Treatment and Prevention
Many psychological treatments can help with anxiety, but the most effective form of treatment is cognitive behavioral therapy (CBT). Medications are also effective, so many people use CBT along with medications to manage anxiety.
With CBT, irrational fears are challenged in a logical fashion. As a part of CBT, exposure therapy may be used and involves confronting the object of the fear. This may need to be done slowly. Exposure therapy works best for specific phobias (like fear of spiders or flying) that often don't respond to medications. Support groups may also be helpful for some people.
Medications that help control anxiety affect the three main chemical messengers involved with anxiety: serotonin, norepinephrine, and gamma-aminobutyric acid (GABA). Medications used may include serotonin reuptake inhibitors (SSRIs; e.g., fluoxetine*, paroxetine, escitalopram), serotonin-norepinephrine reuptake inhibitors (SNRIs; e.g., duloxetine, venlafaxine), and anti-anxiety medications such as benzodiazepines (e.g., lorazepam, alprazolam, clonazepam). For a small number of people, benzodiazepines can be habit-forming.
Other medications that can be used include tricyclic antidepressants (TCAs), such as clomipramine, monoamine oxidase inhibitors (MAOIs), and buspirone.
Many people with anxiety benefit from lifestyle modifications, including the following approaches:
- Reduce caffeine consumption.
- Reduce alcohol consumption.
- Reduce or stop smoking.
- Practice relaxation techniques (e.g., proper breathing, yoga, meditation).
- Eat a healthy diet, sleep well, and exercise regularly.
- Gain perspective by talking about your feelings with someone close or with a professional counselor.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
Paul Ballas, DO, Attending Psychiatrist, Friends Hospital, Philadelphia PA. Review provided by VeriMed Healthcare Network.