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How to Overcome Anxiety With or Without Medication

By: Sai Srihaas Potu

Anxiety disorders are among the most prevalent and disabling psychiatric disorders in the United States and worldwide. Basic research has provided critical insights into the mechanism regulating fear behavior in animals and a host of animal models have been developed in order to screen compounds for anxiolytic properties.


For many, anxiety is an ever-present uninvited guest; in our circle of friends, among family members, and communities at large. It seems to be rampaging through society like a noncontagious cognitive plague, forming a low-level hum that hides in the corners of our collective minds.


Anxiety is a nebulous term that covers a great deal of psychological ground. At the thinnest end of the wedge, before an exam or a job interview, we might feel anxious. This is both understandable and normal; it is not a cause for concern. Anxiety is only a problem when it extends beyond logical worry in an unreasonable, unwarranted, uncontrollable way. Situations that should elicit no negative emotions all of a sudden seem life-threatening or crushingly embarrassing. Currently, the standard treatments for anxiety disorder are:


1. Cognitive Behavioral Therapy (CBT) is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events. The benefit of this therapy is that we can change the way we think to feel and act better even if the situation does not change. CBT focuses on determining the thought and behavior patterns responsible for sustaining or causing anxiety or panic attacks.

2. Dialectical Behavior Therapy (DBT) is a form of cognitive therapy that emphasizes individual psychotherapy as well as group skills training to help people learn new skills and strategies—including mindfulness and distress tolerance–to manage their anxiety and panic.


3. Exposure Therapy involves exposing the patient in a safe and controlled environment to physical sensations they experience during an anxiety or panic attack. The idea is that by repeating the things that may trigger a panic attack those triggers will eventually lose their power.


4. Medication can be used to control or lessen symptoms related to anxiety disorder. It is most effective when combined with other treatments, such as the aforementioned cognitive behavioral therapy and exposure therapy. Medications used to treat panic disorder include antidepressants, though they take several weeks to reach effectiveness. Benzodiazepines such as Ativan and Xanax work quickly. However, they are addictive and should only be used for a short time.

At the same time, there are many other ways that people can overcome their problems with anxiety. Even without a doctor, people can try to treat their own anxiety with these four options below:

1. Take a moment to center yourself and bring yourself back into the present moment. Tune into 4 things around you that you can see, 3 things that you can touch, 2 things that you can smell, and 1 thing that you can taste (you can carry around mints, or gum, to use in this situation). You will distract yourself from the anxiety that is trying to take over your body.

2. Carry loose change or count backward by 3’s. These techniques help those who are about to have a panic or anxiety attack by forcing the brain to focus on another, overriding activity. The act of counting at random intervals helps people to focus, overriding the anxious thoughts that are trying to creep in. Loose change is a great way to do this. Add a dime to a nickel and you have 15. Add another two pennies and you have 17, so on and so forth. By showing yourself that you are capable of controlling your thoughts by this systematic, deliberate counting, and focusing on something outside of yourself, you will begin to feel calmer. Similarly, count backward from 100 by intervals of 3. This is another way to force your brainpower onto a task that is not your anxious thoughts, allowing you to regain control of the situation.

3. Progressive muscle relaxation. Using relaxation exercises can be an effective way to reduce your stress and anxiety. Alternate between tensing and relaxing different muscle groups throughout the body. Tensing your muscles is a common symptom of anxiety and by learning to immediately relax those muscles you’ll program your body to relax when it feels the tension.

4. Focus on one single task at a time. You will instantly feel less overwhelmed. If you are in the car, focus on staying in the middle of the lane. If you are at work or school, take care of the most important thing you need to do that day. Focusing on a single activity distracts your mind from the anxiety it is producing.

Thanks to an explosion of research in the past 10 years, our understanding of fear-related behavior is among the most developed knowledge area in psychology. Due to continued gaps in our understanding of the pathophysiology of anxiety disorders and the absence of valid, reliable human biomarkers, researchers have not been able to understand more about anxiety. However, a close collaboration between basic and clinical researchers will help scientists understand more about the mechanism behind anxiety which will help the vast majority of the public better cope with anxiety-related emotions and disorders.


References:

1. Baldwin DS, Waldman S, Allgulander C. Evidence-based pharmacological treatment of generalized anxiety disorder. International Journal of Neuropsychopharmacology. 2011.

2. Erickson SR, Guthrie S, Vanetten-Lee M, Himle J, Hoffman J, Santos SF, et al. Severity of anxiety and work-related outcomes of patients with anxiety disorders. Depression and Anxiety. 2009.

3. Watanabe N, Churchill R, Furukawa TA. Combined psychotherapy plus benzodiazepines for panic disorder. Cochrane Database of Systemic Reviews. 2009.

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