Treatments for Anxiety

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1 Treatments for Anxiety This leaflet explains some of the symptoms of anxiety as well as the options for treating it. Children and Families Community Services Mental Health Secure Services Specialist Services Adult Mental Health Page 1

2 What is anxiety? Anxiety is a normal human feeling. We all experience it when faced with difficult or threatening situations such as a driving test, or a job interview. Anxiety can be experienced as a feeling of apprehension, fear, nervousness, or dread accompanied by restlessness or tension. Symptoms that you may experience may include; sweating, restlessness, being startled easily, feeling tense or jittery, a racing heart, worrying, and feeling overcome with panic. Although this anxiety is unpleasant, it rarely lasts long and we usually manage to cope with it. However, for one in ten people, the anxiety doesn t go away and it can begin to affect the rest of their lives. The good news is that it is possible to help deal with anxiety, even if that anxiety is serious. Part of tackling anxiety is understanding and learning more about it. This leaflet is designed to outline some anxiety-related conditions, and some of the options available to help you cope with it. What are the main types of Anxiety? Panic attacks: A short-lived period of extreme anxiety (up to 20 minutes) characterised by a sudden and intense sensation of fear and impending doom. Generalised Anxiety Disorder (GAD): This is a persistent and severe form of anxiety, but experienced in a more general way. As an example, you may feel worried all the time about what could go wrong. You may also feel tense or restless or find that your heart is racing without knowing exactly what you are worrying about. Phobias: A specific type of anxiety and fear occurring in particular circumstances, for example, a fear of heights, spiders, or flying. Two further types of phobia are agoraphobia and social phobia. Agoraphobia: This is a much broader problem - best described as a fear of being in places from which it is difficult to escape. This can Page 2

3 include crowds and public places such as cinemas or public transport. People with severe agoraphobia can, not surprisingly, lead very restricted lives. Social Phobia: This phobia can be described as having a marked fear of behaving in an embarrassing way, whilst under the gaze of others. This can lead to an avoidance of those situations. This may include anxiety experienced when having to eat, drink, or speak in the presence of other people. As a result, people with social phobia may have difficulties in social situations even finding them impossible because of the degree of anxiety that they experience. Obsessive Compulsive Disorder (OCD): Obsessional thoughts are intrusive thoughts or impulses, which are difficult to ignore, and associated with anxiety. Compulsions are the acts carried out to relieve this anxiety. As an example; the obsessional fear of germs may lead to compulsive hand washing that is carried out to relieve this anxiety. Post Traumatic Stress Disorder (PTSD): This is the name given to the after-effects of an unusually frightening or horrifying experience. If you have PTSD you will tend to re-live your traumatic experience by dreaming or thinking about it, or by being reminded of it by something you see or hear. People with PTSD may experience numbing and show a loss of interest in the outside world. Other possible symptoms may show, such as anxiety. What are the alternatives for the treatment of anxiety? Based on the evidence for the longest lasting effect, the following interventions are: Psychological Therapy Medications Self-help Medications, psychological therapies and self-help are listed below, and may be used alone or in combination. Page 3

4 What are the benefits of Psychological Therapy? There is convincing evidence that talking therapies are helpful in treating many psychological problems. Also, there are no physical health risks to engaging in therapy, as the treatment is non-invasive. The following is a list of some of the therapies you may be offered should you be referred to (for example) a Community Mental Health Team (CMHT) or a clinical psychologist, cognitive behavioural therapist or counsellor. Cognitive Behavioural Therapy (CBT) CBT is a particular type of talking therapy that can be used to emphasise the way in which your anxiety is shaped by how you think about it ( Cognitive is to do with thinking). Altering your behaviour is the next step, and is about learning new ways to cope. Counselling If your anxiety is triggered by practical problems in your life, it might help to have someone to talk to. Counsellors aim to help people make positive choices about their lives. Anxiety management or relaxation classes You may be offered anxiety management classes to help you deal with your anxiety. These may be combined with classes that teach relaxation techniques. Are there any risks involved with talking therapies? While talking therapies are very safe, talking things through may bring up bad memories or strong emotions that may be challenging to deal with at first. It is certainly not unusual to feel worse before you feel better. Therapy can sometimes affect your relationships with your friends in a negative as well as a positive way. It is possible that you may become dependent on your therapist and feel strongly attached to him or her. It is the therapist s job to understand Page 4

5 these feelings and help you deal with them as they arise. It can also happen that there is a genuine mismatch, either with the therapist as a person or with the particular type of therapy, and this is difficult for both parties. A good therapist will monitor the process and bring these matters up for discussion. What are the benefits and risks of medications? If your anxiety is severe your doctor may prescribe some form of medication. The following types of medication may be prescribed: Antidepressants Advice from NICE is to use an SSRI antidepressant medication. Any changes or side effects should be monitored fortnightly and the treatment reviewed after 12 weeks. If one of these types of antidepressant doesn t work at first, NICE advice that another may be tried. The person who is treating you should explain the possible side effects, withdrawal symptoms, the delay in the effect of the medication and the need to take it as prescribed. Benefits: Used to treat depression, but can be helpful for some types of anxiety. Combining antidepressants with talking treatments has been found to be successful for both panic disorder and OCD. Risks: All medications can have side effects associated with them. If you are worried about these you should discuss them with the person who prescribes your tablets such as your doctor. Benzodiazepines e.g. Diazepam Benefits: Short term relief for severe anxiety. Risks: They can be addictive, and are not recommended for phobias, OCD or panic disorder. Some people feel more anxious and have side effects when benzodiazepine treatment stops. Beta Blockers e.g. Propranolol Benefits: They control fast or irregular heartbeats and other bodily symptoms of anxiety which are useful in the short-term treatment of stage fright and the relief of panic symptoms. Risks: Beta blockers do not help people stop avoiding things they fear. Page 5

6 They are not suitable for people with medical heart problems or asthma. Self-help There are many things that you can do which may help to reduce your anxiety. This is known as self-help. Fully describing all of these is outside the scope of this leaflet, but may include: Awareness and education Thinking positively Using relaxation techniques Increasing exercise and eating a healthy diet Talking and discussing your worries with your friends and family Altering your thoughts related to anxiety Changing your behaviour related to anxiety Self-help groups Complementary therapies Although self-help can be very useful, particularly for milder anxiety, it may not be enough on its own. If your anxiety is severe you may need to seek the help of a professional. Normally you would access this through your doctor, practice nurse or care coordinator. Note: Not all of the methods of treatment, outlined in this leaflet, will be offered to you. If you seek help, you will be offered treatments relating to your needs and the treatment options available for you. What more can I do? Try and find out as much as possible about your anxiety Understanding the problem is one of the keys to dealing with it Remember that symptoms of anxiety, while uncomfortable, are not dangerous. (There may be effects on the body from long term exposure to anxiety, as with any prolonged stress, so seek help and advice if you are worried) Most people can benefit from self-help, but your family doctor, health visitor, or practice nurse may be able to give you further help in dealing with your anxiety. Page 6

7 Help and information Anxiety UK Helpline: No Panic This is a totally voluntary charity, whose aim is to aid the relief and rehabilitation of people suffering from Panic Attacks, Phobias, Obsessive Compulsive Disorders, other related Anxiety Disorders, including Tranquilliser Withdrawal, and to provide support to sufferers and their families and carers. They provide a confidential helpline from 10am to 10pm, every day, staffed by trained volunteers. Tel: (Freephone) Mind Infoline: NICE National Institute for Health and Care Excellence Mid City Place, 71 High Holborn, London, WCIV 6NA. Tel: British Association for Counselling and Psychotherapy BACP House, 15 St John s Business Park, Lutterworth, Leicestershire LE17 4HB Tel: The Wellbeing and Mental Health Helpline provides an information and listening service for people in Lancashire. It is available between 7.00 pm and pm Mondays to Fridays and from noon until midnight on Saturdays and Sundays Tel: Freephone Page 7

8 This information is intended as a guide only. If you are concerned about the mental health of yourself or another person, you may wish to consult your GP for further advice. Other sources of information: The Wellbeing and Mental Health Helpline This provides an information and listening service for people in Lancashire. It is available between 7:00pm and 11:00pm Mondays to Fridays and from 12:00 noon until 12:00 midnight on Saturdays and Sundays. Freephone Customer Care If you wish to pay a compliment about the Trust s services, make a comment, raise a concern or complaint, please contact the Customer Care Department on , freephone or If you have problems reading the print we can provide this leaflet in large print, audio book or Braille. W przypadku jakichkolwiek problemow z odczytaniem tekstu z przyjamnoscia dstarczymy Panstwu ulotke z duzym drukiem, tasme do odluchu lub tekst w jezyku Braille. Lancashire Care NHS Foundation Trust. All rights reserved. Not to be reproduced in whole or in part without the permission of the copyright owner. Data Protection Lancashire Care NHS Foundation Trust adheres to The Data Protection Act The Trust will endeavour to ensure that your information remains secure and confidential at all times. For further information regarding data protection please visit the Trust s website or ask a member of staff for a copy of our leaflet entitled Sharing Information With Us. Copies of this leaflet are available from: Lancashire Care NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston PR5 6AW Tel: Website: Date Produced: Review Date: Leaflet Code: Name of Leaflet: April 2015 April /2015 Treatments for Anxiety Page 8

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