anxiety. Just be

skeptical about the information you find on the Internet, unless it comes from

an established mental health organization. Also, use caution and common sense in

deciding how much personal information to reveal when chatting online. Remember

that chat rooms aren’t a substitute for therapy. If you’re looking for group

therapy, join a group run by a mental health

professional. Loneliness or inactivity can promote anxiety. Getting involved in

activities and developing new friendships can help.

Treatments for Anxiety Disorders

When a Loved One Has an Anxiety Disorder

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It's difficult to see a loved one distressed. But if someone you love has an

anxiety disorder, there are several things you can do to help:

Encourage a loved one to get treatment and stick with it. Remind the person

about taking medication and keeping therapy appointments.

Care for yourself. Being a caretaker is a difficult job. You may want to get

counseling or therapy for yourself. The support of a group of people who are

also caring for someone with anxiety can be invaluable. Several mental health

organizations sponsor such groups (see Resources) and provide information on

anxiety disorders and the latest treatments.

Offer emotional support. Your patience and love can make a huge difference.

Ask questions and listen carefully to the answers. Try not to judge or minimize

the other person's feelings, but offer hope. Suggest activities that you can do

together, such as seeing a movie or going for a walk. Keep in mind that it takes

time to get better.

How SSRIs Work Close Window When neurotransmitters

such as serotonin bind with receptors on a neighboring neuron, they carry the

impulse to the next cell. But in someone with an anxiety disorder, the cell

that released the serotonin may reabsorb it too quickly. As a result, there may

not be enough serotonin available to bind to the next cell and allow the signal

to pass. SSRIs slow the reuptake of serotonin, leaving more of this

neurotransmitter in the synapse. This permits it to work for a longer time,

improving the transmission of nerve impulses.

How Benzodiazepines Work Close Window

Benzodiazepines encourage calm by entering the brain quickly and binding the

receptors for the neurotransmitter gamma-aminobutyric acid (GABA). GABA reduces

brain activity. When benzodiazepines bind to GABA receptors, they enhance

GABA’s calming effects.

Medications for Anxiety Disorders

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Medications prescribed to treat anxiety disorders fall into two main

categories: antidepressants and antianxiety drugs. The latter term is a misnomer

because they are no longer the only kinds of drugs that have antianxiety

properties. In fact, antidepressants have become the first choice for many

anxiety disorders. Other types of medications, such as beta blockers and

sedatives, are also used for anxiety.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Dual Reuptake Inhibitor

Tricyclic Antidepressants (TCAs)

Monoamine Oxidase (MAO) Inhibitors

Benzodiazepines

Buspirone (BuSpar), Beta Blockers, and Sedatives

Medications for Anxiety Disorders

How SSRIs Work Close Window When neurotransmitters

such as serotonin bind with receptors on a neighboring neuron, they carry the

impulse to the next cell. But in someone with an anxiety disorder, the cell

that released the serotonin may reabsorb it too quickly. As a result, there may

not be enough serotonin available to bind to the next cell and allow the signal

to pass. SSRIs slow the reuptake of serotonin, leaving more of this

neurotransmitter in the synapse. This permits it to work for a longer time,

improving the transmission of nerve impulses.

How Benzodiazepines Work Close Window

Benzodiazepines encourage calm by entering the brain quickly and binding the

receptors for the neurotransmitter gamma-aminobutyric acid (GABA). GABA reduces

brain activity. When benzodiazepines bind to GABA receptors, they enhance

GABA’s calming effects.

Selective Serotonin Reuptake Inhibitors (SSRIs)

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This class of antidepressants became a first-line treatment for many anxiety

disorders during the 1990s. The serotonin system is active in many regions of

the brain, affecting anxiety, mood, arousal, impulses, and aggression. SSRIs

work by slowing the reuptake of serotonin, which means they prevent this

neurotransmitter from being quickly reabsorbed by the neurons that released it.

This prolongs the time that the serotonin can work at receptor sites. (See How

SSRIs Work ).) SSRIs also appear to change the number and sensitivity of

receptors and may indirectly influence other neurotransmitters that play a role

in anxiety, including norepinephrine and dopamine. (See Brain Cell

Communication.)

The main reason for the popularity of SSRIs is that they have fewer and less

severe side effects than do older medications for anxiety. SSRIs are prescribed

for generalized anxiety disorder, obsessive-compulsive disorder, social phobia,

panic disorder, and post-traumatic stress disorder. There are several kinds of

SSRIs, each having a slightly different mode of action.

Though they are usually well tolerated, SSRIs can have troublesome effects in

some people. They can cause sexual dysfunction, weight gain, and insomnia.

Sometimes they even temporarily heighten anxiety symptoms. Your doctor should

monitor you closely for this reaction and, if necessary, switch your medication.

SSRIs can also interact with certain antihistamines, anticonvulsants, or other

antidepressants. Reactions to SSRIs vary. What induces side effects in one

person may not cause any problems in another. Therefore, it may take some trial

and error to determine which medication is right for you.

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