Brenna Dunn

Efficacy of Anxiety Treatments

Do you have the feeling of constant worry, restlessness, and inability for that feeling to

go away? This is called anxiety, a mental health disorder that causes you to be anxious in certain

situations that creates worry or panic and interferes with daily activities (WebMD, 2017). There

are many treatments that have been used to help people with their anxiety. Some include

anxiolytic, sedative, and antidepressant drugs (Bystritsky, Khalsa, Cameron, & Schiffman,

2017). Others with mild cases may have symptom relief by avoiding alcohol and caffeine, as

well as trying to do more physical activity to relieve unnecessary stress (Abrams, 2017). Over

the years, anxiety has become a more relevant problem and doctors are trying to understand why

anxiety rates have risen so dramatically. They have also been finding new treatments to help

those who are affected. Doctors are beginning to assess every aspect of the body affected by the

disorder, including the biological, psychological, and physical implications in order to help a

person who is suffering as a whole (Bystritsky et al., 2017)​. ​They have studied whether cognitive

behavioral therapy or medication is more helpful to a patient and as well as what is not helpful.

Throughout these studies, doctors have made successful progress on finding better treatments for

anxiety as the need arises (Bystritsky et al., 2017). I have become interested in this topic because

of personal experience, and I’m someone who understands how it works. I would like to see

what new treatments they have discovered like selective serotonin reuptake inhibitor (SSRI) that

fights against the serotonin dysfunction (​Gerez, Suárez, Serrano, Castanedo, & Tello, 2016)​.

Something else I would like to venture is why anxiety has become such an epidemic and what it

does to the body.

 Anxiety has become so relevant because today’s society is so demanding and stress levels

have become higher. One reason is that of sleep deprivation (Abrams, 2017). Students

specifically are given mass amounts of school work along with other life tasks like a job, or

physical activity, all while still trying to have downtime, and this can be a difficult thing to

balance. People are resorting to energy drinks and coffee to provide large amounts of caffeine to

stay alert for the work they need to accomplish. Caffeine, a stimulant that causes the body to go

into overdrive when too much is consumed, causing insomnia, and can even make you focus less

and feel worse. Technology has also been a big issue that has worsened anxiety. People are

constantly using their phones instead of focusing on what needs to be done, which causes

last-minute panicking, triggering anxiety (Abrams, 2017). A passage in the article ​Thrive Global

talks about the effects of technology on people by saying, “Reducing screen time, as best you

can, at all ages of development, is key to reducing anxiety” (Abrams, 2017, para.13). Also, a lack

of healthy eating habits and a greater exposure to unhealthy foods need to be emphasized

because fattening foods are key stress indicators for causing more anxiety (Abrams, 2017). When

all of these are put together, they cause severe anxiety. There have been many instances where

kids would drop out of school because their disorder has taken over their mind and body and

they can no longer keep up with their studies. So, how can we find better solutions for those with

anxiety? What treatments are seen to help and how can we prevent the stress triggers in our

lives?

One of the bigger issues included with anxiety is how comorbidities have become a trend,

meaning that those with anxiety may also have depression or panic disorders (​Gerez et al., 2016)​.

One of the studies explained that irritability has a direct correlation with anxiety, they used this
to conduct a study among children ages 7-19 with anxiety to assess their experience as they grew

up (​Cornacchio, Crum, Coxe, Pincus, & Comer, 2016)​. This is all because, for some a traumatic

event in their life may have caused drastic change, causing your body's neurotransmitters to

change and react differently (Bystritsky et al., 2017). This can lead to severe anxiety and

depression from lack of support and recuperation from the event (Abrams, 2017). Another way

comorbidities may come into play is when the body becomes resistant to medication and the

patient may have more than one disorder that needs attention which can create other problems

with the prescribed medication. In one of the studies they included 192 medicated patients and a

control group with 30 others to assess the effects of medication on people with anxiety (​Gerez et

al., 2016)​. In another research article on effects of medicine and therapy, it goes into detail on the

effects of neurotransmitters when it states, “Neuronal circuits are governed by multiple

neurotransmitter systems; the most extensive of these are gamma-aminobutyric acid (GABA)

and glutamate. The neural systems of the three major neurotransmitter systems—serotonin,

dopamine, and norepinephrine—have been extensively studied in normal and pathological

anxiety states. Another article suggests that ​disorders with anticipatory anxiety (ie, GAD) are

seen as the pathological correlate of exploring a dangerous environment...” (​Bystritsky et al.,

2017, p.33). This helps explain that the neurotransmitters in your body are largely affected by

anxiety within your three specific systems. As the obesity rate grows around the world, it's

interesting that anxiety has increased also. This is because exercise helps reduce stress and

anxiety levels so by joining sports teams and being with other people could be an anxiety

remedy. Overall, anxiety has grown to affect over 40 million adults worldwide (Folk & Folk,

2017).
 Pharmacological therapy is beneficial for many reasons. This is because those who have

multiple disorders like anxiety and depression can be more treatable and controlled by

medication. Selective Serotonin Reuptake Inhibitor (SSRI) is a common depression medication,

but is used for anxiety as well (Bystritsky et al., 2017). Anxiety not only affects you

psychologically but physically as well. Some symptoms include trembling, sweating, muscle

tension, even difficulty breathing (Folk & Folk, 2017). By using medication, these symptoms are

suppressed, and the body is able to relax (Bystritsky et al., 2017). It is also easier accessible to

those who need it. In comparison to therapy, medication can be taken at the start of the day and

doesn't take up much of the time, where as therapy is not always available for everyone. Most

insurances don't cover therapy treatment or even provide it for their patients (Bystritsky et al.,

2017).

Therapy is vital for some of those with anxiety; it can help them find a coping mechanism

for the things they are worried about. There are also alternatives found for patients who have

excessive worry and it helps relieve their tension. Most therapists use the “Fight, Flight, and

Freeze Response” (Ellis, 2009, para.1) to show what we do when we’re anxious. The fight is to

show how we defend ourselves and our body by either getting away from a situation or verbally

communicating when in trouble. The flight is to show when we hide, and make ourselves small

so that we won't be noticed and protect our body (Ellis, 2009). The freeze mechanism is slightly

different; the body tenses up and doesn't know what to do so we just stand there, “like a deer in

the headlights in traumatic situations” (Ellis, 2009, para.1). Having experience with therapy has

shown me that medicine does not have the same impact on someone as therapy does. While in

therapy, it can make patients more vulnerable and able to talk through the event to help with loss
and feelings (Bystritsky et al., 2017). Where as with medication, it just suppresses the emotions

and physical limitations to make a day to day life easier. Psychologists give insight on how the

brain and body are reacting when anxiety is overwhelming the body. But although these therapy

sessions are helpful, they are still very unavailable to most of those who need them. In a study

that compared medication and cognitive behavioral therapy, the need for therapy in primary care

is discussed through the statement, “...The treatment of anxiety usually takes place in the primary

care setting. Given the increasing limits on primary care physicians’ time, it is not surprising that

anxiety disorders are underrecognized and undertreated” (Bystritsky et al., 2013, p. 37). The

research in this article, focuses on the elements of how we can improve primary care to help

those who have anxiety. Within cognitive behavioral therapy, it is more helpful if the patient

uses the skills they are taught in each session in their day to day lives, or else the therapy is

meaningless so the patient’s willingness to change is essential. They also say, “Although many

treatments are effective for anxiety, not all of them can help everyone and not all of them are

effective for all anxiety disorders. A simple phobia is easier to treat than a complicated case of

PTSD” (post traumatic stress disorder) (Bystritsky et al., 2013, p. 37). All of these implements

may cause anxiety and some are more treatable by therapy and some may be better with

medication, it all simply depends on the person, background, and situation (Bystritsky et al.,

2013).

When the two therapies are put together, they tend to complement each other. While

medication is active in your system 90% of the time, it helps the patient focus on training their

body to think positively and listen to their behavioral psychologist (Bystritsky et al., 2013).

However throughout the study between the two, psychologists have found that those with anxiety
disorders respond better to medication because it calms them and suppresses alternative

emotions. The study explains that this could be because of the constant variables of , “the

availability of a therapist; the affordability of cognitive behavior therapy, which costs more than

medication, especially if drugs are prescribed in primary care settings; and patient preference”

(Bystritsky et al., 2013, p. 37). The research is based off individuals in a primary care facility

who receive care for anxiety disorders. One thing that may affect the studies overall data is the

presence of many comorbidities in patients. It would also be interesting to know if they studied

general anxiety disorders alone, would the results have been the same.

Anxiety is becoming extremely relevant and demand for prevention information is

increasing. Some key ways to manage anxiety are reducing caffeine intake, increasing physical

activity, managing stress, and making sure to get enough sleep (Abrams, 2017). For those who

have more challenges behind their anxiety, medication and psychological therapy are both very

promising treatments. Based on all of the studies, it can be concluded that patients should still be

assessed individually by their mental state, background, and physical limitations to decide what

is best (Bystritsky et al., 2013). The methodology concluded that medication is more helpful in

relation to behavioral cognitive therapy. Because of the low accessibility of therapy, this is

considered a bias within the study, the patients did not all have equal access to both types of

treatment which affected the results (Bystritsky et al., 2013). They also saw a bias in another

study because some of the patients had volunteered to participate (​Gerez et al., 2016)​. This

research has made me much more knowledgeable on the topic; it is important for me to be aware

of these treatments and the effects of each so that I can help those who need it. Within my future

career as a nurse, I want to be able to help those who are in a place that I once was. I will be able
to tell them about the multiple treatment options out there, and hopefully be able to tell them

what is available for them in their primary care facility, because mental health is just as

important as physical health.

 References

Abrams, R. (2017). Why are So Many Teens and 20-Somethings Today Anxiety-Ridden?

Retrieved from

https://journal.thriveglobal.com/why-are-so-many-teens-and-20-somethings-today-anxiet

y-ridden-6318a0f8a8678

Bystritsky, A., Khalsa, S. S., Cameron, M. E., & Schiffman, J. (2013). Current diagnosis and

treatment of anxiety disorders. ​Pharmacy and Therapeutics​, ​38​(1), 30​. ​Retrieved from

www.ncbi.nlm.nih.gov/pmc/articles/PMC3628173/

Cornacchio, D., Crum, K. I., Coxe, S., Pincus, D. B., & Comer, J. S. (2016). Irritability and

severity of anxious symptomatology among youth with anxiety disorders. ​Journal of the

American Academy of Child & Adolescent Psychiatry​, ​55​(1), 54-61.​Retrieved from

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5340317/

Ellis, A. (2009). Fight, flight, or freeze response to stress. Retrieved from

http://www.stressstop.com/stress-tips/articles/fight-flight-or-freeze-response-to-stress.php

Folk, J. (2017). Anxiety Disorder General Statistics. Retrievedfrom

http://www.anxietycentre.com/anxiety-statistics-information.shtml

Gerez, M., Suárez, E., Serrano, C., Castanedo, L., & Tello, A. (2016). The crossroads of anxiety:

distinct neurophysiological maps for different symptomatic groups. ​Neuropsychiatric

disease and treatment​, ​12​, 159.

WebMD. (2017). What Are Anxiety Disorders? Retrieved from

https://www.webmd.com/anxiety-panic/guide/anxiety-disorders#1