A Comprehensive Overview of Treatment Options for Anxiety

Note that the title of this article is Treatment of Anxiety, not, Treatment of Anxiety Disorders. Anxiety is a fact of everyday life for the vast majority of people, including those who have no psychiatric diagnosis. In fact, anyone entirely devoid of anxiety would, quite probably, carry a diagnosis related to that absence. In that important sense, anxiety is normal, so why would we treat a "normal" response? The answer to that is not simple, but, for the most part, we should not. Unfortunately, it is not difficult to find providers who will, and that can lead to some long term problems of various types. I shall turn back to that knotty issue a bit later in this article. First, a brief definition of anxiety (given in greater detail in other articles) and then a look at the armamentarium of possible treatment options.

Anxiety is a response that has two somewhat separable components. One part of anxiety is the physical response of the nervous system that involves an imbalance in the autonomic nervous system such that the sympathetic branch is far more active than the parasympathetic branch. What this means is that the body is prepared for vigorous action (fight or flight). Blood is shunted into the muscles, sweating increases, the heart rate goes up, and respiration becomes more rapid; the body generally prepares for maximum physical activity. These changes are very similar to those in fear or rage responses.

Along with these physiological changes, anxiety is marked by an intense need to escape from the situation or the stimulus that provokes it. In acute anxiety attacks, there is often no identifiable stimulus to avoid, but the desire to avoid and escape is there, nevertheless. By definition, in all cases, the response is out of proportion to any objective threat. Mentally, anxiety is akin to the psychic analog of physical pain; you want it to stop. The range of anxious responses, though, is very broad, from mild discomfort to paralyzing panic. Previous articles discussed the various forms of pathological anxiety reactions, both chronic and acute. (put link here). How is this treated?