Anxiety Treatment

A racing heart, butterflies in the stomach, sweaty palms, and cold feet.....Sound familiar? Whether it is a job interview, a public speaking engagement, or a first date, nearly everyone feels nervous and worried from time to time. However, anxiety disorders, which are the most prevalent types of mental health disorders, are generally neither brief nor mild in nature. Typically, these illnesses, which impair annually the lives of nearly 40 million Americans in the 18 years of age or older bracket, last a minimum of six months and usually worsen if left untreated. National healthcare costs resulting from anxiety disorders are in the range of $42 to $45 billion per year and constitute one-third of the annual U.S. mental health bill which stands at more than $140 billion. Anxiety disorders can cause 1) significant clinical distress, 2) substantial impairment of occupational and interpersonal functioning or relationships, 3) a disruption of one's daily life, and 4) a sense of psychological and physical immobilization. 

1. Generalized anxiety disorder (GAD)
    
   Patients diagnosed with GAD are plagued with exaggerated and chronic tension and worry, sometimes for no apparent reason. The most efficacious treatment for this condition consists of anxiety counseling coupled with a psycho-pharmacologic remedy. Medications, however, should preferably be applied only as a short-term treatment and for purposes of addressing acute anxiety symptoms. Psychotherapy is intended to diffuse a client's low-level and continuously-present anxiety. Patients also benefit from relaxation exercises and skills, such deep breathing, with or without the utilization of biofeedback. This technique enables patients to receive visual or audio reactions concerning their body's physiological symptoms and simultaneously acquire relaxation skills. These skills may be easily learned in a brief therapy time frame. Studies have shown that patients who practice the skills learned while in session can eliminate anxiety or, at the very least, substantially reduce it and lead productive lives upon completion of the therapy. As anxiety therapy progresses, mental health specialists teach their clients how to relax their muscles and engage them in general imagery techniques. Stress reduction and general coping skills, as well as hypnotherapy, are equally beneficial treatments for patients. 
    
2. Panic disorder
    
   Individuals diagnosed with this condition experience sudden and repeated sensations of terror without warning and develop anticipatory anxiety between one episode and the next. Seeking treatment is critical since, left untreated, panic disorder is potentially incapacitating. Furthermore, by treating the condition at its onset, the likely progression to agoraphobia may be halted. To assist patients in overcoming panic disorder, a tripartite approach comprised of medication, anxiety therapy, and education, is usually employed. Successful treatment of many individuals afflicted with panic disorder often occurs without prescribing any medication. Clients are taught imagery and relaxation techniques, which may be applied during panic attacks to lessen the emotional fear and physiological symptoms. Another suitable therapeutic intervention is biofeedback. Although individual counseling, which is usually time-restricted and transpires in less than 12 sessions, is the most commonly-employed modality, group therapy may be as effective for learning relaxation and other skills.        
    
3. Social phobia
    
   This is characterized by a persistent fear of embarrassing oneself, being humiliated in the presence of others, or being subject to scrutiny on the part of strangers. Exposure to performance or social situations triggers distress or anxiety. The patient is cognizant of the fact that his or her fear is irrational or excessive. Anxiolytics or mild tranquilizers offer great relief of anxiety symptoms and play a significant role in controlling phobic disorders. Tricyclic anti-depressants have also proven to be very effective in treating social phobias and panic attacks. Social phobics are usually assigned exercises to practice between sessions and benefit greatly from intensive psychodynamic psychotherapy. Another beneficial treatment consists of utilizing the behavioral method of exposure. One type of desensitization involves augmenting anxiety-causing situation with each level of discomfort that the patient conquers. Implosion or flooding, which involves exposing the client to a large quantity of phobic material, is also utilized. 
    
4. Obsessive-compulsive disorder (OCD)
    
   Patients with this condition engage in compulsive behavior to relieve the anxiety caused by obsessions. Treatment usually takes the form of cognitive-behavioral therapy and medication.
    
5. Specific phobias
   
   
   Many individuals experience marked fears that are unreasonable and intense (i.e. heights, flying, sight of blood, closed spaces). Therapists often employ modeling techniques to guide clients in tackling anxiety-producing situations. The most commonly-utilized treatment is psychotherapy, specifically, cognitive behavioral therapy. Interventions of the latter, which have proven to be helpful, include relaxation techniques, systematic desensitization, exposure, and cognitive restructuring.
   
   
6. Post-traumatic stress disorder (PTSD) and acute stress disorder
   
   
   These conditions typically follow a traumatic incident which caused tremendous helplessness or terror to the patient. The traumatized individual relives the event (i.e. war, auto accident, natural disaster, rape, torture, plane crash) through thoughts, dreams, perceptions, or images. Three psychotherapeutic approaches have been successful in treating acute stress disorder and post-traumatic stress disorder:
   1. Prolonged exposure, which consists of asking the victim to envision the traumatic incident while verbally describing it to the psychotherapist;
   2. Cognitive processing therapy, which blends cognitive restructuring and exposure; and
   3. Stress inoculation training, in which patients are taught different coping skills to assist them in conquering their fears.