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Expert Q&A: Anxiety Disorders

It is normal for people to experience anxiety and have worries about different aspects of their lives. If you remember back to a time when you had a big exam or presentation, it is normal to feel nervous or on edge. The difference between normal anxiety and an anxiety disorder is when anxiety becomes persistent or recurrent, preventing you from full participation in life. Anxiety can range from relatively mild (occasional “butterflies,” jitteriness, accompanied by a sense of unease) to severe (frequent, disabling panic attacks). Severe anxiety disorders can lead someone to alter his or her lifestyle to accommodate the anxiety, for example avoiding activities. When anxiety begins to cause dysfunction in your daily life, that’s when it’s time to consider it’s more than normal anxiety.

Relaxation techniques and meditation can certainly help with your anxiety. In fact, non-medication options are the first-line treatment for the mild anxiety that most of us experience from time to time. There are many books, online resources, and apps with relaxation exercises (often paired with deep breathing) and meditation guidance. They are relatively simple to learn, yet highly effective. These approaches can provide relief and can be used anywhere once the person understands the method. Mental health professionals can guide the person who needs a more personal approach to learning relaxation or meditation.

Yes. There are many medications that have FDA approval to treat anxiety disorders. For individuals who prefer medication, it is recommended to start with a selective serotonin reuptake inhibitor (SSRI). There is no evidence for any particular SSRI being better than another. This class of medications is not only helpful for panic attacks, but it’s also first-line treatment for generalized anxiety disorder, agoraphobia, and social anxiety disorder. They can be quite effective and have few side effects, although it takes a few weeks to start noticing their benefit.

In the past, benzodiazepines were commonly used to provide relief from anxiety. However, best practice today is to consider these medications when there’s been a partial response to an initial medication option. In these cases, a long-acting benzodiazepine is preferred. While these medications are effective, they should be used for short-term relief. They have many side effects, including drowsiness, and can be habit-forming at higher doses. People taking these medications should not use heavy machinery or drive until they understand how the medication might affect them.

Anxiety disorders are the most common psychiatric disorders in children and adolescents. Cognitive behavioral therapy (CBT) is indicated for all of the childhood anxiety disorders. Therapy alone can be an effective treatment for mild cases. For more moderate to severe anxiety, first-line treatment for children who require medication management for an anxiety disorder is a selective serotonin reuptake inhibitor (SSRI).

While there are some supplements that may be considered for helping anxiety symptoms in children, it’s essential to consult with your physician before starting any new supplement regimen.

Content Author

Brook Choulet, M.D.

Brook Choulet, M.D.

Concierge Sports & Performance Psychiatrist
Founder, Choulet Performance Psychiatry
President, American Board of Sports & Performance Psychiatry

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