Anxiety Treatments

Originally published on June 1, 2020 Last updated on August 21, 2020

Written by:

Anxiety treatments, like medications and therapies, address the fear, worry, and nervousness of these disorders by targeting the dysfunctional thoughts, behaviors, and balance of brain chemicals. Nearly one in every five adults in the U.S. have an anxiety disorder each year, but with treatment for anxiety, the effects of this condition can be reduced or even eliminated.¹

Professionals understand how to treat anxiety, and these services are widely available and effective for those in need. Treatments for anxiety typically include therapy and/or medication, and there are also several lifestyle changes that may help alleviate symptoms of anxiety as well.

Therapy for Anxiety

For people experiencing any symptoms of anxiety disorders like worry, panic, intense fears, and physical tension, therapy for anxiety is a great treatment choice. Therapy or psychotherapy usually involves speaking to a therapist in an individual, group, or family setting. For added convenience, appointments can occur in the home, a school, an office, or virtually with phone and videoconferencing.

Many therapies for anxiety disorders are effective and evidence-based, so insurance companies will generally cover the majority of options. In an attempt to remove barriers preventing treatment, many insurances do not require a prescription or referral to start sessions. Fewer anxious symptoms may be only a phone call away.

Cognitive Behavioral Therapy

Perhaps the most helpful form of psychotherapy for anxiety disorders is called cognitive behavioral therapy (CBT). Rather than being just one treatment, CBT is an umbrella term that includes many useful tools and techniques that aim to improve thinking patterns and behaviors.

Cognitive therapy, one method of CBT, works by having the client begin to identify and dispute the unhelpful thoughts that create or maintain anxious symptoms.² By replacing anxious thoughts with calm ones, the person changes the way they feel.

Exposure therapy is another branch of CBT useful for managing anxious symptoms. This method involves working with a therapist to confront worries in person or through imagery. A person who is afraid of heights may gradually go higher in an office building until they are standing on top of a tall building.²

The typical timeline for CBT anxiety treatment ranges from just a few weeks to many months, depending on the origin and intensity of symptoms. Someone with a straightforward phobia may move through exposure treatment in several sessions, while a person with complex anxiety may require years of exposure and cognitive therapy.

Acceptance and Commitment Therapy

Acceptance and commitment therapy (ACT) helps to manage anxious symptoms with a combination of acceptance, mindfulness, and behavioral changes. By living in the moment without the need to analyze and judge themselves, people can experience fewer worries and fears. With the addition of behavior modifications to cope with harmful thoughts and feelings, ACT, like CBT, emphasizes the value of addressing thoughts and behaviors to limit anxiety.³

ACT is effective for anxiety disorders with timelines that range from weeks to years. After the assessment phase, a therapist can offer guidance on the expected timeframe to achieve the desired results.

Dialectical Behavioral Therapy

Dialectical behavioral therapy (DBT) began as a way to address chronically suicidal clients and people with personality disorders, but good evidence suggests this treatment is effective for anxiety disorders as well. DBT blends elements of CBT and Eastern influences to focus on both acceptance and change.

At times, DBT therapists present sessions in time-limited blocks of treatment focused on:³

Mindfulness
Relationships and communication
Distress tolerance
Emotional regulation

By moving through these separate modules of treatment, the person can address their anxiety as well as other mental health concerns. DBT often involves individual and group therapy sessions.

Eye Movement Desensitization and Reprocessing

Eye movement desensitization and reprocessing (EMDR) is a treatment style that seems to change the way the brain processes information. Where CBT, ACT, and DBT are all forms of talk therapy, an EMDR therapist guides the client through a process that permits them to experience fear, worries, and nervousness in less distressing ways.³

Empirical evidence supports EMDR use for post-traumatic stress disorder, and the therapy is being used more frequently for anxiety-related issues like panic attacks and phobias.

EMDR offers results much more rapidly than talk therapy. Some clients note symptoms resolution in as few as three 90-minute sessions.⁶

Other Types of Therapy You May Encounter

As so many people live with the unwanted effects of anxiety each day, new and under-the-radar treatments are constantly being explored as ways to quickly and effectively decrease anxiety.

Some other types of therapy or therapy techniques you may encounter for anxiety symptoms include:⁴

Relaxation Techniques

Relaxation techniques, like deep breathing, progressive muscle relaxation, guided imagery, and autogenic training, may be included as part of CBT sessions or independently from professional treatment. By calming the body and the mind, these treatments address the consequences of anxiety.

Hypnotherapy

Hypnosis and hypnotherapy can help reduce anxiety, especially when linked to dental or medical procedures. At this time, though, there is not enough overwhelming evidence to fully support it as an anxiety treatment.

Mindfulness Meditation

Studies have found mindfulness meditation helpful for anxiety across numerous groups of people. People with cancer or chronic disease, pregnant women, family caregivers, and others may benefit from meditation. In the future, people can expect more research aiming to prove that mindfulness and other forms of meditation can definitively improve anxiety symptoms.

Anxiety Medications

Alone, or in combination with therapy, medication is an effective treatment option for anxiety. People interested in medication must practice caution as some medications used for anxiety can result in unwanted, long-term effects like tolerance, addiction, and physical dependence. People concerned about these results should consult with their prescriber, always take medications as prescribed, and may want to consider therapy first.

Medications for anxiety are offered by a number of prescribers including:

Psychiatrists
Pediatricians
Primary care physicians
Nurse Practitioners

Depending on the insurance plan, the specific medication, and dose, anxiety medications are regularly covered by insurance. Like other medications, they will be subjected to normal copays.

Selective Serotonin Reuptake Inhibitors and Serotonin-Norepinephrine Reuptake Inhibitors

Selective serotonin reuptake inhibitors (SSRIs) are a group of medications that all act by allowing the brain to absorb larger levels of serotonin with the goal of decreasing anxiety symptoms.⁵ These same medications are used in the treatment of depression and obsessive-compulsive disorder (OCD), a condition that shares many similarities with anxiety disorders.

Examples of SSRIs used for anxiety disorders include:⁵

citalopram (Celexa)
escitalopram (Lexapro)
fluoxetine (Prozac)
paroxetine (Paxil)
sertraline (Zoloft)

Serotonin-norepinephrine reuptake inhibitors (SNRIs) operate much in the same way as SSRIs but with the added benefit of interacting with norepinephrine as well as serotonin.

SNRIs include:⁵

venlafaxine (Effexor)
duloxetine (Cymbalta)

These medications are equally effective as SSRIs, but medications from this category may work better than other drugs for some people. For OCD, treatment should avoid SNRIs as they are not as effective for these symptoms.⁵

Side effects from these medications are relatively mild and may include sleeping problems, sexual issues, and weight gain. This is not a comprehensive list of side effects and a doctor or pharmacist can have a more in depth conversation about all of the possible side effects.⁵ This class of medications typically needs a month or more to become effective, so clients will do well to practice patience and flexibility, since it could take several trials to identify a helpful medication. People should never stop use or change the dose, frequency, or route of administration without their prescriber’s consent.²

Other classes of antidepressants, called tricyclics and monoamine oxidase inhibitors (MAOIs), are still effective but used less frequently due to the problematic side effects they may cause.²

Benzodiazepines

SSRIs and SNRIs are antidepressants commonly used for anxiety treatments, but anti-anxiety medications like benzodiazepines are used specifically to address panic attacks, anxiety, and extreme fears.² These medications are very effective and produce results much quicker than antidepressants, but they do present several significant challenges.²

The primary drawback of benzodiazepines is the risk of tolerance. Over time, people need increasingly larger doses as the brain lessens its response to the drugs. Tolerance is linked to additional issues like physical dependence and addiction, so people should only use these medications for short-term anxiety treatment.²

Benzodiazepine drugs include:⁵

alprazolam (Xanax)
clonazepam (Klonopin)
diazepam (Valium)
lorazepam (Ativan)

The Drug Enforcement Administration (DEA) classifies benzodiazepines as a controlled substance, which means their prescription and distribution is closely monitored.

Beta-Blockers

As a group of medications usually prescribed to lower blood pressure, beta-blockers can also help to relieve the physical symptoms of anxiety. Anxious effects like quick heart rate, shakiness, and feeling flushed can all improve with beta-blockers.² Although these medications may not be the first choice for anxiety, they remain viable options.

Beta-blockers that may be used for anxiety treatment include:²

acebutolol (Sectral)
atenolol (Tenormin)
bisoprolol (Zebeta)
metoprolol (Lopressor)
nadolol (Corgard)
nebivolol (Bystolic)
propranolol (Inderal)

Other Anti-Anxiety Options

Though not necessarily classified as medications, some people will pursue the use of natural products and supplements to improve their feelings of calm and limit the stress and tension connected to anxiety.

Natural products which may aid anxiety treatment are:⁴

Chamomile: Early studies that show chamomile extract as a way to manage generalized anxiety are encouraging but will require further inspection.
Kava: Made from a root, kava (kava kava) seems to have a positive influence on anxiety, but the supplement may result in liver damage so people must understand this risk.
Melatonin: Used as a natural way to support sleep, melatonin may assist with reducing anxiety, especially before surgery.
Other possibilities: Some may find success in lowering their anxiety with natural products consisting of passionflower or valerian. With the current evidence, these products cannot be fully supported.

Like with other treatments, anyone considering the use of these alternative options should consult their treatment team to discuss the possible risks and benefits involved. Before starting any supplement, a person should also discuss the supplement with their prescriber or pharmacist to check for interactions with any prescription medications they are taking.

Lifestyle Changes & Self-Help Strategies for Anxiety

Professional treatment options for anxiety, like therapy and medications, are wonderful ways to improve symptoms, but lifestyle changes and self-help strategies for anxiety can serve as an additional way to shrink the influence of anxiety.

These at-home interventions are commonly free, low-risk, and easily accessible and include:^1,2,4

Listening to music: As simple as it may seem, listening to music can reduce the unwanted symptoms of anxiety. A few minutes of a favorite song can produce a positive impact.
Meditative movement: Activities like tai chi, qi gong, and yoga may create feelings of relaxation and peace that combat anxiety. Spending a few minutes engaged in these can improve a person’s physical and mental well-being.
Physical activity: Other forms of exercise, like walking, weight training, biking, and swimming, can all help limit symptoms of anxiety. Physical activity helps change a person’s setting and can increase the levels of wanted brain chemicals.
Stress management: Lowering stress might not eliminate a person’s anxiety, but it will help. By identifying sources of stress and exploring ways to minimize their effects, managing stress will help to manage anxiety.
Support groups: Support groups involve people meeting with others who have similar experiences and symptoms to gain information and build a sense of community. Support groups differ from therapy groups, since the former groups lack professional facilitators.
Connecting to loved ones: Feeling connected to supportive friends and family members offers tremendous anxiety reduction. Communicating thoughts and feelings about the worries and fears can go a long way in reducing anxieties.
Limiting alcohol and other drugs: Abusing substances may seem like an appealing way to increase comfort and feel calm, but drugs and alcohol used for self-medication typically create larger problems in the future. Avoiding these substances and pursuing healthier coping skills will lead to better long-term effects.

Beyond these at-home strategies, people will benefit from using the skills learned in therapy between sessions. Therapy types like CBT may offer exercises to be completed at home. This homework may involve thinking or behavioral strategies geared towards limiting the effects of anxiety.

Hospitalization for Anxiety

Inpatient psychiatric hospitalization represents the highest level of care for people with anxiety. Psychiatric inpatient is a short-term treatment aimed at increasing symptom stability and ensuring safety for the person as well as the people around them. To this end, inpatient hospitalizations are usually reserved for people who are actively suicidal or homicidal.

Aside from thoughts of death, people may consider inpatient treatment if anxiety is resulting in:

Limited hygiene and self-care
Dangerous coping skills like substance abuse or compulsive behaviors to manage symptoms
Harmful diet or food restrictions linked to anxiety
An inability to care for self and those dependent on them

Inpatient typically focuses on brief interventions to adjust medications or connect to additional services once inpatient hospitalization ends.

For people with intense anxiety or co-occurring anxiety and depression, inpatient treatment may be a needed modality. In many situations, though, anxiety disorders can be well-managed with outpatient care.

Questions to Ask About Anxiety Treatments

Anxiety treatments will vary drastically across providers and settings, so asking questions is a great way to gather information and prepare for upcoming treatments. Asking questions is also a great way to guide treatment, rather than having other people make all of the decisions.

Questions to Ask about Therapy

When starting out with therapy, be sure to ask:²

What therapy style would be best for my symptoms?
Is it normal for therapy and thinking about therapy to make me more anxious?
What is the role of homework and out-of-therapy treatment?
What is the projected course of therapy? How often will we meet and for what duration?
Will symptoms get worse before they improve?
Have you successfully treated people with my symptoms?
Would adding medication be a helpful way to improve my outcomes?
Are there any risks to this treatment style?
How much will this cost me?

Questions to Ask about Medications

Important questions to ask the prescriber when starting medications include:²

When will I see the benefit of this medication?
What are the common and expected side effects of this drug?
Does this medication carry any change for tolerance or dependence?
How long can I be on this medication?
How do I proceed if I encounter serious reactions?
Can I stop this medication if I don’t like it?
How much does this medication cost and will my insurance company pay for it?
If a medication worked for a family member will it work for me?

Questions to Ask about Lifestyle & Self-Help Strategies

Many lifestyle changes carry little risks, but you should always keep your treatment team informed of significant changes and ask:^2,4

Will these changes interfere with my therapy and medication?
Can I stop taking my medications if I make these lifestyle changes?
Should I discontinue these lifestyle changes if they don’t work quickly?
What role do sleep, diet, and physical activity play in my anxiety and anxiety treatment?

Additional Resources for Anxiety

So many organizations are doing valuable work in the arena of anxiety. With their efforts, an expert’s ability to prevent, identify, and resolve anxiety improves every day.

Some key organizations leading the way include:

Anyone hoping to learn more about anxiety or other mental health conditions that are adversely affecting their lives or the life of a loved one should seek out the quality information from these sources. Doing so can add hope and direction for the future.