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Because there are different anxiety disorders and many potential causes, no single treatment works for all of them. Treatment must be tailored specifically for each individual; what works well for one person may not work for another. Anxiety can be complicated by co-occurring mental or physical conditions, as well as by relationships and other environmental stressors. For these reasons, you should work with your doctor or therapist to determine the treatment option—or combination of options—that works best for you.
Unless you experience adverse side effects, don't be too quick to abandon a treatment because it doesn't provide instantaneous results. Weeks may pass before you detect improvement. Discuss all side effects with your mental health provider; it's often worth sticking with an effective treatment and seeking out ways to reduce or eliminate any negative side effects. Importantly, never stop taking medication without consulting your doctor first because an abrupt stop may cause other health problems.
The medications described below can be obtained only with a prescription. Primary care physicians can diagnose and treat anxiety, but they may recommend that you consult a psychiatrist for severe or treatment-resistant anxiety disorders.
Serotonin is a chemical that acts as a neurotransmitter, carrying signals along and between nerves—and it also plays a role in mood regulation, which is helpful for someone with anxiety. SSRIs block certain nerve cells in the brain from reabsorption, or reuptake, which leaves more serotonin available. SSRIs include fluoxetine, fluvoxamine, sertraline, citalopram, paroxetine, and escitalopram. Brand names associated with SSRIs include Paxil, Prozac, and Zoloft. SSRIs may be used to treat post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder, social anxiety disorder (SAD), and obsessive-compulsive disorder (OCD).
SNRIs increase the levels of serotonin and norepinephrine (a chemical also known as a stress hormone) by inhibiting their reabsorption into brain cells. SNRIs include venlafaxine, milnacipran, desvenlafaxine, levomilnacipran, and duloxetine. Cymbalta and Effexor are examples of SNRI brand names. A physician may prescribe SNRIs for patients with GAD, SAD, or panic disorder.
A doctor may also consider an off-label use of a drug specified by the Food and Drug Administration (FDA) as effective for a condition other than an anxiety disorder or one that is approved outside the United States.
You might also be interested in A Brief Overview of Anxiety Medication
The treatment options listed here require the assistance of a mental health or medical provider or other licensed professional.
Peer support groups offer an opportunity to share experiences and offer advice. In addition to fostering relationships between people with similar struggles, participating in a support group validates the shared experience of anxiety.
Group therapy led by a mental health professional is often called a skills-training group. Moderators in these sessions may employ CBT or DBT to teach coping skills or use exposure therapy to provide a supportive environment for exposure to a feared situation. A process group may be a good fit for people with social anxiety or generalized anxiety disorder (GAD). The theory behind these groups is that, as you develop friendships with others in the group, over time the sources of anxiety will emerge and can be addressed.
Brain Stimulation Therapies
These procedures target the regions of the brain that influence stress, anxiety, mood, and fear response.
For those who seek alternatives to traditional medicine or would like to supplement their treatment, self-help and complementary and alternative medicine (CAM) may be useful.
The nutrients L-theanine16 and tryptophan may help decrease anxiety if added to your diet. Ongoing research seeks to determine whether vitamin E, omega 3 polyunsaturated fatty acids, glycine, and inositol supplements could have protective or other anti-anxiety benefits.
Using diet to manage anxiety may also require avoiding or moderating some foods and beverages. A study in 2005 found that the preservative sodium benzoate, found in jelly, soda, and other products, contributes to anxiety. There is also some evidence that links age and high-cholesterol to anxiety. Because of their stimulating effects —which can increase anxiety—sugar and caffeine should be consumed in moderation. In addition to all of the anxiety-exacerbating problems that can come with drinking too much, alcohol is a diuretic that can speed up the loss of valuable nutrients17.
Meditation is a conscious practice of focusing your thoughts in one specific direction, redirecting them when they begin to wander. It is usually best practiced in an environment without sensory distractions such as crying babies, barking dogs, cold temperatures, pungent odors, or uncomfortable furniture.
Many consider mindfulness a subcategory of meditation. It keeps your thoughts focused on the present moment, even if they wander. For example, you might notice muscle tension in your shoulders, then the sound of the clock ticking and the pattern of your breathing. In practicing mindfulness, it's important that you recognize your own experiences without casting judgment.
Of supplements marketed for anxiety, chamomile19 and kava20 have shown some promise. Studies of passionflower21 have shown mixed results or were tested only in small groups of people. No studies have reported benefits of using St. John's Wort to treat anxiety. In fact, if you have been prescribed an SSRI or SNRI, adding St. John's Wort can cause a potentially life-threatening condition known as serotonin syndrome. The research on lavender oil, lemongrass, bacopa monnieri, and other herbs is ongoing; there simply is not enough information to know whether they can treat anxiety, work better than a placebo, and most importantly, if they are safe to use at all.
Grants and Funding: We proudly support the research and programs of 501(c)(3) non-profit organizations and institutions such as: the Anxiety Disorders program of the Jane & Terry Semel Institute for Neuroscience & Human Behavior at the University of California, Los Angeles; the Pacific Institute of Medical Research; the International Foundation for Research and Education on Depression (iFred); and SchoolsForHope.org, an iFred educational project. Working with these partners enables Anxiety.org to extend its commitment to its mission. All the donations received, as well as 100% of Anxiety.org revenue in 2019, will be contributed to build, develop, and further the understanding, investigation, discovery, and treatment of the full spectrum of anxiety and related disorders.