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Answers to Commonly Asked Questions on Anxiety
Disorders
Find answers to your mental health questions from Ramsay Health Care specialists
The Diagnosis and Treatment of Anxiety
If Anxiety is controlling a person’s life, what can people do to remove this
controlling feeling and the symptoms?
A: Anxiety can control people’s lives in a bad way; it can interfere with their functioning, emotionally,
socially and functionally. Mainly based on fear and avoidance; these are the two factors that lead to
ongoing Anxiety. The ways to work around that is mainly through talking therapies, but also being aware,
accepting and challenging these beliefs to what we call greater exposure therapies, where you have these
thoughts saying that something bad is going to happen, and you test it under support and you have good
outcomes, so this is a process which takes about six to nine months, or even longer and has the best
outcomes for relapse prevention.
What treatments are available to treat the symptoms of Anxiety?
A: The Treatment of Anxiety is quite varied; there are different kinds of treatment approaches for Anxiety.
Medications are one form of treatment, the other forms of treatment are talking therapies which are
commonly used in conjunction with medications mainly, and the third form of treatment is mindfulness and
lifestyle changes which are just as important in the treatment of Anxiety. So talking about medications,
there are a wide range of medications we use for managing the physical symptoms of Anxiety. Talking
therapies are very good at looking at behaviours and thoughts and of course lifestyle approach is the best
way to decrease stress and response to Anxiety.
What is involved with Cognitive Behavioural Therapy (CBT) and what is expected of
the participants?
A: Cognitive Behavioural Therapy is a very structured talking therapy which is used for Anxiety disorders
and other mood disorders. It is the ‘here and know’ therapy that you are actively involved with the
Psychotherapist, talking about the current issues. It’s based on three things; behaviours, thoughts and
feelings. It is clear that behaviour is based on what we think and that helps us to feel the way we feel. So
Cognitive-behavioural therapy targets on Behavioural modification, changing some of the behaviours. It
helps with challenging thoughts, there’s certain thought processes which come with Anxiety, such as ‘all or
nothing’ catastrophic thinking and that challenge, and this in turn helps us change how we feel – good or
bad about ourselves.
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What is the most effective treatment for Anxiety?
A: The most effective treatment for Anxiety is a combination of talking therapies, cognitive behavioural
therapy, as well as medications which we usually prescribe for at least six to nine months or longer to
prevent relapse and have better outcomes of functioning.
Typically, how long does treatment last?
A: The treatment of Anxiety varies from person to person as well as the triggers associated with that. For
an acute Anxiety disorder the treatment is usually for six to nine months with good response and relapse
prevention. However, if a person who has chronic Anxiety or relapses they may need treatment for two or
three years, even longer depending on their symptoms and triggers.
What kinds of medication are used for Anxiety disorders?
A: There are different medications used for the treatment of Anxiety disorders. The common classes of
medications use are antidepressant, as people are aware of. The other classes are mood stabilisers and the
third class we use are called benzodiazepines, which are used short term for the management of acute
Anxiety. Antidepressants, they work on different chemicals and they are the main form of treatment, while
benzodiazepines are shortly used for three to four weeks or even less because they are associated with
dependence.
What is the role of antidepressants in the treatment of Anxiety?
A: Antidepressants play a very important role in the treatment of Anxiety, especially in the acute phase of
Anxiety. They help reduces the physical symptoms of Anxiety, such as the sleep problems, the motivation,
concentration, the appetite and the energy levels. However, once they start feeling better in these areas
they are then able to deal with some of their thoughts and beliefs. So they play a very important part in
moderate to severe Anxiety and with panic symptoms; they do have a role to help alleviate the symptoms
and improve functioning.
What are the most common concerns about using antidepressants in the treatment
of Anxiety?
A: People usually have a fear about starting Antidepressants and coming off Antidepressants. The common
fear is based on being dependant on Antidepressants and whether they will be able to function without
Antidepressants. We usually reassure them Antidepressants are used for the time of acute Anxiety. Once
the acute Anxiety is settled and have coping skills, most of the people can come off Antidepressants and
they do not cause any dependence and tolerance. There is a fear about coming off Antidepressants and
having a relapse, however by the time the patient has completed nine months of treatment they are very
well equipped with other tools and aware, except their condition and have their support groups available.
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Is Anxiety caused by a chemical imbalance in the brain, and how do medications
work?
A: So Anxiety is caused by a chemical imbalance in the Brain. In the Brain messages are passed through
electrically excited neurones and unique chemicals called neurotransmitters which are used to pass
messages from one to the other. There are there types of neurotransmitters which are used to pass the
messages, these include Noradrenaline, Serotonin and Dopamine. Apparently when people are having
Anxiety disorders there’s an imbalance of these chemicals, which leads to the development of Anxiety, and
this is the basis of trialling antidepressants. The role of Antidepressants or other medications is to correct
the balance in these pathways and help the messages pass more smoothly and help with better functioning.
Are the any side effects from taking Anxiety medication?
A: Medications do have side effects unfortunately; there are a range of side effects people can experience
from different kinds of medications. The common side effects people experience are nausea, vomiting
which are common to all medications, however when trialling antidepressants there are specific side effects
such as agitation, some people can feel the worsening of their negative thoughts and they can have extra
side effects in body movements which can be present. They not dangerous or life threatening, however if
the symptoms do occur we recommend they talk to their Doctor or Psychiatrist and under supervision stop
the medications. It is also important not to stop the medications on your own accord, because you can have
withdrawal symptoms.
How long does it take for medication to start working, and is there a right time to
come off medications after treatment?
A: Generally when medications are prescribed it takes six to twelve weeks for the medication to work. The
first few weeks the symptoms observed are side effects. The first ten days. This is generally followed by
feeling of wellness in terms of sleep, appetite, concentration. By around the twelve weeks a person will
generally will let us know they are feeling better, usually in about nine months to twelve months is the right
time to whine off medications, provided the person has invested enough in other talking therapies and
lifestyle changes and has knowledge and awareness of their warning signs and has accepted the condition.
How does treatment differ for someone who is pregnant?
A: The treatment of Anxiety during pregnancy is different to treatment of Anxiety in normal population.
During pregnancy it is very important to treat Anxiety because we look at the risk versus benefit. The risk of
not getting treating Anxiety has a poor outcome on the mother as well as the foetus and postnatally there
is a risk of Postnatal Depression. However, treating Anxiety during pregnancy has limitations, especially
medications and we prefer to use talking therapies as the first line and supportive therapies and if needed
occasionally do use certain classes of medications, taking in mine that it can impact the foetus.
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