Which aspect of treatment seems to be the most effective technique in treating problems with anxiety?

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Everyone worries or feels nervous from time to time. Anxiety is a normal human reaction to stressful situations. But for people with anxiety disorders, those fears and worries aren’t temporary. Their anxiety persists, and can even get worse over time.

Anxiety disorders can severely impair a person’s ability to function at work, school, and in social situations. Anxiety can also interfere with a person’s relationships with family members and friends. Fortunately, though, there are effective treatments for anxiety.

In some cases, medications have a role in treating anxiety disorders. Yet research shows behavioral treatment, alone or in combination with medication, is a highly effective treatment for most people with an anxiety disorder.

Understanding anxiety

Anxiety disorders are common in both adults and children. About 18% of U.S. adults and 25% of adolescents age 13 to 18 will experience anxiety, according to the National Institute of Mental Health. About 4% of adults, and nearly 6% of teens, have anxiety disorders classified as severe.

There are several major types of anxiety disorders:

• Generalized anxiety disorder is characterized by persistent worry or anxious feelings. People with this disorder worry about a number of concerns, such as health problems or finances, and may have a general sense that something bad is going to happen. Symptoms include restlessness, irritability, muscle tension, difficulty concentrating, sleep problems, and generally feeling on edge.
• Panic disorder is marked by recurrent panic attacks that include symptoms such as sweating, trembling, shortness of breath, or a feeling of choking; a pounding heart or rapid heart rate; and feelings of dread. Such attacks often happen suddenly, without warning. People who experience panic attacks often become fearful about when the next episode will occur, which can cause them to change or restrict their normal activities.
• Phobias are intense fears about certain objects (spiders or snakes, for instance) or situations (such as flying in airplanes) that are distressing or intrusive.
• Social anxiety disorder is also known as social phobia. People with this disorder are fearful of social situations in which they might feel embarrassed or judged. They typically feel nervous spending time in social settings, feel self-conscious in front of others, and worry about being rejected by or offending others. Other common symptoms include having a hard time making friends, avoiding social situations, worrying for days before a social event, and feeling shaky, sweaty, or nauseous when spending time in a social setting.
• Obsessive-compulsive disorder is characterized by persistent, uncontrollable feelings and thoughts (obsessions) and routines or rituals (compulsions). Some common examples include compulsive hand washing in response to a fear of germs, or repeatedly checking work for errors.
• Posttraumatic stress disorder (PTSD) can develop after a severe physical or emotional trauma such as a natural disaster, serious accident, or crime. Symptoms include flashbacks of the trauma, nightmares, and frightening thoughts that interfere with a person’s everyday routine for months or years after the traumatic experience.

Seeing a psychologist about anxiety disorders

Though many types of anxiety disorders exist, research suggests that most are driven by similar underlying processes. People with anxiety disorders tend to become easily overwhelmed by their emotions, and they tend to have particularly negative reactions to those unpleasant feelings and situations.

Often, people try to cope with those negative reactions by avoiding situations or experiences that make them anxious. Unfortunately, avoidance can backfire and actually feed the anxiety.

Psychologists are trained in diagnosing anxiety disorders and teaching patients healthier, more effective ways to cope. A form of psychotherapy known as cognitive-behavioral therapy (CBT) is highly effective at treating anxiety disorders. Through CBT, psychologists help patients learn to identify and manage the factors that contribute to their anxiety.

Through the cognitive component of therapy, patients learn to understand how their thoughts contribute to their anxiety symptoms. By learning to change those thought patterns, they can reduce the likelihood and intensity of anxiety symptoms.

With the behavioral component, patients learn techniques to reduce undesired behaviors associated with anxiety disorders. Specifically, patients are encouraged to approach activities and situations that provoke anxiety (such as public speaking or being in an enclosed space) to learn that their feared outcomes (such as losing their train of thought or having a panic attack) are unlikely.

Psychotherapy for anxiety disorders: What to expect

Psychotherapy is a collaborative process, where psychologists and patients work together to identify specific concerns and develop concrete skills and techniques for coping with anxiety. Patients can expect to practice their new skills outside of sessions to manage anxiety in situations that might make them uncomfortable. However, psychologists won’t push patients into such scenarios until they’re sure they have the skills they need to effectively confront their fears.

Psychologists sometimes use other approaches to treat anxiety disorders in addition to CBT. Group psychotherapy, which typically involves several people who all have anxiety disorders, can be effective for both treating anxiety and providing patients with support.

Family psychotherapy can help family members understand their loved one’s anxiety and help them learn ways to interact that do not reinforce anxious habits. Family therapy can be particularly helpful for children and adolescents suffering from anxiety disorders.

Anxiety disorders are very treatable. Most patients who suffer from anxiety are able to reduce or eliminate symptoms after several (or fewer) months of psychotherapy, and many patients notice improvement after just a few sessions.

Psychologists are highly trained and will tailor a treatment plan to address the unique needs of each patient. To find a licensed psychologist in your area, visit Psychologist Locator.

The American Psychological Association gratefully acknowledges Shannon Sauer-Zavala, PhD, Lynn Bufka, PhD, and C. Vaile Wright, PhD, for contributing to this fact sheet.

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