Anxiety is a very real part of life for many individuals. The pressures of life, escalated fears and phobias, or reversion to a previous trauma may trigger a bout of anxiety. However, when anxiety becomes prolonged or constant, treatment should be sought. The affects of clinical anxiety can range from mildly uncomfortable to extremely chaotic or even suicidal. Understanding the types of anxieties and available therapies provides the best chance for controlling and hopefully curing anxiety.
What is Anxiety?
The body is a complex organism that contains many chemicals and hormones. When under stress or in a state of fear, the body will produce chemical reactions that result in a spurt of adrenaline or ignite a fight or flight signal. This is normal and necessary to keep us safe and provide the sometimes necessary pressure to meet and achieve goals and strenuous tasks.
In the case of anxiety disorders, the mind/body reaction to fear or pressure reaches a state of constant fear, often irrational and reoccurring. When anxiety reaches the point of causing one to be unable to deal with normal everyday stressors or social situations, it can be classified as a disorder and become quite debilitating.
Who Suffers from Anxiety Disorder?
Anxiety is a disorder that affects individuals indiscriminately. Everyone from corporate executives to stay at home mothers are susceptible to anxiety. Children are also not exempt from experiencing the symptoms of this disorder.
Everyone experiences stress points in their life and many factors affect their ability to deal with stress effectively. Current health, emotional state and life responsibilities are just a few of the factors that determine how someone may respond to anxiety. A person who is overworked and has little emotional support may be more likely to suffer from anxiety disorder than one who is comfortable in their career and has an extensive and reliable support system.
Common Types of Anxiety
Anxiety presents itself in many forms, but the most common forms as defined by the National Institute for Mental Health are:
- General Anxiety Disorder
- Obsessive Compulsive Disorder (OCD)
- Panic Disorder
- Social Phobia
- Post Traumatic Stress Disorder
Read on for an explanation of each disorder, common methods of diagnosis, common treatments, as well as alternative treatments.
General Anxiety Disorder
Individuals with general anxiety can be classified as chronically worrisome. They often overreact to stress or slight trauma and become extremely agitated by events that others would find perfectly normal. Often individuals suffering from general anxiety have a fear of mixing in society or being in any type of unfamiliar setting. They may also experience physical symptoms as well as loss of sleep.
Diagnosing General Anxiety Disorder
A diagnosis of General Anxiety Disorder is made after careful consultation with a mental health professional. The therapist will look to see that the patient illustrates the inability to manage daily life and find appropriate coping mechanisms. Before making a diagnosis, the health practitioner will ensure that the patient is not just dealing with enormous stress, but also becomes extremely worried about perceived problems that cannot be substantiated. This is a hallmark of General Anxiety Disorder.
Below is the official diagnosis criterion of the American Psychiatric Association. A diagnosis is made if a patient has experienced excessive fear or worry, which he is unable to control, accompanied at a minimum of three of the symptoms below for at least six months.
- Feeling restless, keyed up, or on edge
- Feeling tired frequently
- Difficulty concentrating or mind going blank
- Muscle tension
- Difficulty falling or staying asleep
Causes of General Anxiety Disorder
Anxiety is a complicated illness in which there are many possible causes. While genetic testing has shown that it is possible to inherit a gene that may make you more susceptible to experiencing anxiety, there are other factors as well. Research has indicated that the inability of certain neurotransmitters in the brain to function properly may be a contributing factor. Specifically, blockage of the neurotransmitter gamma aminobutyric acid (GABA) is believed to be a contributing factor in the heightened sense of worry experienced by anxiety sufferers.
Another prominent cause is to possess a nervous system that is less flexible to changes in your environment or brain in relation to worry or fear. The nervous system alerts the body in times of danger, prompting the fight or flight response. However, when the danger has passed, the parasympathetic nervous system releases signals that help the body calm down and return to its normal biological and mental state.
In individuals suffering from generalized anxiety, the parasympathetic nervous response is impaired, leaving them in a heightened state of anxiety, even after the danger has passed. Over a prolonged period of time, this can cause serious mental health issues, as the individual is unable to adequately distinguish between danger and safety.
Treating General Anxiety Disorder
Traditional treatment for general anxiety varies and is dependant on the severity of an individual’s symptoms. The most common forms of treatment are:
- Having ongoing consultations with a mental health professional can alleviate General Anxiety Disorder. A patient may be able to work out the reasons for their anxiety without resorting to medication by working with a skilled therapist. A therapist knowledgeable in anxiety disorders can provide an objective assessment of your fears. They can also provide solutions to aid the patient in recognizing and combating unwarranted anxiety, such as cognitive behavior therapy (CBT), relaxation training, and facing the issues head on.
- Anti-anxiety and anti-depression medications are commonly given to anxiety sufferers. Their function is to calm the brain and bring about a sense of relaxation and wellbeing. It is best if medication is administered in conjunction to therapies such as CBT and other coping therapies. It is interesting to note that research has found that non pharmaceutical therapies, such as CBT had more of an impact on anxiety over the long term than combining medicine and stress reducing therapies, or than with anti-anxiety medication alone.
Alternative Health Therapies
Holistic therapies for general anxiety are built upon the premise that the mind and body are intrinsically interwoven. What affects one part of the body negatively will have a trickle down affect to other areas of the body as well. By the same theory, isolating and treating the root cause of anxiety will aid in the restoration of wellbeing for the entire body.
Holistic practitioners believe that while general anxiety can be caused by traumatic life experiences and neurotransmitter obstructions, nutritional and mineral deficiencies, as well as hormonal imbalances often play a prominent role. Recommended nutritional therapies include:
- Kava root
- Rodiola Herb
- St. John’s Wort
- Vitamin B
- Following a hypoglycemic diet
- Eliminating foods to which you may have an allergy
Other Alternative Anxiety Treatments
Holistic health practitioners will also evaluate a patients overall health and look for hormonal imbalances, lack of amino acids and essential fatty acids, as well as sleep irregularities. Also, CBT, exercise and other forms of stress management will be introduced. The focus of an alternative health provider will be to bring the entire body back into harmony, thus eliminating the symptoms of General Anxiety Disorder.
Another alternative treatment is the “Linden Method”, developed by former anxiety sufferer, Charles Linden. He is of the opinion that anxiety is caused by a switch in the brain becoming stuck in panic mode. He, along with a team of professors and psychotherapist work together in the Linden Center to help other anxiety suffers through a series of simple exercises. See more on the Linden Method in the video below.
Obsessive Compulsive Disorder (OCD)
OCD, as it is commonly referred to, is an anxiety disorder which is comprised of two specific components, mental and physical:
Obsessive Disorder– In the mental component of OCD, the individual suffers from repeated thoughts, beliefs or visuals that have a disturbing affect on their mental state. These are unwanted thoughts and may even be repulsive or cause intense fear. However, even though the individual may sense the things they obsess over are irrational, they are powerless to stop.
Compulsive Disorder– In an effort to cope with the continued obsessions that plague them, an individual will employ certain actions, sometimes superficial and often repetitive. There is an irrational belief that continued repetition of a perceived soothing action will keep the obsessions at bay. The problem lies in the fact that the compulsive actions rarely reduce the frequency or severity of obsessions. The sufferer simply becomes trapped in a cycle of obsessive/compulsive behavior.
Obsessions vary, but some of the most frequently observed are:
Germophobia, or obsessing over cleanliness. Individuals have a heightened feeling that they are being overrun by germs or and that everything will potentially make them ill. The associated compulsion is often obsessive hand washing, cleaning, and not allowing any foreign objects into their environment.
Chronic doubts or worrying. Examples of this include doubts about whether appliances are left on, tasks were completed or doubting other’s feelings towards you. The associated compulsive behaviors include repeatedly checking faucets, electronics, bank accounts and the actions of others. Also common is repeatedly seeking assurance and validation from teachers and loved ones.
Aggressive Impulses.-This obsession centers on frequent thoughts of doing harm to oneself or others. Examples include thoughts or visions of harming children, spouses or yourself. Obviously this type of obsession is very traumatizing for the individual and they take drastic compulsive measures to try to eliminate it. These measures include voluntary solitary confinement or not allowing themselves to be around children, even their own. Another compulsion is to routinely remove or hide objects that might be used to harm someone.
Fear of Deprivation. -Individuals suffering from this form of OCD may have an irrational fear of loss of wealth. The fear of someday going without is extremely vivid and even conjures up images of homelessness and starvation. Sufferers feel as if every penny or bit of food, or other commodity may be their last. They do not feel secure in future provisions at all.
As a result of this obsession, the individual becomes a hoarder. They may save everything they can, even things that should rightfully be thrown away. They are also hesitant to spend money, as it may be their last and may even dig through refuse for things they think that they can save for future use. Hoarders often have extremely cluttered houses, because they compulsively collect and save items for “a rainy day”
Often, the compulsive behavior is very stressful to the individual, but not more so that the underlying obsessions. The thought pattern is that by continuing the compulsive behavior, one can stave off the obsessive impulses and thoughts that plague them.
Causes of OCD
There are thought to be a number of factors in developing OCD. Individuals may be genetically predisposed to this disorder. Although a specific gene has not been isolated, evidence suggests that children of an OCD parent are at slightly higher risk for developing the disorder themselves.
Studies have also indicated that the inhibition of the neurotransmitter serotonin plays a role in developing OCD. When serotonin levels were artificially increased, OCD symptoms subsided.
While still a subject of research, the level of brain activity is indicative of OCD. Preliminary research shows a marked difference in the brain activity of individuals with OCD, vs. those without. Specifically, differences were noted in the orbital cortex and the basal ganglia.
Normal anxiety medication has not been shown to be widely effective on OCD. This reinforces the fact that it is an altogether different form of anxiety. Interestingly enough, drugs manufactured to treat depression and of which the core component is serotonin have proven successful.
Cognitive Behavior Therapy (CBT) has proven successful in reducing or eliminating the symptoms of OCD. With an emphasis on behavior, the individual is reconditioned to respond differently to feelings that previously caused compulsions. This often involves repeated exposure to the distressing thought or item with the aim and minimizing its ability to cause fear. Serotonin boosting medication is often paired with CBT or other behavioral therapies.
Supplementation of Inositol, a b vitamin was also found to be affective in reducing the symptoms of OCD, according to a study published in the American Journal of Psychiatry. Also, reduction of caffeine and other stimulants are recommended, as well as adding spirulina and flaxseed to ones diet.
Panic Disorder is characterized as a pattern of unpredictable episodes of intense fear, panic or anxiety. Often unexpected by those who suffer from them, panic attacks can be extremely debilitating.
Not just a mental state, a panic attack affects the body as well. Common symptoms at the onset of an attack include:
- Shortness of breath
- Chest pains
- Feeling as is you are suffocating
- Heart palpitations
- Gastrointestinal distress
- The sensation of losing control
- Feeling disconnected from reality
- Fear of reoccurring attacks
- Tingling or numbness in extremities
- Feeling as if you are having a heart attack
In order to be classified as a panic attack, you must experience at least four of the above symptoms. Additionally, the intensity of the attack must reach a peak and then begin to subside within ten minutes.
Panic Attacks vs. Panic Disorder
Most people suffer from a bout of panic at least once or twice in their lives. However, this does not mean you suffer from panic disorder. Many individuals have had an isolated panic attack in response to a stressful or traumatic situation. However it resolves itself naturally and is not ongoing and debilitating.
On the other hand, approximately six million adults nationwide suffer from Panic Disorder. There are a larger number of women who suffer from Panic Disorder than men, with a ratio of 2:1. The disorder is characterized by repeated high levels of anxiety and terror in specific situations. Sometimes the trigger for an attack cannot be anticipated. However, some patients are very aware of their triggers, for instance being in an elevator or looking down a flight of stairs.
The individual suffering from Panic Disorder becomes controlled by the anxiety. If they fear crossing the street, they may refrain from leaving the immediate area in which they live or not go outside unless accompanied by someone else. Depending on the reason for the panic attacks, an individual’s life can be severely impacted and their ability to work and socialize restricted.
In some cases, Panic Disorder can lead to developing Agoraphobia. Often thought of as a “fear of open spaces”, individuals who suffer from agoraphobia usually have the opposite fear. They are acutely claustrophobic and have a fear of enclosed spaces or of places where they cannot easily leave in the event of a panic attack.
Individuals with agoraphobia are often reluctant to go to places like shopping malls, movie theaters, or other crowded venues. Some are even afraid to be in a car alone and thus they do not drive. Many agoraphobics are extremely afraid that they may pass out or even die if they are unable to escape such an area during an attack. Understandably, this places many restrictions on their activities and it is estimated that a third of individuals who suffer from Panic Disorder become housebound.
Note that not all individuals with Panic Disorder will develop agoraphobia, however a significant number do. If you suffer from regular panic attacks, your health care professional will likely evaluate you for agoraphobia as well.
Causes of Panic Attacks
The cause of Panic Disorder and Agoraphobia is still under research, however a few variables have been identified.
Researchers performed PET scans, which detect the level of brain activity, on individuals with and without Panic Disorder. The results showed a marked different in the level of brain activity between the two groups, specifically in the region known as the hippocampus. Scientists have not yet been able to establish exactly why there is a difference and more research is needed.
Neurotransmitters, which transport brain signals, play a large role in panic attacks. There are three that apply specifically: serotonin, cholecystokinin and norepinephrine. While each neurotransmitter plays a role in anxiety levels, norepinephrine has been identified as the most prominent influencer in Panic Disorder. Medications that block norepinephrine have been found to be effective in reducing Panic Disorder.
Overreacting to and misinterpreting symptoms that develop from stress and anxiety are also a means to induce a panic attack. Often, an individual may experience an accelerated heartbeat or shakiness from anxiety and mistake it for a heart attack. As a result, they are thrown into a panic and fear that they will die before help comes. Many normal anxiety symptoms are over exaggerated and misinterpreted by individuals with Panic Disorder, essentially causing them to induce their own panic attacks.
Life changes are another cause of panic attacks. As we go through life cycles, we often experience stressful situations, such as divorce, work related problems or the death of a loved one. The inability to cope with these events can cause anxiety, which can accelerate into full blown panic attacks. Having a good support network to help you weather storms in your life can help to reduce the risk of developing anxiety and Panic Disorder.
Treating Panic Attacks
If you feel that you are suffering from panic attacks, the first step is to consult your primary care physician. They can evaluate your symptoms and refer you to a mental health professional in the event that it is needed.
Once you begin seeing a mental health professional, they may employ a number of techniques to help you confront and eliminate your panic attacks. Some of the more common forms of treatment are:
Cognitive Therapy – This therapy focuses on teaching an individual to objectively and realistically examine the symptoms they are experiencing. This allows them to see the symptoms for what they are-normal symptoms of anxiety, instead of symptoms of a bigger problem such as a heart attack or a stroke. Once they embrace this understanding, they can then work on calming the reason for the anxiety and thus reduce their symptoms.
Introceptive Exposure – This is a therapy that seeks to recreate sensations or feelings that lead to panic in an effort to confront and control them. Many people may experience dizziness when looking down from a tall height or an accelerated heartbeat in relation to another fear. With introceptive exposure, the individual exposes themselves to the situation repeatedly and should eventually see that the dire outcome the anticipated does not occur. Once the patient sees this, the feeling or emotion should lose its ability to cause fear and panic.
Vivo Exposure– This means intentionally exposing oneself to the exact situation that usually brings about panic attacks. If a person fears crowds, they will walk assisted through a mall or other high density area a few times a week. Hopefully by doing so and suffering no adverse affects, the individual realizes that their fear is unfounded.
Modulated Breathing– If an individual experiences symptoms of dizziness, heart racing and breathlessness during panic attacks, their therapist will likely work with them on learning how to slow down and regulate their breathing. When in a panic, the breath becomes quick and shallow. This sends less oxygen to the brain, which results in less cognitive ability and awareness. This further increases the severity of the anxiety symptoms. By learning to control your breathing and return to a normal pattern, rationale and calm can be restored quickly by the person experiencing a panic attack. This is a useful technique for dealing with all forms of stress and anxiety.
Antianxiety and Antidepressant Medication– In addition to the above therapies, many clinicians will also prescribe either an anti-anxiety medication or an anti-depressant depending on your symptoms. However, beware of simply taking medication without learning ways to deal with and minimize your symptoms. This is the key to long term success. Once a patient exhibits the ability to deal better with anxiety and reduce the frequency of panic attacks, their doctor will most likely gradually reduce the amount of medication prescribed with the hopes of eventually weaning the patient completely.
Alternative Treatment for Panic Disorder
Aromatherapy– Some essential oils, such as lavender have a calming affect on the body. Placing a handkerchief to your nose that contains a few drops of lavender oil is said to help alleviate a panic attack. Scents such as chamomile and vanilla are also calming, while patchouli is a mood enhancer and helps remove anxiety.
Yoga– This is recommended because of the focus on deep, rhythmic breathing and inner focus, which should help one to regulate anxiety and maintain a measure of calm and inner harmony.
Body Work –Methods such as massage and Reiki are also recommended as a way to balance the body’s energy. Eastern holistic medicine sees most physical or psychological ailments as the body’s life force (chi) being out of alignment.
Hypnotherapy– In a state of hypnosis, a therapist can lead the patient to explore the fears that are leading to panic attacks. They can also offer hypnotic suggestion that can reprogram the patient’s feeling about, and reaction to the fearful object, thought or place.
Vitamin Supplements– Some vitamins and minerals are known to improve the brain’s ability to handle stressful situations. Conversely, a shortage of nutrients can increase the likelihood of anxiety. Recommended supplements include:
- Vitamin B Complex, in addition to Vitamin B 6
- Vitamin C
- Vitamin E
Holistic practitioners also believe that hormone imbalance can lead to feelings of anxiety and even panic attacks. To counter this problem, taking naturally occurring hormone replacement therapy can rebalance your hormones and reduce or eliminate the symptoms of anxiety.
Post Traumatic Stress Disorder
Commonly referred to as PTSD and attributed to war veterans, Post Traumatic Stress Disorder can affect people in many walks of life and become a long lasting condition. There are several criteria for being diagnosed with PTSD. According to the American Psychiatric Association, the patient must exhibit the following:
Symptoms of PTSD
- The patient has experienced or witnessed a bona fide trauma in which they feared for their life experienced serious injury or feared for their physical well being. Also covered under PTSD is a traumatic event they witnessed carried out on someone else. This must be a physical threat and emotional abuse or trauma, while harmful, does not qualify.
- The patient has responded to the trauma with the emotion of fear or horror and they felt hopeless to help themselves or the person in danger. This is a very debilitating feeling and a central theme in PTSD.
- The patient must exhibit a pattern of re-experiencing the trauma in the form of dreams or nightmares, flashbacks, disturbing memories, becoming fearful or upset when reminded of the trauma in any way or becoming physically paralyzed from feeling the physical sensations of the trauma as if it were happening again.
- The patient must also show a pattern of avoidance. This means that they do not like to be reminded of the trauma and avoid anything that could bring it to the fore again. Also, the individual has difficulty remembering details of the event and may have purposely or unintentionally pushed them out of his conscious mind.
- The patient is extra alert in a way that they were not before the trauma. For example, they may be unable to sleep more than an hour at a time because of a need to stand guard or check locks. They may also be jumpy and the simplest noises startle them.
To be diagnosed with Post Traumatic Stress Disorder, an individual must experience these symptoms for at least one month and they have to have significantly impacted their life (i.e. work or ability to be social).
Traumatic Events that Can Prompt PTSD
- Being the victim of a violent crime, such as a rape, assault, mugging, etc.
- Sexual abuse, especially ongoing
- War or combat experience
- Being involved in, or witnessing a severe accident
- Experiencing kidnapping or torture
- Being a prisoner of war
- Terrorist Attack
- Being diagnosed with a life threatening illness
There are many modes of treatment available to PTSD sufferers. With a skilled therapist and a rigorous treatment plan, it is possible to overcome this disorder.
It is recommended by authorities in the field of PTSD treatment to implement a multi-pronged psychological treatment plan. The treatment plan should include the following:
The guiding principle of this therapy is that when we are exposed to something often enough, it changes from being a fear or an annoyance, to just being part of the background noise. With a traumatic, exposing yourself to the event either by confronting it or mentally reliving it repeatedly under the guidance of a therapist can be quite healing.
Oftentimes something may be quite frightening, but when you talk it over with a trusted advisor or therapist, it looses some of the sting. Even if it is still very traumatic, you are able to walk through the events in a safe manner guided by someone who knows when to advise you to press on towards a breakthrough and when continuing may be detrimental.
These are a group of techniques that are beneficial for treating many forms of anxiety. The goal is for the patient to clearly recognize an oncoming bout of anxiety and take decisive, positive measures to minimize the severity, or eliminate the attack altogether. These techniques include:
Breathing techniques which allow the patient to take control at the onset of an attack. By employing deep, slow breathing, you can slow down the accelerated pulse, dizziness and chest pain often associated with an anxiety attack.
Positive affirmations or self talk helps the patient to reinforce that they can take control of the situation. They repeat phrases that indicate strength and perseverance, which combats the feeling of fear and hopelessness that often comes with anxiety.
Relaxation techniques are important to treating PTSD. When we are scared, we tense up and the flight or fight mechanism kicks in. However, as PTSD is in relation to an event that already occurred, there is no need for this mechanism and if it occurs repeatedly, it is very draining on the body and psyche. Learning how to relax the body at the onset of an attack or flashback can do much to turn the situation from a fearful one to simply reviewing a memory.
Assertiveness training addresses the feeling of being a victim that many trauma survivors live with. They feel as if they were powerless to communicate their wishes or stave off the traumatic event. Learning to express their thoughts and needs in an honest and non-confrontational manner, the patient is empowered and feels a measure of control over their life.
Alternative Treatment for PTSD
In addition to the psychological therapies listed above, holistic practitioners recommend lavender and lemon balms to help sooth the brain, as well as St. John’s Wort which helps eliminate depression.
Also, Dr. Edward Tick founded “Soldiers Heart”, an organization which helps veterans reenter society and reduce the symptoms of PTSD. His approach was developed after studying warrior traditions around the world and in ancient societies. Each culture he observed had rituals, such as ritual cleansing, storytelling and atonement and reconciliation with former enemy combatants and civilians. Through these means, warriors were able to minimize the baggage of war and live normal lives. More information on Dr. Tick’s methods can be found in the video below.
Social Phobia (Social Anxiety Disorder)
While many people may feel shy or nervous at the thought of giving a presentation of meeting their prospective in-laws, social anxiety is an altogether ailment. Social Phobia affects approximately 15 million Americans and usually manifests in the late teens to early 20s.
Types of Social Phobia
There are three clinical classifications for social phobia, as follows:
Performance Based Social Anxiety Disorder– An
individual who suffers from this form only encounters problems when they
are called on to perform in front of others. This can
include delivering a presentation or being called on to answer a question in class.
Generalized Social Anxiety Disorder– The most prevalent form of social anxiety, individuals experience anxiety in a number of social settings. They may find it hard to meet and keep friends and equally as terrifying to speak in front of a group. Most of the research that has been conducted to date has been on this form of social anxiety.
Avoidant Personality Disorder– An individual with this form suffers from chronic social anxiety and avoids fearful situations and most people at all cost. Left untreated, these individuals are often unable to maintain friendships, hold down a job or maintain a romantic relationship.
Symptoms of Social Phobia
To be diagnosed with Social Phobia, the American Psychiatric Association has developed the following criteria:
- The individual experiences persistent fear in the same public situation(s), or when they are called on to perform some task.
- The individual experiences terror or extreme anxiety when presented with the situation
- The individual understands that the fear is irrational in relation to the situation
- The stress of the situation brings the individual to alter their daily life or avoid being in certain situations
- The patient will be checked to ensure the symptoms are not caused by anther illness or condition.
What Causes Social Anxiety Disorder?
Brain Activity- Scientists are just beginning to study this phenomenon and as yet the research around brain activity has been inconclusive. A few studies that employed PET brain imaging showed increased brain activity in the amygdale- the portion that responds to threats and fear, as well as decreased activity in the cortical region, which is responsible for interpreting things as they happen. With additional research, hopefully scientists will isolate what causes these reactions.
Neurotransmitters– In studying the mechanisms that send messages to nerve endings in the body, the research is again inconclusive. Some studies have shown a decrease of dopamine- a neurotransmitter that is found in high quantities in more social people. The studies point to lower levels of serotonin in individuals with Social Anxiety Disorder, as well.
Heredity– There is some evidence that social anxiety can be passed down through families. However, some researchers believe that rather than being a matter of genetics, it is more a learned behavior. For example, if you grew up with a mother who was a shut-in because she feared going out, then that fear may pass to you as well.
Treating Social Phobia
Therapies for reducing and eliminating Social Phobia fall into the class of medications or behavioral therapies. Medication has been documented to successfully treat 70% of social anxiety sufferers. However, most health care providers will employ a combination approach of medication and behavioral therapy. This way, the patient learns practical coping mechanisms and may eventually have their medication reduced or stopped altogether.
Social Anxiety Medication
Medication used to treat Social Phobia falls into five different categories:
Selective Serotonin Reuptake Inhibitors (SSRIs)- Usually the first medication of choice, SSRIs increase the amount of the neurotransmitter Serotonin, which helps to relieve anxiety and improve the mood. Common SSRI medications include Prozac, Paxil and Zoloft.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)- Prescribed for treating Generalized Social Anxiety Disorder, this medication also increases serotonin levels, but has the additional benefit of modulating depression regulating neropinphrine levels as well. Common SNRIs include Pristiq, Cymbalta and Effexor.
Benzodiazepines (BDZs)- This classification of medication works faster than other forms to decrease the symptoms of anxiety, but it can also cause dependency. This should be weighed carefully before beginning this therapy. BDZs also do not positively affect depression, so if you suffer from depression as well as anxiety, they may not be the best choice. Popular BDZs include Klonopin and Valium.
Monoamine Oxidase Inhibitors (MAOIs)- Once the most popular therapy to fight social anxiety, widespread use of MAOs has been largely discontinued. The medication has produced dangerous side affects and thus its use is not recommended. However, some practitioners will still prescribe them if all other therapies have failed.
Beta-blockers- This class of medications is effective from those who suffer from performance anxiety (public speaking, etc). Beta-blockers work to calm the nervous system and minimize symptoms such as tremors, sweating and heart palpitations. The leading Beta-blocker prescribed by physicians is Inderal.
Behavioral Therapies for Social Anxiety Disorder
Behavior therapy can be extremely effective to reducing or even eliminating social anxiety over the long term. However, it is not a quick fix. To be successful, the patient must commit considerable time and effort into confronting the subject of their anxiety head on. In the case that the actual situation that prompts anxiety cannot be replicated, the patient will be guided through reenacting the scenario in their imagination.
A qualified therapist will guide the patient through continuously exposing themselves to the object of their fright, confronting it and reconditioning their response. While it may not work for every patient, behavioral therapy offers the best chance of long term success. Often, this therapy is initially paired with medication, which the patient is weaned off of once they learn to recondition their response to the object of fear. Approximately half of the patients that embark on behavior therapy experience a significant reduction in their anxiety.
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