Anxiety Relief Techniques
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Treatment for anxiety disorders
In
general, anxiety disorders are treated with medication, specific types
of psychotherapy, or both. Treatment choices depend on the problem and
the preference of the person. Before starting treatment, a doctor must
conduct a careful diagnostic evaluation to determine whether a person's
symptoms are caused by an anxiety disorder or a physical problem. If
diagnosed an anxiety disorder, the type of disorder or the combination
of these disorders are identified, as well as any coexisting conditions
such as depression or substance abuse. Sometimes alcoholism, depression
or other coexisting conditions have such a strong effect on the
individual that treating the anxiety disorder must wait until the
coexisting conditions are under control.
People with anxiety
disorders who have already received treatment should tell in detail
their current doctor about that treatment. If they received medication,
they should tell their doctor what medication was used, what the dosage
was at the beginning of treatment if the dose was increased or
decreased during the treatment, what side effects occurred and whether
the treatment helped them to reduce anxiety. If they received
psychotherapy, they should describe the type of therapy, how often they
attended sessions, and if the therapy was useful.
Often people
think they have "failed" at treatment or that treatment did not work
when, in reality, it was not given an adequate period of time or was
administered incorrectly. Sometimes people must try several different
treatments or combinations thereof, before they find one that works for
them.
Medication
Medication will not cure anxiety disorders,
but can keep them under control while the person receives
psychotherapy. The medication must be prescribed by physicians, usually
psychiatrists, who can offer psychotherapy themselves or work together
with psychologists, social workers or counselors who provide
psychotherapy. The principal medications used for anxiety disorders are
antidepressants, antianxiety medications (pills for anxiety / nerves),
and beta blockers to control some of the physical symptoms. With proper
treatment, many people with anxiety disorders can live normal,
fulfilling lives.
Antidepressants
Antidepressants were
developed to treat depression, but are also effective for anxiety
disorders. Although these medications begin to alter brain chemistry
after the first dose, their full effect requires a series of changes
occur, usually taking 4 to 6 weeks before symptoms start to fade. It is
important to continue taking these medications long enough to let them
work.
Selective inhibitors of serotonin reuptake
Some of the
newest antidepressants are called selective inhibitors of serotonin
reuptake inhibitors (SSRIs). SSRIs alter the levels of the
neurotransmitter serotonin in the brain, which, like other
neurotransmitters, helps brain cells communicate with each other.
Fluoxetine
(Prozac ®), sertraline (Zoloft ®), escitalopram (Lexapro ®), paroxetine
(Paxil ®), citalopram (Celexa ®) are some of the inhibitors selective
serotonin reuptake inhibitors commonly prescribed for panic disorder ,
OCD, PTSD, and social phobia. Selective inhibitors of serotonin
reuptake are also used to treat panic disorder when it occurs in
combination with OCD, social phobia, or depression. Venlafaxine
(Effexor ®), a drug closely related to selective inhibitors of
serotonin reuptake, is used to treat GAD. These medications are started
at low doses and gradually increased until a beneficial effect.
Selective
inhibitors of serotonin reuptake have fewer side effects than older
antidepressants, but they sometimes produce slight nausea or jitters
when people start taking them. These symptoms fade with time. Some
people also experience sexual dysfunction with selective inhibitors of
serotonin reuptake, which can be corrected by adjusting the dose or
switching to another selective inhibitor of serotonin reuptake.
Tricyclic
Tricyclics
are older than the selective inhibitors of serotonin and work as well
as selective inhibitors of serotonin reuptake inhibitors for anxiety
disorders other than OCD. Also started at low doses and gradually
increase. They sometimes cause dizziness, drowsiness, dry mouth, weight
gain, which can usually be corrected by changing the dosage or
switching to another tricyclic medication.
Tricyclics include
imipramine (Tofranil ®), which is prescribed for panic disorder and GAD
and clomipramine (Anafranil ®), which is the only tricyclic
antidepressant useful for the treatment of OCD.
The monoamine oxidase
The
monoamine oxidase inhibitors are the oldest class of antidepressant
medications. The monoamine oxidase that is commonly prescribed for
anxiety disorders are phenelzine (Nardil ®), followed by
tranylcypromine (Parnate ®), isocarboxazid (Marplan ®), which are used
to treat the disorder panic and social phobia. People taking monoamine
oxidase inhibitors can not eat certain foods and beverages (including
cheese and red wine) that contain tyramine or take certain medications,
including some types of birth control pills, painkillers (such as Advil
®, Motrin ® or Tylenol ®), medicines for colds and allergies, and
certain herbal supplements, these substances may interact with
monoamine oxidase inhibitors to cause dangerous increases in blood
pressure. The development of a new skin patch of monoamine oxidase can
help reduce these risks. The monoamine oxidase inhibitors can also
react with selective inhibitors of serotonin reuptake and cause a
serious condition called "serotonin syndrome", which can cause
confusion, hallucinations, increased sweating, muscle stiffness,
seizures, changes in blood pressure or heart rate, and other
potentially fatal diseases.
Anti-anxiety drugs
Potency
benzodiazepines combat anxiety and have few side effects except for
somnolence (sleepiness). Because people can get used to them and may
need higher and higher doses to achieve the same effect,
benzodiazepines are generally prescribed for short periods of time,
especially for people who have abused drugs or alcohol or is easily
become dependent on medication. An exception to this rule are people
with panic disorder, who can take benzodiazepines for up to a year
without damage.
Clonazepam (Klonopin ®) is used for social
phobia and GAD, lorazepam (Ativan ®) is used for panic disorder, and
alprazolam (Xanax ®) is used for both panic disorder to GAD.
Some
people may experience withdrawal symptoms if they stop taking
benzodiazepines abruptly instead of tapering off and anxiety can return
once the medication is stopped. These potential problems have led some
physicians to avoid using these drugs or use them in inadequate doses.
Buspirone
(Buspar ®), a azapirone is a newer anti-anxiety medication used to
treat GAD. Possible side effects include dizziness, headaches, and
nausea. Unlike benzodiazepines, buspirone must be taken consistently
for at least two weeks to achieve an anxiolytic effect.
Beta blockers
Beta
blockers such as propranolol (Inderal ®), used to treat heart
conditions, can prevent the physical symptoms that accompany certain
anxiety disorders, particularly social phobia. When you can predict a
scary situation (such as giving a speech), a doctor may prescribe a
beta blocker to keep under control the physical symptoms of anxiety.
Taking Drugs
Before taking a medication for an anxiety disorder:
Ask your doctor to tell you about the effects and side effects of medication.
& Tell your doctor about any alternative therapies or medicines you are using that are not prescribed by a doctor.
&
Ask your doctor when and how to end the drug. Some medications can not
be stopped abruptly but should be gradually reduced under the
supervision of a physician.
& Work with your doctor to determine what treatment is right for you and what dose is appropriate.
& Note that some drugs are only effective if taken regularly and that symptoms may recur if the medication is stopped.
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Psychotherapy
Psychotherapy
involves talking with a trained mental health, such as a psychiatrist,
psychologist, social worker or counselor, to discover what caused an
anxiety disorder and how to manage their symptoms.
Cognitive Behavioral Therapy
Cognitive-behavioral
therapy is useful for the treatment of anxiety disorders. The cognitive
part helps people change thinking patterns that lead to their fears,
and the behavioral part helps people change the way they react to
situations that provoke anxiety.
For example,
cognitive-behavioral therapy can help people with panic disorder learn
that their panic attacks are not really heart attacks and can help
people with social phobia learn to overcome the belief that other
people are watching and judging the time. When people are ready to
confront their fears, they are shown how to use exposure techniques to
desensitize themselves to situations that trigger their anxieties.
People
with OCD who fear dirt and germs are encouraged to get their hands
dirty and wait increasing amounts of time before washing them. The
therapist helps the person cope with the anxiety that waiting produces;
after the exercise has been repeated several times, the anxiety
diminishes. People with social phobia may be encouraged to spend time
in feared social situations without being tempted to flee and to make
small social blunders and observe how people respond to them. Because
the response is usually far less harsh than the person fears, these
anxieties are lessened. People with PTSD may be supported through
recalling their traumatic event in a safe situation, which helps reduce
the fear it produces. Therapists cognitive-behavioral therapy also
teach deep breathing and other exercises to relieve anxiety and promote
relaxation.
Behavioral therapy based on exposure has been used
for several years for the treatment of specific phobias. Gradually, the
person encounters the object or situation that is feared, at first,
perhaps only through pictures or tapes, and then face to face. Often
the therapist will accompany the person to a feared situation to
provide support and guidance.
The CBT is undertaken when people
decide they are ready for it and with their permission and cooperation.
To be effective, therapy should be directed to the person's specific
anxieties and must be tailored to your needs. No side effects other
than the discomfort of temporarily increased anxiety.
Often,
behavioral or cognitive-behavioral therapy lasts 12 weeks. It can be
conducted individually or in groups with people with similar problems.
Group therapy is particularly effective in the case of social phobia.
Often, between sessions, assign "homework" for participants. There is
some evidence that the benefits of CBT last longer than those of
medication for people with panic disorder, and the same may be true for
OCD, PTSD, and social phobia. If a disorder recurs at a later, the same
therapy can be used to treat it successfully a second time.
Medication
can be combined with psychotherapy for specific anxiety disorders and
this is the best treatment approach for many people. Click here for more anxiety relief techniques.
Getting Help for Anxiety Disorders
If
you think you have an anxiety disorder, the first person you should
consult is your family doctor. A doctor can determine if the symptoms
that alarm you are due to an anxiety disorder, another medical
condition, or both.
If diagnosed an anxiety disorder, usually
the next step is to consult a mental health professional. Physicians
may be more useful for anxiety disorders are those who have had
training in cognitive-behavioral therapy and / or behavioral therapy,
and are willing to use medication if necessary.
You should feel
comfortable talking with the mental health professional you choose. If
not, you should seek help elsewhere. Once you find a mental health
professional with whom you feel comfortable, you two should work
together as a team and make a plan to treat your anxiety disorder.
Remember
that once you start your medication, it is important not to interrupt
abruptly. Certain medications should be reduced gradually under the
supervision of a physician or otherwise negative reactions may occur.
Be sure to talk with the doctor who prescribed your medication before
stopping. If you are having problems with side effects, it is possible
that these can be eliminated by adjusting the amount of medication you
take and when to take it.
Most insurance plans, including
organizations of health maintenance, will cover the treatment of
anxiety disorders. Check with your insurance company and determine what
this covers. If you are uninsured, the Division of Health and Human
Services in your county government may offer mental health care center
in a public mental health, which he charges people according to what
you can afford. If you are on public assistance, can obtain care
through your state Medicaid plan.
If you don't want to take
strong prescription meds, and would like to try a more natural
alternative anxiety relief technique, check out a method called Panic Away.
A detailed free booklet
from the US government that describes the symptoms, causes, and
treatments of the major anxiety disorders, with information on getting
help and coping, can be gotten here... http://www.nimh.nih.gov/health/publications/anxiety-disorders/index.shtml