How to manage anxiety

How to Manage Anxiety with Medication and Therapy

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  1. Understanding Anxiety
  2. Medication for Anxiety
  3. Therapy for Anxiety
  4. The Benefits of Therapy for Anxiety
  5. Combining Medication and Therapy
  6. How to Determine the Best Treatment Plan
  7. Natural and Alternative Treatments
  8. Final Thoughts and Key Takeaways
  9. Future Outlook on Anxiety Treatment

Anxiety is a common mental health condition characterised by feelings of worry, nervousness, or fear that are strong enough to interfere with one’s daily activities. According to the World Health Organisation, anxiety disorders are the most common mental disorders globally, affecting an estimated 264 million people​. This widespread prevalence underscores the significant impact anxiety has on individuals and public health systems worldwide.

Effective anxiety management is crucial for maintaining overall well-being. Unmanaged anxiety can lead to severe physical and mental health issues, including depression, substance abuse, and chronic health conditions like heart disease. Managing anxiety not only improves quality of life but also enhances productivity and social interactions.

There are several anxiety treatment options available, with medication and therapy being the primary methods. Medications, such as antidepressants and anxiolytics, can help alleviate the symptoms of anxiety by altering brain chemistry. On the other hand, therapy, including Cognitive Behavioural Therapy (CBT), addresses the underlying psychological factors contributing to anxiety, providing patients with strategies to manage their condition effectively. Combining these treatments often leads to better outcomes, offering a comprehensive approach to manage anxiety.

Understanding Anxiety

Understanding anxiety in-depth is crucial for effective management and treatment. This section delves into the various types of anxiety disorders, their symptoms, and the underlying causes and risk factors.

Generalised Anxiety Disorder (GAD): Generalised Anxiety Disorder is characterised by persistent and excessive worry about numerous aspects of everyday life, such as health, work, or social interactions. This worry is difficult to control and often leads to physical symptoms like restlessness, fatigue, and muscle tension. People with GAD often anticipate disaster and may be overly concerned about money, health, family, work, or other issues.

Panic Disorder: Panic Disorder involves recurrent, unexpected panic attacks, which are sudden periods of intense fear that may include palpitations, sweating, trembling, shortness of breath, or a feeling of impending doom. These attacks can occur without warning and significantly impact daily functioning and quality of life. Sufferers often live in fear of the next attack, which can lead to a significant disruption in their daily activities​.

Social Anxiety Disorder: Also known as social phobia, Social Anxiety Disorder involves intense fear or anxiety about social situations where others might scrutinise the individual. This fear can lead to avoidance of social interactions, impacting personal and professional relationships. Individuals with this disorder fear being embarrassed, humiliated, or judged by others​.

Specific Phobias: Specific Phobias are intense, irrational fears of specific objects or situations, such as heights, animals, or flying. Exposure to the phobic stimulus can provoke immediate anxiety, leading to avoidance behaviour. These phobias can significantly interfere with an individual’s daily routine, occupation, and social life .

Anxiety symptoms can vary widely among individuals but generally include excessive worry, restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances. Physical symptoms such as increased heart rate, sweating, trembling, and gastrointestinal issues are also common. Recognising these symptoms is essential for early intervention and treatment.

Potential Causes and Risk Factors: Anxiety disorders can result from a complex interplay of genetic, environmental, psychological, and developmental factors. Common risk factors include a family history of anxiety or other mental health conditions, exposure to stressful or traumatic events, chronic medical conditions, and certain personality traits, such as being overly timid or withdrawn. Understanding these causes and risk factors can aid in the development of effective treatment plans.

Medication for Anxiety

Anxiety medication is a primary treatment method for managing anxiety, often used alongside therapy. Understanding the various types of anxiety medication, their mechanisms of action, and their side effects is essential for effective anxiety management. Common options include SSRIs, SNRIs, benzodiazepines, and beta-blockers, each tailored to address different symptoms and patient needs

SSRIs (Selective Serotonin Reuptake Inhibitors): SSRIs are commonly prescribed for anxiety disorders. They work by increasing the levels of serotonin, a neurotransmitter that helps regulate mood. Common SSRIs include fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro). SSRIs are generally considered safe and effective, though it may take several weeks to notice their full effect.

SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors): SNRIs, like SSRIs, increase the levels of serotonin and norepinephrine in the brain. These neurotransmitters play a key role in mood regulation. Common SNRIs include venlafaxine (Effexor) and duloxetine (Cymbalta). SNRIs are often prescribed when SSRIs are not effective.

Benzodiazepines: Benzodiazepines are fast-acting medications that provide quick relief from acute anxiety symptoms. They work by enhancing the effect of the neurotransmitter GABA, which has a calming effect on the brain. Common benzodiazepines include alprazolam (Xanax), lorazepam (Ativan), and diazepam (Valium). Due to their potential for dependence, they are usually prescribed for short-term use​.

Beta-blockers: Primarily used to treat high blood pressure, beta-blockers like propranolol can also help manage physical symptoms of anxiety, such as rapid heart rate and tremors. They are particularly useful for performance anxiety​.

Other Medications: Other medications used to treat anxiety include tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), and buspirone. These are typically used when other treatments have not been effective.

Related: What is polypharmacy and why is it important?

Mechanism of Action for Each Class of Medication:

  • SSRIs: Increase serotonin levels by inhibiting its reuptake into neurons.
  • SNRIs: Increase both serotonin and norepinephrine levels by inhibiting their reuptake.
  • Benzodiazepines: Enhance the effect of GABA, producing a calming effect.
  • Beta-blockers: Block the effects of adrenaline on the body, reducing physical symptoms of anxiety.
  • Tricyclic Antidepressants and MAOIs: Increase levels of norepinephrine and serotonin by preventing their breakdown or reuptake.

Understanding these mechanisms helps in tailoring treatment to the individual’s specific needs and responses to medication.

Related: The importance of high-risk medication monitoring

Common Side Effects:

  • SSRIs and SNRIs: Nausea, headache, dry mouth, dizziness, sexual dysfunction.
  • Benzodiazepines: Drowsiness, dizziness, dependence, withdrawal symptoms.
  • Beta-blockers: Fatigue, cold hands, dizziness, weakness.

Long-term Considerations:

  • Long-term use of SSRIs and SNRIs is generally safe, but monitoring is necessary to manage any potential side effects.
  • Benzodiazepines are not recommended for long-term use due to the risk of dependence.
  • Regular review and adjustment of the treatment plan are essential for optimal management.

Importance of Medical Supervision: Regular medical supervision ensures that the medication is effective and that any side effects are managed promptly. Adjustments to the dosage or type of medication may be necessary based on the individual’s response to treatment​. Medications are a crucial part of anxiety treatment, helping to manage symptoms and improve quality of life. However, they must be used under medical supervision to ensure safety and effectiveness. Combining medication with therapy often yields the best results in managing anxiety disorders.

Therapy for Anxiety

Therapy is a cornerstone of anxiety management, offering various approaches to help individuals understand and manage their anxiety effectively. This section provides an overview of effective therapies and their benefits.


Cognitive Behavioural Therapy (CBT) is one of the most widely used and effective therapies for anxiety. It focuses on identifying and changing negative thought patterns and behaviours that contribute to anxiety. CBT involves techniques such as cognitive restructuring, exposure therapy, and relaxation training, helping patients develop coping strategies and reduce anxiety symptoms.


Dialectical Behaviour Therapy (DBT), originally developed to treat borderline personality disorder, has also been effective in treating anxiety. DBT combines cognitive-behavioural techniques with mindfulness practices. It emphasises balancing acceptance and change, helping patients manage intense emotions, reduce self-destructive behaviours, and improve relationships.


Exposure therapy involves gradually exposing patients to the situations or objects that trigger their anxiety in a controlled and safe environment. This helps desensitise patients to their fears and reduces avoidance behaviour. It is particularly effective for specific phobias, social anxiety disorder, and PTSD​.


Mindfulness-based therapies, such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), incorporate mindfulness practices to help patients stay present and reduce the impact of negative thoughts and feelings. These therapies teach patients to observe their thoughts without judgment, reducing anxiety and stress.

Other Therapeutic Approaches: Other effective therapies for anxiety include Acceptance and Commitment Therapy (ACT), which focuses on accepting anxiety as a part of life and committing to actions aligned with personal values, and Interpersonal Therapy

The Benefits of Therapy for Anxiety

The Benefits of Therapy for Anxiety

Therapy helps manage anxiety by providing tools and techniques to understand and alter thought patterns and behaviours. It helps patients build resilience, improve coping mechanisms, and reduce anxiety symptoms over time.

Long-term Benefits of Therapy: The long-term benefits of therapy include sustained reduction in anxiety symptoms, improved emotional regulation, better interpersonal relationships, and enhanced overall well-being. Therapy also equips patients with lifelong skills to manage stress and prevent relapse.

Techniques Used in Therapy: Therapists use a variety of techniques to help manage anxiety, including cognitive restructuring (challenging negative thoughts), exposure techniques (gradual exposure to anxiety triggers), relaxation exercises (deep breathing, progressive muscle relaxation), and mindfulness practices (staying present and non-judgmental).

Combining Medication and Therapy

Combining Medication and Therapy

Combining medication and therapy is often considered the most effective approach for managing anxiety. This integrated strategy addresses both the physiological and psychological aspects of anxiety, leading to more comprehensive treatment outcomes.

Why Combining Medication and Therapy Can Be More Effective: Combining medication and therapy can provide a balanced approach to anxiety treatment. Medications can offer quick relief from symptoms, helping to stabilise the patient and make it easier to engage in therapeutic activities. Meanwhile, therapy can address the underlying psychological factors contributing to anxiety, providing long-term coping strategies and preventing relapse. Studies have shown that individuals who receive both medication and therapy tend to have better outcomes compared to those who receive only one form of treatment​.

How to Determine the Best Treatment Plan

When determining the best treatment plan for anxiety, several factors need to be considered:

  • Severity of Symptoms: The intensity and duration of anxiety symptoms can influence whether medication, therapy, or a combination is needed.
  • Patient Preferences: Individual preferences and past experiences with treatments should be taken into account.
  • Co-existing Conditions: The presence of other mental health conditions or physical illnesses can impact treatment choices.
  • Response to Previous Treatments: Reviewing what has or hasn’t worked in the past can guide current treatment decisions​.

 Healthcare providers like doctors and clinical pharmacists play a crucial role in creating and managing a treatment plan for anxiety. They conduct thorough assessments to understand the patient’s specific needs, monitor progress, and adjust treatments as necessary. Providers often collaborate in a multidisciplinary team, including psychiatrists, psychologists, and primary care physicians, to ensure a comprehensive approach to manage anxiety. Regular follow-ups and open communication between the patient and healthcare team are essential for the success of the treatment plan​.

Combining medication and therapy leverages the strengths of both approaches, providing immediate symptom relief and long-term management strategies. By considering individual factors and involving healthcare providers in the planning process, patients can receive a tailored and effective treatment for anxiety.

Natural and Alternative Treatments

There are a number of common supplements used for anxiety. Several natural supplements for anxiety are popular for their potential calming effects. These include:

  • St. John’s Wort: Often used for mild to moderate depression, it can also help alleviate anxiety symptoms. However, it can interact with other medications, so medical advice is essential before starting it​.
  • CBD (Cannabidiol): Derived from cannabis, CBD is known for its calming effects without the psychoactive impact of THC. Research suggests that it may help reduce anxiety, but more studies are needed to confirm its effectiveness and safety. Medical advice is essential before starting it​.
  • Valerian Root: This herbal supplement is commonly used to promote sleep and reduce anxiety. It’s believed to increase the levels of GABA in the brain, producing a calming effect. Medical advice is essential before starting it​.
  • Chamomile: Often consumed as tea, chamomile has mild sedative properties that can help reduce anxiety and promote relaxation. Medical advice is essential before starting it​.
  • Diet: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can improve overall well-being and reduce anxiety. Avoiding caffeine and sugar, which can exacerbate anxiety symptoms, is also beneficial​.
  • Exercise: Regular physical activity is proven to reduce anxiety. Exercise increases the production of endorphins, which are natural mood lifters. Activities such as yoga and tai chi are particularly effective for reducing stress and anxiety​.
  • Sleep Hygiene: Establishing a regular sleep routine and creating a restful sleep environment can help manage anxiety. Poor sleep can exacerbate anxiety symptoms, so it’s crucial to prioritise good sleep habits.

While natural treatments for anxiety can be effective for some individuals, they are not universally suitable for everyone. Natural supplements may offer fewer side effects compared to prescription medications, but their effectiveness can vary, and they are not as rigorously tested as pharmaceuticals. For instance, while extensive research and clinical trials back SSRIs and SNRIs, the evidence for supplements like St. John’s Wort and CBD is less comprehensive.

  • CBD: Some studies have shown that CBD can help reduce anxiety, particularly social anxiety. However, more large-scale clinical trials are needed to confirm its efficacy and safety​.
  • Chamomile: Research has indicated that chamomile can significantly reduce generalised anxiety disorder symptoms, offering a natural option for managing anxiety​.
  • Valerian Root: While it is widely used for its calming effects, scientific evidence supporting its effectiveness in treating anxiety is still limited.
  • Interactions: Natural supplements can interact with medications and other supplements, potentially causing adverse effects. It’s crucial to consult with a healthcare provider before starting any new supplement.
  • Quality and Dosage: The quality and dosage of natural supplements can vary widely. It’s important to use products from reputable sources and follow recommended dosages to avoid potential risks.

Natural and alternative treatments can be valuable components of an anxiety management plan. However, they should be used with caution and ideally under the guidance of a healthcare professional to ensure safety and efficacy. Combining these approaches with conventional treatments can provide a comprehensive strategy for managing anxiety.

Final Thoughts and Key Takeaways

Throughout this article, we explored various methods to manage anxiety, emphasising the importance of a multifaceted approach. Key points include:

  • Understanding Anxiety: We discussed the definition, types, symptoms, and causes of anxiety disorders, highlighting the need for accurate diagnosis and tailored treatment plans.
  • Medication for Anxiety: We reviewed common medications such as SSRIs, SNRIs, benzodiazepines, and beta-blockers, including their mechanisms, benefits, and side effects.
  • Therapy for Anxiety: Various effective therapies like Cognitive Behavioural Therapy (CBT), Dialectical Behaviour Therapy (DBT), and mindfulness-based therapies were covered, explaining their benefits and long-term impact.
  • Combining Medication and Therapy: The advantages of an integrated approach were discussed, showing how combining medication with therapy can lead to better outcomes.
  • Natural and Alternative Treatments: We looked at natural supplements and lifestyle changes that can help manage anxiety, comparing their effectiveness and safety with conventional medications.

It is crucial for individuals experiencing anxiety to consult healthcare providers. Professional guidance ensures proper diagnosis, effective treatment plans, and monitoring of progress. Healthcare providers can offer a combination of medications, therapies, and lifestyle recommendations tailored to each individual’s needs, leading to more successful management of anxiety​.

Future Outlook on Anxiety Treatment

The future of anxiety treatment is promising, with ongoing advancements and trends aimed at improving patient outcomes. These include:

  • Telehealth Services: Increasing accessibility to mental health services through telehealth platforms, allowing for remote consultations and therapy sessions.
  • Personalised Medicine: Advances in pharmacogenomics may enable more personalised approaches to medication, improving efficacy and reducing side effects.
  • Innovative Therapies: New therapeutic approaches, including virtual reality therapy and advanced mindfulness techniques, are being explored to enhance treatment options.
  • Integration of Technology: Utilising mobile apps and digital platforms to provide continuous support, track progress, and offer immediate interventions when needed.

These trends and advancements highlight a future where anxiety treatment is more accessible, personalised, and effective, leading to better management and improved quality of life for individuals with anxiety disorders​.

In conclusion, managing anxiety effectively requires a comprehensive approach that includes medication, therapy, and lifestyle changes. By seeking professional help and staying informed about new treatments and advancements, individuals can find the best strategies to manage their anxiety and improve their overall well-being.

Adeem Azhar

Adeem Azhar

Co-Founder and Chief Executive Officer Fervent about healthcare, technology and making a human difference.

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