Two Most Common Anxiety Disorders Treatment Options

The two most common anxiety disorders treatment options are medication (anti-depressants and anti-anxiety drugs primarily) and psychotherapeutic approaches (cognitive-behavioral therapy, e.g.). Research and practice have allowed mental health professionals to develop specific recommendations for which of these approaches-or which combination-is most appropriate for each of the six types of anxiety disorder.

Panic Disorder. The American Psychological Association now recommends Cognitive-Behavioral Therapy as the preferred initial treatment approach for people suffering from panic attacks or panic disorder.

The treatment of panic attacks with cognitive restructuring has three stages: reducing the fear of the attack itself; reducing fear of the physical symptoms that occur during an attack; and reducing fear of the situations or things that the patient associates with the panic attacks and therefore avoids. The process begins with a reconstruction and analysis of the patient's history of panic episodes, and introduces counter-information to contextualize their fears. Controlled behavioral experiments may then be used, during which patients are encouraged to let themselves experience the full impact of a panic attack while applying cognitive observational techniques they have learned. Interoceptive exposure and desensitization exercises are also used in controlled circumstances to help panic sufferers practice dealing with their specific physical symptoms such as dizziness, palpitations or hyperventilation. Exposure and desensitization can also help people lose their over-reactiveness to objects, activities or situations they fear and avoid.

Obsessive-Compulsive Disorder. Patients with OCD seem to response less positively with cognitive-behavioral therapy alone, though a variation of exposure therapy called "response prevention" can be helpful. Patients practice completely resisting their ritual behaviors upon being repeatedly exposed (at least 20 hours usually) to the things that trigger the ritual response. Anti-depressants seem to be particularly useful in the treatment of OCD.

Phobias. Specific phobias are among the anxiety disorders most successfully treated through CBT. Once patients overcome their initial reluctance to seek help-which can make it difficult to diagnose the problem in the first place-desensitization through gradual exposure is relatively straightforward and fast. Social phobia is a more complex problem, because the triggers are more internal and rooted in distorted self-assessment. However, social phobia is responsive in many cases to CBT. Group treatment is often useful by helping patients recognize similar distortions and fears as they occur in other people. Beta blockers can also help people with social phobia deal with specific situations, such as a public performance or presentation. SSRIs and MAOI anti-depressants can also be indicated.

Post Traumautic Stress Disorder. People with PTSD often have very severe symptoms (frequently including panic attacks),. The triggers and stimuli they avoid are likely to be complex and numerous. PTSD sufferers are particularly likely to fear that they are "going crazy." They generally need to work with highly experienced and sensitive therapists.

General Anxiety Disorder. This can be one of the least responsive conditions to cognitive-behavioral therapy because it is so generalized that it can be difficult to identify specific targets for desensitization or exposure therapy. GAD sufferers are less likely to have specific avoidance behaviors, so behavioral exposure is not particularly indicated. GAD also tends to be closely associated with depression, and the treatment of choice is often psychopharmacological. The Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed medications for people with GAD.

Many practitioners recommend and prescribe anti-anxiety drugs (benzodiazepines) as a primary treatment option for anxiety disorders, particularly panic disorder. Others prefer to avoid these drugs in part because they are so immediately effective. Patients may feel so much immediate relief that they are less motivated and willing to undertake the more demanding and time-consuming tasks involved in cognitive-behavioral approaches that lead to more lasting long-term success.