You Don’t Have to Suffer: Treatment Options for Anxiety

Individual Therapy for Anxiety

Individual therapy (or “talk therapy”) is typically the first line of treatment for anxiety disorders. While in therapy, individuals work one-on-one with a trained therapist or psychologist and learn how to resolve anxious thoughts and feelings. The personal insights and skills taught in these sessions will not only ease anxiety, but also help to prevent a relapse. The typical length of time for therapy for anxiety is 12-16 weekly sessions, but the number of sessions varies based on the complexity of the anxiety, the therapist's style, and other variables.

Talk therapy can come in many styles when it comes to treating anxiety, but the approaches listed below are the most common and have the most evidence that indicates they actually work:

• Cognitive-Behavioral Therapy (CBT): A shorter-term form of therapy that helps clients challenge and overcome unhelpful anxious thoughts. Exposure therapy is a common CBT method that can help “expose” you to the same things that cause you anxiety (e.g. heights, public speaking, embarrassment, etc.), but with a greater sense of control over the situation.

• Dialectic Behavioral Therapy (DBT): A skills-based therapy that includes mindfulness, regulating emotions and distress, as well as improving interpersonal skills.

• Acceptance and Commitment Therapy (ACT): A style of therapy that focuses on “psychological flexibility,” mindfulness, and accepting (rather than challenging) negative thoughts.

• Mindfulness-Based Stress Reduction (MBSR): A shorter-term (typically 8 weeks) form of therapy that blends mindfulness, yoga, meditation, body awareness, and looking into patterns of thoughts, feelings, and actions that hold us back from successfully getting in touch with our sense of well-being.

When you are in a therapy session, keep in mind that in order for it to be effective, it is incredibly important for you to be completely honest, to come consistently to sessions, and to be willing to do the work. Frank and open discussions will help you move forward and break out of your anxiety. You will likely also see improvements faster if you are willing to engage in therapy homework between sessions.

How to Find the Right Therapist for Your Anxiety

For some, finding the right therapist can be a bit of a challenge. Here are some variables to consider when searching for a therapist:

• Credentials: Therapists can hold a number of degrees. Masters-level clinician degrees include Licensed Clinical Social Workers (LCSW), Licensed Marriage and Family Therapists (LMFT), and Licensed Professional Clinical Counselors (LPCC). Doctoral-level clinician degrees include Licensed Doctor of Clinical Psychology (PsyD) and Licensed Doctor of Philosophy (PhD). To look up a therapist’s license, consult the therapist’s state licensing board website.

• Fees: It’s important to ask about fees prior to scheduling your first session. Therapy out of pocket can be expensive (e.g. $100-$300 per 45-minute session, depending on location, experience, and expertise). Not all therapists take insurance. If you wish to use insurance or an employee assistance program (EAP), contact your insurance company or EAP for a list of in-network therapists. If a prospective therapist is an out-of-network provider, ask if he or she can provide you with a ”Superbill” that you can submit to your insurance company for potential reimbursement. If not, ask the therapist if he or she offers a “sliding scale” that can reduce your cost depending on your income level. If none of those options are available, and the cost of therapy is still a concern, seek out a supervised intern/resident or a community clinic that may be funded by a government grant, etc.

• Style of Therapy: As mentioned above, there are a number of different styles or “theoretical orientations” of therapy (including numerous additional styles not listed above). It’s a good idea to ask your therapist what style they offer (or read about them online) to ensure it is “evidence-based.”

• Right Fit: Other variables to consider include gender preference, culture, ethnic, and religious preference, experience/expertise, the estimated length of treatment, location (including in-office vs. online/video-based therapy), therapeutic “chemistry,” and personality matches.

Lastly, feel free to “shop around” to find the provider that you feel you can trust and is non-judgemental and skilled in treating your anxiety. If you are not satisfied with the services or style of the first therapist you meet, it’s okay to seek out another provider. A nice starting point for finding a therapist is on the Psychology Today directory. There, you can search for a provider by location, specialty, gender, and style, and you can find therapist biographies.

Psychiatric Medication for Anxiety

There are several different types of medications that can help with treating an anxiety disorder. Psychiatric medications are typically prescribed by Primary Care Physicians (PCP) or psychiatrists. It’s not uncommon for individuals who have never taken psychiatric medications to talk to their PCP about starting medication prior to being referred to a psychiatrist. (The doctors at K Health can have conversations about taking care of your mental health and can write prescriptions for common medications). Note that many people on medication experience uncomfortable side-effects (such as weight gain, sexual problems, or nausea) while taking psychiatric medications. There are four major classes of drugs that can be used. It helps to understand them so that when they are prescribed, you know what to expect.

• Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs are forms of antidepressants. They are often prescribed to people with anxiety as the preferred drug treatment over the other types, as there is little risk of developing a dependence or an addiction to them. Common SSRIs include Celexa, Lexapro, Prozac, Luvox, Paxil, Pexeva, Viibryd, and Zoloft.

• Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): SNRIs are also antidepressants. Common ones include Effexor, Cymbalta, Pristiq, Khedezla, Savella, and Fetzima. It’s important to note that neither SSRIs nor SNRIs have an immediate effect on your mood. They need time to build up in your system and it can take anywhere from two to six weeks for an antidepressant to take effect.

• Tricyclic Antidepressants: These are older drugs that are usually the go-to option for those who can’t tolerate the negative side effects of SSRIs and SNRIs. They work in a similar way by blocking the brain’s neurotransmitters from being reabsorbed into the cells. Common forms of tricyclic antidepressants include Clomipramine, Amoxapine, Amitriptyline, Desipramine, and Nortriptyline. They can take as long as eight weeks before you begin to feel the real effects. It is important to use extra caution when taking tricyclic drugs as they are a major cause of overdoses in the United States.

• Benzodiazepines: Benzodiazepines are more of a sedative than a means of addressing anxiety. They are good at relaxing tense muscles, and they make it easier for the body to relax. They work quickly, so you could find your anxiety easing within just minutes after taking them. They are quite effective for short-term use but are rarely prescribed for the long-term—mainly because as the body gets used to them, they become less and less effective. As a result, each time you take them, you will need more to get the same results. If taken over an extended period of time, they can become quite addictive. For this reason, they are often used to deal with short-term anxiety issues. Common benzodiazepines include Xanax, Klonopin, Valium, and Ativan.

Self-Help Resources for Anxiety

Books for Anxiety

When Panic Attacks: The New, Drug-Free Anxiety Therapy That Can Change Your Life
By David D. Burns

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When Panic Attacks is an exceptional book covering both basic and advanced CBT techniques for treating anxiety. Readers are presented with both helpful information and worksheets to help themselves find relief by challenging their negative beliefs and practicing exposure exercises.

The Anxiety and Phobia Workbook
By Edmund Bourne

The Anxiety and Phobia Workbook helps readers to get a deeper understanding of the varying elements that can cause anxiety. Once you know the beast you’re working with, you can use the exercises in the workbook to develop strategies that will help to counteract your anxiety. There are exercises included that will fit all different levels of anxiety so you can find the one that will work best for you.

The Mindfulness and Acceptance Workbook for Anxiety: A Guide to Breaking Free from Anxiety, Phobias, and Worry Using Acceptance and Commitment Therapy

The Mindfulness and Acceptance Workbook for Anxiety teaches its readers how to address their anxiety through acceptance and commitment therapy. With these tools, you can clearly lay out your values and pursue them through committed action and mindfulness.

Mobile Apps for Anxiety

• Headspace is a mobile app that offers a plethora of guided meditation exercises to help treat anxiety and other mental health conditions.

• Sanvello is the #1 rated anxiety management mobile app in the App Store. It includes guided mindfulness meditations, breathing exercises, and cognitive techniques for improving stress and anxiety.

• Rootd is a mobile app that will help you to fight your panic attacks and anxiety. It includes a number of mindfulness exercises, along with a step-by-step guide to ease anxiety when it strikes.

Anxiety disorders can be a real nemesis but there are multiple options that can help you to cope, strategize, and fight back. Anxiety doesn’t have to rule your life. If you still are not sure where to start, consult a therapist or your primary care provider for further information.

Get Help for Your Anxiety with K Health

You can also chat with a doctor in the K Health app about your symptoms and options from medication to therapy.

Continue reading for self-guided techniques for dealing with anxiety.