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Treating Anxiety

Anxiety is the number one reason women seek therapy and the number two reason for men. In other words, anxiety is extremely common. A whole lot of us are dealing with anxiety, whether it’s anxiety brought on by social situations, panic attacks, or an overall sense of anxiety where we can worry endlessly about almost anything.

Interestingly, we don’t have great medication options for anxiety. There are the benzodiazepines, like Xanax and Klonipin. They definitely get rid of anxiety in the short term. But as soon as you stop taking them, the anxiety returns. And using these medications can leave you needing to sleep or unable to work safely or productively. These medications can be very hard for some people to get off of later on, as well. And, finally, there is growing research that the benefits of benzodiazepines for anxiety may be only short lasting; studies have shown that anxiety increases after eight weeks on Xanax compared to a placebo. Some antidepressants are helpful in reducing anxiety but the reduction of anxiety may not be as much as the person is hoping for when they take the medication. In other words, some antidepressants can offer limited relief.

The two most effective treatments for anxiety are longer-lasting and more effective than prescription medications, with fewer side effects but with one drawback: they require more effort. If you guessed that I’m talking about exercise and talk therapy, you are right! Exercise has such amazing mental health benefits that if it was a pill, it’d be the best-selling, most prescribed pill ever. It’s that good. Talk therapy is also an effective way to address anxiety and here you have multiple different approaches. Some anxiety is the result of a misperception of the risks or dangers compared to the person’s resources or ability to deal with the feared event. CBT is a good therapy for addressing this. ACT is a talk therapy which teaches people that they can tolerate their anxiety and do the things they want to do despite the anxiety which is telling them maybe they’d better not. Phobias are treated by gradually exposing the person to the feared situation or thing (elevators, spiders, flying, etc) and allowing the fight-or-flight system to realize that nothing catastrophic happens. The brain learns that the panic-inducing situation or thing doesn’t need to induce panic any longer. You can see how differently talk therapies work than prescription medications.

Exercise works on several aspects of anxiety. First, it can serve as a simple distraction from whatever the source of anxiety is. Secondly, exercise can stimulate a variety of neurochemicals that change brain chemistry and lessen anxiety. On a physical level, exercise can reduce muscle tension. The fight-or-flight system monitors muscle tension as one cue that danger may be present, so reducing muscle tension helps send the physical signal that there is nothing to be anxious about. And, finally, exercise strengthens the executive function areas of the brain and these help keep the amygdala (the heart of the fight-or-flight system) under more control. And according to the Anxiety and Depression Association of America, as little as five minutes of aerobic activity can result in anti-anxiety effects! A ten minute walk at a brisk pace or other activities with similar levels of exertion can deliver several hours of reduced anxiety. You can read more about it here. And the great thing about exercise is you can start as soon as you’d like without having to spend money. It can be as simple as putting on your shoes and heading for a walk. (You get bonus points if you walk in a green space or in nature!)

See my blog posts for information about other approaches to treating anxiety through nutrition here and here and addressing physical causes.

As you are investigating the treatment options and considering medications and therapy, you might reasonably think you’ll start with medication for immediate relief while the talk therapy gets started. Here’s the kicker to that: talk therapy is not likely to be as effective if you are on medications which are reducing your anxiety. That is, the talk therapy has less to address and work with. If you can tolerate it, pass up the medications and allow therapy to start working on the full force of your anxiety symptoms. This way, you can be confident that the results you’ve achieved will “stick” because there will not be increased anxiety after a prescription is no longer taken.

There is a LOT to be anxious about these days. If you’d like someone to give you tools for dealing with your anxiety or someone to simply listen and hear you, give me a call or text at (816) 226-4678. I offer a free 30-minute consultation.

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