Anxiety disorders are the most common psychiatric condition in North America (American Family Physician 2005; 71: 733-739). Moreover, an unfortunate reality is that many anxiety sufferers endure additional distress as a result of not knowing their complete treatment options. This article will briefly outline available treatment choices, so that those suffering with anxiety can become more empowered to make treatment decisions appropriate for themselves.
Before we discuss how to treat anxiety, however, we should do a brief overview of the types of anxiety to better appreciate the subject. Generalized Anxiety Disorder is excessive, unrealistic worrying; Obsessive-Compulsive Disorder is persistent reoccurring thoughts that cause the cause the person to perform ritualized routines to free their anxieties; Post-Traumatic Stress Disorder involves flashbacks and hyper-arousal after exposure to a traumatic event; Panic Disorder is debilitating attacks of panic accompanied by heart palpations, difficulty breathing and overwhelming fear; and Social Anxiety Disorder is an extreme fear of being judged by others leading people to avoid social settings.
What can you do to treat these types of conditions? Conventional treatment for all forms of anxiety involves both counseling and medication. Counseling focuses on identifying why the anxiety is occurring and uses exercises, such as relaxation techniques, to manage the anxiety. Evidence shows that these behavioral modification techniques are an effective treatment of anxiety disorders; however, regular sessions with a therapist and self directed techniques must be continued for patients to benefit.
The most commonly prescribed medication for anxiety is a class of drugs called benzodiazepines. These drugs work by decreasing neuron firing in the brain, and thus reduce anxiety and the related symptoms. However, a major concern with these medications is addiction. Patients will experience withdrawal symptoms such as anxiety, irritability, impaired memory, and insomnia within 72 hours of discontinuing the medication and these symptoms can persist for months to years. To prevent this from occurring medication, doses should be tapered or stopped after an appropriate period of time. Unfortunately, all too often, the side effects from withdrawing the medication lead to chronic life-long use. Although medications can be beneficial during acute crises of anxiety, patients should be weaned off their prescription after a short term and have other treatment options in place.
Going beyond the conventional drug therapy option, anxiety sufferers have a detailed list of potential effective interventions. Dietary factors can be a huge contributor to a person’s anxiety. Hypoglycemia, or low blood sugar, can cause anxiety. Symptoms of hypoglycemia include irritability, nervousness, poor concentration, and fatigue. Two of the main causes of hypoglycemia are skipping meals and an unbalanced diet. Infrequent and poor food choices, particularly refined foods and sweets, are the most common causes of low blood sugar levels. Sugar and processed foods should be eliminated and a diet rich in fruits, vegetables, whole grains and lean proteins should be employed when treating anxiety.
Alcohol and caffeine are other dietary factors that influence anxiety. The immediate effect of alcohol may be calming, but it can cause anxiety-like symptoms as it is broken down in the body, and thus should be used in small amounts if not completely avoided. Caffeine is a well-known stimulant which can increase anxiety and should be completely avoided.
After dietary adjustments have been implemented, supplementation is necessary. A form of medicine that uses substances found naturally in the human body, such as minerals, vitamins, and amino acids, is called orthomolecular medicine. Niacinamide, commonly referred to as a form of vitamin B-3, has been shown to have an effect similar to prescription drugs (Nature 1979; 278: 563-565). It acts by modulating neurotransmitters commonly unbalanced in anxiety (Prousky, Journal of Othomolecular Medicine 2004; 19: 104-110). In contrast to conventional drugs, however, it is not addictive and has few to no side effects. Inositol is another substance that has shown to have anti-anxiety effects similar to conventional drugs. In a study published in the American Journal of Psychiatry (1995; 152: 1084-1086), inositol was shown to significantly decrease the severity and frequency of panic attacks. 5-HTP is an amino acid precursor to serotonin (a neurotransmitter involved in the regulation of mood). A study published in the Internal Clinical Psychopharmacology (1987; 2: 33-45) showed that 5-HTP was effective in reducing symptoms of anxiety. Omega-3 fatty acids, especially those found in fish oil have been shown to affect brain processes that control mood and anxiety in animal models (Biol Psychiatry 2005; 57: 343-350). A must read book that highlights and details the othomolecular treatment of anxiety is written by Dr. Jonathan Prousky, ND, and is titled Anxiety: Orthomolecular Diagnosis and Treatment.
Lastly, botanicals can be used to complement nutritional and orthomolecular therapies in treating anxiety. Melissa officialis (lemon balm), Passiflora Incarnata (passionflower), Scutellaria laterflora (scull cap), and Valeriana officinale (valerian), to mention a few, all have a long history of use for the treatment of anxiety.
Anxiety sufferers should be aware that medical research has identified safe and effective treatments that are often not mentioned by medical doctors. These treatments can be used in combination with conventional treatments or on their own. It is important to educate yourself about available treatment options and to seek supervision from a physician knowable in alternative approaches to help you explore your options.