The sooner people with an anxiety disorder receive appropriate treatment, the greater the chance of recovery. In most cases, anxiety disorders can be treated well.
In the treatment of anxiety disorders, a combination of drug and psychotherapeutic approaches has proven to be particularly effective.
Treatment depends on the type and severity of anxiety disorder.
On the other hand, individual wishes and preferences of patients are important.
Only if the therapy meets your own needs, can it also have its optimal effect. There are different forms of psychotherapy. In particular, cognitive behavioral therapy has been shown to be effective in the treatment of anxiety disorders. However, some people feel better with another type of therapy. A detailed conversation with your doctor or psychotherapist is crucial, so that you both agree on the type of treatment which is most suitable for you.
He gets scared and would like to run away. Another person may judge the same situation as harmless, which would cause other emotions in him. For example, he will be happy to see the dog, pet him, etc.
How a person evaluates something depends, among other things, on their experiences in the past. Thus, certain events or experiences can lead to a person developing incorrect or unfavorable beliefs.
In cognitive therapy, the affected person should recognize to what extent thinking, feeling and behavior influence each other. He learns which of his thought processes and behaviors lead to the fear being sustained. Many people are unaware of the negative thoughts that often go through their heads. A diary in which the person concerned records his thoughts and reactions in certain situations can be very helpful.
In order to make sure that a situation (e.g seeing a dog) is not really threatening, it is important to confront it. In the exposure therapy and under therapeutic guidance an anxiety patient enters the dreaded situation - usually first in his/her imagination and later in reality. The aim is to remain in the situation until the fear noticeably subsides, so that the person realizes that there is no reason for anxiety. If a person is afraid of taking elevator, therapist can talk to him directly about the situation. The person learns step by step that he/she does not have to be afraid of the situation. If an exposure is difficult or impossible, for example, fear of flying, the so-called virtual-reality exposure can be applied. Instead of the real situation, the patient learns to reduce his or her fear in a virtual world.
Psychodynamic procedures include analytic as well as deep psychotherapy.
Supporters of psychodynamic psychotherapy assume a psychoanalytic approach: everything that a person thinks, feels or does is influenced by unconscious experiences. Above all, inner, usually unconscious conflicts can stand behind strong fears. These conflicts may, for example, have been caused by certain events from childhood and now express themselves in the form of anxiety.
During treatment, the therapist and the person concerned initially work on revealing the underlying conflict in order to subsequently process it. The person should recognize that the fears behind the conflict are unfounded and have nothing to do with reality. In addition, he/she should learn to solve his conflicts more constructively.
Antidepressants are usually used in order to treat an anxiety disorder.
The person affected should learn that he is able to face his fear and overcome it even without medication. Therefore, it is important that, for example, confrontation exercises do not take place under the influence of anxiolytics (medications that inhibit anxiety).
Antidepressants can have anxiolytic and soothing effect. In treatment of anxiety disorders the following antidepressants are used:
Antidepressants intervene in the brain’s metabolism and in the concentration of neurotransmitter substances between nerve cells. Neurotransmitters are brain chemicals that communicate information throughout brain and body. They relay signals between nerve cells, i.e. neurons. The brain uses neurotransmitters to signal heart to beat, lungs to breathe, and stomach to digest. Stress, poor diet, neurotoxins, genetic predisposition, drugs (prescription and recreational), alcohol and caffeine usage can cause these levels of serotonin, noradrenaline or dopamin to be out of balance and optimal range
How do SNRI and SSRI (reuptake inhibitors) work?
First, what's reuptake? It is the process in which neurotransmitters are naturally reabsorbed back into nerve cells in the brain after they are released to send messages between nerve cells. A reuptake inhibitor prevents this from happening. Instead of getting reabsorbed, the neurotransmitter stays, at least temporarily, in the gap between the nerves, called the synapse. In this way, levels of neurotransmitters are kept higher which improves communication between the nerve cells
Side effects can be:
MAO inhibitors prevent the breakdown of so-called monoamines (dopamine, epinephrine, norepinephrine, serotonin), so that they are present in higher concentrations and thus have an anti-depressant and anti-anxiety effect. Possible side effects include dry mouth, restlessness, gastrointestinal problems and headaches.
So-called tricyclic antidepressants relieve anxiety and inner restlessness. They interfere with the concentration of various neurotransmitter substances in the brain by inhibiting their uptake into the nerve cells. Thus, neurotransmitters (the messenger substances)are available in a higher concentration for transmission between the nerve cells. Undesirable side effects include low blood pressure, dry mouth or dizziness.
Good to know: It takes at least two weeks for antidepressants to take full effect.
Other active ingredients
Other drugs that may be used in anxiety disorders include:
Pregabalin: The so-called calcium channel modulator is used especially in generalized anxiety disorders
Buspirone: Buspirone has an anxiolytic effect and can be used for treating people with generalized anxiety disorder if other therapies have not succeeded.
Opipramol: Although the active substance opipramol can be counted among the tricyclic antidepressants, it does not inhibit the reuptake of the messengers serotonin and norepinephrine. Opipramol has an anxiolytic and calming effect and is recommended for generalized anxiety disorder when other therapies have not achieved the desired results.
To bridge the time to the effects of antidepressants, doctors sometimes rely on so-called benzodiazepines. They belong to the group of tranquilizers, helping with insomnia, as well.
Benzodiazepines show their calming effect very quickly, but can make patients dependent. Therefore, you should take them only for a short time and only as long as necessary.
Relaxation and sports
Since anxiety is usually associated with a high level of tension, it is particularly effective when the person learns to put himself in a state of relaxation. Progressive muscle relaxation, for example, is ideal for this: Jacobson's progressive muscle relaxation system specifically relaxes individual muscle groups by first straining them and letting them relax.
A variation of progressive muscle relaxation is Applied Relaxation. In this method, the tension that is built up during a fear should be consciously perceived and quickly broken down. The relaxed state can be linked to a signal word, so that after some time, a targeted relaxation alone using the signal is possible.
Also regular physical activity can have a positive effect for those suffering from anxiety disorders.
Relaxation and exercise alone cannot cure an anxiety disorder, but they can significantly relieve symptoms and aid treatment.