When does anxiety need medication?

Anxiety is a normal part of life and, in the right moments, can be critical for our survival by warning us of clear and present danger. In some ways, anxiety can be compared to a guardian angel that gives us a heads up when something is awry.  But for those whose anxiety is severe and sustained, it can be the very devil.

For some, anxiety can be so severe, that it becomes nearly impossible to function day to day. Seemingly simple tasks like leaving the house, driving a car, socializing with friends, and even getting a good night’s sleep, can prove too difficult a task.

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An overwhelming feeling of anxiety can be just as tormenting as any physical pain, and because it often doesn’t carry any outward, obvious symptoms, you may be left to suffer in silence.  it’s reassuring then to know that you’re not alone.  Anxiety affects around 40 million adults in the United States alone.

As a first line of defence, many sufferers often turn to medication.  While the right medication may be great for treating symptoms of anxiety, the effect of medications may not last and taking medication doesn't really address the underlying issue.  In fact, in some cases, long-term use of certain medications may be detrmental.

How bad should anxiety be before it requires medication?

As a rule of thumb, if your anxiety is so intense, excessive, and persistent that it interferes with your ability to function day to day, then you may want to talk to your doctor about taking medication. 

Here are the tell-tale signs that your anxiety may be getting out of hand:

• You’ve exhausted all other worthwhile, drug-free treatment options with no luck
• You find it difficult or are unable to carry on with your daily activities, such as going to school or work, seeing friends, parenting, etc.
• You’re having trouble sleeping
• You have difficulty concentrating on a task
• You’re unable to control your anger
• You feel isolated from family and friends because of your feelings and behaviour
• You cannot leave the house out of chronic fear, worry, and stress
• You’re displaying suicidal thoughts or behaviours
• You have physical symptoms of anxiety such as shaking, shortness of breath, heart palpitations, and hot or cold flashes

The earlier you recognize these symptoms, the easier it can be to treat them.  Speak with your doctor as soon as possible if you are experiencing these symptoms; together you can explore your options and decide on the best treatment course for you.

Why should anti-anxiety medication be used as a last resort?

In the moments leading up to a dreadful panic attack, popping pills can seem like the only useful option for someone who is desperate to relieve their suffering, and before you know it, what was intended as a short-term, occasional treatment, soon becomes your go-to remedy for alleviating your feelings of apprehension.

In actuality, taking a pill for your anxiety is like putting a Band-Aid on a deep gash – it may temporarily stop the symptoms, but it does not address the root cause.

There are a whole host of anti-anxiety medications, including benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), beta-blockers, and pregabalin. Yet such medications are all too often overprescribed, and some, such as benzodiazepines, can lead to addiction.  Side effects are also common, leaving anxiety sufferers with the unpleasant decisions about the pros and cons of taking medication to begin with. 

Here are some reasons why drugs may not always be the best solution:

• They are often used as a first-line treatment for even mild symptoms of anxiety, which can cause lead to dependence or, in some cases, addiction.
• Research has led to questions about the effectiveness of such drugs in the long-term, citing that some anti-anxiety medications can lose their effect after 4 to 6 months of consistent use.
• Stopping the medication once you’ve been taking it for some time can induce withdrawal symptoms that are often worse than the original problem, such as rebound anxiety, depression, suicidal thoughts, irritability, shaking, stomach pains, nausea, and much more.

Side-effects are also common and can include:

• Dizziness,
• Drowsiness
• Nausea
• Headaches
• Constipation
• Diarrhoea
• Weight gain
• Dry mouth
• Sexual dysfunction

How can medication be helpful in relieving anxiety?

On the flip side, anti-anxiety medications do have their perks, just as long as you know that there is a right time and a place for them.

Despite the disadvantages of these drugs, if you genuinely feel that you need medication, there’s no shame in asking for help. In fact, when taken safely and combined with therapy and lifestyle changes, the pros can far outweigh the cons.

So, if you feel like you’ve reached your wits’ end, it might be a good idea to ask your doctor to add a suitable medication to your treatment plan.

Here are some benefits of taking anti-anxiety drugs:

• Benzodiazepines are a popular prescription drug for anxiety due to their ability to bring relief from an episode of anxiety within 30 minutes to an hour. They work by slowing down the nervous system, helping you to relax both physically and mentally.
• SSRIs are usually indicated for depression but because they work by increasing the levels of the chemical serotonin (the feel-good factor) in the brain, they are also a good option for treating anxiety. These drugs also have a much lower risk of dependence and abuse than benzodiazepines. They can however, take 4 to 6 weeks to take effect, so taking them as needed rather than daily, is not an option. 
• Beta-blockers are typically used to treat high blood pressure and heart problems, but because they block the stress hormone adrenalin, they can also help keep the physical symptoms of anxiety, such as a high heart rate, shaking, sweating, and dizziness, in check.
• The anti-seizure drug, pregabalin, is another viable option, as it stops the brain from releasing chemicals that make you feel anxious, worried, and stressed. 

What other options are there for anxiety relief?

Unfortunately, anti-anxiety medications aren’t magic pills that instantly solve all of life’s problems.  The calming effects of anxiety medication - minus the scary side-effects - can also be achieved through other means, such as therapy, exercise, and other self-help strategies.

What’s more, some of these methods can also help you identify and address the underlying triggers of your anxiety, proving to be a much more effective solution in the long run. Let’s take a closer look at what these options are:

• Talk it out: You’ll be surprised at how much a simple conversation with someone you know and trust, such as a family member or close friend, can provide relief from whatever anxieties or fears you may be harbouring.
• Keep active: Regular exercise has been proven to decrease overall levels of tension and stress, help you sleep better, and improve your mood and confidence.
• Seek therapy: Techniques like cognitive behavioural therapy (CBT) help to clarify anxiety-provoking thought patterns, teaching you how to stop such thoughts in their tracks, and reduce the likelihood of a future anxiety attack.  
• Do some yoga: Different yoga postures can prompt a relaxation response in the mind and body, helping to alleviate the physical discomfort caused by anxiety and promote a sense of calm and ease.
• Practice mindfulness and meditation: Mindfulness calms anxious feelings by helping you learn to observe your mental state in the present moment and develop adaptive and effective reactions to deal with difficult thoughts and situations.
• Observe good sleep hygiene: The golden hour before your bedtime is crucial; use this precious time to shut off from the outside world.  Step away from your cell phone, turn off your TV, and instead, do something that will help you unwind, like reading a book or meditating. Try and aim for at least 7 to 8 hours of sleep at the same time each night in a dark and quit room.

Although anxiety can make you feel like you're being consumed from the inside out, having multiple treatment methods at hand can help you take control.

To begin with, a drug-free method is often the best approach; altering your lifestyle and state of mind may be be the most effective option for providing relief in the long-term.

If your symptoms don’t get better, then you always try medication as well – just remember that this shouldn't be your first or only treatment option.

At the end of the day, there’s no one-size-fits-all approach when it comes to battling anxiety; speak with your doctor and together you can decide on which options are best for you.

References

1. Mayo clinic 2018, Anxiety disorders, viewed 28^th July 2020, https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961
2. Mind 2017, Anxiety and panic attacks, viewed 28^th July 2020, https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/anxiety-treatments/#Medication
3. NHS 2018, Generalized anxiety disorder in adults, Crown publishers, viewed 27^th July 2020, https://www.nhs.uk/conditions/generalised-anxiety-disorder/treatment/

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