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Psychotherapy anxiety disorder


Therapy for Anxiety Disorders - HelpGuide.org

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Anxiety disorders - Diagnosis and treatment

Diagnosis

You may start by seeing your primary care provider to find out if your anxiety could be related to your physical health. He or she can check for signs of an underlying medical condition that may need treatment.

However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy).

To help diagnose an anxiety disorder, your mental health provider may:

  • Give you a psychological evaluation. This involves discussing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems — such as depression or substance misuse — which can make diagnosis more challenging.
  • Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.

Care at Mayo Clinic

Our caring team of Mayo Clinic experts can help you with your anxiety disorders-related health concerns Start Here

Treatment

The two main treatments for anxiety disorders are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.

Psychotherapy

Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for anxiety.

Cognitive behavioral therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Generally a short-term treatment, CBT focuses on teaching you specific skills to improve your symptoms and gradually return to the activities you've avoided because of anxiety.

CBT includes exposure therapy, in which you gradually encounter the object or situation that triggers your anxiety so you build confidence that you can manage the situation and anxiety symptoms.

Medications

Several types of medications are used to help relieve symptoms, depending on the type of anxiety disorder you have and whether you also have other mental or physical health issues. For example:

  • Certain antidepressants are also used to treat anxiety disorders.
  • An anti-anxiety medication called buspirone may be prescribed.
  • In limited circumstances, your doctor may prescribe other types of medications, such as sedatives, also called benzodiazepines, or beta blockers. These medications are for short-term relief of anxiety symptoms and are not intended to be used long term.

Talk with your doctor about benefits, risks and possible side effects of medications.

More Information

  • Anxiety disorders care at Mayo Clinic
  • Psychotherapy

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Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do:

  • Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities.
  • Avoid alcohol and recreational drugs. These substances can cause or worsen anxiety. If you can't quit on your own, see your doctor or find a support group to help you.
  • Quit smoking and cut back or quit drinking caffeinated beverages. Both nicotine and caffeine can worsen anxiety.
  • Use stress management and relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety.
  • Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor.
  • Eat healthy. Healthy eating — such as focusing on vegetables, fruits, whole grains and fish — may be linked to reduced anxiety, but more research is needed.

Alternative medicine

Several herbal remedies have been studied as a treatment for anxiety, but more research is needed to understand the risks and benefits. Herbal and dietary supplements aren't monitored by the Food and Drug Administration (FDA) the same way medications are. You can't always be certain of what you're getting and whether it's safe. Some of these supplements can interfere with prescription medications or cause dangerous interactions.

Before taking herbal remedies or dietary supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take.

Coping and support

To cope with an anxiety disorder, here's what you can do:

  • Learn about your disorder. Talk to your doctor or mental health provider. Find out what might be causing your specific condition and what treatments might be best for you. Involve your family and friends and ask for their support.
  • Stick to your treatment plan. Take medications as directed. Keep therapy appointments and complete any assignments your therapist may give you. Consistency can make a big difference, especially when it comes to taking your medication.
  • Take action. Learn what triggers your anxiety or causes you stress. Practice the strategies you developed with your mental health provider so you're ready to deal with anxious feelings in these situations.
  • Keep a journal. Keeping track of your personal life can help you and your mental health provider identify what's causing you stress and what seems to help you feel better.
  • Join an anxiety support group. Remember that you aren't alone. Support groups offer compassion, understanding and shared experiences. The National Alliance on Mental Illness and the Anxiety and Depression Association of America provide information on finding support.
  • Learn time management techniques. You can reduce anxiety by learning how to carefully manage your time and energy.
  • Socialize. Don't let worries isolate you from loved ones or activities.
  • Break the cycle. When you feel anxious, take a brisk walk or delve into a hobby to refocus your mind away from your worries.

Preparing for your appointment

You may start by seeing your primary care provider. He or she may refer you to a mental health professional.

What you can do

Before your appointment, make a list of:

  • Your anxiety symptoms. Note when they occur, whether anything seems to make them better or worse, and how much they affect your day-to-day activities and interactions.
  • What causes you stress. Include any major life changes or stressful events you've dealt with recently. Also note any traumatic experiences you've had in the past or as a child.
  • Any family history of mental health problems. Note if your parents, grandparents, siblings or children have struggled with any mental health problems.
  • Any other health problems you have. Include both physical conditions and mental health issues.
  • All medications you're taking. Include any medications, vitamins, herbs or other supplements, and the doses.
  • Questions to ask your doctor to make the most of your appointment.

Some basic questions to ask your doctor include:

  • What's the most likely cause of my anxiety?
  • Are there other possible situations, psychological issues or physical health problems that could be causing or worsening my anxiety?
  • Do I need any tests?
  • Should I see a psychiatrist, psychologist or other mental health provider?
  • What type of therapy might help me?
  • Would medication help? If so, is there a generic alternative to the medicine you're prescribing?
  • In addition to treatment, are there any steps I can take at home that might help?
  • Do you have any educational materials that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor will likely ask you several questions, such as:

  • What are your symptoms, and how severe are they? How do they impact your ability to function?
  • Have you ever had a panic attack?
  • Do you avoid certain things or situations because they make you anxious?
  • Have your feelings of anxiety been occasional or continuous?
  • When did you first begin noticing your feelings of anxiety?
  • Does anything in particular seem to trigger your anxiety or make it worse?
  • What, if anything, seems to improve your feelings of anxiety?
  • What traumatic experiences have you had recently or in the past?
  • What, if any, physical or mental health conditions do you have?
  • Do you take any prescription drugs?
  • Do you regularly drink alcohol or use recreational drugs?
  • Do you have any blood relatives who have anxiety or other mental health conditions, such as depression?

Preparing and anticipating questions will help you make the most of your time.

By Mayo Clinic Staff

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Treatment of Anxiety and Panic Disorders at the EMC Clinic of Psychiatry and Psychotherapy in Moscow

Anxiety disorders is a group of disorders in which irrational uncontrollable fear and a persistent feeling of anxiety become the predominant symptoms, which can occur in situations that do not really pose a current danger .

Anxiety is a normal adaptive response of the body to changing conditions or threatening events. However, fears can be a serious problem for a person if the level of anxiety reaches pathological proportions. This imposes restrictions on the normal functioning of the patient, which significantly reduces his quality of life. Also, the long-term existence of an anxiety disorder dramatically increases the risk of other mental disorders, such as depressive disorder (by about 15 times) and pathological addictions (by about 20 times).

Major anxiety disorders include the following disorders:

Panic disorder - the main symptoms of the disease include recurring attacks of irrational anxiety (panic), not limited to a specific situation or any specific circumstances.

Dominant symptoms : sudden onset tachycardia (rapid heartbeat), sweating, tremors, dry mouth, chest pain, difficulty breathing, feeling of suffocation and nausea, as well as dizziness and a feeling of unreality of what is happening.

Agoraphobia is a group of anxiety disorders that includes a number of phobias, which include a painful fear of open spaces and public places. Patients experience uncontrollable anxiety when they are in a crowd, refuse to visit shops and other crowded places, limit their exits from the house unaccompanied, and have difficulty using public transport on their own. Agoraphobia is one of the most maladaptive types of phobic disorders.

Dominant symptoms : when immersed in a frightening situation, patients experience a sharp increase in anxiety, increased heart rate and breathing, sweating and dizziness appear, in some cases a panic attack develops. As a rule, such patients try in every possible way to avoid those situations that cause them a panic attack, which contributes to the consolidation of an anxiety disorder, changes their usual lifestyle and interferes with normal life.

Generalized anxiety disorder - manifested by a constant feeling of anxiety, tension and persistent anxiety about a variety of life events, the likelihood of which is extremely small. In this case, anxiety is not limited to any specific external circumstances, so it is often difficult for the patient to outline the circle of situations that trigger panic.

Dominant symptoms : the most typical complaints are a feeling of constant nervousness, trembling, muscle tension, sweating, tachycardia, dizziness, discomfort in the epigastric region. Often the patient experiences fear for his loved ones, suffers from gloomy forebodings. For a diagnosis of generalized anxiety disorder, the symptoms described must have been present for at least 6 months.

Social phobia - this anxiety disorder is based on the fear of being seen by others, as well as being in an awkward position, being ridiculed or humiliated, which leads to the formation of a reaction to avoid such situations. Often this disorder is combined with low self-esteem and fear of criticism. Fears can manifest themselves when eating in a public place, the need to maintain a conversation during a casual meeting with friends in the presence of strangers, visiting public places and group activities.

Dominant symptoms : hand tremor, nausea (fear of vomiting may be present), urge to urinate or defecate (or fear of such an urge), flushing of the face. Sometimes the patient takes one of these side manifestations of anxiety for the underlying disease. Avoidance of frightening situations causes significant psycho-emotional stress, since the person himself realizes that his reaction is excessive and has no reasonable grounds.

Specific phobias are fears limited to narrowly specific situations, such as, for example, being in close proximity to animals of a certain biological species, being in the dark, at height, in a confined space. Specific phobias also include fear of air travel, fears of eating certain foods, visiting a doctor, medical procedures, and the sight of blood. When confronted with fearful stimuli or when thoughts about them arise, the person "triggers" anxiety and the symptoms described above are observed.

Benefits of treatment at EMC
  • Thorough diagnosis of the patient's mental state, identification of risk factors.
  • Designing an individual treatment program, including pharmacotherapy, cognitive behavioral therapy, if necessary, TMS.
  • The Clinic for Psychiatry and Psychotherapy constantly organizes trainings that teach relaxation skills and coping with anxiety symptoms.

Principles and algorithms for psychotherapy of neurotic anxiety disorders (anxiety-phobic, panic and generalized anxiety disorders) | Karavaeva

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