Anxiety Disorder – Diagnosis and Treatment
How do I know if I have a general anxiety disorder?
The first step is to rule out the possibility that your symptoms are caused by a medical condition that is not psychiatric. The conditions that cause similar symptoms of anxiety are hyperthyroidism or other endocrine problems, too much or too little calcium, low blood sugar, and some heart problems. Some medicines can also sometimes cause anxiety. A deeper evaluation by your health care provider will determine if any of these conditions are the cause of your symptoms.
If no other medical offender can be found and the symptoms seem out of proportion to experiencing any condition, then you may be diagnosed with an anxiety disorder.
What is the Anxiety Disorder Treatment?
Medication for Anxiety
The drug is useful for reducing symptoms of generalized anxiety disorder and is often prescribed in combination with other treatments. Certain types of anxiety medications can be habit-forming and are usually short-term or necessary.
Different anxiety disorders have different medications. Some are preventative but some are designed to fix the problem.
Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), are widely used to treat and prevent many types of anxiety disorders. Examples of SSRIs commonly used to treat generalized anxiety include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). The antidepressants duloxetine (Cymbalta) and venlafaxine (Effexor), SNRIs (serotonin and norepinephrine reuptake inhibitors) act on the brain’s serotonin and norepinephrine receptors, and some tricyclic antidepressants such as imipramine (Tofranil). Newer antidepressants such as mirtazapine (Raymon) are also prescribed regularly.
Antihistamines (such as hydroxyzine) and beta-blockers (such as propranolol) can cause mild cases of anxiety as well as performance anxiety, a type of social anxiety disorder. Antidepressants such as SSRIs or SNRIs or tricyclics should be taken daily whether or not there is a concern on that particular day as determined by your health care provider. Antihistamines or beta-blockers are usually taken only when necessary for anxiety, or immediately before an anxiety-provoking event (eg, taking propranolol shortly before giving a speech). Finally, some anticonvulsant drugs, such as gabapentin (Neuropt) and pregabalin (Lyrica), are beginning to show value in the treatment of some forms of anxiety in early research studies.
If you have acute anxiety (panic attack), you will need to take the anti-anxiety medication. The most prominent anti-anxiety drugs for the purpose of immediate relief are known as benzodiazepines; They include alprazolam (Xanax), clonazepam (Klonopin), chlordiazepoxide (Librium), diazepam (valium), and lorazepam (Ativan). Their drawbacks are: Benzodiazepines sometimes cause drowsiness, irritability, dizziness, memory and attention problems, and physical dependence. However, in recent decades they have largely replaced barbiturates as they become safe in large doses.
Another anti-anxiety drug is buspirone (Buspar). It has fewer side effects than benzodiazepines and is not associated with dependence. However, Buspar can have side effects of its own and may not always be effective if a person has used benzodiazepines in previous years.
Therapy for Anxiety
Psychotherapy, with or without treatment, is often an important part of treatment for generalized anxiety disorder.
Several specific forms of psychotherapy have been described in research studies to reduce GAD symptoms. Two – psychotherapy and supportive-expressive therapy – focus on anxiety as an outbreak of feelings about important relationships. Another form of psychotherapy, called cognitive-behavioral therapy, involves learning behavioral relaxation techniques as well as reorganizing patterns that promote anxiety.
Biofeedback is another helpful tool. In a series of sessions with a therapist, you look at your brain-wave pattern on an electroencephalograph and slowly learn to control the waves. It teaches you how to achieve a more relaxed state. Physicians estimate that after about a dozen sessions, you will be able to control mental activity without the help of a therapist or monitoring device.