The good news is that treatment for anxiety – for those that seek it out – is usually successful. Your first port of call is your GP to discuss your options and receive a referral to the best psychologist or counsellor, for your needs, in your area.
“The most recommended psychotherapy for anxiety disorders is cognitive behavioural therapy,” says Rudy Nydegger, psychologist and author of Dealing with Anxiety and Related Disorders.
“It is not a template therapy method where each patient and each disorder is treated in a predictable and specific way. Rather CBT is an approach that relies on the use of many different techniques that are designed to deal with each unique situation and individual and focus primarily on the changing of particular behaviours, developing better strategies for managing troublesome situations, and learning how to think about, perceive and interpret circumstances in ways that lead to a healthier adaptation to conditions that are producing the symptoms.”
This could include learning how to self-monitor symptoms, relaxation and breathing retraining, and experimenting with behaviour, visualisations and relapse prevention techniques. While it’s not a quick fix – compared to medication, for instance – it will ultimately produce longer-lasting results.
“Using cognitive rehearsal and imagining how to do things differently help a patient to initiate new behaviours,” says Nydegger. “A technique called reframing is frequently employed to help people learn new ways to think about particular problems or situations.”
A meditative practice of mindfulness-based stress reduction (MBSR) is increasingly used as part of a holistic approach to the treatment of anxiety, as well as for chronic physical illness and pain.
“Mindfulness is a way of noticing how our attention gets pulled in different directions, and it’s a way of practicing the gentle, persistent art of returning our attention to the present moment,” says Dennis Tirch, cognitive therapist and author of Overcoming Anxiety.
“Mindfulness training has been demonstrated to be an effective treatment for a range of psychological problems, such as depressive relapse, anxiety and emotion-regulation difficulties. By developing our ability to be mindful, and by learning how to apply mindfulness to more healthy methods of coping with stress, we may become able to change our habitual and unhelpful responses to anxiety.”
Talk to your psychologist about mindfulness training and check out some of the free mindfulness meditation apps available.
Is your lifestyle increasing your vulnerability towards anxiety? For a majority of anxiety sufferers, the answer is a resounding ‘yes’. Perhaps it’s time to de-clutter, delegate and slow down.
“If you feel that your life is spiralling out of control – with too many demands from your work, home, partner, family and friends – maybe it’s time to simplify,” suggests Wendy Green, author of Anxiety – a Self-Help Guide to Feeling Better. “If you regularly feel under pressure and stressed because of a lack of time, try reviewing how you structure your days. Keep a diary for a week to see how you spend your time and then decide which activities you can cut out or reduce to make more time for the things that are most important to you.”
It won’t hurt to be a little selfish, occasionally, for the sake of your mental health.
“Try saying ‘no’ to the non-essential tasks you don’t have time for or just don’t want to do,” says Green. “It’s a little word, but it can dramatically reduce your stress levels. If you find it hard to say ‘no’, then perhaps you need to develop your assertiveness skills.”
Nutrition can have a powerful impact on anxiety, for better and for worse, and can form an important part of an overall approach to rehabilitation.
“We use a number of therapies to treat anxiety, including exercise physiology, psychology, nutritional, medical and naturopathic support, gut health work and detoxification support for clients dependent on alcohol, medications, illicit drugs, sugar and caffeine, which we see a lot of in people living with anxiety,” says Pettina Stanghon, founder of mental health rehabilitation centre Noosa Confidential.
Dr Malcolm Clark, Melbourne GP and author of Doctor in the House, says that stress and anxiety play a major role in irritable bowel syndrome, both in triggering and worsening symptoms, including bloating, abdominal cramps, flatulence and loose, frequent bowel motions or constipation.
“Sufferers often report the return of their rotten symptoms when they are under increased stress at work or at home,” he says. “Depressed or anxious people seem to suffer from this problem more often than the rest, suggesting these may also be causes.”
To combat ‘gut anxiety’, eat a low GI diet (which also helps regulate blood sugar levels), reduce fatty foods and alcohol, and increase fibre intake.
Developing a healthy exercise habit is highly complementary to an overall anti-anxiety approach.
“Exercise is likely the oldest form of self-management of anxiety, although alcohol is a close second,” says Bret Moore, psychologist and author of Taking Control of Anxiety. “Numerous studies have been conducted over recent years showing that exercise alone, or in combination with psychotherapy, is effective in reducing anxiety associated with a variety of anxiety disorders.”
In fact, one study found that regular exercise can be as effective as medication in people with panic disorder.
“Vigorous and sustained physical activity promotes the release of endorphins: neurotransmitters in the brain that promote a sense of euphoria and contentment,” says Moore. “This phenomenon allows joggers to overcome fatigue and pain during long-distance running.”
A number of medications are available that provide effective relief – but not a cure – from anxiety. The first option, usually, are SSRI’s (or selective serotonin reuptake inhibitors). Traditionally used to treat clinical depression, and a little slow to kick in from the outset (they can take a couple of weeks to ‘build up’ to the complete benefits) they have proven to be very successful for many people. MAOI’s (monoamine oxidase inhibitors), which inhibit the breakdown of serotonin and norepinephrine in the brain, are a similar option that may be recommended.
The old-school anti-anxiety tranquilliser meds – still used for individual cases – are benzodiazepines; immediate and highly effective, they do come with a catch.
“As effective as tranquillisers can be, they are less frequently prescribed today because they are addictive if taken for a long period of time and at a high enough dose,” says Nydegger “Also, increased tolerance can become an issue, which means a patient needs to continually increase the dosage for it to be effective.”
Beta-blockers may also be used for planned events, such as a speech or presentation, where anxiety can go into overload. They work by calming the heart, reducing hand trembling and may even be helpful with blushing and sweating.