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Treatment of anxiety disorders

Anxiety disorders — treatment of generalized anxiety, panic and social anxiety with therapy and, when needed, medication.

A care process for excessive and persistent anxiety that disrupts daily life, combining evidence-based psychotherapy, medication when needed and lifestyle adjustments.

Indication

  • Generalized anxiety disorder (persistent worry, tension)
  • Panic disorder and panic attacks
  • Social anxiety disorder
  • Specific phobias (flying, elevators, needles, etc.)
  • Agoraphobia (avoidance of crowded or enclosed spaces)
  • Health anxiety and anxiety presentations with somatic symptoms
  • Anxiety developing after trauma or stress

Preparation

  • Triggers of anxiety and their frequency are noted briefly
  • Tests may be requested to rule out medical causes (thyroid, cardiac rhythm, anemia)
  • Caffeine, energy drink and stimulant intake are shared
  • All medications and supplements in use are reported to the clinician

How it's performed

  1. The clinician determines the type and severity of anxiety using interviews and validated scales
  2. Necessary tests are performed to rule out medical causes of physical symptoms
  3. For mild to moderate cases, CBT-based psychotherapy is recommended first
  4. Gradual exposure together with breathing and relaxation techniques is applied
  5. When functional impairment is significant, SSRI/SNRI antidepressants may be initiated
  6. Benzodiazepines are used cautiously, only short-term and in selected cases, due to dependence risk

Post-procedure

  • The effect of antidepressants on anxiety usually becomes apparent within 2-4 weeks
  • Continuing treatment for 6-12 months reduces recurrence
  • Exercise, regular sleep and limiting caffeine support recovery
  • Early follow-up is advised if symptoms return
  • Medication is not stopped without medical advice; tapering is gradual

Risks

  • A temporary increase in anxiety, nausea or sleep changes can occur when starting medication
  • Benzodiazepines carry a risk of dependence with long-term use
  • Temporary distress may occur during exposure exercises
  • In pregnancy and breastfeeding, medication choice is balanced against potential risks
  • Caffeine, alcohol and stimulants may reduce the effect of treatment

FAQ

Is a panic attack the same as a heart attack?

Although a panic attack can mimic the symptoms of a heart attack, it is a different condition. However, when chest pain or shortness of breath occurs for the first time, cardiac causes still need urgent assessment.

Do I have to take anxiety medication forever?

No. Treatment duration depends on the type and severity of symptoms. After the first response, treatment is usually continued for 6-12 months and then tapered gradually under medical supervision.

Can therapy alone resolve anxiety?

In mild to moderate anxiety disorders CBT alone can be effective. In more severe cases, combining therapy with medication is recommended.

Are exercise and breathing techniques enough?

Regular exercise and breathing or relaxation techniques help reduce anxiety, but they do not replace medical treatment in cases that cause functional impairment.

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