Different Types of Therapy: Which is Best for Anxiety?

Anxiety is a normal and healthy emotion, and you might experience higher anxiety levels before a first date or before giving an important presentation. However, when a person feels consistent and overwhelming anxiety, it might become a mental health condition. Anxiety disorders are a category of mental health conditions characterized by excessive fear, worry, and apprehension.

If you’re struggling with excessive worry or high anxiety levels, you’re not alone. According to the National Institute of Mental Health (NIMH), anxiety disorders are among the most common mental health conditions in the United States, and approximately 19% of the general population has a diagnosed anxiety disorder.

Anxiety can interfere with everyday life, and feelings of anxiety can be difficult to control. Fortunately, anxiety disorders are highly treatable, with many anxiety patients noticing significant improvement from psychotherapy.

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Types of Anxiety Disorders

If you experience intense, persistent, and excessive anxiety, you may have a diagnosable anxiety disorder. The most common types of anxiety disorders include:

• Generalized anxiety disorder (GAD): Individuals with GAD struggle with chronic anxiety, nervousness, and worry, even when there is little or nothing to provoke it.
• Social anxiety disorder (social phobia): Those with social anxiety disorder experience excessive worry, low self-esteem, and excessive self-consciousness in social situations. In some cases, social phobia is limited to a specific type of situation. In more severe cases, social phobia can cause significant psychological distress in everyday social situations, leading to avoidant behavior.
• Panic disorder: Unexpected and repeated panic attacks characterize panic disorder. For some people, the fear of experiencing a panic attack can make it difficult to function daily.
• Phobias: Individuals with specific phobias struggle with severe anxiety toward a particular object or situation. In more severe cases, particular phobias can lead to avoidant behavior, causing individuals to avoid everyday circumstances. For example, agoraphobia, which involves an overwhelming fear of situations where there is no “escape,” can make it challenging to leave the house.
• Obsessive-compulsive disorder (OCD): Those with OCD experience persistent, intrusive thoughts (obsessions), which lead to repetitive behaviors (compulsions). Individuals with OCD typically use compulsions such as counting or cleaning to reduce the anxiety caused by obsessions.
• Posttraumatic stress disorder (PTSD): After exposure to a traumatic event, some individuals develop PTSD. Those with post-traumatic stress disorder experience intense anxiety symptoms after an adverse event ranging from nightmares to self-destructive behaviors, such as substance misuse.
• Separation anxiety disorder: Individuals with separation anxiety experience excessive anxiety when separated from home or loved ones. Separation anxiety is a normal part of development, but extreme separation anxiety is one of the most common childhood anxiety disorders. In some cases, separation anxiety can occur during adolescence and adulthood.

If you think you might have an anxiety disorder, it’s essential to seek professional help. Before you’re officially diagnosed with clinical anxiety, your psychologist or clinician will administer a diagnostic interview to determine whether you meet the diagnostic criteria outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). DSM-5 diagnostic criteria include feeling excessive anxiety more often than not and experiencing other anxiety symptoms such as insomnia, headaches, and nausea.

Symptoms of Anxiety

For most people, anxiety involves a combination of psychological and physical symptoms. When the symptoms of anxiety interfere with your everyday life, they could be signs of an anxiety disorder.

According to the American Psychiatric Association, the symptoms of anxiety include:

• Sleeping problems, such as fatigue and insomnia
• Unexplained aches, muscle tension, and headaches
• Digestive problems, such as nausea
• Excessive worry
• Low self-esteem
• Rapid heart rate
• Difficulty concentrating
• Irritability

Treatment Options for Anxiety

Although anxiety can feel debilitating, anxiety disorders are highly treatable. While psychotherapy is typically used as a first-line treatment for anxiety, some people may benefit from a combination of medication and psychological therapy. If you think you may have an anxiety disorder, exploring the following treatment options can help you manage your symptoms and improve your quality of life.

Therapy

Psychotherapy, or talk therapy, is integral to the success of your anxiety treatment plan. Therapy interventions such as cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), psychodynamic psychotherapy, and exposure therapy are proven research-based treatments in helping individuals with anxiety disorders manage their mental health. Working with a psychologist, counselor, or social worker can help you learn new ways to cope with anxiety in daily life.

Medication

Depending on the severity of your specific symptoms, your psychiatrist may recommend a combination of medication and psychotherapy. While pharmacotherapy can’t cure anxiety, medication can help you manage the symptoms of anxiety and increase your quality of life.

Many types of medications can help treat anxiety, and you and your clinician may have to try several medications to find the right medication and dose with minimal side effects. The pharmacologic treatment of anxiety disorders typically involves antidepressants, anti-anxiety medications, beta-blockers, or benzodiazepines, with each having its mechanism of action and effects on anxiety. The most common medications used in the treatment of anxiety include:

• Benzodiazepines promote muscle relaxation and calm the mind. Examples of benzodiazepines include lorazepam (Ativan), diazepam (Valium), and clonazepam (Valium).
• Buspirone is used to treat both short-term and long-term anxiety by altering chemicals in the brain that regulate mood.
• Selective serotonin reuptake inhibitors (SSRIs) are antidepressants that increase the body’s serotonin levels. Examples of SSRIs include sertraline (Zoloft), paroxetine (Paxil), and fluoxetine (Prozac).
• Tricyclic antidepressants work similarly to SSRIs in treating most anxiety disorders. Like SSRIs, psychiatrists start with a low dose and gradually increase the dose depending on the side effects and symptom improvement.
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) boost the body’s serotonin and norepinephrine levels by blocking or delaying their reuptake. Venlafaxine (Effexor) is commonly prescribed for anxiety disorders.

Although you might notice a significant difference in your symptoms after starting medication, it’s essential to keep in mind that pharmacotherapy is not a substitute for psychotherapy. Instead, the medication should supplement psychological therapy. Additionally, be sure to consult your psychiatrist before taking herbal supplements or vitamins with your prescribed medication.

Check-Ups

Sometimes, the symptoms of anxiety can mimic the symptoms of medical conditions, such as heart disease. To take care of your physical health, it’s essential to schedule regular appointments with your primary care provider. After ruling out possible physical health conditions, your primary care doctor can give you a referral to local mental health services.

Self-Care

When you take care of your body and mind, you’ll be able to cope better with everyday stresses and emotional strains. If you’re dealing with a hectic schedule, it can help to view self-care as an investment in your mental and physical health.

To reduce anxiety symptoms, be sure to avoid caffeine and nicotine, make time for your favorite hobbies, and engage in regular exercise. In a randomized controlled trial by Nyberg et al., researchers found that physical activity reduced the symptoms of anxiety by releasing endorphins, with anxiety patients reporting significant improvement in symptoms.

Social Support

The benefits of a robust social support network are both far-reaching and long-lasting. According to a meta-analysis by Harandi et al., the presence of a social support network can make a significant difference in an individual’s ability to manage their mental health.

If you don’t feel comfortable opening up to friends or family members, support groups are available for anxiety patients. Joining a support group enables you to voice your concerns, relate to others in a group setting, and learn valuable social skills. Many studies have also shown that support groups and group therapy are valuable treatment components for individuals with posttraumatic stress disorder following a traumatic experience.

Types of Therapy for Anxiety

The goal of all therapeutic interventions is to help you with anxiety identify the source of your anxiety, understand your triggers, and learn new ways to change your reaction to them. Some types of therapy teach techniques to help you replace negative thoughts and change your behaviors.

Because each anxiety disorder has significant differences, your psychological treatment is tailored to your specific symptoms and type of anxiety. Therapy can be conducted in individual, couple, family, or group settings. The frequency of your therapy appointments and the length of your treatment will depend on your anxiety symptoms and anxiety disorder.

Psychiatrists, clinicians, psychologists, and other mental health professionals use different types of therapy to treat anxiety. Depending on your specific symptoms, diagnosis, and preferences, you’ll be able to work with your therapist to determine the most appropriate treatment plan. Different types of psychotherapy used in the treatment of anxiety disorders include the following.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) is highly effective in the treatment of anxiety. During CBT treatment, your psychologist will help you learn different ways to identify and manage the factors that contribute to your anxiety.

CBT involves a combination of cognitive therapy and behavior therapy. Through cognitive therapy, you’ll learn the basics of cognitive restructuring, which involves identifying the thoughts that trigger their anxiety. By learning how to replace negative thoughts with more realistic thoughts, you can improve their anxiety symptoms. Meanwhile, through behavior therapy, you’ll learn CBT methods to reduce problematic behaviors associated with anxiety-related disorders. During behavior therapy, your psychologist will encourage you in anxiety-provoking activities, and you’ll learn that your feared outcomes are unlikely.

Cognitive-behaviour therapy is also an effective treatment for a wide range of mental health conditions, including major depression, autism spectrum disorder (ASD), and mood disorders. A systematic review and meta-analysis of CBT found that the effects of cognitive-behavioral therapy showed robust efficacy in reducing anxiety symptoms in youth with ASD.

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT), a type of CBT, was originally used to treat borderline personality disorder (BPD). Today, DBT is used to treat a variety of mental illnesses, including anxiety disorders, depressive disorders, and bipolar disorder.

During DBT, you’ll focus on accepting your anxiety while working to change your thoughts and behaviors. DBT teaches four powerful skills: mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation.

Exposure Therapy

Exposure therapy is a common CBT method used to treat anxiety-related disorders, including social anxiety, specific phobias, and PTSD. Exposure therapy uses a technique known as systematic desensitization, where clients are gradually exposed to anxiety-invoking objects or situations. Systematic desensitization involves the following steps.

1. Relax: Your therapist will teach you relaxation techniques, such as progressive muscle relaxation, guided imagery, and deep breathing to help manage your anxiety symptoms.
2. List: Your therapist will help you create a list of your triggers, ranking them in order of intensity.
3. Expose: Your therapist will gradually expose you to anxiety-provoking objects or situations, helping you use relaxation techniques to manage your level of anxiety.

There are several ways your therapist may expose you to triggers, including imaginal exposure, in vivo exposure, and virtual reality exposure. According to a 2001 clinical trial, virtual reality exposure therapy is especially helpful in treating PTSD.

Psychodynamic Therapy

Compared to CBT, psychodynamic therapy is a less structured form of therapy that involves exploring the past to achieve insight into present problems. The goal of psychoanalytic therapy is to uncover past conflicts and work through these issues. During psychodynamic therapy, your psychotherapist will work with you to determine the childhood issues that may be linked to adult anxiety disorders.

Psychodynamic therapy is a supportive therapy that emphasizes the patient-therapist relationship. In a recent study of the long-term outcomes of CBT and psychodynamic therapy, social anxiety patients reported remission rates of 40% for both types of therapy, demonstrating that both CBT and psychoanalysis are efficacious treatments for anxiety disorders and other psychiatric disorders.

Interpersonal Therapy

Interpersonal therapy (IPT) is a form of psychotherapy commonly used in the treatment of depression and anxiety disorders. During IPT, you’ll learn how to recognize interpersonal issues, such as conflicts with loved ones, avoidance, and problems communicating with others. With the help of your therapist, you’ll learn healthy ways to express emotions and communicate with others.

Acceptance and Commitment Therapy

Acceptance and commitment therapy (ACT) is also an effective treatment for anxiety and related disorders. During ACT, you’ll learn different ways to identify your life values and act according to those values.

Researchers found that internet-based ACT treatment works for a variety of anxiety disorders. In an additional study, a combination of commitment therapy and cognitive therapy was shown to be effective in treating anxiety and depression patients in clinical practice.

Eye Movement Desensitization and Reprocessing

Though practiced less than in the past, eye movement desensitization and reprocessing therapy (EMDR) is a form of therapy designed to alleviate the stress associated with traumatic experiences. During EMDR, your therapist will direct eye movements to external stimuli. In some cases, other stimuli, including hand-tapping and audio stimulation, are used during EMDR.

Numerous research studies have shown that EMDR therapy can help people experience the benefits of psychotherapy in the short term. Especially for individuals with PTSD, EMDR can help start the healing process and promote relapse prevention posttreatment, according to several analyses.

What to Expect from Therapy

Contrary to popular belief or what you see on TV, you won’t instantly be cured after your first therapy session. In fact, you may experience ups and downs as you continue treatment. You are apt to feel relief and renewed hope that you’ll be able to make changes to improve your life. When you decide to seek professional help for your anxiety, you’ll be able to explore your anxiety, recognize your triggers, and identify the cause of your negative thoughts and feelings.

If you don’t feel as though you can truly open up to your therapist after your first several sessions, it doesn’t mean therapy isn’t right for you—it just means your psychotherapist isn’t the right match. Some people meet with a few different therapists before finding the best fit for their mental health needs. Ultimately, you may need to try a few different approaches and meet with multiple therapists before finding a treatment that works for you.

Finding the Right Therapist

The sooner you seek professional help, the sooner you’ll start feeling better. Even if your anxiety symptoms don’t interfere with your ability to function, they can still negatively impact your mental health and quality of life.

Whether you’re interested in psychodynamic psychotherapy, internet-based cognitive-behavioral therapy (ICBT), or group counseling, reach out to a mental health professional through The Therapy Group of DC. At The Therapy Group of DC, we know that starting psychological treatment can feel daunting, especially given the stress and uncertainty surrounding COVID-19.

Our real-time intelligent therapy scheduling system will help you find a therapist you feel comfortable with. One of our licensed counseling psychologists or clinical psychologists will help you manage your anxiety, learn healthy ways to cope with anxiety symptoms, and take control of your mental health.