Anxiety is more than having sweaty palms and butterflies in your stomach. Symptoms of anxiety can include feelings ovf worry, fear and impending doom that are so severe they interfere with your ability to work, maintain relationships and get a decent night’s sleep.
Anxiety is like any other medical condition – you need ways to manage the anxiety and maintain a new level of comfortable stress (motivating, but not too challenging).
The great news…Anxiety disorders are the most treatable of all mental illnesses!
Medication and counselling are two very effective treatments for anxiety. Medications are typically prescribed by physicians and psychiatrists, while counselling is provided by mental health professionals (e.g., psychologists). Health care providers should be licensed to practice and trained to treat anxiety. Self-care and treatment/therapy recommendations between sessions should also be continued.
About Medication
If anxiety is severe and interferes with a person’s ability to function effectively, medication may be called for. Antidepressant medications (usually a class of medication called selective serotonin reuptake inhibitors “SSRI”) are often used to treat anxiety. Brand names may include, but are not limited to: Celexa®, Prozac®, Luvox®, Paxil®, Zoloft®, and Effexor ®. Not all antidepressants have official indications for the treatment of all anxiety disorders and sometimes it is a matter of trying different medications to determine the most effective kind and dose. Treatment usually starts at a much lower dose than for treating depression. Health care providers will prescribe the most suitable treatment medication, when necessary.
Anxiolytic medications (including benzodiazepines and buspirone) may help with acute anxiety or agitation or while other medications have not yet taken effect. However they are not commonly prescribed because of their potential for dependence.
Questions to Ask a Healthcare Provider
It is important to be educated about any medications that are taken for any illness, and it is no different for medications taken for anxiety. Here are some general questions that may be asked of a doctor or pharmacist:
- How long will it take before I feel better?
- How often, and how much, do I take?
- What are the possible side effects, if any, and what can I do to best manage them?
- What is the best-tolerated treatment for my particular situation?
- Will this medication interfere with other medication(s) or herbal remedies that I take?
- Do I have allergies to this medication?
- What should I do if I don’t feel better or if I miss a dose?
- Is there any written information I can get about this medication?
- Is there anything I should not do when taking this medication (e.g., operate heavy machinery, consume alcohol)?
If you don’t understand something about a medication, ask your doctor or pharmacist.
Cognitive Behavioural Therapy (CBT)
CBT an effective counselling method for treating anxiety and it can help to eliminate severe or mild levels of anxiety. Some of the techniques of CBT that are most helpful are relaxation techniques, gradual exposure to situations that trigger anxiety, problem-solving skills to deal with stressors, and challenging anxiety-provoking thoughts.
A large component of CBT is educational - learning the source of anxiety, recognizing that symptoms are not a sign of ill health, and realizing how avoidance of fearful situations prolongs anxiety.
If anxiety is complicated by other problems, like depression or substance abuse, treatment may involve a few more techniques and it may take a bit longer, but it can be effective.
Note: Ask questions and learn about treatment options. Regardless of the type of therapy chosen (medication and/or counselling), personal preferences and motivation will be important for success.
References:
- Bandelow B, et al. (2015). Efficacy of treatments for anxiety disorders: A meta-analysis. International Clinical Psychopharmacology. 30:183.
- Bystritsky A. Complementary and alternative treatments for anxiety symptoms and disorders: Herbs and medications. Retrieved September 29, 2018 from: https://www.uptodate.com/contents/search.
- Bystritsky A. Pharmacotherapy for generalized anxiety disorder in adults. Retrieved September 29, 2018 from: https://www.uptodate.com/contents/search.
- Craske M. Psychotherapy for generalized anxiety disorder in adults. Retrieved September 29, 2018 from: https://www.uptodate.com/contents/search.
- Craske M, et al. Approach to treating generalized anxiety disorder in adults. Retrieved September 29, 2018 from: https//:www.uptodate.com/contents/search.
- Help with anxiety disorders. American Psychiatric Association. Retrieved September 29, 2018 from: https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders.
- Reinhold JA, et al. (2015). Pharmacological treatment for generalized anxiety disorder in adults: An update. Expert Opinion in Pharmacotherapy. 16:1669.
- Stein MB, et al. (2017). Treating anxiety in 2017: Optimizing care to improve outcomes. Journal of the American Medical Association. 318:236.
