Anxiety is a highly debilitating and common disorder. 18 percent of adults and 25 percent of adolescents are estimated to suffer from an anxiety disorder, making it the most diagnosed psychological problem in the United States. Whether it is generalized anxiety, social anxiety, or a panic disorder, it is likely to cause a fair amount of physical, mental, or emotional disruption in your life. Luckily, anxiety issues are treatable with a variety of techniques and therapies. Here are the best treatments to help alleviate your anxiety and help you get on with your life.
Cognitive Behavioral Therapy (CBT)
CBT is by far the most studied type of psychotherapy for treating anxiety. As its name suggests, the focus is on changing maladaptive thoughts and instituting behaviors to help reduce anxiety symptoms. It has been consistently proven to reduce the symptoms of anxiety.
As part of CBT, you are likely to undergo cognitive restructuring as well as exposure and relaxation exercises.
Put simply, CBT posits that distortions in thinking lead people to feel and maintain anxious feelings. Thoughts are blown out of proportion and worries are increased. The goal of the therapist is to help clients think more realistically which will lead to less anxiety.
Exposure is sometimes performed as a separate therapy but is often subsumed under CBT. It is the process of confronting anxiety-provoking situations in order to reduce anxiety. By confronting, rather than avoiding, the client learns that the situation is not as frightening as it may have initially appeared.
Like exposure, relaxation can be done separately from CBT but it is often used as a behavioral method. Relaxation is the opposite of anxiety. If you can perform exercises to help you relax (e.g., deep breathing) then your anxiety will be significantly reduced.
Acceptance and Commitment Therapy (ACT)
ACT is a more recent but rapidly growing psychotherapy. It is similar to CBT in that the focus is on thoughts and behaviors that maintain anxiety, but the approach is different. The goals are acceptance of unwanted thoughts and a commitment to life values.
Acceptance of Unwanted Thoughts
In ACT, the goal is to accept, rather than change, anxiety-provoking thoughts. Once you accept them, you can in a sense “let them go” so they will not cause further anxiety. There is a recognition that a thought does not have to lead to distressing feelings unless we give it that power. This process is known as cognitive defusion.
One of the main components of ACT is the use of mindfulness, which allows you to consider thoughts in the present moment without judgment, thus making it a perfect tool to help achieve a level of acceptance. It is also commonly employed as a therapeutic exercise in CBT and DBT.
Commitment to Value Increasing Behavior
The goal here is to take action to meet your values, not just to overcome anxiety. Although you may institute some of the same behaviors as in CBT (such as exposure), you perform them in pursuit of life satisfaction rather than symptom reduction.
Dialectical Behavior Therapy (DBT)
Another offshoot of CBT, DBT was originally developed by Marsha Linehan for use with patients with borderline personality disorder. It has since been adapted for use with anxiety and many other mental health issues. Its focus is to teach skills to enhance mindfulness, emotion regulation, distress tolerance, and relationship stability. DBT is a comprehensive treatment—it offers individual and group therapy with additional consultation and coaching.
Emotion regulation skills reduce your vulnerability to negative emotions and counteract unpleasant feelings that one inevitably experiences. One critical DBT concept for effective coping with negative emotions is acting opposite to feelings that are not appropriate for the situation. Acting opposite to anxiety is very much in accordance with cognitive-behavioral treatment: clients are encouraged to confront situations rather than follow their initial urge to avoid them. With consistent confrontation, anxiety will reduce over time.
Distress tolerance is a valuable DBT tool. By learning to deal with uncomfortable feelings, one can endure anxiety-provoking situations. Distraction is a classic example. While it is not a long-term anxiety cure, it is a skill that can get you through intense periods of anxiety, such as a panic attack.
Eye Movement Desensitization and Reprocessing (EMDR)
Originally introduced as a treatment for trauma, EMDR has branched out as an intervention for anxiety and other difficult issues. It is commonly performed by asking the client to visually track the therapist’s fingers as they remember an anxious or painful thought. It is hypothesized that the tracking decreases the intensity of the anxiety-producing thought and, therefore, allows the client to more easily process it.
The benefit of EDMR in the treatment of anxiety is clear. It allows one to confront worries that would otherwise be too powerful to approach. Anxious people have a strong urge to avoid situations that induce anxiety. Unfortunately, avoidance only leads to increased levels of worry.
By making those situations more palatable, EMDR helps clients find the strength to address important issues. EMDR remains somewhat controversial because its inner workings are not easily understood. However, despite its mysteriousness, research continues to find it an effective treatment for trauma and anxiety.
Similar to EMDR, psychodynamic therapy can be hard to unravel. It is not as structured as other therapies and can be difficult to replicate. In addition, treatment usually takes longer and can be more intensive. For example, it is not uncommon for a client to attend multiple sessions a week for many months, if not years. Because it is hard to operationalize, it has not been the subject of as much anxiety research as CBT or its related treatments.
Psychodynamic therapy focuses on past experiences and relationships as the cause of present dysfunction. Instead of being problem-focused, it emphasizes overall individual functioning.
The goal is to increase self-awareness by bringing unconscious psychological processes into consciousness. It is posited that a person will make a positive change by gathering insight into their problems. The relationship with the therapist is critical for honest communication and exploration.
Psychodynamic therapy emphasizes parent-child relationships and early experiences in personality development. According to psychodynamic theory, anxiety issues may be the result of a maladaptive upbringing and unhealthy caregiver attachment. By resolving these inner conflicts, psychodynamic therapy has been shown to help alleviate anxiety.
Short-Term Psychodynamic Psychotherapy (STPP)
In an attempt to make psychodynamic therapy more accessible, STPP was created, which is time-limited and manualized. It retains the basic principles of psychodynamic therapy, just in a briefer format. As with traditional psychodynamic therapy, the aim is to uncover the sources of the feelings that are often hidden under the surface.
Because of its brevity, the therapist needs to quickly gain the client’s trust to form an alliance that will allow effective examination of past events that prevent optimal functioning. STPP has had success in treating both depression and anxiety.
Interpersonal Therapy (IPT)
Although there is some controversy as to whether IPT can be considered a psychodynamic therapy, it is often designated under that category. It focuses on current relationship patterns as the cause of psychological dysfunction. The goal of IPT is to help address relationship problems which will, in turn, help resolve interpersonal conflict and resulting psychological issues. Due to its focus on relationships, it is a prime candidate to treat social phobia but can address any anxiety brought about by interpersonal problems.
Although it is desirable to try psychotherapy first, there is no denying that medication works well for many people and has a very high success rate. Of course, medications often have side effects and only work while you take them. If you want long-lasting effects, using medication with psychotherapy is advised. Make sure to find a licensed psychiatrist to determine the medication and dosage that works best for you.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs (e.g., Lexapro, Paxil) are the most often prescribed medications for anxiety and depression. They take a few weeks to work at an optimal level but have been found helpful in the treatment of multiple anxiety disorders with relatively few side effects.
Benzodiazepines (e.g., Xanax, Valium) work well and quickly. Unfortunately, they are highly habit-forming and should be prescribed sparingly. They also cause acute drowsiness and have serious withdrawal effects.
These evidence-based methods of therapy have the potential to greatly improve your quality of life and help mitigate your anxious thoughts. It should be noted that you will often find therapists who integrate more than one type of treatment depending on the needs of the client. For example, it is not uncommon for a therapist who primarily uses psychodynamic principles to introduce certain CBT concepts into their work. Whatever type of therapy you choose, you can be sure that working with a licensed mental health professional will help you achieve your goals of overcoming anxiety.