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Treatments for Anxiety: Which is the Best and Which is Right For You?

Anxiety is a normal emotion usually experienced in response to stress, unfamiliar situations, or a perceived threat. It is normal to occasionally feel anxious, but if it becomes more severe, persistent, and interferes with daily life, it may be a sign of an anxiety disorder.

Anxiety disorders are the most commonly diagnosed mental health disorders, with an estimated 19% of adults presenting with any type of anxiety disorder in the past year [11], and 31% [11] of U.S. adults experiencing an anxiety disorder at some point in their lifetime.

Anxiety disorders encompass a group of mental health conditions characterized by excessive and persistent worry, fear, and apprehension. These disorders are recognized and classified by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Common types of anxiety disorders include panic disorder, which involves recurring panic attacks and the fear of future attacks; obsessive-compulsive disorder (OCD), marked by intrusive thoughts and repetitive behaviors; generalized anxiety disorder (GAD), characterized by excessive worry about various aspects of life; and social anxiety disorder, where individuals experience intense fear and avoidance of social situations.

Symptoms may include agitation, irritability, trouble concentrating, sleep problems, and muscle tension. Individuals with severe cases of anxiety may also experience panic attacks. These sudden intense episodes of fear can cause physical symptoms such as a rapid heartbeat, sweating, and trembling. Treatment for anxiety disorders often involves a combination of medication and psychotherapy.

While anxiety can be a challenging condition to live with, it is important to remember that it is treatable. Individuals with anxiety can manage their symptoms and live fulfilling lives with proper support and treatment. This article will explore some of the most effective anxiety treatments, including therapy, medication, and self-care techniques.

Medications

Several medications are available to treat anxiety: each works differently and acts on neurotransmitters (chemical messengers) in the brain. Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), benzodiazepines, and beta blockers are some of the most commonly prescribed anxiety medications.

SSRIs

SSRIs are medications used to treat depression and anxiety disorders. SSRIs block reuptake, meaning more serotonin is available to transmit messages between nerve cells. [5] Serotonin regulates mood, appetite, and sleep. Low mood, anxiety, and sleep problems are associated with serotonin imbalances in people with depression and anxiety disorders. [5] Commonly prescribed SSRIs include fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro).

SNRIs

SNRIs block serotonin and norepinephrine reuptake, meaning these neurotransmitters remain in the brain for extended periods. This allows them to continue exerting their effects on the brain, improving mood and reducing anxiety.

Some common SNRIs include duloxetine (Cymbalta), desvenlafaxine (Pristiq), and venlafaxine (Effexor).

SSRIs and SNRIs are considered first-line treatments due to their effectiveness and relatively low risk of side effects. [3,14] It can take several weeks to feel the full impact of reducing symptoms. [3]

Tricyclic antidepressants

Tricyclic antidepressants are a class of medications primarily used to treat depression but also to treat sleep and anxiety disorders and chronic pain. Tricyclic antidepressants increase the levels of certain chemicals, such as serotonin and norepinephrine, in the brain. This helps to improve mood and reduce the symptoms of depression. 

Common tricyclic antidepressants include amitriptyline (Elavil), nortriptyline (Pamelor), and imipramine (Tofranil).

Anxiolytics

Anti-anxiety medications are called anxiolytics. These medications reduce anxiety symptoms, such as worry, fear, and nervousness. In addition to treating anxiety, anxiolytics are sometimes used to treat insomnia, seizures, and muscle spasms.

Several different anxiolytics exist, such as benzodiazepines, buspirone (BuSpar), and hydroxyzine. Benzodiazepines are the most commonly prescribed anxiolytics, including Xanax, Valium, and Ativan. Anxiolytics enhance a brain chemical called GABA, which calms anxiety and the nervous system. While anxiolytics treat anxiety disorders, side effects are possible, such as sleepiness, dizziness, and confusion.

Beta-blockers

In addition to treating physical symptoms like high blood pressure, angina, heart failure, and arrhythmias, beta-blockers also treat other medical conditions. They work by blocking the effects of adrenaline, which increases heart rate and blood pressure. In addition to their cardiovascular benefits, beta-blockers are sometimes prescribed for anxiety and migraine headaches. Some common beta blockers include metoprolol, atenolol, and propranolol.

While beta-blockers are safe and effective, they can cause side effects for some people. These can include fatigue, dizziness, and low blood pressure. Tell your doctor if you experience any side effects while taking beta blockers is important.

Don’t give up hope if you have tried one or more treatments for anxiety that haven’t worked. Contact Neuro Wellness Spa to speak to a psychiatrist and find treatment options that work for you.

Spravato

Spravato (esketamine) is a newly developed FDA-approved medication for treating treatment-resistant depression. However, there is also growing evidence to support its use as a treatment for anxiety disorders.

Traditional treatment options for anxiety disorders include therapy, medication, and self-help strategies. However, some people with anxiety disorders do not respond to these treatments, leaving them with limited options. Spravato offers an alternative option for treatment-resistant anxiety disorders. The medication works by targeting the glutamate system in the brain, which is believed to cause anxiety. Spravato is administered via nasal spray, and its effects can be felt within hours of the first dose. Studies have shown that Spravato can effectively reduce symptoms of some anxiety disorders, such as post-traumatic stress disorder (PTSD) and treatment-resistant depression (TRD).[8]

It is important to note that Spravato is not a cure for anxiety disorders and should be used in conjunction with other treatments, such as therapy and self-help strategies. As with any medication, Spravato has potential side effects. These include dizziness, nausea, and dissociation. It is important to discuss the risks and benefits of Spravato with a healthcare professional before starting treatment.

If you are interested in trying Spravato for anxiety and have not found relief from conventional treatments, contact Neuro Wellness Spa to learn more about this innovative new treatment.

Brain Stimulation

Brain stimulation is a relatively new method of treating anxiety disorders involving targeted magnetic pulses to specific regions of the brain, stimulating neural activity and regulating brain circuitry associated with anxiety.

Transcranial magnetic stimulation (TMS)

TMS is a non-invasive treatment for anxiety disorders. This therapy involves using magnetic pulses to stimulate the nerve cells in the brain and improve mood regulation. Studies have demonstrated that TMS can positively affect anxiety symptoms, including reducing anxiety levels, and suggest an overall positive therapeutic effect of TMS for treating GAD and PTSD [6,13]. Researchers believe that TMS may interfere with the functioning of neurotransmitters in cerebral circuits, which may influence the regulation of anxiety as a symptom or as an anxiety disorder. [13] TMS has been FDA-approved to treat other mental health conditions like depression but is being used as an “off-label” treatment for anxiety disorders.

Neuro Wellness Spa can provide the support and guidance you need, if you are considering TMS therapy. Our experienced team of professionals can help you determine if TMS is the right choice for you. We can assist you at every step of the process. Contact us today to learn more about TMS therapy and how Neuro Wellness Spa can help you on your wellness journey.

Psychotherapy

Psychotherapy or psychological therapies refer to the use of psychological methods to help individuals cope with mental health issues such as anxiety. There are several options available to individuals seeking psychotherapy for anxiety.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is one of the most commonly used therapy types for treating anxiety. CBT works by helping individuals learn to change negative thought patterns and behaviors that perpetuate anxiety. CBT focuses on “cognitive restructuring,” which focuses on helping individuals with anxiety highlight the existence of places thoughts get stuck, and then encourages individuals to foster more flexible and realistic interpretations of events over time and change how they approach different situations. [7]

Exposure therapy

Exposure therapy is another option used for anxiety. This therapy involves gradually exposing the individual to their fears in a controlled environment to help them overcome their anxiety. This therapy can be effective for individuals with phobias or post-traumatic stress disorder (PTSD). [1]

Psychodynamic therapy

Psychodynamic therapy focuses on exploring unconscious thoughts and feelings to gain insight into anxiety symptoms. This therapy can be helpful for individuals who have experienced past trauma or have a history of anxiety. [12]

Dialectical behavioral therapy

Dialectical behavioral therapy (DBT) is a type of CBT that works to help individuals change behavior patterns and develop strategies to gain a greater awareness and acceptance of their situation. [16] Research has shown DBT helps reduce physical anxiety symptoms. [16]

Lifestyle Changes and Alternative Treatments

While medication and therapy are conventional treatments for anxiety, there are also lifestyle and alternative treatments that can be helpful add-ons to other therapies, such as the following:

Exercise

Routine exercise has been shown to reduce anxiety symptoms by releasing endorphins, improving mood, and reducing muscle tension. Aiming for at least 30 minutes of moderate exercise per day is recommended. Exercise doesn’t have to be limited to running and gym workouts.

One 2021 large-scale Swedish study that followed more than 300,000 skiers found that they had a significantly lower risk of developing anxiety than non-skiers. Their findings support recommendations that engaging in exercise reduces the risk of anxiety in men and women. [15]

Balanced diet

Besides maintaining mental health, foods high in essential vitamins and minerals, such as leafy greens, nuts, and whole grains, can also reduce anxiety.

Adequate sleep

Studies show that roughly 50% of anxious people have insomnia or other sleep problems. [4] Lack of sleep can worsen anxiety symptoms. It is important to get enough sleep, and it is helpful to establish bedtime routines and limit screen time before bed.

Mindfulness meditation

Mindfulness meditation can help improve stress, depression, and anxiety. [2]  It helps reduce anxiety by calming the mind and increasing self-awareness. This can be done through guided meditations or on your own.

Social support

Spending time with family and friends can help reduce anxiety symptoms. It helps to have a support system that can provide emotional support and encouragement.

Limiting caffeine and alcohol intake

Too much caffeine and alcohol can worsen anxiety symptoms, so it is important to limit how much you consume.

Yoga

Yoga combines physical movement with mindfulness and has been shown to reduce anxiety and stress levels. [9]

Acupuncture

Acupuncture is a technique in which needles are inserted into parts of the body to treat specific conditions. It has been shown to reduce anxiety symptoms and promote relaxation.

Herbal supplements

Some herbs, such as passionflower, valerian root, and kava, have been shown to reduce anxiety symptoms, but it is important to talk to your healthcare provider before starting any new supplements because they can sometimes interact with other medications. [10]

It is important to note that alternative treatments should not replace medication or therapy for those with severe anxiety disorders. However, they can be effective complementary treatments and may be worth exploring for those with milder symptoms. As always, talking to a healthcare professional before starting any new treatments is important.

Key Takeaway

There are many different treatment options available for those suffering from anxiety. Working with a healthcare professional to determine the best course of action for each individual is important. While there is no one-size-fits-all solution, managing and overcoming anxiety with the right treatment plan is possible.

If you’re looking for mental health practitioners experienced in anxiety treatment, Neuro Wellness Spa is here for you. Our team of experts is dedicated to helping you treat anxiety symptoms and improve your quality of life. With range of treatments and personalized care including medication management, psychiatry, psychotherapy, and TMS therapy, you can rest assured that you’re in good hands. Don’t wait any longer to take control of your mental health. Contact Neuro Wellness Spa today to schedule your consultation and start your journey toward a happier, healthier you.

References

1. American Psychological Association (n.d.). What is Exposure Therapy? https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy

2. American Psychological Association. (2019, October 30). Mindfulness meditation: A research-proven way to reduce stress. https://www.apa.org/topics/mindfulness/meditation

3. Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues clinical neuroscience, 19(2), 93–107. https://doi.org/10.31887/DCNS.2017.19.2/bbandelow

4. Chellappa, S. L., & Aeschbach, D. (2022). Sleep and anxiety: From mechanisms to interventions. Sleep medicine reviews, 61, 101583. https://doi.org/10.1016/j.smrv.2021.101583

5. Chu A, Wadhwa R. Selective Serotonin Reuptake Inhibitors. [Updated 2023 May 1]. In:StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554406/

6. Cirillo, P., Gold, A. K., Nardi, A. E., Ornelas, A. C., Nierenberg, A. A., Camprodon, J., & Kinrys, G. (2019). Transcranial magnetic stimulation in anxiety and trauma-related disorders: A systematic review and meta-analysis. Brain and behavior, 9(6), e01284. https://doi.org/10.1002/brb3.1284

7. Curtiss, J. E., Levine, D. S., Ander, I., & Baker, A. W. (2021). Cognitive-Behavioral Treatments for Anxiety and Stress-Related Disorders. Focus (American Psychiatric Publishing), 19(2), 184–189. https://doi.org/10.1176/appi.focus.20200045

8. Derakhshanian, S., Zhou, M., Rath, A., Barlow, R., Bertrand, S., DeGraw, C., Lee, C., Hasoon, J., & Kaye, A. D. (2021). Role of Ketamine in the Treatment of Psychiatric Disorders. Health psychology research, 9(1), 25091. https://doi.org/10.52965/001c.25091

9. Karisetty, R. H., Shivanna, S., Pradhan, B., Srinivasan, T. M., & Bhat, R. G. (2020). A Comparative Study between Vedic and Contemporary Education Systems using Bio-Energy Markers. International journal of Yoga, 13(2), 152–155. https://doi.org/10.4103/ijoy.IJOY_61_19

10.  Mayo Clinic (n.d.). Herbal treatment for anxiety: Is it effective? https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/expert-answers/herbal-treatment-for-anxiety/faq-20057945\

11.   National Institute on Mental Health (n.d.). Any Anxiety Disorder. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder

12.  Pitman, S. R., & Knauss, D. P. C. (2020). Contemporary Psychodynamic Approaches to Treating Anxiety: Theory, Research, and Practice. Advances in experimental medicine and biology, 1191, 451–464. https://doi.org/10.1007/978-981-32-9705-0_23

13.  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

14.  Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review. Expert opinion on pharmacotherapy, 19(10), 1057–1070. https://doi.org/10.1080/14656566.2018.1491966

15.  Svensson, M., Brundin, L., Erhardt, S., Hållmarker, U., James, S., & Deierborg, T. (2021). Physical Activity Is Associated With Lower Long-Term Incidence of Anxiety in a Population-Based, Large-Scale Study. Frontiers in psychiatry, 12, 714014. https://doi.org/10.3389/fpsyt.2021.714014

16.  Tavakoli, T., Hoseini, M., Tabatabaee, T. S. J., Rostami, Z., Mollaei, H., Bahrami, A., Ayati, S., & Bijari, B. (2020). Comparison of dialectical behavior therapy and anti-anxiety medication on anxiety and digestive symptoms in patients with functional dyspepsia. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 25, 59. https://doi.org/10.4103/jrms.JRMS_673_19

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