Treatment of Anxiety Disorders

The psychological treatment with the strongest evidence for most types of anxiety disorders is cognitive behavioural therapy, which includes exposure. Cognitive behavioural therapy aims to help individuals gradually face (“expose themselves to”) the situations or activities they fear or have been avoiding due to anxiety. This should be carried out without relying on avoidance strategies or safety behaviours, allowing the patient to see that their anxiety naturally reduces without needing to escape the situation. 

During exposure, the patient and therapist agree on a treatment plan to gradually face the feared situations and reduce anxiety. These are tackled in order of difficulty, starting with the least anxiety-provoking and gradually moving towards the most challenging, based on the person’s specific needs. Exposure sessions are carried out both during therapy appointments and as homework, using real-life practice, guided imagery or online tools. 

This form of psychological treatment requires active involvement from the patient over a sustained period, often lasting several weeks or months. Achieving meaningful change through one’s own efforts is particularly important for those with anxiety disorders, as it boosts self-confidence and helps them to continue facing feared situations and maintain the progress they’ve made.

While cognitive behavioural therapy is considered the first-line psychological treatment for anxiety disorders and proves effective for a large percentage of individuals, a significant subset of patients does not achieve a satisfactory response. In such cases, it may be appropriate to explore alternative approaches, some of which have shown promising results in recent years. These include mindfulness-based stress reduction (MBSR) and acceptance and commitment therapy (ACT).

Pharmacological treatment. Pharmacological treatments have also demonstrated efficacy in the management of most anxiety disorders. The most widely prescribed medications are selective serotonin reuptake inhibitors (SSRIs). Although these are often referred to as “antidepressants,” they have been thoroughly researched and found to be effective in the treatment of anxiety disorders as well. Besides SSRIs, other medication options are available for treating anxiety disorders.