Feeling Anxious and Panicky - Treatment Matters

written by Dr Rabin Gonzaga on 25 December 2005

Treatment matters

A VARIETY of treatment methods are available for anxiety and panic disorders. From the medical perspective, the use of medication can be helpful and is usually reserved in more severe cases, where the level of functioning of an individual is moderately to severely impaired.
Medications can be broadly divided into two categories. Tranquilisers are commonly used to treat these disorders and are useful in the short term. Long term use can bring about the problem of dependence and tolerance. What this means is that one can get physically dependent on these drugs and after long term use, increasing doses are needed to obtain the same therapeutic effect.
At present, the main (and safest) form of drug treatment for anxiety and panic disorders are antidepressant drugs. While antidepressant medication, as its name suggests, is used in the treatment of clinical depression, they also have significant anti-anxiety action. They act primarily on serotonin and noradrenalin pathways, providing reduction in the symptoms of anxiety and panic by bringing forth a balance in neurotransmitter function. Treatment with antidepressants is more likely to be effective than tranquilisers and have a more sustained therapeutic effect.
Psychological treatments are important in anxiety and panic disorders. Breaking old habits and learning new ones can be difficult and require a lot of practice. The mainstay of treatment is Cognitive Behavioural Therapy (CBT). CBT uses techniques to challenge negative thought patterns, teaches distraction techniques, cognitive reframing and other psychological techniques to reduce symptoms of anxiety and panic.
In addition to this, patients are taught relaxation exercises and breathing techniques to lower their level of arousal when anxious or suffering a panic attack. Frequently, a combination of medication and CBT or elements from CBT is used for maximal effect.
In addition to conventional medicine, complementary treatments have long been used to manage anxiety disorders. Therapies such as acupuncture, massage, yoga and tai chi or qigong can be helpful. These treatments may help alleviate the physical symptoms of stress and hence attenuate the physical manifestations of anxiety and panic attacks.
These are useful methods that can be combined as a holistic approach to the treatment of anxiety and panic disorders and should be used in conjunction with medical and/or psychological therapies. There are some reports that supplements have an affect on stress and presumably, on anxiety states. Anecdotal reports suggest supplements such as B complex vitamins and omega 3 fish oils can be helpful. In fact, there is more evidence that omega 3 fish oils may be helpful in the treatment of mood disorders. Again, supplement use should be in conjunction with conventional treatment such as medication and psychological therapy.
It is important to note that in addition to all the treatments mentioned above, people who suffer from anxiety and panic disorders need to make some lifestyle modifications. It is important to reduce alcohol intake and not partake in the use of recreational drugs.
Studies have shown that excessive use of alcohol and prolonged use of recreational drugs such as cannabis, amphetamines, ecstasy, and heroin may actually increase anxiety and panic disorders. This negates the original reason for abusing such substances.
Moderate exercise is also a powerful tool to release natural endorphins which give a person a feeling of well-being. Good sleep hygiene is important to reduce stress on the body and hence reduce anxiety and panic attacks.