Anxiety Therapy and Integrated Strategies

Anxiety disorders affect millions worldwide, impacting daily functioning and overall well-being. While medications can help alleviate symptoms, therapy plays a role in providing comprehensive care. Explore how integrating therapy with medication management and therapeutic interventions like the Neuro Wellness Spa (NWS)Therapy Program can significantly improve outcomes for individuals struggling with anxiety.

Understanding Anxiety Disorders

Anxiety disorders rank among the most prevalent mental health issues, as reported by the World Health Organization (WHO), with over 300 million cases in 2019 [18]. In the United States, they top the list of mental illnesses, impacting approximately 40 million adults annually, representing about 18.1% of the population [3].

These disorders are characterized by intense fear and worry, often accompanied by physical tension and other challenging symptoms [18]. Such symptoms can significantly disrupt daily life and cause considerable distress. Despite the availability of effective treatments, only about 1 in 4 individuals with anxiety disorders seek help [18].

Symptoms of anxiety disorders vary but may include trouble concentrating, irritability, physical discomfort, and avoidant behavior. Left unmanaged, anxiety disorders can increase the risk of secondary depression, substance use disorder, or suicidal thoughts[18].

Anxiety disorders encompass a spectrum of conditions marked by excessive worry, fear, or nervousness, all of which can significantly impact daily functioning [14]. There are numerous types of anxiety disorders, each with its own set of distinct symptoms. Let’s explore some of the common types.

Types of Anxiety Disorders

Panic Disorder

Panic disorder involves recurrent, unexpected panic attacks characterized by a sudden surge of intense fear or discomfort, often accompanied by specific physical symptoms [5, 14]. These attacks, which can peak within minutes, may lead individuals to develop a fear of future episodes and avoid situations or places where attacks have occurred [14].

Panic attacks can strike without warning, with their frequency varying among individuals [5]. Diagnosis typically entails experiencing at least one panic attack followed by persistent concern about having more attacks or making behavioral changes to avoid associated situations [5].

Symptoms of Panic Disorder may include [5]:

  • Palpitations
  • Sweating
  • Trembling or shaking
  • Shortness of breath or feeling suffocated
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Dizziness, lightheadedness, or faintness
  • Chills or heat sensations
  • Numbness or tingling sensations
  • Derealization or depersonalization
  • Fear of losing control or going crazy
  • Fear of dying

Social Anxiety Disorder

Social Anxiety Disorder is a mental health condition marked by intense fear or anxiety regarding social situations, where individuals may feel judged, embarrassed, or scrutinized by others [14].

Individuals with social anxiety disorder commonly avoid social interactions or endure them with extreme distress, fearing negative evaluation or rejection [14]. This fear can substantially affect daily functioning and quality of life [14].

Symptoms of social anxiety disorder may include [14]:

  • Persistent fear of social situations
  • Avoidance of social activities or events
  • Intense anxiety or panic in social settings
  • Physical symptoms like sweating, trembling, or blushing
  • Fear of being judged or embarrassed in public.
  • Difficulty speaking or performing in front of others.
  • Anticipatory anxiety before social events

Separation Anxiety Disorder

Separation Anxiety Disorder (SAD) is one of the most common childhood anxiety disorders and is characterized by excessive anxiety when separated from caregivers or attachment figures beginning between 6 to 12 months with most children outgrowing it around age 3[9]. However, if SAD persists throughout childhood it can lead to attachment issues later in life [9].

Symptoms of Separation Anxiety Disorder may include [9]:

  • Recurrent distress during separation from home or attachment figures
  • Continuously worrying about losing the attachment figure(s) or harm befalling them.
  • Reluctance or refusal to attend school or work due to fear of separation.
  • Refusal to be alone in various settings.
  • Repeated nightmares about separation
  • Physical symptoms when separation is anticipated, such as headaches or stomach aches.

Generalized Anxiety Disorder (GAD):

Generalized Anxiety Disorder (GAD) is marked by excessive worry or anxiety about various aspects of life, including work, relationships, health, and everyday activities [14].

Individuals with GAD often struggle to control their worries and may experience physical symptoms of anxiety [14].

Symptoms of generalized anxiety disorder may include [14]:

  • Persistent and excessive worry about multiple areas of life
  • Difficulty controlling worry or intrusive thoughts.
  • Restlessness or feeling on edge.
  • Muscle tension or physical discomfort
  • Fatigue or difficulty concentrating
  • Irritability or difficulty sleeping

Treating Anxiety Disorders

Navigating the landscape of anxiety disorder treatments involves exploring various options, including medications like SSRIs, SNRIs, benzodiazepines, antipsychotics, and anticonvulsants, as well as psychotherapy and emerging techniques like Transcranial Magnetic Stimulation (TMS).

Anxiety Medications

Medications are often a key component of anxiety therapy, helping to alleviate symptoms and manage the physical aspects of anxiety. Commonly used medications for anxiety include [4]:

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs, such as escitalopram, increase serotonin levels in the brain. Serotonin is a neurotransmitter associated with mood regulation, and by blocking its reabsorption, SSRIs help alleviate symptoms of anxiety by promoting feelings of calmness and well-being.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs like venlafaxine affect both serotonin and norepinephrine levels in the brain. Norepinephrine is involved in the body’s stress response, so by inhibiting its reuptake and serotonin, SNRIs help regulate mood and reduce anxiety symptoms.

Benzodiazepines

Benzodiazepines, like diazepam, offer rapid relief from acute anxiety symptoms. However, due to the risk of dependence and tolerance, they are usually prescribed for short-term use only.

Antipsychotic Medications

Antipsychotic medications, such as quetiapine, are primarily used to treat conditions like schizophrenia and bipolar disorder but can be prescribed off-label for anxiety disorders to manage symptoms.

Anticonvulsant Medications

Anticonvulsant medications, like pregabalin, are typically used for conditions such as neuropathic pain and seizures but are also approved for treating generalized anxiety disorder (GAD), helping to manage anxiety symptoms [4].

The Benefits of Medication alongside Therapy

It is recommended that medications be used in conjunction with psychotherapy. Combining psychiatric medications with psychotherapy can enhance treatment effectiveness for several different anxiety disorders like panic disorder, social phobia, and obsessive-compulsive disorder (OCD).

Several studies have found that the combination of medication and Cognitive Behavioral Therapy (CBT) is more effective than either treatment alone for certain anxiety disorders like panic disorder, social anxiety disorder, and generalized anxiety disorder [8].

Furthermore, for social phobia and obsessive compulsive disorder (OCD), there is sufficient evidence indicating that combined treatment is superior to medication alone [8]. The effects of combined treatment are approximately twice as large as medication alone compared to placebo [8].

Therapy for Anxiety

In addressing anxiety disorders, therapy can play a pivotal role in providing individuals with the tools to manage their symptoms effectively. At Neuro Wellness Spa (NWS), our Therapy Program includes Brief Integrative Psychotherapy as a key component designed to meet the diverse needs of individuals dealing with anxiety.

Brief Integrative Psychotherapy effectively addresses anxiety by blending elements from various psychotherapeutic models. It prioritizes combining supportive and expressive techniques within a time-limited framework, fostering positive changes in behavior and interpersonal functioning [6].

Aligned with the principles of Brief Integrative Psychotherapy, our NWS Therapy Program emphasizes:

  • Flexibility: Recognizing the unique challenges of anxiety, our therapy program adapts to individual needs and characteristics.
  • Focus on Interpersonal Dynamics: Our therapy targets maladaptive interpersonal patterns and aims to enhance clients’ interactions with others, fostering a sense of security and connection.
  • Active Participation: Encouraging clients to engage actively empowers them to confront their anxiety and strive for lasting change.
  • Time-Limited Framework: Sessions are structured within a specified timeframe, addressing immediate concerns and promoting progress toward anxiety management.
  • Customized Approach: Tailoring interventions ensure maximum effectiveness in anxiety treatment, aligning with each client’s specific goals and needs.

To provide successful brief integrative therapy, our team provides a comprehensive but rapid assessment and tailors specific intervention strategies to the client’s individual needs to heal, grow, and cope more effectively.

Since no single type of therapy model can address the range of problems that clients experience, our therapists utilize a range of therapy modalities, approaches, and techniques to draw from to provide the most effective treatment for each unique situation.

Types of Therapy for Anxiety

Cognitive-Behavioral Therapy (CBT)

Cognitive-Behavioral Therapy (CBT) is a highly effective method for treating various anxiety disorders [1]. Patients learn to identify how their thoughts, feelings, and behaviors fuel their anxiety symptoms and are taught techniques to counteract undesired behaviors [1].

CBT has been well-documented to offer symptom reduction or elimination within several months, making it a widely used and valuable treatment for various anxiety disorders [1, 4]. It assists individuals in recognizing and modifying negative thought patterns and behaviors associated with anxiety.

Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT) encourages individuals to accept their thoughts and feelings rather than trying to control or avoid them. Acceptance and commitment therapy (ACT) aims to help individuals live meaningful lives. It treats various mental health conditions, such as anxiety disorders.

Research has shown that ACT can significantly improve psychological flexibility and overall well-being [12]. When used to treat anxiety disorders, ACT helps individuals become more flexible in response to emotional discomfort and encourages experiential acceptance [11].

Psychodynamic Therapy

Psychodynamic therapy is a type of talk therapy based on the principles of psychoanalysis. It focuses on how unconscious thoughts and feelings influence a person’s actions and experiences [2]. The primary objective is comprehending these hidden forces and their impact on behavior. The therapy often involves exploring childhood experiences and relationships to help make sense of current struggles. It also emphasizes how a person relates to their therapist, as this can reflect patterns from their past [2].

Narrative Therapy

Narrative therapy emphasizes separating individuals from their problems and destructive behaviors [15]. This perspective allows clients to see their problems as protective mechanisms rather than purely negative influences, empowering them to envision a future aligned with their true identity, capabilities, and purpose, independent of their problems [15]. The therapy aims to help individuals recognize that making mistakes does not equate to being inherently bad. It guides them to deconstruct and reconstruct healthier storylines through respectful self-reflection [15], facilitating a shift towards more positive and constructive life experiences [15].

Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) integrates cognitive-behavioral techniques with mindfulness and acceptance-based strategies, which is effective for anxiety disorders [12]. It reduces self-harm behaviors, improves emotion regulation, and targets emotional dysregulation through eight-week sessions [17]. DBT improves interpersonal effectiveness and social support networks, reducing anxiety symptoms [17]. Research supports DBT for anxiety disorders, reducing anxiety levels and emphasizing collaboration for optimal patient outcomes [17].

Eye Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing (EMDR) is a therapy that utilizes bilateral stimulation techniques such as eye movements, taps, or tones. It is mainly used for treating post-traumatic stress disorder (PTSD) and other trauma-related conditions.

EMDR aims to help individuals process traumatic memories and alleviate associated symptoms by facilitating the brain’s natural healing processes. This therapy is based on the Adaptive Information Processing (AIP) model, which explains how the brain stores traumatic memories differently from normal memories. Traumatic memories often lack the necessary connections for healthy healing, leading to symptoms such as anxiety, panic, or depression [7].

EMDR helps reprocess these memories, enabling individuals to experience them without feeling overwhelmed. It is commonly used to treat PTSD but is also effective for other mental disorders, including anxiety disorders, depression, and personality disorders [7]. Research suggests that EMDR can lead to significant reductions in PTSD symptoms and improve overall psychological well-being [12].

Mindfulness-Based Therapies

Mindfulness-based therapies, such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), incorporate mindfulness meditation practices into therapeutic interventions. These therapies aim to increase present-moment awareness and acceptance of one’s experiences. Mindfulness-based therapies are effective in reducing symptoms of anxiety, depression, and stress [12].

The best therapy for anxiety can vary from person to person because different approaches work for different individuals. While many see CBT as the gold standard, other evidence-based therapies or a combination can also be effective.

The Neuro Wellness Spa (NWS) Therapy Program: A Holistic Approach

At Neuro Wellness Spa, our brief integrative psychotherapy program is meticulously designed to provide individualized support for individuals struggling with anxiety. It stands out for its flexibility, allowing us to adapt to each client’s distinct needs and obstacles, ensuring a personalized approach that optimizes therapeutic outcomes.

Our NWS therapy program consists of 13 sessions, which begin with a comprehensive clinical assessment. Following the initial evaluation, the subsequent sessions seamlessly integrate various evidence-based therapies tailored to address the client’s psychological challenges. This approach ensures comprehensive care that is finely tuned to meet each individual’s unique needs, maximizing the benefits of therapy and the treatment plan’s effectiveness.

Who Can Benefit from Brief Integrative Psychotherapy?

Brief integrative psychotherapy is well-suited for individuals who:

  • Present specific, well-defined concerns
  • Demonstrate motivation to engage actively in therapy.
  • Possess a degree of psychological insight, enabling them to reflect on their thoughts, feelings, and behaviors.
  • Can establish realistic therapeutic goals.

These foundational principles guide our therapists in delivering empathetic, tailored care that facilitates healing and growth, ensuring a meaningful therapeutic journey for every client at Neuro Wellness Spa.

What other treatments are available to help with anxiety?

Psychotherapy is a powerful and effective tool in treating many different mental health conditions, like anxiety. Still, many other treatment options are available, like transcranial magnetic stimulation (TMS) and several types of medications.

Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation (TMS) is a noninvasive procedure used to treat anxiety disorders. By applying magnetic fields to specific brain areas, like the dorsolateral prefrontal cortex (DLPFC), TMS aims to modulate neural activity [16]. This modulation targets the neural circuits associated with emotional processing and regulation; potentially alleviating symptoms linked to anxiety disorders [16].

How Effective is TMS for Anxiety?

Studies demonstrate the effectiveness of TMS in reducing anxiety symptoms across various disorders, including generalized anxiety disorder (GAD), panic disorder, and post-traumatic stress disorder (PTSD) [16]. For instance, individuals with GAD experienced a significant decrease in anxiety symptoms after 25 sessions of TMS treatment. Moreover, subjects with GAD showed positive results following 30 TMS sessions, with notable effectiveness even in the sham coil group, highlighting the need for further exploration [16].

How Does TMS Therapy Work for Anxiety?

The dorsolateral prefrontal cortex (DLPFC) is a common target during TMS treatment for anxiety disorders. High-frequency and low-frequency TMS, typically administered over 10 to 20 sessions, have shown sustained response effects [16]. Additionally, stimulating the motor cortex, especially in the sensorimotor region, has demonstrated promising results in reducing anxiety symptoms related to neurological disorders [16].

Combining TMS Therapy and Psychotherapy

Combining transcranial magnetic stimulation (TMS) with therapy for anxiety disorders offers several benefits, including enhanced efficacy, faster relief, reduced medication dependence, targeted treatment of specific brain regions, long-lasting effects, improved quality of life, and the ability to customize treatment plans to individual needs. TMS can complement therapy by providing precise brain stimulation, leading to sustainable improvements in anxiety symptoms and overall well-being.

Find out if TMS Therapy is Right for You

It’s important to note that while TMS can be an effective treatment for anxiety disorders, it may not be suitable for everyone, and individual responses to treatment can vary. It’s essential to consult with qualified mental health professionals to determine the most appropriate treatment approach based on your specific needs and circumstances.

With a total of 125,128 TMS sessions administered (and counting) and an impressive 73% response rate, TMS therapy at Neuro Wellness Spa has shown considerable effectiveness in alleviating anxiety symptoms. This high response rate indicates that a significant proportion of individuals undergoing TMS treatment experience positive outcomes, highlighting the potential of this therapy as a promising option for managing anxiety disorders.

At Neuro Wellness Spa, we understand that anxiety is a difficult condition that can significantly interfere with daily life. That’s why our integrated therapy program combines evidence-based psychotherapy with personalized medication plans and innovative treatments like Transcranial Magnetic Stimulation (TMS).

Relief from Symptoms with Anxiety Therapy

Our experienced medical team works closely with therapists to craft medication plans that complement psychotherapy, enhancing the effectiveness of both approaches. Whether it’s medications like Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), or others, we ensure that every aspect of your treatment aligns with your individual needs and goals.

Additionally, participating in therapy alongside medication management or TMS treatment maximizes the benefits of each method, leading to better symptom management and an improved quality of life. Our Therapy Program offers a comprehensive approach that addresses the root causes of anxiety, empowering individuals to confront their challenges and regain control over their lives.

If you or a loved one is struggling with anxiety or another mental health condition, contact us today to learn more about our in-person and online psychiatry, alternative treatments like TMS therapy, and our talk therapy program. At Neuro Wellness Spa, we’re dedicated to delivering thorough care that encourages lasting healing and enhances overall well-being.

References

  1. American Psychological Association. (2023, November 30). How psychologists help with anxiety disorders. https://www.apa.org/topics/anxiety/disorders
  2. American Psychological Association. Psychodynamic psychotherapy. April 19, 2018. https://dictionary.apa.org/psychodynamic-psychotherapy
  3. Anxiety & Depression Association of America. Anxiety Disorders – Facts & Statistics. https://adaa.org/understanding-anxiety/facts-statistics
  4. Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in clinical neuroscience, 19(2), 93–107. https://doi.org/10.31887/DCNS.2017.19.2/bbandelow
  5. Cackovic, C., Nazir, S., & Marwaha, R. (2023). Panic Disorder. In Stat Pearls. StatPearls Publishing.
  6. Center for Substance Abuse Treatment. Brief Interventions and Brief Therapies for Substance Abuse. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. (Treatment Improvement Protocol (TIP) Series, No. 34.) Chapter 7—Brief Psychodynamic Therapy. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64952/
  7. Cleveland Clinic. EMDR Therapy. https://my.clevelandclinic.org/health/treatments/22641-emdr-therapy
  8. Cuijpers, P., Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A. T., & Reynolds, C. F., 3rd (2014). Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis. World psychiatry: official journal of the World Psychiatric Association (WPA), 13(1), 56–67. https://doi.org/10.1002/wps.20089
  9. Feriante J, Torrico TJ, Bernstein B. Separation Anxiety Disorder. [Updated 2023 Feb 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560793/
  10. Gray K. (2017). How to Map Theory: Reliable Methods Are Fruitless Without Rigorous Theory. Perspectives on psychological science: a journal of the Association for Psychological Science, 12(5), 731–741. https://doi.org/10.1177/1745691617691949
  11. Hasheminasab M, Babapour Kheiroddin J, Mahmood Aliloo M, Fakhari A. Acceptance and Commitment Therapy (ACT) for generalized anxiety disorder. Iran J Public Health. 2015;44(5):718-719.
  12. Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues Clin Neurosci. 2015;17(3):337-346. doi:10.31887/DCNS.2015.17.3/akaczkurkin
  13. Locher, C., Meier, S., & Gaab, J. (2019). Psychotherapy: A World of Meanings. Frontiers in Psychology, 10, 460. https://doi.org/10.3389/fpsyg.2019.00460
  14. Penninx, B. W., Pine, D. S., Holmes, E. A., & Reif, A. (2021). Anxiety disorders. Lancet (London, England), 397(10277), 914–927. https://doi.org/10.1016/S0140-6736(21)00359-7
  15. Psychology Today. Narrative Therapy. https://www.psychologytoday.com/us/therapy-types/narrative-therapy
  16. Rodrigues, P. A., Zaninotto, A. L., Neville, I. S., Hayashi, C. Y., Brunoni, A. R., Teixeira, M. J., & Paiva, W. S. (2019). Transcranial magnetic stimulation for the treatment of anxiety disorder. Neuropsychiatric disease and treatment, 15, 2743–2761. https://doi.org/10.2147/NDT.S201407
  17. Tavakoli T, Hoseini M, Tabatabaee TSJ, et al. Comparison of dialectical behavior therapy and anti-anxiety medication on anxiety and digestive symptoms in patients with functional dyspepsia. J Res Med Sci. 2020;25:59. doi:10.4103/jrms.JRMS_673_19
  18. World Health Organization. Anxiety Disorders. https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders
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