Anxiety disorder can be very crippling, an obstacle to carrying out necessary everyday functions and leading a fulfilling life. While anxiety can be useful in helping us survive potential threats to our safety and well being, anxiety disorder takes it to the extreme. This type of anxiety occurs not only during times of perceived stress, but in other times when there typically would be nothing to fear. What’s worse is that if it is left untreated, anxiety disorder can worsen and become even more pervasive. In those cases, the struggle with anxiety disorder can be debilitating.
That is why it is critical to treat cases of anxiety disorder in order for patients to gain some semblance of a more normal life. One of the most common methods of treatment is the use of medication. It can be a valuable tool to help regain balance in life, either used on its own or in conjunction with therapy. Here is a closer look at how anxiety medication works in treating this disorder.
Types of Anxiety Disorder
Anxiety disorder can take different forms, each one with certain symptoms. The type of disorder can determine which kind of medication may be prescribed.
Generalized Anxiety Disorder
Typically, this diagnosis is made if a patient is overly anxious nearly every day for a period of six months or more. With this type of anxiety disorder, someone can experience irritability, fatigue, excessive worrying, headaches, tense muscles, chest pains, lack of focus and difficulty sleeping. The anxiety can be experienced in just about any area of a person’s life, including work, family, relationships, school, and social gatherings.
The most common hallmark of this disorder is a panic attack. These attacks can occur spontaneously; sometimes they are brought on by a particular situation, but other times there is no identifiable trigger. Panic attacks don’t last long, but in the midst of one the sensations can be intense: a pounding heart, bodily shaking, difficulty breathing, excessive sweating and a perceived loss of control. Unfortunately, people with panic disorder tend to worry about when an attack will occur, which exacerbates the problem.
Anxiety disorder can also manifest itself in a particular fear. It can center around a specific phobia, such as a fear of heights or spiders. Agoraphobics have an intense dislike of being outside and tend to shut themselves away in order not to deal with it. Social anxiety disorder also falls under this umbrella and, as its name implies, focuses on terror experienced in social situations ranging from parties to classrooms to offices. When people are anxious about a loved one not being near them at all times, that could be a possible case of separation anxiety disorder. People with phobias not only fear the object of their phobia but will avoid it at all costs in order to not deal with the resulting anxiety that comes from it.
Commonly known as OCD, this disorder is characterized by uncontrollable thoughts and actions that tend to be repeated over and over again. The anxiety occurs when the thoughts and behaviors can’t be eliminated, no matter how hard the person tries.
Post-traumatic Stress Disorder
PTSD is usually triggered by an event of severe trauma, such as serving in a war or an incident of sexual abuse. PTSD sufferers may endure flashbacks, nightmares or panic attacks as they relive the traumatic event and have to cope with the accompanying stress.
If someone experiences any type of anxiety disorder, ideally they will seek treatment from a qualified, reputable program staffed by knowledgeable professionals well versed in this area of expertise. A treatment plan should be tailored to each individual, and medication may be a key component.
The Role of Medication for Treating Anxiety Disorders
If a doctor considers medication necessary, there are different types to choose from. Again, they can be combined with psychotherapy, which typically takes the form of cognitive-behavioral therapy, or used on their own. A doctor should continually monitor the treatment plan and make adjustments when necessary to achieve the best results.
Anxiety medications are given by prescription only, and different medications are used for different types of anxiety disorders. It is important to note that medication is generally used to treat and relieve symptoms of anxiety disorders and should not be considered a cure-all. The major types of anxiety medications include:
These medications that are typically prescribed to treat depression can also help with anxiety because they target mood and stress. There are two main types of antidepressants that are used for anxiety disorders: selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Less frequently used medications in this category include tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs).
SSRIs include fluoxetine (Prozac®), citalopram (Celexa®), paroxetine (Paxil®), sertraline (Zoloft®) and escitalopram (Lexapro®). SNRIs are duloxetine (Cymbalta®) and the generic drug venlafaxine. Antidepressants take time to work, and often need to be recalibrated to find the proper medication and dosage.
How they work: SSRIs increase the brain’s amount of serotonin, a type of neurotransmitter chemical that is used by brain cells to communicate with each other. The higher the serotonin levels, the better the brain communicates, which can help ease anxiety. SNRIs help balance brain chemistry by affecting serotonin as well as another neurotransmitter, norepinephrine.
What they are used for: All types of anxiety disorders.
Along with antidepressants, benzodiazepines are considered first-line medications for anxiety disorders. There are some key differences: Benzodiazepines take effect more quickly than antidepressants, but they also have a higher risk of developing a tolerance, so they work better in the short term or for flare-ups than in the long term. For prolonged use, antidepressants are usually preferred, as benzodiazepines can trigger withdrawal symptoms. These types of medications include clonazepam (Klonopin®), alprazolam (Xanax®) and lorazepam (Ativan®).
How they work: Benzodiazepines target a neurotransmitter called gamma-aminobutyric acid (GABA). In effect, they slow down a busy, active brain in order to calm the person down.
What they are used for: General anxiety disorder, panic disorder and social anxiety disorder.
Beta-blockers take a different approach when it comes to medication. Unlike antidepressants and benzodiazepines, these medications address physiological concerns, as opposed to psychological ones, that are related to anxiety disorders. Beta-blockers have the capability to relieve symptoms such as an elevated heart rate, tremors or shaking over a short period of time. Sometimes beta-blockers may be used in advance of situations that can trigger anxiety as a preventative measure. For instance, if someone has a fear of flying, they can take a beta-blocker before getting on an airplane. Common beta-blockers include bisoprolol, metoprolol and propranolol.
How they work: As in their name, beta-blockers “block” chemical signals from the nervous system to prevent them from settling on “beta” receptors. These signals can be released in times of anxiety, and can trigger increased heart rate and blood pressure, among other symptoms.
What they are used for: Social anxiety disorder, phobias and panic disorder.
This medication is typically used to help people with chronic anxiety. Buspar is the common brand name for buspirone.
How it works: Like SSRIs, buspirone targets the serotonin levels in the brain.
What it is used for: General anxiety disorder.
With any medication used to treat anxiety disorder, it is vitally important to understand why your doctor has prescribed a particular drug and discuss the benefits, insurance coverage and costs, and any potential side effects. Follow your doctor’s instructions exactly and contact your physician’s office immediately if you experience side effects or other issues.
Risks of Anxiety Disorder Medications
Like any medication, those designated for anxiety disorders can carry some risks. There are a range of side effects, which, depending on the medication, can include dry mouth, diarrhea/constipation, lower appetite, sleep issues, nausea and heartburn. Some medications can also spark feelings of nervousness, irritability or, in severe cases, suicidal thoughts. Because these side effects can pose significant health problems, a doctor should be consulted if any of them appear.
Patients should also make sure their physicians know about anything they may be taking that could interfere with anxiety disorder medications. That includes over-the-counter drugs, herbal or vitamin supplements, other medications or even regular consumption of caffeine or alcohol.
Finally, anxiety disorder medications such as benzodiazepines carry the risk of abuse and addiction. Some medications can have a powerful effect on the brain and if they are taken frequently, a tolerance can develop. That means more of the medication needs to be taken to obtain the desired effect, and continued, accelerated use can lead to dependency. If the medication dependency interferes with a person’s daily life and take the drug becomes the sole focus, it can indicate a possible addiction. People who abuse antidepressants and benzodiazepines over a long period of time may also suffer withdrawal symptoms when they attempt to stop using the medication.
Treating an anxiety disorder with medication requires the skill and expertise that can only be found at a high-quality facility. Casa Palmera has a caring and experienced staff that can guide patients through an individualized anxiety treatment plan, which can include a carefully managed medication plan. If you or someone you know is grappling with an anxiety disorder, contact us today.