The treatment options listed below require the assistance of mental health or medical providers or other licensed professionals.
- Cognitive behavioral therapy: CBT focuses on identifying, understanding, and changing thinking and behavior patterns related to anxiety in regular meetings with a licensed, CBT-trained therapist. Therapists who practice CBT may use interpersonal therapy (IPT) to help their clients develop coping skills, encourage them to record their thoughts throughout the week as they occur, and attempt exposure therapy if appropriate for their disorder (read more below).
- Dialectical behavioral therapy: DBT is a specific type of CBT. The term "dialectics" refers to a philosophical practice of examining multiple or often contradictory ideas, combining acceptance and change simultaneously. For example, a patient can accept where she is in her life and also feel motivated to improve it. DBT places an emphasis on mindfulness, enabling people to recognize and attempt to understand thoughts as they occur.
- Exposure Therapy: As this term suggests,exposure therapygradually exposes an individual to the feared situation in a safe, controlled environment. Eliminating the actual fear is the ultimate goal. Practitioners begin by having the patient repeatedly imagine the feared situation or object and potential responses to it. Often used in treatingOCD, phobias, andPTSD., this therapy may incorporate virtual reality or computer simulations to create a more realistic yet completely safe method of exposure.
- Group Therapy: The phrase "group therapy" describes a few therapeutic environments6with participants beyond a single patient and provider. In addition to normalizing an individual's experience by relating to others, group therapy may offer an alternative for those who are unable to afford one-on-one therapy. Peer support groups offer an opportunity to share experiences and offer advice. In addition to fostering relationships between people with similar struggles, participating in a support group validates the shared experience of anxiety. A process group may be a good fit for people with social anxiety or generalized anxiety disorder (GAD). The theory behind these groups is that, as you develop friendships with others in the group, over time the sources of anxiety will emerge and can be addressed.
- Hypnosis:催眠治疗师可能医生、治疗师、心理学hologists, social workers, nurses, or other licensed professionals.Hypnosis7helps people achieve a very relaxed state through breathing, guided imagery, or muscle-relaxing techniques and make them more amenable to suggestions. The hypnotherapist may use imagery or simple verbal suggestions to reduce the severity of anxiety symptoms. Some people may see positive results after one or two sessions. If hypnosis shows promising results, a hypnotherapist may also teach ways to practice self-hypnosis.
The medications described below can be obtained only with a prescription. Primary care physicians can diagnose and treat anxiety, but they may recommend that you consult a psychiatrist for severe or treatment-resistant anxiety disorders.
What is most commonly prescribed for anxiety?
- SSRIsandSNRIs: These two classes were initially prescribed as antidepressants but, more recently, research has found that they might help with anxiety as well. They were named based on how they work in the brain: selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). To understand these, some terms need to be defined. First, aneurotransmitteris like a messenger or a runner in a relay race; when an impulse affects a nerve fiber, that fiber then releases a substance (i.e., the neurotransmitter) that will transfer the message to the next stop along the path, which ultimately leads to a muscle, gland, or other target cells.
血清素是一种用作神经递质的化学品，沿着神经之间的信号 - 它也在情绪调节中发挥作用，这有助于焦虑的人。SSRI阻断来自重吸收的脑中的某些神经细胞，或reuptake, which leaves more serotonin available. SSRIs include fluoxetine, fluvoxamine, sertraline, citalopram, paroxetine, and escitalopram. Brand names associated with SSRIs include Paxil, Prozac, and Zoloft. SSRIs may be used to treat post-traumatic stress disorder (PTSD),118bet金博宝 (GAD),金宝博188滚球推荐,118bet金博宝app (SAD), and obsessive-compulsive disorder (OCD).
- Benzodiazepines: These drugs work on the GABA (gamma-aminobutyric acid) neurotransmitter, which plays numerous roles related to sleep, relaxation, anxiety, mood changes, and memory. Although benzodiazepines are typically fast-acting, they also tend to be habit-forming, so doctors usually try other medications first, especially in their patients with a history of addiction. Among the benzodiazepines that may be prescribed for the treatment of anxiety are lorazepam, clonazepam, and diazepam. Some of the brand names are Xanax, Librium, Valium, and Ativan. Individuals who suffer from panic disorder, SAD, or GAD may be prescribed benzodiazepines as part of their treatment plan.
- Beta Blockers:This class of drugs blocks the binding of epinephrine (also known as the hormone adrenaline) and norepinephrine to nerve receptors. Typically used to treat cardiac conditions, beta-blockers like atenolol and propranolol1可以在绩效情况下专门针对社交焦虑症的患者处方，例如在公共场合，而不是长期治疗。品牌名称Beta阻滞剂包括进入的，Tenormin和LoCressor。β-托架通常仅用于治疗不常见的，性能相关的社会焦虑发作。
- Off-Label and Other Drugs: A physician may prescribe other types of medications, such as a tricyclic antidepressant (imipramine); a monoamine oxidase inhibitor, or MAO inhibitor; an anxiolytic (buspirone); or others that work via different mechanisms, such as mirtazapine. Currently, ketamine2is receiving increased scholarly interest as a potential treatment for depression3and anxiety; the FDA gave it priority status4as a treatment for depression, and some physicians have been using it as an off-label5treatment for anxiety.
A doctor may also consider an off-label use of a drug specified by the Food and Drug Administration (FDA) as effective for a condition other than an anxiety disorder or one that is approved outside the United States.
How do you treat anxiety without medication?
- DBS:Deepbrain stimulationis a procedure8that involves implanting an electrode in the brain. In the same way that a pacemaker delivers an electrical current to the heart to keep it beating as it should, the electrode helps regulate the patient's mood. Because it is an invasive procedure, DBS has typically been reserved for severe, treatment-resistant obsessive-compulsive disorder (OCD). Although still in the initial stages of research, DBS may also be an effective treatment for PTSD9.
- RTMS：Most researched for OCD, repetitive transcranial magnetic stimulation delivers magnetic field pulses to the brain via an electrode10placed on the patient's scalp. rTMS is increasingly being considered and studied11as a treatment for other anxiety disorders including panic disorder, PTSD, and social anxiety disorder.
- Vagus Nerve Stimulation: Because the vagus nerve is connected to many areas of the brain, it has been studied as a way to indirectly deliver impulses to deeper areas without being as invasive as brain surgery. Although in an early stage of research, vagus nerve stimulation shows promise for refractory cases of PTSD, panic disorder, and OCD12.
- Other Brain Stimulation Therapies: Additional therapies include transcranial direct current stimulation (tDCS), transcranial electrical stimulation (tES), and electroconvulsive therapy (ECT). Because anxiety-specific studies on these procedures are scarce, they are not considered first-line treatments for anxiety disorders; however, ongoing research suggests that these may provide further options for treating generalized anxiety disorder, OCD, PTSD, and social anxiety disorder.
For those who seek alternatives to traditional medicine or would like to supplement their treatment, self-help and complementary and alternative medicine (CAM) may be useful.
How can I treat anxiety naturally?
- Self-Help: Many self-help books and materials (DVDs, CDs) are available. Before investing in these, consider the background and credentials of the author or producer, as well as the credibility of the publisher. Ask your mental health care or primary care provider for recommendations, check reputable websites13, or consult trusted family and friends.
- 锻炼: When you pick up the pace physically, your body releases endorphins, which are hormones that can improve your mood.Activitiesthat require concentration, such as catching a ball or following an aerobics routine, also keep your brain occupied. Replacing negative thoughts with neutral or positive ones can help calm you down. And exercise may increase confidence and personal satisfaction as you begin to accomplish your goals and overcome challenges.
- Diet and Nutrition: Some research suggests an association between nutrient deficiencies and different manifestations of anxiety. For example, zinc deficiency may have a relationship to panic disorder14and OCD. Other deficiencies that may contribute to anxiety are magnesium15and vitamins D, B6, and B12. Your doctor will likely order a blood test if a deficiency is suspected.
The nutrients L-theanine16andtryptophanmay help decrease anxiety if added to your diet. What vitamin is good for anxiety? Ongoing research seeks to determine whether vitamin E, omega 3 polyunsaturated fatty acids, glycine, and inositol supplements could have protective or other anti-anxiety benefits.
Using diet to manage anxiety may also require avoiding or moderating some foods and beverages. A study in 2005 found that the preservativesodium benzoate在果冻，苏打水和其他产品中发现，有助于焦虑。还有一些evidence将年龄和高胆固醇与焦虑联系起来。由于它们的刺激作用 - 可以适量消耗焦虑 - 糖和咖啡因的刺激作用。除了喝得太多的所有焦虑的焦虑问题外，酒精是一种利尿剂，可以加快丧失宝贵的营养素17.
- 冥想和思想: Although separate concepts,meditation and mindfulnessare often practiced together, especially for the treatment of anxiety. Both focus on thoughts that drive anxiety for many people. Meditation is a conscious practice of focusing your thoughts in one specific direction, redirecting them when they begin to wander. It is usually best practiced in an environment without sensory distractions such as crying babies, barking dogs, cold temperatures, pungent odors, or uncomfortable furniture. Many consider mindfulness a subcategory of meditation. It keeps your thoughts focused on the present moment, even if they wander. For example, you might notice muscle tension in your shoulders, then the sound of the clock ticking and the pattern of your breathing. In practicing mindfulness, it's important that you recognize your own experiences without casting judgment.
- Relaxation Techniques：许多方法有助于人们放松，包括指导图像（听脚本来可视化平静的环境）和呼吸练习，以减缓心率和重点思想。另一种方法，渐进式肌肉松弛，涉及在整个身体中加紧和释放不同的肌肉群。在此过程中，请注意阳性感觉和每个释放的压力减少。其他放松技术包括按摩，太极拳，瑜伽，灵气18or other healing touch therapies, and music and art therapy or similar creative outlets.
- Herbal Supplements：作为焦虑治疗的草药补充的科学研究已经有限，不确定。必须使用补充剂作为互补或替代处理，必须非常谨慎地进行。在服用任何草药补充之前，请与医生讨论，以最大限度地减少不良药物相互作用或副作用的可能性。阅读更多信息Natural supplements for anxiety.
Of supplements marketed for anxiety, chamomile19and kava20have shown some promise. Studies of passionflower21have shown mixed results or were tested only in small groups of people. No studies have reported benefits of using St. John's Wort to treat anxiety. In fact, if you have been prescribed an SSRI or SNRI, adding St. John's Wort can cause a potentially life-threatening condition known as serotonin syndrome. The research on lavender oil, lemongrass, bacopa monnieri, and other herbs is ongoing; there simply is not enough information to know whether they can treat anxiety, work better than a placebo, and most importantly if they are safe to use at all.