How Can I Bring My Anxiety Disorder Under Control?

What is anxiety disorder?

Psychologists define anxiety disorder as a chronic behavior of excessive fear and worry that dominates a person’s life to the point that he or she become socially or economically dysfunctional. Fear and worry are part of everyday life and our genetically coded response to coping with day-to-day stress. In early human history that stress was a mammoth, now it’s your boss or the monthly credit card bill. So, some level of anxiety in your life is normal. It only becomes a clinical diagnosable disorder once it starts taking over your entire life and interferes with your relationships, your job and hobbies.

It’s vital that you bring this anxiety under control early on, as later it will be more difficult to treat and take longer to cure. Before we look at the treatment options, let’s take a look at what are the most common forms of anxiety disorder. Each is characterized by different anxiety forms and triggers.   

• General anxiety disorder (GAD) is marked by chronic worrying about minute details of everyday life and social interactions.
• Panic disorder refers to sudden, uncontrollable panic attacks accompanied by an accelerated heartbeat, a feeling of overwhelming despair and sweating.
• Obsessive compulsive disorder (OCD) is diagnosed in people who keep on obsessively thinking about certain issues and, in response to the latter, are compelled to repetitive compulsive behaviors. 
• Posttraumatic stress disorder (PTSD) is a chronic condition of shock and anxiety triggered by a traumatic experience such as war, crime, bereavement or any other extreme physical or mental stress. 
• Social anxiety disorder is a type of anxiety disorder that happens in social interactions, such as fear of talking to people or feelings of awkwardness in social situations.

These are the five broad categories of anxiety disorders. In many cases a patient is suffering from a combination of at least two of them in varying degrees and with cross-reinforcements. 

How common is anxiety disorder and who’s at risk?

 According to the Anxiety and Depression Association of America (ADAA), some 40 million adults in the U.S. population suffer from anxiety disorder in any given year, which makes it the most common mental disorder. With ~15 million cases annually, social anxiety is the most often seen anxiety disorder category. Anxiety disorders are found among people of various ages and social backgrounds, but it’s twice as common in women as in men. Anxiety disorders often start during adolescence and are most common in the age group of 18-34-year olds. People older than 65 have the lowest prevalence of anxiety disorder among all age groups.

Here are a few risk factors that make it more likely for a person to get anxiety disorder:

• Traumatic experiences and events
• Chronic mental stress
• Precedents of anxiety disorder in the family 
• Personal history of depression or other mental conditions
• Personal history of narcotics or alcohol abuse 

Can anxiety disorder be treated?

Indeed, it can, and with high success rates. But according to the ADAA only about 37% of Americans suffering from the illness seek medical treatment, which is unfortunate. There are two kinds of treatment available: medications and behavioral therapy by licensed therapists.

The most often prescribed drugs for anxiety disorder are selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). Zoloft, Paxil, Prozac, Lexapro and Celexa are SSRIs and are considered standard anxiety disorder treatment. Two popular SNRIs are Effexor and Cymbalta. There’s also a third category: sedatives like Zanax and Klonopin.

All of them require prescriptions and your physician will decide which drug may work best for you. That depends on your type of anxiety, how the side effects of each medication match your health and preexisting medical conditions, other drugs that you may take and possible allergic reactions.

Typically, for an SSRI or SNRI to take full effect it requires about a month or two. During this initial treatment period it’s important that you keep track of your improvements and any side effects you may experience. Keeping a treatment diary is recommended; this will also allow your doctor to better monitor your progress. 

If you don’t feel any improvements after 2-3 months of treatment, talk to your doctor about maybe putting you on a different medication. It could be that you are not responding well to your current ongoing treatment.

References:

Bandelow, Borwin, and Sophie Michaelis. “Epidemiology of Anxiety Disorders in the 21st Century.” Dialogues in Clinical Neuroscience, vol. 17, no. 3, 2015, pp. 327–35, www.ncbi.nlm.nih.gov/pmc/articles/PMC4610617/. Accessed 23 Feb. 2020.

Strawn, Jeffrey R., et al. “Pharmacotherapy for Generalized Anxiety Disorder in Adult and Pediatric Patients: An Evidence-Based Treatment Review.” Expert Opinion on Pharmacotherapy, vol. 19, no. 10, 3 July 2018, pp. 1057–1070, www.ncbi.nlm.nih.gov/pmc/articles/PMC6340395/, 10.1080/14656566.2018.1491966. Accessed 23 Feb. 2020.

“Choosing SSRI or SNRI for Anxiety or OCD? Meta?analysis May Help.” The Brown University Child & Adolescent Psychopharmacology Update, vol. 22, no. 1, 23 Dec. 2019, pp. 1–3, 10.1002/cpu.30455. Accessed 23 Feb. 2020.