Anxiety affects all of us at different times in our lives. For most, feelings of anxiety and worry are just a small part of our lives. We are able to work through the situation causing us to feel anxious and move on.
For others, anxiety can cause crippling worry without warning. It can prevent them from participating in social events or activities they used to enjoy. It can be hard for those around them to understand what they are going through.
Fortunately, there are a variety of treatments available to help those suffering from anxiety.
What is Anxiety?
Anxiety is a common emotion experienced by millions of Americans. These feelings typically surface when we are experiencing something stressful or uncomfortable, and they usually fade when those inciting events are over. When you feel anxious about something, you can experience a variety of symptoms. They can include sweating, feeling nervous, increased heart rate, trouble catching your breath, shaking, or stomach problems. It can be hard to focus or sit still. Everyone experiences these symptoms to different degrees, and we each have different situations that trigger our anxiety.
For some people, anxiety is not always associated with certain activities or situation. In some cases, symptoms of anxiety can come on without warning or reason. The anxiety can be out of proportion with the actual situation you are experiencing. It can prevent you from participating in certain events for fear you will start feeling anxious. The symptoms of anxiety can persist beyond the situation that initiated those feelings. When anxiety impacts your daily life or stops you from doing things you would like to do, it can be a sign that you are experiencing an anxiety disorder.
There are different types of anxiety disorders that impact people. Generalized anxiety disorder is defined by symptoms of excessive worry, restlessness, or concern about a situation that is out of proportion with the event. Others have social anxiety disorder, where they struggle to engage in social events due to anxiety, or phobias, which is a feeling of extreme anxiety related to a specific situation or object. Some anxiety disorders occur more often in children such as selective mutism, which can prevent them from talking in certain environments, or separation anxiety disorder, which causes extreme anxiety when separated from certain loved ones. Other types of anxiety include agoraphobia, substance- or medical condition-induced anxiety, and unspecified anxiety disorder.
Stats About Anxiety
Anxiety disorders are surprisingly common among Americans. It is estimated that at least one in five adults have some form of anxiety disorder. Unfortunately, a low percentage of people seek help for this mental health condition; a reported 36% of those suffering from anxiety actually seek and receive treatment. Women are more likely to suffer from anxiety disorders than men. Children are also impacted by anxiety with a reported incidence of 25% of anxiety disorders among adolescents.
Anxiety can be associated with other mental health disorders. It is reported that about half of those who are diagnosed with depression also suffer from anxiety. Anxiety has also been found to be related to eating disorders and attention deficit hyperactivity disorder.
There are many medications available to help manage symptoms of anxiety. Different medications will work better for some people than others depending on the cause of anxiety symptoms and related mental health problems.
SSRIs, or selective serotonin reuptake inhibitors, are medications in the antidepressant family. They help alleviate symptoms of depression by increasing the amount of serotonin available in the brain which has been found to improve mood and symptoms of depression. While these and other antidepressant medications have been found to work well for people suffering from anxiety, they often do not provide fast relief from symptoms. It can take weeks, and sometimes months, to see the full effects of these medications. However, they provide longer-term relief than the faster acting medications and are better for managing symptoms of anxiety long-term. There are many SSRIs available to treat anxiety and/or depression. They include sertraline, fluoxetine, paroxetine, citalopram, and escitalopram.
SNRIs, or serotonin-norepinephrine reuptake inhibitors, reduce symptoms of anxiety and depression in a similar way to SSRIs. The main difference is the chemicals in the brain that they impact; while SSRIs only increase serotonin in the brain, SNRIs also increase levels of norepinephrine. Like SSRIs, these medications take longer to work but help people suffering from anxiety get better long-term control of their symptoms. If you have tried an SSRI and did not experience a relief in symptoms, you could try an SNRI. Some medications in this class include venlafaxine and duloxetine.
Like SNRIs, tricyclic antidepressants increase the amount of serotonin and norepinephrine found in the brain to improve mood and symptoms of anxiety. These medications are older than the SSRI and SNRI medications. They have been found to have more side effects than the newer antidepressant medications, so they are not used as much as they used to be. Sometimes these are prescribed at lower doses to help those with anxiety or depression who have trouble sleeping. Some of the tricyclic antidepressants are nortriptyline, amitriptyline, or imipramine.
Benzodiazepines are commonly prescribed to help those suffering from symptoms of anxiety. Unlike the previously mentioned antidepressant medications, benzodiazepines work right away to alleviate symptoms. They help you feel relaxed, both physically and mentally, and reduce feelings of worry or concern. Benzodiazepines are most appropriate for people who need help relaxing for specific situations, such as for medical procedures or if they experience panic attacks or phobias. They can also be prescribed to help people who have trouble sleeping, although they should not be used long-term for this problem.
These medications are controlled substances, and they carry a risk of abuse or addiction, so they should be used cautiously and sparingly. If they are used more regularly or long-term, they may require an increase in the dose as the body can get used to the medication making it less effective over time. Some examples of benzodiazepines are alprazolam, lorazepam, and diazepam.
Beta-blockers are actually a type of medication used to manage blood pressure and heart health. Because they work by reducing heart rate and blood pressure, two things that can be increased when experiencing anxiety, they are sometimes prescribed to help people manage their symptoms of anxiety. They are most commonly used for people with anxiety around public speaking. Taking a beta-blocker before a presentation can help lower your heart rate and help you feel calmer while speaking. The most commonly prescribed beta-blocker for this indication is propranolol.
Alpha-blockers are medications that are typically used to lower blood pressure or trouble going to the bathroom due to benign prostatic hyperplasia (BPH). Some research has found prazosin, an alpha-blocker medication, can reduce nightmares and other debilitating symptoms associated with post-traumatic stress disorder.
Other Anxiety Medications
There are some other medications that have been used to reduce symptoms of anxiety. Buspirone is a medication used to treat symptoms of anxiety. It is thought to work by increasing the effectiveness of serotonin in the brain. It has fewer side effects and risk of dependency than benzodiazepines but is effective for managing symptoms. Sometimes antihistamines, such as diphenhydramine or hydroxyzine, are also used to help decrease symptoms of anxiety. Other medications used to help reduce symptoms of anxiety include antipsychotic medications and medications used to treat seizures.
How Does a Doctor Decide Which Medication is Best For You?
There are many factors that can help your doctor determine which medication is best for you. There has been a lot of research done on these medications and their use in anxiety. Because of that, your doctor can determine which medication has been found to work best for your specific type of anxiety. For example, SSRIs have been found to work for those who suffer from obsessive-compulsive disorder but SNRIs have not.
In some cases, anxiety is not the only mental health or medical condition you may be suffering from. In these instances, your doctor can try medications that may help to alleviate symptoms from the different problems you are experiencing. If you suffer from depression and generalized anxiety disorder, an SSRI or SNRI may benefit you. If you have high blood pressure and suffer from post-traumatic stress disorder, an alpha-blocker would likely benefit you.
Medications can affect each person a little differently. Because of this, it may take some trial and error before a good medication regimen is found. Don’t be afraid to ask questions about the medications you are prescribed, and make sure you share any concerns you have or side effects you experience with your doctor. Open communication will help both of you determine which medications will work best for you.
A Few Notes on Side Effects
All medications can cause side effects, and some people are more susceptible to side effects than others. That being said, being educated about side effects to watch for can help you make an informed decision about the medications you would like to try and make sure you have a safe experience while finding the medication that works best for you. Most of the medications used to treat anxiety can cause some drowsiness, or sleepiness because they alleviate anxiety by reducing muscle tension and mental restlessness. Each class of medications also has more specific risks of side effects.
SSRI and SNRI medications have similar side effects. These can include nausea, sexual dysfunction, changes in appetite and weight, and changes in sleep. Tricyclic antidepressants can have similar side effects but can also cause dry mouth, constipation, drops in blood pressure, and blurry vision.
Beta-blockers and alpha-blockers both decrease blood pressure. Because of this, they should not be used for people with anxiety who have low blood pressure without any medications.
Benzodiazepines work by reducing muscle tension and feelings of worry or restlessness. This makes them effective but can also cause feelings of extreme sleepiness. Because of this, they should not be taken with alcohol or other medications that can also cause extreme sleepiness unless discussed with your doctor. They also have a risk of dependency, which also means they can cause withdrawal if they are taken for a long period of time and then stopped suddenly.
Therapy has been found to work well to help people who suffer from anxiety to manage their symptoms and regain control of their condition. Cognitive behavioral therapy is most often used to treat those who suffer from anxiety. During these sessions, a therapist will talk with you about the concerns you have and how anxiety is impacting your life. They will help you identify strategies to reduce your symptoms of anxiety and manage the situations or events that trigger your symptoms.
For some people, in-person therapy is not an option because their anxiety prevents them from attending or participating fully in the sessions. Medications can help these people reduce their symptoms, so they can get the most out of their therapy session. There are also people with anxiety who require medications as well as the help they get from their therapist. They may need to continue on medications long-term, but they can benefit from the help their therapist provides as well.
If you suffer from anxiety, ask your physician or therapist about treatment options that are available to you. In addition to therapy, there are a large variety of medications available to help manage symptoms and reduce the incidence of anxiety. Medications can be prescribed and adjusted to help target the specific needs of each individual. While some medications work faster than others to relieve symptoms, they all play an important role in maintaining a life with less anxiety. When trying to find a medication that would work best for you, it is important for you and your provider to discuss your symptoms and sources of anxiety, the side effects of each medication, and the long-term plan for improving your mental health. Working together, you can find a solution to your anxiety problems that helps you get back to a life you enjoy.