How to recognize and treat debilitating anxiety

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Anxiety symptoms can vary from person to person, but usually fall into the following three categories:

• physical symptoms
• thought patterns
• behavior

Physical symptoms

• muscle tension
• racing or pounding heart
• restlessness
• muscle twitching or tremors
• sweating
• shortness of breath
• nausea
• upset stomach
• diarrhea
• headaches
• lightheadedness
• insomnia
• fatigue
• frequent need to urinate

Emotional

• persistent worrying
• feelings of dread or apprehension
• believing the worst is going to happen
• “all or nothing” thinking
• overgeneralizing

Behavior

• being watchful for danger
• avoiding situations or events that cause fear
• feeling irritable or frustrated in situations that cause fear
• social withdrawal
• seeking reassurance
• second-guessing
• compulsive actions, such as repeatedly washing hands

Anxiety disorders are the most common mental health condition in the United States, affecting 40 million adults every year. This figure is equivalent to 18.1% of the U.S. population.

According to the National Alliance on Mental Illness (NAMI), researchers believe that anxiety disorders can occur as a result of both genetic and environmental factors.

• Genetic factors: Evidence suggests that anxiety disorders can run in families. Therefore, people may be more likely to have an anxiety disorder if they have relatives who have an anxiety disorder.
• Environmental factors: Traumatic or stressful life events can also trigger anxiety disorders. Examples include:
  • losing a loved one
  • experiencing abuse or violence
  • living with a long-term illness

Other risk factors include a person’s individual brain chemistry and personality.

Below are some of the treatment options that can help to alleviate debilitating anxiety.

Therapy

There are a number of different therapies that can help to treat anxiety. The therapy a person receives may depend on the type of anxiety they have, as well as their personal preferences. Some examples include:

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy (CBT) aims to help people identify and change negative thinking and behavioral patterns that can activate or exacerbate their anxiety.

CBT is a practical, problem-solving therapy. It involves learning and practicing skills, language, and ways of thinking that help empower individuals to have an active role in their treatment. During CBT, a person will work closely with their therapist to:

• learn more about their condition and anxiety triggers
• learn skills or strategies to help control their anxiety
• complete tasks or assignments to practice their new skills and strategies

According to the Anxiety & Depression Association of America (ADAA), CBT is a highly effective and long-lasting treatment. People typically experience the benefits of CBT after 12–16 weeks of consistent practice.

Exposure therapy

Exposure therapy involves gradual and controlled exposure to situations that people find fearful. The aim is to assist people in developing healthy coping strategies that will help reduce their fear response.

Exposure therapy can help with the following anxiety disorders:

• social anxiety
• obsessive compulsive disorder (OCD)
• phobias

Acceptance and commitment therapy (ACT)

Acceptance and commitment therapy (ACT) teaches people mindfulness and acceptance strategies to help them cope with negative thoughts, sensations, or feelings. This type of therapy can help people:

• have better control over their reactions to unpleasant feelings
• learn not to avoid potentially negative or stressful situations
• accept their thoughts and emotions
• feel clarity in their own values
• commit to behavioral changes

Dialectical behavioral therapy (DBT)

Dialectical behavioral therapy (DBT) is a complex and multilayered therapy that combines CBT methods with Eastern meditation techniques to focus on both acceptance and change.

DBT uses a combination of group therapy, individual therapy, and additional access to a person’s mental health professional to teach the following:

• mindfulness
• stress tolerance
• emotion regulation
• interpersonal skills

Eye movement desensitization and reprocessing (EMDR)

Eye movement desensitization and reprocessing (EMDR) originates from the idea that negative thoughts, feelings, and behaviors result from problems with processing information and memories.

During EMDR, a person’s therapist will typically have them recall distressing mental images while they help guide the person to shift their eyes back and forth in a bilateral motion. This is to provide bilateral stimulation, which uses alternating right and left stimulation to activate the brain’s two hemispheres. It may also involve other movements, such as tapping their hands.

EMDR seems to affect how the brain processes information, effectively allowing people to experience disturbing material in a less distressing way.

According to the ADAA, EMDR may work similarly to rapid eye movement (REM) sleep. It may be effective in treating the following anxiety disorders:

• panic attacks
• phobias
• post-traumatic stress disorder (PTSD)

Medication

Anxiety treatment may involve taking medication on either a short- or long-term basis. Below are some medications a doctor may prescribe for the treatment of anxiety.

Selective serotonin reuptake inhibitors (SSRIs)

Serotonin is a neurotransmitter that has a positive effect on mood, emotion, and sleep. It works by carrying messages between nerve cells in the brain. Nerve cells usually reabsorb the serotonin after the message is delivered.

Selective serotonin reuptake inhibitors (SSRIs) prevent nerve cells in the brain from reabsorbing serotonin. This increases levels of serotonin in the brain, helping to improve mood and relieve symptoms of anxiety.

SSRIs may be an effective treatment for all types of anxiety disorders.

Common side effects of SSRIs include:

• insomnia
• sleepiness
• sexual dysfunction
• weight gain

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Norepinephrine is a neurotransmitter that plays a role in attention, mental focus, and memory. Selective norepinephrine reuptake inhibitors (SNRIs) work by preventing nerve cells in the brain from reabsorbing serotonin and norepinephrine. This increases levels of both neurotransmitters in the brain, thereby helping to improve mood and alleviate anxiety.

Side effects of SNRIs may include:

• headache
• insomnia
• upset stomach
• weight gain
• sexual dysfunction
• minor increase in blood pressure

Benzodiazepines

Benzodiazepines are a type of sedative medication that helps to slow down brain and body functions. They help to treat the physical symptoms of anxiety, such as:

• muscular tension
• headaches
• sweating
• panic attacks
• restlessness
• insomnia

People may take benzodiazepines for the short-term treatment of anxiety, either on their own or in combination with other treatments. However, these medications may be a last-resort treatment, as unlike SSRIs, they are highly addictive.

Tricyclic antidepressants

Tricyclic antidepressants increase levels of serotonin and norepinephrine in the brain, while reducing levels of the neurotransmitter acetylcholine.

Acetylcholine enhances the brain’s sensitivity to external stimuli and increases attention. As such, reducing acetylcholine levels may help to treat certain types of anxiety disorder.

Tricyclic antidepressants can cause the following side effects:

• a drop in blood pressure when a person stands
• dry mouth
• blurred vision
• constipation
• urinary retention

Alternative or complementary treatments

Alternative or complementary treatments may help to alleviate certain anxiety symptoms. Examples of such treatments include:

• relaxation and stress management techniques
• meditation
• yoga
• acupuncture

Exercise

Exercise may help to reduce stress and anxiety. According to NAMI, aerobic exercise may be particularly beneficial.

A person can discuss an appropriate exercise plan with their doctor.

It is important that people seek help for debilitating anxiety. According to the ADAA, anxiety disorders are very treatable, but only 36.9% of people with an anxiety disorder receive treatment.

Due to the nature of anxiety, it may be daunting for a person to see a mental health professional. However, therapy is a highly effective and long-lasting treatment to help people develop tools to manage their anxiety. Many people may see improvements in 12–16 weeks. People can also combine therapy with medications to help manage anxiety disorders.

Anyone who is experiencing debilitating anxiety should make an appointment with a mental health professional or their doctor. They will be able to provide a person with tools, such as breathing and relaxation techniques, methods to challenge anxious thoughts, and medications, to help manage their anxiety disorder.

People may need to try different therapies, therapists, or medications to find a treatment approach that works for them. A person should always consult a doctor before stopping or switching medications or making changes to medication dosages.

Debilitating anxiety is anxiety that involves an irrational sense of fear or dread about everyday situations or tasks. This type of anxiety can interfere with a person’s everyday life.

Anxiety can manifest as physical, emotional, and behavioral symptoms. Anyone who experiences debilitating anxiety should seek professional help. With the right help, anxiety disorders are highly treatable.

The type of treatment a person receives will depend on the type of anxiety they are experiencing, as well as their personal preferences. Treatment options include therapy, medications, or alternative treatments, such as meditation or mindfulness. A person can talk to their doctor about the different treatment options available to them.