What is anxiety?
Occasional anxiety is a normal part of life. Many people worry about things such as health, money, or family problems. But anxiety disorders involve more than temporary worry or fear. For people with an anxiety disorder, the anxiety does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, schoolwork, and relationships.
There are several types of anxiety disorders, including generalized anxiety disorder, panic disorder, social anxiety disorder, and various phobia-related disorders.
How is anxiety treated?
Anxiety disorders are generally treated with psychotherapy, medication, or both. There are many ways to treat anxiety, and you should work with a health care provider to choose the best treatment for you.
Psychotherapy
Psychotherapy or “talk therapy” can help people with anxiety disorders. To be effective, psychotherapy must be directed at your specific anxieties and tailored to your needs.
Cognitive behavioral therapy
Cognitive Behavioral Therapy (CBT) is an example of one type of psychotherapy that can help people with anxiety disorders. It teaches people different ways of thinking, behaving, and reacting to situations to help you feel less anxious and fearful. CBT has been well studied and is the gold standard for psychotherapy.
Exposure therapy is a CBT method that is used to treat anxiety disorders. Exposure therapy focuses on confronting the fears underlying an anxiety disorder to help people engage in activities they have been avoiding. Exposure therapy is sometimes used along with relaxation exercises.
Acceptance and commitment therapy
Another treatment option for some anxiety disorders is acceptance and commitment therapy (ACT). ACT takes a different approach than CBT to negative thoughts. It uses strategies such as mindfulness and goal setting to reduce discomfort and anxiety. Compared to CBT, ACT is a newer form of psychotherapy treatment, so less data are available on its effectiveness.
Medication
Medication does not cure anxiety disorders but can help relieve symptoms. Health care providers, such as a psychiatrist or primary care provider, can prescribe medication for anxiety. Some states also allow psychologists who have received specialized training to prescribe psychiatric medications. The most common classes of medications used to combat anxiety disorders are antidepressants, anti-anxiety medications (such as benzodiazepines), and beta-blockers.
Antidepressants
Antidepressants are used to treat depression, but they can also be helpful for treating anxiety disorders. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects.
Antidepressants can take several weeks to start working so it’s important to give the medication a chance before reaching a conclusion about its effectiveness. If you begin taking antidepressants, do not stop taking them without the help of a health care provider. Your provider can help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms.
In some cases, children, teenagers, and adults younger than 25 may experience increased suicidal thoughts or behavior when taking antidepressant medications, especially in the first few weeks after starting or when the dose is changed. Because of this, people of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.
Anti-anxiety medications
Anti-anxiety medications can help reduce the symptoms of anxiety, panic attacks, or extreme fear and worry. The most common anti-anxiety medications are called benzodiazepines. Although benzodiazepines are sometimes used as first-line treatments for generalized anxiety disorder, they have both benefits and drawbacks.
Benzodiazepines are effective in relieving anxiety and take effect more quickly than antidepressant medications. However, some people build up a tolerance to these medications and need higher and higher doses to get the same effect. Some people even become dependent on them.
To avoid these problems, health care providers usually prescribe benzodiazepines for short periods of time.
If people suddenly stop taking benzodiazepines, they may have withdrawal symptoms, or their anxiety may return. Therefore, benzodiazepines should be tapered off slowly. Your provider can help you slowly and safely decrease your dose.
Beta-blockers
Although beta-blockers are most often used to treat high blood pressure, they can help relieve the physical symptoms of anxiety, such as rapid heartbeat, shaking, trembling, and blushing. These medications can help people keep physical symptoms under control when taken for short periods. They can also be used “as needed” to reduce acute anxiety, including to prevent some predictable forms of performance anxieties.
Choosing the right medication
Some types of drugs may work better for specific types of anxiety disorders, so people should work closely with a health care provider to identify which medication is best for them. Certain substances such as caffeine, some over-the-counter cold medicines, illicit drugs, and herbal supplements may aggravate the symptoms of anxiety disorders or interact with prescribed medication. People should talk with a health care provider, so they can learn which substances are safe and which to avoid.
Choosing the right medication, medication dose, and treatment plan should be done under an expert’s care and should be based on a person’s needs and their medical situation. Your and your provider may try several medicines before finding the right one.
Support groups
Some people with anxiety disorders might benefit from joining a self-help or support group and sharing their problems and achievements with others. Support groups are available both in person and online. However, any advice you receive from a support group member should be used cautiously and does not replace treatment recommendations from a health care provider.
Stress management techniques
Stress management techniques, such as exercise, mindfulness, and meditation, also can reduce anxiety symptoms and enhance the effects of psychotherapy. You can learn more about how these techniques benefit your treatment by talking with a health care provider.
How can I find a clinical trial for anxiety?
Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.
Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. We have new and better treatment options today because of what clinical trials uncovered years ago. Be part of tomorrow’s medical breakthroughs. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you.
To learn more or find a study, visit:
- NIMH’s Clinical Trials webpage: Information about participating in clinical trials
- Clinicaltrials.gov: Current Studies on Anxiety Disorders : List of clinical trials funded by the National Institutes of Health (NIH) being conducted across the country
- Join a Study: Adults – Anxiety Disorders: List of studies being conducted on the NIH Campus in Bethesda, MD
- Join a Study: Children – Anxiety Disorders: List of studies being conducted on the NIH Campus in Bethesda, MD
Where can I learn more about anxiety?
Free brochures and shareable resources
- Generalized Anxiety Disorder (GAD): When Worry Gets Out of Control: This brochure describes the signs, symptoms, and treatment of generalized anxiety disorder.
- I’m So Stressed Out!: This fact sheet intended for teens and young adults presents information about stress, anxiety, and ways to cope when feeling overwhelmed.
- Obsessive-Compulsive Disorder: When Unwanted Thoughts Take Over: This brochure describes the signs, symptoms, and treatment of OCD.
- Panic Disorder: When Fear Overwhelms: This brochure describes the signs, symptoms, and treatments of panic disorder.
- Social Anxiety Disorder: More Than Just Shyness: This brochure describes the signs, symptoms, and treatment of social anxiety disorder.
- Shareable Resources on Anxiety Disorders: Help support anxiety awareness and education in your community. Use these digital resources, including graphics and messages, to spread the word about anxiety disorders.
Multimedia
- Mental Health Minute: Anxiety Disorders in Adults:Take a mental health minute to watch this video about anxiety disorders in adults.
- Mental Health Minute: Stress and Anxiety in Adolescents: Take a mental health minute to watch this video about stress and anxiety in adolescents.
- NIMH Expert Discusses Coping with the Pandemic and School Re-Entry Stress: Learn about the causes or triggers of stress and coping techniques to help reduce anxiety and improve the transition back to school.
- NIMH Expert Discusses Managing Stress and Anxiety: Learn about coping with stressful situations and when to seek help.
- GREAT: Learn helpful practices to manage stress and anxiety. GREAT was developed by Dr. Krystal Lewis, a licensed clinical psychologist at NIMH.
- Getting to Know Your Brain: Dealing with Stress: Test your knowledge about stress and the brain. Also learn how to create and use a “stress catcher” to practice strategies to deal with stress.
- Guided Visualization: Dealing with Stress: Learn how the brain handles stress and practice a guided visualization activity.
- Panic Disorder: The Symptoms: Learn about the signs and symptoms of panic disorder.
Federal resources
- Anxiety Disorders (MedlinePlus – also en español )
Research and statistics
- Journal Articles : References and abstracts from MEDLINE/PubMed (National Library of Medicine).
- Statistics: Anxiety Disorder: This webpage provides information on the statistics currently available on the prevalence and treatment of anxiety among people in the U.S.
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