If you're struggling with anxiety, it can be difficult to know which treatments will be most effective or suitable for you. Some people worry about the side effects of taking medication, while others may feel nervous about telling a stranger about their problems and worries. The good news is that there are plenty of options, many of which are recommended as effective and evidence-based by medical experts - and you don't have to choose just one. We explain how many of the following options can be used in combination with each other to help you gain greater control and mastery over your anxiety.
CBT is a form of psychological therapy, recommended by the National Institute for Health and Care Excellence (NICE).
In CBT, much focus is on your thoughts, or your 'cognitive processes', and your behaviours. The aim of CBT is to alter your emotional states by making changes to how you process events and information, and how you behave, through the help of a solid therapeutic relationship.
Your therapist will develop a shared understanding with you about how anxiety is affecting you, and help you develop strategies based on this understanding, to manage your worries and symptoms.
People often have positive or negative underlying beliefs about worry, e.g. 'worry prepares me', or 'worry is uncontrollable or dangerous', which can in turn perpetuate the worry.
Applied relaxation is an alternative form of psychological treatment for anxiety. It is also recommended by NICE and can be as effective as CBT.
This form of therapy focuses on relaxing your muscles during situations that tend to cause you anxiety. The technique needs to be taught by a trained therapist.
If your anxiety is relatively mild, you may be able to treat it using self-help methods. However, all of these methods can also be used to supplement and complement other treatment types - be that talking therapy, medication, lifestyle changes, or any combination of these.
Online CBT uses similar principles and techniques to face-to-face CBT, but in a digital self-help format, which you can work through on your computer or smartphone at your own pace.
Talking through your feelings can be helpful. You could talk either to a friend or relative, or you can ask your GP to suggest a local self-help group, where you and others can support each other without the guidance of a therapist or other health professional professional.
Your GP may also recommend self-help books, many of which use principles similar to CBT to help you develop coping techniques and strategies. Again, these can also be a really useful guide and prompt between face-to-face CBT sessions.
If you are considering medication to treat depression, discuss the best options with your GP or psychiatrist. A talking therapist will not be able to prescribe anti-depressant or sedative medication.
Selective serotonin reuptake inhibitors (SSRIs) are a form of anti-depressant medication and help to increase the levels of mood-boosting chemical serotonin in your brain. They may take a couple of weeks to take effect, and side effects can include nausea, headaches, low sex drive, digestive problems and insomnia.
Serotonin and noradrenaline reuptake inhibitors (SNRIs) are another type of anti-depressant medication and work by changing the levels of serotonin and noradrenaline in your brain, which boosts your mood. Possible side effects are similar to those associated with SSRIs, including nausea, headaches, drowsiness and insomnia, and SNRIs may also increase your blood pressure.
Unlike SSRIs and SNRIs, Pregabalin is an anti-convulsant - a form of medication typically used to treat conditions such as epilepsy, but it can also be effective as a treatment for anxiety. Again, side effects may include drowsiness, dizziness and headaches, but Pregabalin is less likely than SSRIs or SNRIs to affect your sex drive or make you feel nauseous.
Benzodiazepines are a form of sedative medication that offer fast relief of anxiety symptoms within 30 to 90 minutes of taking the medication. Benzodiazepines are typically only used as a short-term treatment for severe anxiety as they lose their effectiveness and can become addictive if used on a longer term basis. Side effects include drowsiness, headaches, and reduced sex drive and concentration.
As the name suggests, combination therapy involves both taking anti-depressant or sedative medication and seeing a talking therapist for a course of either CBT or applied relaxation. This can be an especially effective treatment for anxiety, as the medication will treat the symptoms of anxiety, while talking therapy tackles the underlying causes and helps you develop techniques for coping better in the future.
There is evidence that introducing more exercise into your lifestyle can help relieve depression, anxiety and stress, and improve your overall sense of wellbeing. This could be something low intensity and meditative, like yoga or pilates, which offers time and space for contemplation and self-awareness; or something more active, like running, cycling, or regular gym sessions, which release feel-good chemicals called endorphins and help to stave off anxiety-causing adrenalin.
Whether or not this is combined with a formal course of applied relaxation, simply learning to relax more can be an effective way of treating your anxiety. You could try some of these breathing and relaxation exercises suggested by our therapists, or opt for relaxing forms of exercise like yoga or pilates. You will also find guided relaxation apps, books, and audio guides - including online - which can be another great form of self-help.
Cutting back on caffeinated drinks like tea, coffee, fizzy drinks and energy drinks, may help to reduce your anxiety as caffeine affects your heartbeat and your sleeping patterns, both of which can affect your ability to cope with anxiety.
Similarly, cigarettes and alcohol can increase your feelings of anxiety. Although they may at times seem to help in the short term, in the longer term both can make your anxiety worse, both because their chemical impact on your body increases anxiety levels, and because you may end up relying on them as a crutch to ease your anxiety, which could then become a dependence.