- Psychological Issues
medications, although not cures, can be very effective at relieving anxiety symptoms. Today, thanks to research by scientists at NIMH and other research institutions, there are more medications available than ever before to treat anxiety disorders. So if one drug is not successful, there are usually others to try. In addition, new medications to treat anxiety symptoms are under development.
For most of the medications that are prescribed to treat aniety disorders, the doctor usually starts the patient on a low dose and gradually increases it to the full dose. Every medication has side effects, but they usually become tolerated or diminish with time. If side effects become a problem, the doctor may advise the patient to stop taking the medication and to wait a week—or longer for certain drugs—before trying another one. When treatment is near an end, the doctor will taper the dosage gradually.
research has also shown that behavioral therapy and cognitive-behavioral therapy can be effective for treating several of the anxiety disorders.
Behavioral therapy focuses on changing specific actions and uses several techniques to decreases or stop unwanted behavior. For example, one technique trains patients in diaphragmatic breathing, a special breathing exercise involving slow, deep breaths to reduce anxiety. This is necessary because people who are anxious often hyperventilate, taking rapid shallow breaths that can trigger rapid heartbeat, lightheadedness, and other symptoms. Another technique—exposure therapy—gradually exposes patients to what frightens them and helps them cope with their fears.
Like behavioral therapy, cognitive-behavioral therapy teaches patients to react differently to the situations and bodily sensations that trigger panic attacks and other anxiety symptoms. However, patients also learn to understand how their thinking patterns contribute to their symptoms and how to change their thoughts so that symptoms are less likely to occur. This awareness of thinking patterns is combined with exposure and other behavioral techniques to help people confront their feared situations. For example, someone who becomes lightheaded during a panic attack and fears he is going to die can be helped with the following approach used in cognitive-behavioral therapy. The therapist asks him to spin in a circle until he becomes dizzy. When he becomes alarmed and starts thinking, “I’m going to die,” he learns to replace that thought with a more appropriate one, such as “It’s just a little dizziness—I can handle it.”
If you, or someone you know, has symptoms of anxiety, a visit to the family physician is usually the best place to start. A physician can help you determine if the symptoms are due to an anxiety disorder, some other medical condition, or both. Most often, the next step to getting treatment for an anxiety disorder is referral to a mental health professional.
Among the professionals who can help are psychiatrists, psychologists, social workers, and counselors. However, it’s best to look for a professional who has specialized training in cognitive-behavioral or behavioral therapy and who is open to the use of medications, should they be needed.
Psychologists, social workers, and counselors sometimes work closely with a psychiatrist or other physician, who will prescribe medications when they are required. For some people, group therapy or self-help groups are a helpful part of treatment. Many people do best with a combination of these therapies.
When you’re looking for a health care professional, it’s important to inquire about what kinds of therapy he or she generally uses or whether medications are available. It’s important that you feel comfortable with the therapy. If this is not the case, seek help elsewhere. However, if you’ve been taking medication, it’s important not to quit certain drugs abruptly, but to taper them off under the supervision of your physician. Be sure to ask your physician about how to stop a medication.
Remember, though, that when you find a health care professional you’re satisfied with, the two of you are working as a team. Together you will be able to develop a plan to treat your anxiety disorder that may involve medications, behavioral therapy, or cognitive-behavioral therapy, as appropriate. Treatments for anxiety disorders, however, may not start working instantly. Your doctor or therapist may ask you to follow a specific treatment plan for several weeks to determine whether it’s working.
NIMH continues its search for new and better treatments for people with anxiety disorders. The Institute supports a sizeable and multifaceted research program on anxiety disorders–their causes, diagnosis, treatment, and prevention. This research involves studies of anxiety disorders in human subjects and investigations of the biological basis for anxiety and related phenomena in animals. It is part of a massive effort to overcome the major mental disorders, an effort that is taking place during the 1990s, which Congress has designated the Decade of the Brain.
Anxiety Disorders Association of America
11900 Parklawn Drive
Rockville, MD 20852-2624
Freedom from Fear
308 Seaview Avenue
Staten Island, NY 10305
National Anxiety Foundation
3135 Custer Drive
Lexington, KY 40517-4001
Obsessive Compulsive (OC) Foundation, Inc.
337 Notch Hill Rd Suites 3 & 4
North Branford, CT 06471
(203) 315- 2190
American Psychiatric Association
1400 K Street, N.W.
Washington, DC 20005
American Psychological Association
750 First Street, N.E.
Washington, DC 20002-4242
Association for the Advancement of Behavior Therapy
305 7th Avenue
New York, NY 10001
Colonial Place Three
2107 Wilson Blvd., Suite 300
Arlington, VA 22201-3042
(800) 950-NAMI (-6264)
National Institute of mental health Toll-free Information Services:
Anxiety Disorders: 1-88-88-ANXIETY
National mental health Association
1021 Prince Street Alexandria, VA
National Mental Health Consumers’ Self-Help Clearinghouse
1211 Chestnut Street
Philadelphia, PA 19107
P.O. Box 1180
Palm Springs, CA 92263
(619) 322-COPE (-2673)
Society for Traumatic stress Studies
60 Revere Drive, Suite 500
Northbrook, IL 60062