How To Treat Anxiety: A Comprehensive Guide

Anxiety disorders are the most common mental illness in the US, with more than 19% of the adult American population¹ suffering from anxiety every year. While anxiety is highly treatable, only about a third of those with anxiety² receive treatment.

Understanding the different types of anxiety disorders and their causes can help you to identify the symptoms early and seek help as soon as possible.

What is anxiety?

Virtually everyone experiences anxiety from time to time. It is normal to feel anxiety during a job interview or before taking an exam. However, if you experience excessive anxiety that overwhelms you and interferes with your everyday activities, you may have an anxiety disorder.

Understanding the difference between normal anxiety and a disorder can help you to get assistance as soon as possible and improve your quality of life.

What are the common types of anxiety disorders?

There are several different types of anxiety disorders. It is important to understand their features in order to diagnose and treat each disorder.

It's also possible to suffer from several anxiety disorders simultaneously. When this happens, a mental health professional may suggest a comprehensive treatment program.

Anxiety disorders include:

Generalized anxiety disorder (GAD)

Excessive worry interferes with your ability to carry out everyday activities. GAD is often accompanied by physical symptoms, such as muscle tension, restlessness, fatigue, and insomnia. Learn more.

Panic disorder

A condition where you experience repeated, unexpected panic attacks. These are intense episodes of overwhelming fear that can be accompanied by strong physical symptoms.  Nearly 5% of the US population³ experiences panic disorder at some point during their lifetime.

Social anxiety disorder (social phobia)

Overwhelming anxiety and excessive self-consciousness when faced with everyday social situations. You may worry about being judged or humiliated by others. Learn more.

Phobias

Specific phobias involve intense and persistent fear of something. You may know your phobia is excessive and/or irrational, but cannot overcome it.

Agoraphobia

This disorder involves an excessive fear and avoidance of places and situations that may cause you to feel trapped or helpless, such as planes, public transportation, or elevators, and crowds.

Separation anxiety

This is a fear of a loved one leaving you. While it is more common in children, adults can also suffer from this disorder.

What are anxiety symptoms?

While each type of anxiety disorder comes with its own symptoms, there are symptoms that are common across all types. These include:

Psychological symptoms

• Fear

• Panic

• Uneasiness

• Tension

• Nightmares

• Difficulty concentrating

• Irritability

Physical symptoms

• Insomnia

• Cold and sweaty hands

• Gastrointestinal problems (diarrhea, constipation)

• Hyperventilation

• Increased heart rate

• Trembling

• Dry mouth

• Dizziness

• Muscle aches

Once the situation that is causing you anxiety resolves itself (e.g. a panic attack stops, or you are no longer facing a situation or object that triggers a phobia), symptoms tend to go away.

If you are experiencing any of these symptoms, it's important to speak to your doctor or a mental health professional for a diagnosis. Once diagnosed, you can start treating the anxiety and improving your quality of life.

What causes anxiety disorders?

The exact cause of anxiety disorders is yet to be discovered, but the medical community suggests it can be caused by a combination of several factors, including:

Environment

Experiencing trauma, such as living in an abusive family, suffering a traumatic event, or sexual abuse could trigger an anxiety disorder.

Heredity

If anxiety disorders run in your family, you are more likely to suffer anxiety compared to someone with no such family history.

Medication

Anxiety symptoms can be a side effect of certain medications, such as those containing caffeine, corticosteroids, and medication for ADHD, asthma, thyroid, seizures, or Parkinson's disease).

Other mental health disorders

If you suffer from depression, you are likely to also experience anxiety.

Lifestyle choices

Drug and alcohol use, especially heavy use, may cause anxiety.

Just because you have developed an anxiety disorder doesn’t mean that you are weak or flawed. This common condition can happen to anyone, regardless of physical health, character strength, social status, or upbringing. There is no shame in having anxiety. The best thing you can do is to seek help.

Diagnosis

If you suspect that you may have an anxiety disorder, contact your doctor. They will perform a physical exam and run some tests to make sure your anxiety disorder symptoms aren't caused by a physical condition.

Your doctor will then ask you questions about your symptoms and lifestyle. After this evaluation, they may refer you to a mental health specialist (a psychologist or psychiatrist) who can diagnose you with anxiety and discuss a treatment plan with you.

Doctors and specialists

While a doctor can make a preliminary diagnosis about whether you have anxiety, you may need to see a psychiatrist or psychologist for further diagnosis and treatment.

Can you self-diagnose anxiety?

While there are many self-diagnosis questionnaires and tests available online, you should get a professional diagnosis before starting any treatment. Remember, some anxiety symptoms could be signs of physical conditions that need immediate medical attention so make sure to contact your doctor in the first instance when you notice symptoms.

Treatment

The two main ways of treating anxiety disorders are therapy and medication.

Common types of therapy include:

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) has two components:

• Cognitive therapy — Addressing how your thoughts and emotions contribute to anxiety.

• Behavioral therapy — Addressing how your behavior contributes to anxiety.

CBT is based on the idea that negative thoughts, not external events, affect the way we feel emotions such as anxiety. This therapy aims at identifying and challenging these thoughts, then replacing them with positive or realistic thoughts.

Exposure therapy

This type of behavioral therapy works by exposing you to anxiety triggers, such as events, environments, or objects, and teaching you how to manage the fear or discomfort they trigger.

Types of exposure include directly facing what is causing you to fear or discomfort, imagining it, virtual reality exposure, and interoceptive exposure (initiating harmless but feared physical sensations).

Exposure therapy can help by:

• Gradually decreasing your reaction to feared objects or situations.

• Weakening previous associations with feared objects or situations.

• Showing you that you are capable of confronting your fears and dealing with anxiety.

• Creating new realistic beliefs about feared objects or situations to increase your level of comfort with them.

Exposure therapy can be highly effective. It has been shown to help up to 90% of patients with specific phobias⁴ to reduce or eliminate their symptoms.

Biofeedback 

Biofeedback therapy can provide you with information about how anxiety affects your body. During the session, a doctor connects sensors to your body, so you can see how it responds when you feel symptoms of anxiety.

Biofeedback monitors:

• Brain waves

• Heart rate

• Breathing

• Muscle contractions

• Sweat gland activity

• Temperature

• Blood pressure

A mental health professional can use biofeedback to help you to understand how your body reacts to anxiety and which treatments do and do not work for you. While not a standalone therapy, biofeedback can be a useful addition to an anxiety treatment program.

Applied relaxation therapy

Applied relaxation therapy (ART) can be an effective therapy for GAD. It involves relaxing your muscles in a specific way during situations that cause anxiety.

ART techniques involve:

• Ability to relax quickly in response to cue words like "relax”

• Exercising progressive muscle relaxation (tense and release)

• Practicing relaxation in places that trigger anxiety

While it's possible to learn muscle relaxation methods on your own, a mental health professional can teach you ART techniques to ensure you are applying them correctly for the best results.

As studies show⁵ that ART tends to have lower effectiveness than CBT, ART can be used to complement CBT rather than as a treatment on its own.

How long does anxiety therapy take?

According to the American Psychological Association, many people with anxiety show significant improvement after 8-10 therapy sessions. For some types of therapy, it can take less time to see results. 

For instance, it typically takes 4-6 sessions of ART to master the technique and start practicing it to reduce anxiety symptoms.

Whichever therapy your mental health professional recommends, you are likely to see improvements in your anxiety condition within a few hours, with better results the longer you continue with treatment.

By starting therapy as soon as possible, you can improve your quality of life by preventing your condition from worsening and suffering physical and mental health consequences.

Therapy can be in-person or online.

Medication

Anxiety can be treated with both therapy and medication. The most common types of medication for treating anxiety disorders include:

Selective serotonin reuptake inhibitors (SSRIs)

This is a category of antidepressants that are commonly used to treat such anxiety disorders as GAD, panic disorder, and phobias. They are often prescribed in combination with CBT for maximum effectiveness.

Generic names for SSRIs in the US are:

• Citalopram

• Escitalopram

• Fluoxetine

• Fluvoxamine

• Paroxetine

• Sertraline

• Vilazodone

SSRIs work by increasing levels of serotonin in the brain. You may need to take this medication for two to six weeks before you start to feel the effects. SSRIs should be taken with caution if you have diabetes, epilepsy, or kidney problems.

Ensure you discuss the possible side effects of using SSRIs, which can be severe, before use.

Benzodiazepines (tranquilizers)

Benzodiazepines are a type of sedative which slow brain and body function to help to reduce symptoms of anxiety disorders. They tend to make you feel relaxed and sleepy and are usually prescribed to treat severe anxiety.

Common benzodiazepines are:

• Clonazepam

• Alprazolam

• Lorazepam

• Diazepam

• Bromazepam

Taking a high dose of benzodiazepines for more than a few weeks increases the risk of addiction. It is important to consult your therapist about the duration of treatment and to carefully monitor your progress.

Beta-blockers

Beta-blockers can help to control anxiety symptoms. While they are typically used to treat heart conditions, this medication can be administered in combination with therapy for anxiety. Beta-blockers work by blocking adrenaline receptors which slows your heart rate and prevents your body from entering fight-or-flight mode in response to an anxiety trigger.

Common beta-blockers are:

• Atenolol

• Bisoprolol

• Metoprolol

• Nadolol

• Nebivolol

• Propranolol

The side effects of beta-blockers include dizziness, diarrhea, vomiting, hair loss, insomnia, and muscle cramps. You should discuss with your doctor if you experience these symptoms, as they can regulate the dosage to suit your personal circumstances.

Other types of anti-anxiety drugs include tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, monoamine oxidase inhibitors (MAOIs), and anxiolytics.

It is important to see a qualified mental health professional if you believe you may have anxiety, as they can prescribe the appropriate medication, if required, for your condition. If you self-diagnose an anxiety disorder, you still need a doctor's confirmation before proceeding with any treatment.

Lifestyle

While your mental health professional can provide you with a treatment plan, there are also positive lifestyle changes you can make to improve or reduce anxiety symptoms, especially when combined with therapy and/or medication. These include:

Exercise

Aerobic exercise (walking, running, cycling, swimming, etc) helps with alleviating anxiety symptoms. Research shows⁶ that exercising regularly can improve your mental health.

Yoga or tai chi

The poses involved in these practices can help to reduce anxiety symptoms. Research shows⁷ that just one hour of yoga per week can lessen anxiety symptoms.

Meditation

Regular meditation improves your ability to regulate emotions, helping you deal with anxiety. Studies show⁸ that meditation has moderate positive effects on alleviating anxiety symptoms.

Lifestyle changes

Eliminating bad habits, reducing caffeine, alcohol, and quitting smoking, and eating a healthier diet can all help you to improve your mental health and better manage anxiety.

The lowdown

Anxiety disorders are very common mental health issues that affect millions of Americans. By seeking help early, a mental health professional can diagnose and provide you with a treatment plan to help you see positive results in just a few weeks.

The key treatments for anxiety disorders are therapy and medication. These can be complemented by lifestyle changes, such as meditation, yoga, exercise, and a healthy diet.

Understanding the different types of anxiety disorders, their causes, symptoms, and how to treat them can help you to improve your quality of life and avoid ongoing negative consequences.