Anxiety

Anxiety disorders; how are they treated?

Anxiety disorder treatments
Dr. Darren Bassett
Written by Dr. Darren Bassett

A little-known fact among people outside of the mental healthcare industry is that Anxiety disorders are the most common of all mental health problems. Research into these disorders has shown that up to 1 in 4 adults will suffer from an anxiety disorder in their lifetime and that up to 1 in 10 people will have an anxiety disorder each year. So how do we treat anxiety disorder?

Because everybody’s anxiety disorder is different, the treatments must also be different in order to heal the individual fully. It’s a sad thought that today there are still practitioners who can only treat a patient with a single, and probably not effective for them, treatment.

Added to this, that the type of treatment you will be sent for by your GP may not be the correct type of treatment for your exact personality and anxiety disorder symptoms. If you also think about the restricted resources the NHS have to work with then you can really narrow down the treatments for anxiety disorder into four main categories:

  • Psychotherapy (talk therapy with a trained mental health professional)
  • Medications
  • Exercise
  • Natural remedies and complementary treatments

There are other options available though, which we will have a look at near the end of this article.  For now, let’s focus on what is typical in the UK right now.

Anxiety disorder and medications

This is the route I least like, I am not an advocate of medication which doesn’t address the underlying issue. It’s like putting a plaster over a hole in a bucket full of water. Sure it will work for now, but eventually, all of that water (anxiety) will burst through and make a real mess. Much better to deal with it while it is manageable and will have less impact on the individual.

However, the range of medication for anxiety disorder is vast, and in a perfect world would be used in conjunction with a therapy which suits the individual.

If you get caught up in the medication trap, your GP will almost certainly prescribe one of these types of medications for an anxiety disorder:

  • Antidepressants (despite the name, they’re the first-line treatment)
  • Anti-anxiety medications (sometimes called anxiolytics)

Why would a GP put a plaster on such a potential issue? Cost and speed. Drugs are a far cheaper and faster way to treat a patient and the results are usually seen within a few days. It’s worth remembering though that very few cases are reported where medication alone has cured somebody with anxiety disorder.

Is therapy good for anxiety?

No matter if you are suffering from mild anxiety or a severe case that requires immediate attention, the second rule (after mind-altering drugs) for the NHS and medical community is Cognitive Behavioural Therapy (CBT).

You’ve no doubt heard of CBT before, it is a form of psychotherapy where the therapist attempts to control and rewire the patients negative thinking which is undoubtedly the cause for anxiety disorder in the first place. It is a simple sit down and talk therapy where the patient starts to understand their negative behaviour and attempts to take control of their thought patterns, changing them for positive ones.

Now while it is a very good therapy for anxiety, there is no such thing as a perfect single therapy for any condition.

So what can you expect during a CBT session? The patient simply works with the therapist to identify factors which contribute to anxiety; this may be changing harmful thoughts, deep breathing, relaxation techniques etc..

As you can see, with CBT change has to come from within, as with any therapy. However with combined therapy (see the end of the article) there are many ways to help the patient become more attuned to wanting change, the very base problem with anxiety. After all, CBT requires a change from within, so if the anxiety disorder is preventing that then the therapy will not be successful.

All therapy for anxiety isn’t going to be a quick fix, that’s why medication is often over-prescribed, CBT is no exception. Taking about three to four months to start to see any benefit, however, any benefit achieved from this type of therapy is long lasting and means you can at least get off medication eventually.

“One of the biggest strengths of CBT is that the improvement tends to be durable and long-lasting,” says Suma Chand, PhD, director of the Cognitive Behavior Therapy Program in the department of psychiatry and behavioural neuroscience at St. Louis University School of Medicine in Missouri. “By the end of the sessions, the person has learned strategies that can be used for the rest of his or her life. Most importantly, the treatment also results in changes in the thinking patterns and beliefs that maintained their anxiety.”

CBT itself has many variants, for example, exposure therapy. This is where a person has a fear, phobia or OCD for example, and the therapist gradually exposes the patient to ever increasing levels of their trigger, causing them to eventually become desensitised to it.

Does exercise really reduce anxiety?

YES! Even if your therapist or GP doesn’t include exercise in your treatment, I would suggest, assuming you have no medical reason why you can’t exercise, to just get some light exercise.

And here is why…

In February 2015 there was a review of multiple studies that looked at a number of conditions and the effect of exercise. It was found that some exercise could be as helpful as medication or CBT for patients with anxiety disorders and shows better results than a placebo.

The problem is that when you feel anxious, do you really feel like exercising? Probably not! It’s certainly difficult to put the theory into practice when you have anxiety.

“Some people have anxiety so extreme that a ten-minute walk can be hard to undertake,” says Beth Salcedo, MD, medical director of the Ross Center for Anxiety & Related Disorders in Washington D.C. and board president of the Anxiety and Depression Association of America.

“Anxiety and depression, which often occur together, lead to lower motivation, so it may be that medication might help in this case to give patients enough energy to exercise,” says Ken Duckworth, MD, medical director for the National Alliance on Mental Illness and assistant professor of psychiatry at Harvard Medical School in Cambridge, Massachusetts.

Also worth noting is that patients with a fear that exertion will bring on symptoms of a panic attack, even the thought of exercising could be a trigger in those with anxiety triggered panic disorder.

Natural ways to cope with your anxiety
  • John’s wort: Probably everyone has heard of this supplement. This plant has been used to treat various conditions such as depression, anxiety, and sleep disorders for many years. Research gives the impression that St. John’s wort may be little more effective than a placebo. Also worth noting is that it could potentially be dangerous to take with certain prescription drugs, including antidepressants, contraceptives, and HIV and cancer medications.
  • Acupuncture: If your anxiety allows you to be jabbed with needles then this may be an option. There has been a small amount of scientific evidence which actually suggests that acupuncture could possibly help reduce anxiety symptoms. It may be even more effective when combined with other treatments, such as CBT or combined therapy.
  • Meditation: Now let me just clear this up, you don’t have to sit there, crossed legged humming to yourself. I have prepared a meditation worksheet for you to download, and also a 60-second relaxer worksheet. There is a growing amount of scientific evidence showing that meditation — especially a type of meditation which I teach clients called mindfulness-based stress reduction — can help to significantly reduce anxiety and depression symptoms wherever you are.
  • Valerian root:  Another well-known herb, used to treat anxiety and sleep disorders for centuries. Sadly there isn’t much scientific evidence, however, this is one I occasionally use myself for times when my stress levels are a little too high at night. There isn’t much evidence other than circumstantial to suggest it is helpful for anxiety, but who doesn’t need a good night sleep?
  • Kava: A very common herb, a crushed root of a Polynesian shrub. Some studies suggest that kava could possibly be used for treating symptoms of anxiety. However, as with all of these supplements, speak with your doctor before taking them. The Food and Drug Administration (FDA) issued a warning that using kava supplements may lead to liver damage in some people.
  • Lavender: Lavender oil is somewhat of a Marmite solution. You either love it or hate it, and it will either wake you right up and stimulate you or it will have the desired effect of toning down your anxiety and relaxing your mind. Many swear by its calming or soothing effect, but there’s little scientific evidence to support the use of lavender for treating an anxiety disorder.
  • Yoga: My least favourite suggestion here, mainly because if your anxiety is preventing you doing exercise, then you won’t do yoga either. However, you should at least try it, in the comfort of your own home. It combines physical postures, breathing exercises, and a little light meditation. Interestingly, scientific research actually suggests that practising yoga can help reduce anxiety.

Never just start taking supplements without first talking with your GP! While I am giving you the statutory warnings, never start a new exercise or yoga regime without consulting your doctor.

Combined therapy for anxiety

If you were to compare therapies for anxiety, combined therapy would be the gold standard. Combined therapy is exactly what it says, multiple different therapies used in conjunction with each other to enable the patient to quickly and efficiently heal their anxiety using multiple tools that a single therapist has at their disposal.

Here is the issue, many therapists only ever learn a single therapy. Finding therapists like myself that has many tools to use to help you heal faster are thin on the ground.

Let me explain it like this; you go to therapist A who can provide you with CBT services, you go religiously and it takes three months to start seeing positive results. You feel better and start exercising which increases your positive mood and you start to make faster progress.

Or, you can go to therapist B who can assess how you need to heal, combine therapies of NLP (Neuro-Linguistic Programming), Hypnotherapy, CBT or REBT and help you with some mind-scaping and cognitive neuroscience. You once again see the therapist religiously and start to feel more positive in a couple of weeks, you start to exercise, increasing your positive mood even faster. You listen to a custom hypnotherapy audio at home each day between seeing the therapist and that accelerates your progress ten-fold. Within 6 weeks you can start to see the therapist much less and even have call-in sessions instead of taking time off work.

As you can see, combined therapy is a much more thorough, faster and complete way to heal anxiety, depression and almost any mental health disorder.

 

If you work within a company and want to learn more about mental health and how to effectively manage it using combined therapy, please just contact me and I will try and get back to you personally within a few working days.

Resources
Simple meditation techniques

Simple Meditation Techniques

60 second relaxer

60 Second Relaxer

About the author

Dr. Darren Bassett

Dr. Darren Bassett

Specialising in law companies, Dr Darren Bassett has an extensive knowledge of mental health in the workplace. Working with small and large organisations alike, Darren helps guide them, enabling dramatic change from within with the least drama and cost.

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