When It’s Time to Treat Your Anxiety

Almost everyone experiences anxiety at some point in their life. It’s one way your body lets you know you’re in a challenging situation. Brief feelings of uncertainty and anxiety can be beneficial and can encourage personal growth. However, when those feelings linger and start to impact your daily life, you may wonder if medication is the answer.

How is anxiety first treated?

Anxiety that interferes with day-to-day functioning or affects work, school, or social life, may be a symptom of an anxiety disorder. This interruption in daily routine is often the point at which treatment interventions are needed.

The type of anxiety you’re experiencing, plus any co-occurring conditions (like depression), will determine your treatment plan. Treatment typically starts with a conversation. This may be with your primary care doctor or a mental health professional.

You may feel most comfortable discussing your symptoms with your family doctor initially. Family practice doctors, nurse practitioners, and OB-GYNs are all able to prescribe medication to treat immediate symptoms. Your primary care doctor can also recommend a mental health professional, who will assess you and determine which form of psychotherapy, or talk therapy, may work best for you and your needs.

While medication can address present symptoms, it isn’t a “cure-all.” Psychotherapy options, such as cognitive behavioral therapy (CBT), help identify the underlying cause of anxiety disorders and manage the condition in the long term.

When you might need medication

Anxiety disorders often require psychotherapy to see long-term results. During this process, however, the symptoms you experience may be severe enough to affect aspects of your day-to-day life, such as your relationships, job performance, and school work. If this happens, medication can be prescribed to help you manage your symptoms.

There are several ways you can tell that it might be time to consider medication:

You feel constantly restless or on edge

Feeling restless and on edge can mean more than just “worrying.”

You may experience panic attacks. Your heart rate and breathing may become rapid, and you may feel a constricting sensation in your chest.

While not usually life-threatening, panic attacks can be so alarming that you start to worry about having them. This fear can prevent you from going about your daily routines.

You experience physical effects

Constant anxiety and stress can cause many physical symptoms, including:

• stomachaches
• headaches
• muscle tension

These aches and pains can do more than just make you uncomfortable. You also may find that you experience:

• a change in eating habits
• a fluctuation in your weight
• an inability or unwillingness to do activities you used to enjoy

Heart palpitations, which can make you feel as though your heart is “fluttering” or “skipping a beat,” can happen during moments of intense anxiety.

You may even feel shortness of breath as your body attempts to increase the levels of oxygen going to your muscles.

You have trouble sleeping

Lying awake all night with anxiety can significantly affect your sleep.

Lack of sleep, or sleep deprivation, can cause mood shifts and memory issues. It can also increase your chance of developing other medical conditions, such as heart disease and diabetes.

You feel immobilized with fear

Certain anxiety disorders can cause you to feel paralyzed by the fear of certain situations or experiences.

Social anxiety disorder, for example, may stop you from going out to public places.

Phobias can cause you to go out of your way — even at your personal expense — to avoid people, places, or things that cause you to feel anxiety.

You begin to have relationship problems

Anxiety disorders can affect relationships in a number of ways. Changes in mood, increased irritability, and social withdrawal can be confusing and hurtful to loved ones.

You might also have trouble managing your symptoms. All of these symptoms can interfere with relationships at home and at work.

If you’re having issues in your relationships, medications may help you balance some of the symptoms responsible.

You can’t concentrate

Anxiety can make your ability to concentrate fly out the window. This can cause problems at work, and you might suddenly find that your job is in jeopardy.

Medications may help you find focus again.

Which anxiety medication is right for you?

Not all medications used to treat anxiety disorders are the same. Some have sedative, or relaxing, effects while others also work to prevent symptoms of depression.

The most common types of medications used for anxiety disorders include:

• anti-anxiety medications
• antidepressants
• beta-blockers

Benzodiazepines referred to as anti-anxiety medications, work by creating a mild sedative effect. They are beneficial if you need immediate relief, such as with panic disorder.

However, benzodiazepines are often only prescribed for short periods due to their tendency to cause physical and emotional dependence and withdrawal if stopped abruptly or the dose is lowered quickly. After withdrawal from benzodiazepines, anxiety symptoms can worsen.

Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), work by increasing the amount of available serotonin in the brain, which helps elevate mood.

SSRIs are not as fast-acting as benzodiazepines — it generally takes 4 to 12 weeks to respond to an antidepressant. Your doctor will likely evaluate you after 4 to 6 weeks to determine if the medication is working for you.

If your symptoms are being managed, treatment with an antidepressant might continue for at least one year. If the doctor decides to stop an antidepressant, it will be gradually tapered off.

Though commonly used to treat heart-related conditions, such as high blood pressure, beta-blockers are also helpful for managing symptoms of anxiety. However, they are only used for performance anxiety — such as “stage fright” — and are not typically recommended for other types of anxiety disorders.

The anxiety medication that works best for you will depend on many things, including your symptoms, existing medical conditions, and lifestyle.

When you and your doctor are discussing anxiety medications, consider asking these questions:

• How long does it take the medication to start working?
• What are the common side effects?
• Will my preexisting medical condition be affected by the medication?
• How often do I have to take the medication?
• What happens if I miss a dose?
• Do I have to eat before taking the medication?
• Is it safe to drink alcohol while taking the medication?
• Does the medication have activity limitations? (Can I operate a vehicle and eat my usual diet?)
• Will the medication require regular laboratory tests or monitoring?
• Are there any lifestyle changes I need to make to improve how well the medication works?
• Why is this medication better than the other options?
• How do I stop taking this medication if I need to stop for any reason?

Just because a medication is commonly prescribed doesn’t mean it’s the best choice for you.

If your livelihood depends on operating heavy equipment, for example, you may need to avoid medications that could prevent you from doing your job.

Your lifestyle can also influence your medication choice. A medication that makes you excessively sleepy may not be practical if you have to take it several times a day.

If you have an extreme fear of needles, a medication with regular blood screening may not be at the top of your list.

While medication can help treat symptoms of anxiety disorders, it’s not the only option available.

You may find medications aren’t as effective as you’d hoped, or side effects are just as concerning as your symptoms. Sometimes, the cost of medications can prevent them from being an option for you.

Your doctor can help you decide if there are additional management methods that may work for you.

Some forms of anxiety can be eased by making lifestyle changes or developing new coping skills.

Nonmedication treatment options for anxiety disorders include:

• relaxation techniques, such as yoga and tai chi
• deep breathing
• hypnosis
• mindfulness techniques
• acupuncture
• exercise
• healthy diet
• support groups

Often, the best outcomes are achieved by approaching anxiety treatment from multiple avenues.

Medication can help take the sting out of severe symptoms while self-initiatives and psychotherapy can help manage anxiety in the long term.

Anxiety disorders come with a variety of symptoms, many of which can prevent you from carrying out your usual daily activities.

When anxiety becomes overwhelming, medications may help you regain your ability to function.

The type of medication that works best for you will depend on the anxiety disorder you live with and your personal lifestyle.

Often, the most successful treatment plans involve a combination of medication, psychotherapy, and self-care practices.

If anxiety makes you feel out of control, constantly unhappy, or as though friends and family are leaving you behind, a mental health professional may be able to help.