Generalized Anxiety Disorder Treatment
Patients who get involved in treatment for generalized anxiety disorder have a good prognosis for managing this mental illness. Treatment typically involves a combination of behavioral therapies to help the patient actively manage symptoms and medications that help maintain mood over a long period of time. Treatment may also include alternative therapies, relaxation strategies, stress coping mechanisms, and techniques for self-care that can be used on an ongoing basis to maintain wellness.
Generalized anxiety disorder, or GAD, is one type of anxiety disorder, and a common type of mental illness that affects more than three percent of the U.S. population. GAD is a condition characterized by stress and worry that are excessive, persistent, and difficult to impossible to control. Anxiety is a normal emotion everyone experiences, but GAD causes a near-constant sense of dread and anxiety that goes beyond what is expected for a person’s circumstances.
Anxiety disorders can cause significant distress and impairment in a person’s life. GAD can cause excessive worry, an inability to relax or enjoy life, physical symptoms that are uncomfortable as well as potentially serious complications like social isolation, substance abuse, or problems at work or school. GAD is treatable, though, and prognosis is good for most patients who commit to long-term therapy, medications, lifestyle changes, and self-care.
Effective Treatments for Generalized Anxiety Disorder
Based on research, the most effective way to treat GAD in most patients is through a combination of therapy, medication, and relaxation strategies. Additionally, many people benefit and are able to maintain relief from anxiety through making lifestyle changes and engaging in self-care. Every person is unique, and different strategies may have varying degrees of effectiveness, but this combination of care is the basis of effective, long-term management for generalized anxiety.
Where and how a patient chooses to receive this treatment is a personal choice, but for those who really struggle with anxiety a stay in a residential facility has several benefits. It gives them a safe place in which to fully focus on treatment. It also allows for an extended period of time in which to find the right medication that works the best with the fewest side effects. Residential care also gives patients the chance to learn strategies and skills and to develop a plan that will help them learn to live with this chronic illness after active treatment has stopped.
Cognitive Behavioral Therapy for GAD
Therapy is an important component of treatment for generalized anxiety. It helps patients get relief from symptoms by actively getting involved in their own self-care and management of anxiety. Cognitive behavioral therapy, or CBT, is most commonly used to treat anxiety and is considered to be one of the most effective strategies for care. The added benefit of CBT is that it can also help manage depression, which many people struggling with GAD also have.
CBT is a type of behavioral therapy, which means it goes beyond just talking about thoughts and feelings and addresses and aims to change behaviors to help manage mental illnesses. The general strategy of CBT is to learn to recognize and face negative thought and behavior patterns and to take active steps to change them.
Specifically for anxiety, a patient in CBT will learn to recognize anxieties and fears, what triggers them, and to realize that they are irrational and unrealistic. CBT teaches patients to recognize these inaccurate thoughts and also to take steps to change them into more positive and realistic thoughts. CBT for anxiety also includes strategies for changing negative behaviors into positive ones. Specifically, this includes using relaxation techniques to manage anxiety and to avoid overreacting and other negative behaviors as well as coping strategies to be able to face anxiety and deal with it in healthy ways.
A big part of CBT for anxiety involves facing one’s fears and the things, people, and situations that trigger worry and anxiety. This can be stressful initially, but in the long-term it helps patients learn to manage and reduce anxiety. It increases a sense of control, which is useful in minimizing fear and anxiety.
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Medications for Generalized Anxiety Disorder
Medications can be used to manage the symptoms of anxiety, and which medications work best depend on the individual. Some patients may need to try more than one drug before settling on the one that provides the best results with the fewest side effects.
The first line of medical treatment for GAD is the SSRI class of antidepressant medications. SSRIs, or selective serotonin reuptake inhibitors, work by increasing the levels of the chemical serotonin in the brain. Some examples of SSRIs used to treat generalized anxiety are paroxetine (Paxil), fluoxetine (Prozac), and escitalopram (Lexapro).
Anti-anxiety medications may also be used to treat GAD, but these are not considered first-line therapies or long-term solutions for treatment. They are most useful in treating patients in the short-term. Research has found that when combined with SSRIs, anti-anxiety medications are useful in providing quick relief from anxiety. However, they do not provide any better outcomes over the long-term.
Anti-anxiety drugs, typically the benzodiazepines alprazolam (Xanax), diazepam (Valium), and clonazepam (Klonipin), can be used to manage symptoms while SSRIs begin to work. The antidepressant SSRIs can take up to six weeks to begin working, so having another drug to provide immediate relief in the short-term is useful for many patients. Buspirone is another anti-anxiety medication that may be used to manage GAD but is not a benzodiazepine.
Alternative and Holistic Therapies
A good treatment program for generalized anxiety disorder will offer patients a variety of alternative therapies to try as well as a holistic approach to care. While these are not the main components of care, using additional strategies to manage stress and anxiety can be useful. Some examples of holistic and alternative therapies that GAD patients may benefit from include:
- Massage therapy. The physical manipulation and relaxation of muscles can help reduce anxiety.
- Acupuncture. An important component of traditional Chinese medicine, acupuncture aims to realign the energy in the body to get relief from symptoms.
- Meditation. Meditation is also an ancient practice and is used to relax the body and mind and to become more mindful and aware.
- Yoga. Yoga, yet another ancient practice, is both a physical exercise and a mindfulness and relaxation strategy.
- Art therapy. A trained art therapist helps patients manage anxiety and find underlying causes through the creative process.
Lifestyle and Self-Care to Manage Anxiety
Engaging in good self-care is a crucial part of long-term management of anxiety. Long after the professional treatment at a residential facility is complete, a patient can use self-care and lifestyle changes learned in treatment to maintain and manage good mental health. Lifestyle changes may include a variety of things depending on the individual, such as no longer using alcohol, losing weight, changing jobs, or ending stressful relationships.
Self-care is an ongoing practice that involves a number of strategies to take care of one’s own overall wellness:
- Taking time to do enjoyable, relaxing activities
- Getting regular exercise
- Eating a healthy diet and maintaining a healthy weight
- Practicing relaxation techniques, such as meditation, guided imagery, or deep breathing
- Avoiding poor health habits, like substance abuse and smoking
- Avoiding too much caffeine
- Maintaining ongoing treatment
The Importance of Social Support in Managing Anxiety
One final component that is important to treating and managing GAD is social support. Connection to other people helps to reduce feelings of anxiety and can help manage anxiety during particularly difficult situations. While having social support is important, anxiety can actually cause harm to relationships. This is especially true when anxiety is untreated. Treatment for GAD is important for overall wellness and for maintaining the relationships that are so important for supporting someone who struggles with anxiety.
Including social support in the management and treatment of GAD can take several forms. At its simplest, social support means having close friends and family to rely on during and after treatment. But social support can also be more complex. Treatment may include group therapy, for instance, or relationship or family therapy. Ongoing care may also include participation in support groups for people with anxiety, either in person or online.
Treatment for generalized anxiety disorder is multi-faceted. When a patient engages fully in an individualized treatment plan and commits to making long-term lifestyle changes and setting aside time for self-care, the prognosis for living with this chronic condition is very good. Treatment should be tailored to each individual patient, but should include some type of therapy, medication, social support, and good self-care.