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How Can I Treat my Anxiety Disorder?

Anxiety disorders can be treated with a combination of pharmacological therapy and psychotherapy. Studies have shown that when used in combination versus alone, both of these treatments can have faster clinical outcomes with longer-lasting effects. The two classes of pharmacological therapy used to treat anxiety disorders are antidepressants and benzodiazepines. Psychotherapy used to treat anxiety disorders include cognitive behavioral therapy, cognitive therapy, and applied relaxation are well-known first-line therapy approaches.

Pharmacological treatment for anxiety

Antidepressant medication is the first-line pharmacological agent used to treat anxiety. Selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) are the most widely used antidepressant agents to treat anxiety. These medications work by increasing either serotonin or norepinephrine levels in the brain. These are neuronal hormones, formally called neurotransmitters that play a role in mood and anxiety. The following are a list of specific medications to treat anxiety disorders that fall into these medications classes:

Paroxetine (Paxil)-SSRI
Escitalopram (Lexapro)-SSRI
Sertraline (Zoloft)-SSRI
Fluoxetine (Prozac)-SSRI
Venlafaxine (Effexor)-SNRI
Duloxetine (Cymablta)-SNRI

Other pharmacological agents used as a second-line treatment for anxiety include benzodiazepines and buspirone, which is an agent used specifically for generalized anxiety disorder that falls into its own class. Benzodiazepines are commonly known as “nerve pills” or “anxiety pills” and are generally prescribed for short-term use in acute episodes because they are known to have a strong addiction potential. Benzodiazepines work on the same receptor in the brain as alcohol and therefore this class of medication should never be taken in combination with alcohol. The following are benzodiazepines that are used to treat anxiety when antidepressants are not effective or are contraindicated:

Alprazolam (Xanax)
Diazepam (Valium)
Lorazepam (Ativan)
Clonazepam (Klonapin)

Psychotherapy treatment approaches for anxiety disorder

Cognitive behavioral therapy (CBT) is one of the most commonly used and widely accepted psychotherapy treatments for anxiety disorder. This treatment modality uses a combination of interventions such as worry exposure, applied-relaxation, psychoeducation, cognitive re-structuring and problem-solving skills to educate the individual about their triggers and symptoms and then uses behavioral modifications in order to release their irrational thoughts and anxiety triggers.

Exposure therapy is a type of cognitive behavioral therapy in which the individual is exposed to the trigger or threat for a repeated number of times until the feared stimulus or response is eliminated. Exposing an individual to images of crowded malls or train stations who becomes anxious in congested spaces is an example of imaginal exposure therapy. Overtime this individual will become more comfortable with the image and will be able to venture into crowded spaces without having this unrealistic fear. A specific component of cognitive behavioral therapy (CBT) is cognitive therapy, which targets distorted, and inappropriate thoughts and perceptions and using approaches to restructure these thoughts into positive and constructive thoughts. Applied-relaxation is a technique used to teach patient coping skills to relax immediately in an anxiety-provoking environment. Newer forms of cognitive behavioral therapy (CBT) to treat anxiety that have been shown to be effective but are in still early stages of study are mindfulness and acceptance and commitment therapy (ACT).

Discovery Mood and Anxiety Program