Anxiety Disorders – Part II
In the last issue, we describe the three main groups of anxiety disorders, including generalized anxiety disorder, panic disorder, and a variety of anxiety disorders. In this article, we will discuss factors that may increase the risk of anxiety disorders and how to treat them.
Factors that increase the risk of anxiety: Researchers believe that both genetic and environmental factors can contribute to the onset and exacerbation of anxiety disorders. Factors that may generally contribute to these disorders include:
– Improper parenting approaches to the problem of shyness or fear of children from strangers and unfamiliar places in childhood.
– Exposure to stressful living conditions and stressful surroundings in early childhood (this factor can also lead to anxiety disorders in susceptible adults).
– A positive family history of anxiety disorders in first-degree relatives.
– Some diseases, such as hyperthyroidism and arrhythmia, use of certain drugs and psychotropic substances, and excessive consumption of caffeine may also cause or aggravate anxiety disorders.
Methods of treatment of anxiety disorders: These disorders are generally treated simultaneously with the help of medication, psychotherapy or the use of both of these methods. Here are some of these methods:
Cognitive Behavioral Therapy (CBT): In this way, people are taught how to think, behave differently, and respond to situations and objects that cause them anxiety. It can also help to teach social skills to people with anxiety disorders, especially those with social anxiety disorder. Treatment of people with Social Anxiety Disorder is done with CBT using two methods of cognitive therapy and exposure therapy. In cognitive therapy, they are trained to identify and challenge unhelpful thoughts that cause them anxiety, and then teach them how to fight them and they to turn them to ordinary thoughts. Exposure therapies help affected people overcome their fears and slow them down into activities they have previously avoided. This is sometimes done with relaxation exercises. Cognitive and exposure therapies may be used alone or in combination with treatment depending on the severity of the person’s anxiety. CBT may also be taken individually or in the form of group therapy (in people who have a similar problem). Individuals in these groups are required to complete assignments for the next meeting.
Medication: Medications do not completely cure anxiety disorders, but they do alleviate anxiety and other symptoms in people affected. Medications are usually prescribed by a primary care physician or psychiatrist, but in some US states, psychologists who have the necessary training can also prescribe medication. The main drugs include Anti-Anxiety, Antidepressants and Beta-Blockers, which reduce the physical symptoms of anxiety.
Anti-Anxiety Medications: They are used to control and reduce the main symptoms of anxiety, such as panic attacks and extreme anxiety. The most popular of these drugs are the Benzodiazepines group. These drugs have good effects in controlling the symptoms and many doctors tend to use them in the first line of treatment. Despite the positive effects of these drugs, long-term use is not recommended. Because people tolerate these drugs on the one hand, and the efficacy of the drug is reduced, and in the long run they need to take higher doses, on the other hand, some patients may develop dependency on these drugs. Therefore, physicians usually use these medicines for short periods, along with the psychotherapy methods mentioned earlier. If used, these medications should not be discontinued abruptly, as people with withdrawal symptoms and severe anxiety and fear return. For this reason, these medications should be gradually reduced and discontinued by your doctor. Another drug prescribed as anxiolytic is Buspirone, which does not belong to the group of anxiolytic drugs and is commonly used in the treatment of patients with chronic anxiety.
Antidepressants: Antidepressants are not intended to be used in anxiety disorders to control depression, but they have specific effects on the brain that cause positive changes in mood and reduce stress. Doctors may need to test two to three different drugs to find the right drug for one. On the other hand, these drugs need more time to be effective than anti-anxiety drugs. Most drugs in this group should not be abruptly discontinued.
Beta-Blockers: Although these drugs are often used to treat hypertension and heart disease, they have very beneficial effects in controlling the physical symptoms of patients with anxiety disorders, including increased heart rate, tremor, and facial flushing. These medications are usually used for short periods or can be used as prophylaxis (in predictable situations).
In conclusion, it should be noted that the choice of appropriate treatment should be made by a physician or therapist in collaboration with the patient and it is usually better to use more than one treatment. Nowadays, physicians’ interest in using group therapy and stress management techniques along with drug treatments has increased.