Treating Anxiety (Without Benzodiazepines)

Written by Dr. Ryner Lai

January 18, 2021

According to the Anxiety and Depression Association of America (ADAA), anxiety is the most common mental illness experienced in the United States, accounting for a staggering 18.1% of the population yearly. This means that almost 1 in every 5 Americans experience anxiety disorders. 

 

As mental health awareness grows globally, so has the percentage of people who are on anxiety medications. Benzodiazepines as a class of medication have long been associated with the treatment of anxiety disorders. The efficacy of benzodiazepines is well-established in scientific literature, although there is debate about the threshold at which they should be prescribed: benzodiazepines are addictive and they do not treat the cause of the condition – only the symptoms.

 

It is unhelpful to see anxiety disorders solely as a medical diagnosis requiring prescription drugs. Most psychologists advocate for a more holistic approach that also involves non-medication therapies. Let’s explore some of them here. 

 

Counseling 

The symptoms of anxiety are well-known: excessive worry, irritability, problems with sleep, and a sense of panic. However, despite the symptoms of anxiety patients being similar, the causes can be varied and multi-layered.

 

Anxiety can be brought on by a traumatizing life event, a drastic change in life, the loss of a loved one, or a combination of a few factors. Anxiety medication is aimed at providing relief to the symptoms of anxiety; however, it is less effective in actually helping patients deal with the life circumstances that might have contributed to the condition. 

 

This is where talking therapies come in. Talking therapies like counseling offer patients an opportunity to talk through some of the life circumstances that contribute to their anxiety. It crucially also allows patients to explore some of their thought processes in how they react to those life circumstances. 

 

It is in the breaking down of these moments that patients become aware of any unhelpful coping strategies that they have unconsciously adopted. Patients are then empowered to make the necessary changes to break free from the cycle of anxiety. This is the reason that some patients find talking therapies to be the same or even more effective than taking medication. 

 

Practicing Mindfulness 

“Mindfulness” has become a popular buzzword among health and wellness circles, and its meaning can sometimes be obscured. Mindfulness is really about being present in the moment and being aware of your thought processes and reactions as they happen. It is the “simple practice of paying attention” that makes it “the medicine of the moment.” 

 

Mindfulness can be broadly broken down into three key steps

  1. Pausing and becoming aware of the present moment. 
  2. Focusing on your breathing. 
  3. Bringing attention to your whole body. 

 

Mindfulness helps in treating anxiety because it allows you to almost “catch” yourself before your anxious thoughts blow up. It allows you to slow down and be aware of any negative responses to stress – and take real-time action to turn that around. Most of the time, mindfulness is actively discussed during talking therapies, so it will most likely be brought up as a subject by your psychologist or counselor. 

 

Breathing Exercises 

One of the symptoms of anxiety is rapid breathing – patients may feel their chest tightening and start hyperventilating. Therefore, it is no surprise that proper breathing exercises can help your body slow down and better cope with anxious thoughts. 

 

There are many types of breathing exercises that can help you cope with anxiety. The main objective is to slow your breathing down by inhaling and exhaling slowly. This helps you to calm yourself down physically, which then helps you to calm yourself down mentally. 

 

Deep breathing exercises are commonly practiced in fitness classes such as yoga and pilates. It sounds deceptively simple but can work wonders when practiced correctly and consistently. 

 

Non-Controlled Medications for Anxiety

If medications are considered for anxiety, the physician should explore non-addictive and non-controlled medications for it first. 

An effective class of medications to treat anxiety on a more long-term basis are selective serotonin reuptake inhibitors (SSRIs) like Paxil (paroxetine), Zoloft (sertraline), Celexa (citalopram), and Lexapro (escitalopram). 

Serotonin-norepinephrine reuptake inhibitors (SNRIs) can also be an effective longer-term treatment for anxiety disorders. Examples of SNRIs are Effexor XR (venlafaxine) or Cymbalta (duloxetine). 

Both SSRIs and SNRIs have to be taken daily, and are not effective on an ‘as-needed’ basis. 

For acute anxiety attacks, hydroxyzine can be a helpful adjunct, particularly when combined with breathing exercises and mindfulness training. 

Conclusion 

At the end of the day, treatment for mental health conditions is as important as the treatment of physical conditions, and it can lead to patients leading happier, healthier lives. The treatment of anxiety is best approached holistically, involving both medication and non-medication therapies. It is advisable to avoid benzodiazepines as a routine treatment approach for anxiety. 

 

Did you know? QuickMD can treat anxiety online, from the privacy and comfort of your home and we can prescribe anxiety medications online. 

Written by Dr. Ryner Lai

January 18, 2021

Articles on this website are meant for educational purposes only and are not intended to replace professional medical advice, diagnosis or treatment. Do not delay care because of the content on this site. If you think you are experiencing a medical emergency, please call your doctor immediately or call 911 (if within the United States).

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