The definition of anxiety is “an abnormal and overwhelming sense of apprehension and fear often marked by physical signs”. Chronic anxiety can not only damage someone’s psychological health but also physical and can lower their Quality Of Life (QOL), making it import for them to seek treatment.
There are many types of therapies and pharmaceutical drugs used to treat and manage a range anxiety disorders including generalized anxiety (GAD), social anxiety disorders (SAD) and panic disorders. Some people find using pharmaceutical drugs is more effective than going to therapies while other find the opposite.
Research finds that though different people find therapies or drugs better for treatments, its shown that some are more effective than others.
Pharmacotherapy is the treatment of anxiety disorders using pharmaceutical pills. A meta analysis from Quality of Life Research, vol. 23 Effect of Pharmacotherapy for Anxiety Disorders by Stefan G. Hofmann, Jade Q. Wu, Hannah Boettcher and Jamie Sturm showed that it was more effective for people with GAD than people with other anxiety disorders.
They also found that people who had a gradual decrease in their QOL described the impacts of pharmacotherapy compared to those with dramatic decrease in QOL in a short period of time after their disease onset. Their study found that pharmacotherapies are effective to treat people who suffer from GAD but other treatment methods should be used for other types of anxiety disorders.
Antidepressants such as SNRIs and SSRIs have been found to be the most effective pharmacotherapy for Major Depressive Disorder (MDD) but also one of the most effective for SAD and GAD according to “A Systematic Review of Network Meta-Analyses for Pharmacological Treatment of Common Mental Disorders.
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In ‘Clinical Evidence’: Anxiety Disorder by Christopher Gale and Mark Oakley-Browne gives an in depth analysis of different drug therapy treatments including sedation and injections. A type of Benzodiazepines called Diazepam was found to improve QOL in patients with GAD but had many cognitive impairments including short term memory, attention, concentration, and increased paranoia. It also had many physical impairments such as muscle spasms and seizures. Diazepam is given using sedation and can interfere with psychotherapies if the patient is enrolled in them. Benzodiazepines also have a high risk of substance abuse and dependency and people in withdraw can develope rebound anxiety. Compared to antidepressants, Benzodiazepines were found to be less effective but had more side effects.
Self harm is the intentional, direct injuring of oneself. “Deliberate Self Harm In Adolescents: Self Report Survey In Schools In England.” by Hawton, Keith, et al in the British Medical Journal explains the prevalence of suicide and suicidal thoughts in children. They found self harm is more common and prevalent than previously thought. ‘only 12.6% of participants presented to hospital. This was partly due to the high prevalence of self cutting for what medical attention was rarely sought.’ (Hawton,1210). Many people don’t seek medical help for self harm or anxiety as a whole. Not seeking medical attention can lead to higher risk of suicide and self harm and can lead to the continuation of a low QOL.
“Antidepressant Treatment And The Risk Of Fatal And Non-Fatal Self Harm In First Episode Depression: Nested Case-Control Study.” by Martinez, Carlos, et al. in the British Medical Journal found no evidence to support the hypothesis that antidepressants lower fatal and non-fatal self harm.
Generalized anxiety disorder: diagnosis and treatment by Elizabeth A Hoge, Ana Ivkovic and Gregory L Fricchione, talks about different psychotherapy treatments such as Cognitive Behavioral Therapy (CBT), behavioral therapy, relaxation response training, and mindfulness meditation training. CBT is the most commonly used of these therapy and the most widely studied. Many use CBT has a introduction to anxiety treatments as it focuses on general symptoms. While CBT tries to treat anxiety, behavioral therapy aims to understand and later expose the patient to things they fear or that cause anxiety, much like exposure therapy. “automatic anxious thought patterns can be reduced by evaluating thoughts and impressions more objectively” (Hoge et al 39) It can be difficult to treat GAD using behavioral therapy as its more targeted towards treating phobias. With GAD, many worry based triggers are harder to target and diffuse and can shift into other emotions more quickly. A solution to this is to focus on what’s worrying the patients as it might be hiding another emotion such as grief and anger.
Relaxation response training is a type of therapy aimed at providing patients a way to avoid overreactions to stress and anxiety without the need of a therapist, and can be used in times of crisis. “Self-Induced Relaxation: A Practical Strategy to Improve Self-Concepts, Reduce Anxiety, and Prevent Behavioral Problems.” by Margolis, Howard. Explains how relaxation techniques do not require external input or therapists. They’re easy to learn and can be used whenever desired. The goal is to teach patients to achieve ‘a level of calm and psychological confidence which enables them to more effectively control their behavior and thought processes and thus completely handle potentially stressful and anxiety-provoking situations.” (Margolis 355). There are three types of relaxation used to help treat anxiety: Meditation, Progressive Muscle Relaxation, and Visual Imagery.
‘Benson (1975) identified the four basic elements:
These four elements not only help patients relax but also influence their thoughts and help improve their QOL. Meditation is a easy technique which can be used with daily practice and works best if done for at least twenty minutes in the same place and time.
Progressive Muscle Relaxation has two basic premises ‘ one cannot be simultaneously relaxed and stressed, and mental relaxation is a natural consequence of physical relaxation’ (Margolis 357) meaning many people have lots of muscle strain and stress and go unaware of this. The goal of PMR is for students to know when their muscles are stressed and for them to then relax or ‘rest and reset’. PMR is more a portable technique than mediation and can be used almost anywhere.