Anxiety is a feeling that everyone experiences sometimes; it's a natural part of being human. But when this worry and fear are persistent and begin to interfere with your day-to-day life, you could be experiencing an anxiety disorder. Anxiety disorders are the most common mental health disorders in America, affecting 40 million adults in the U.S. each year. There are several types of anxiety disorders, including generalized anxiety disorder, panic disorder, and various phobia-related disorders. Fortunately, they are all highly treatable. Some common and effective treatment options include therapy, anxiety medication, and lifestyle changes.
How is anxiety diagnosed?
The cause of anxiety disorders is often a combination of factors, rather than a single element. Some factors that could trigger this type of mental illness include:
Family history: Some people may have a genetic predisposition towards anxiety. However, it’s important to note that having a family member with an anxiety disorder or other mental illness does not automatically mean you’ll get it.
Stressful events: This can include a job change, death or loss of a loved one, changes in living arrangements, or relationship issues.
Personality traits: Studies suggest that children who are perfectionists or like to control situations are more likely to develop anxiety disorders as adults.
Physical health problems, such as hypertension, diabetes, thyroid disease, and asthma
Preexisting mental health conditions, like depression
Drug and alcohol use
Some symptoms of anxiety disorders that may help your healthcare provider diagnose the condition include:
Restlessness, nervousness, and excessive fear or worry
Tightening of the chest and a racing heart
Obsessive thinking
Trouble concentrating
Avoiding things that trigger your anxiety
You can use these symptoms as a guide, but you’ll need to see a healthcare provider for a diagnosis.
If you think you may be experiencing an anxiety disorder, speak with your primary care provider. They’ll be able to check if there are any underlying illnesses that may be contributing to your feelings and refer you to a mental health specialist if necessary.
If you’re experiencing intense anxiety, it may help ease your stress to prepare for some of the questions your primary care provider, psychiatrist, psychologist, or mental health professional may ask you in order to confirm a diagnosis and develop a treatment plan. There is no lab test to diagnose anxiety, so answering these questions openly and honestly is essential to getting the best anxiety treatment.
Here are some example questions your physician may ask:
Do you take any prescription drugs?
What are your symptoms?
Are your feelings of anxiety occasional or continuous?
Does anything in particular trigger your anxiety?
When did you first notice signs of anxiety?
Do you regularly take drugs and/or alcohol?
Have you ever experienced a panic attack?
Anxiety treatment options
There are various treatment options for anxiety disorders that can help you get back to enjoying life. The two most common treatments are therapy and anxiety medications, with many patients using a combination of both. The type of medication prescribed depends on the type of anxiety disorder you have, as well as other individual considerations, such as other medical conditions you have.
Types of anxiety medication
There are numerous types of medications that can treat anxiety disorders. Your healthcare provider will recommend which type is best for you based on your medical history, any current medications you’re taking, and the specific type of anxiety disorder you’re experiencing. These are some of the most common classes of drugs your provider may prescribe.
Selective serotonin reuptake inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) are antidepressants that are also the most common medications for anxiety. They work by increasing levels of serotonin (a neurotransmitter) in the brain, which helps regulate your mood, sleep, and energy levels.
Popular SSRIs include Lexapro (escitalopram), Zoloft (sertraline), Prozac (fluoxetine), Paxil (paroxetine), and Celexa (citalopram). They are typically prescribed long-term.
Bear in mind, SSRIs may take four to six weeks (or even longer) to reach full effect, and side effects can include drowsiness, nausea, insomnia, sexual problems, and blurred vision.
Serotonin-norepinephrine reuptake inhibitors (SNRI)
Like SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs) are antidepressants that work by increasing neurotransmitter levels in the brain. They do this by blocking the reabsorption of two neurotransmitters, serotonin and norepinephrine. The resulting increased levels of serotonin and norepinephrine help regulate patients’ moods, which is how they treat symptoms of both depression and anxiety.
Commonly prescribed SNRIs are Effexor (venlafaxine) and Pristiq (desvenlafaxine). Possible side effects can include dizziness, headache, dry mouth, insomnia, constipation, and sexual problems.
Tricyclic antidepressants
Tricyclic antidepressants (TCAs) are another class of antidepressants that physicians sometimes prescribe to treat the symptoms of anxiety disorders. Much like SSRIs and SNRIs, they work by rebalancing the levels of neurotransmitters in the brain. Popular TCAs include amitriptyline and nortriptyline.
Some disadvantages to taking tricyclic antidepressants are their delayed onset; they can take up to 12 weeks to take effect. Side effects can include dizziness, dry mouth, constipation, insomnia, and weight gain.
Buspirone
Buspirone is a medication commonly used for the management of anxiety conditions or for short-term relief of anxiety symptoms. It helps alleviate anxiety by acting on serotonin receptors in the brain. Buspirone may be prescribed alone or in conjunction with other medicines.
Benzodiazepines
Benzodiazepines are a group of medications commonly prescribed for their anti-anxiety and tranquilizing effects. They induce a state of relaxation by influencing the gamma-aminobutyric acid (GABA) receptors of the brain, resulting in the slowing of the central nervous system.
Because of their fast-acting and sedative effects, benzodiazepines are prescribed for insomnia and muscle spasm, as well as panic attacks and anxiety.
Like all medications, you should only take them as prescribed by your healthcare provider. Benzodiazepines are often initially prescribed in small doses that are increased gradually as needed.
Because they work to slow down a patient's central nervous system, the most common side effects of this class of drug are drowsiness and impaired coordination. They work best as short-term solutions to anxiety, as they can be addictive. If you decide to stop taking benzodiazepines, speak with your healthcare provider first, as there is a risk of withdrawal symptoms from stopping suddenly.
It’s important never to mix benzodiazepines with alcohol, as the combination can cause serious side effects.
Common benzodiazepines include Xanax (alprazolam), Valium (diazepam), Ativan (lorazepam), and Klonopin (clonazepam).
Beta blockers
Most often used to treat high blood pressure, beta blockers like Inderal (propranolol) can be used off-label (for a non-FDA-approved use) to treat the physical symptoms of acute anxiety, such as rapid heart rate and tightness of the chest.
Because they only treat physical symptoms of anxiety and panic attacks, they’re often prescribed for event-triggered anxiety like stage fright or social anxiety disorders.
Monoamine oxidase inhibitors (MAOIs)
The first class of antidepressants available, monoamine oxidase inhibitors (MAOIs), is no longer considered a first-line choice for anxiety. However, if other options have not been effective, they are a second-line option.
Like most antidepressants, MAOIs work on certain neurotransmitters in the brain, thereby improving patients’ moods. One reason other antidepressants are more popular is that, when combined with certain foods and medications, MAOIs can cause dangerously high blood pressure. That said, they can still be very effective for some people.
Over-the-counter anxiety medicine
There are no medicines available over-the-counter to treat anxiety. If a nutrient deficiency is contributing to your symptoms, supplementing with the missing vitamin may help reduce symptoms. Some natural supplements may help with anxiety symptoms, but evidence is mixed. Always check with a healthcare provider before using any OTC medicines, vitamins, or supplements to treat anxiety. It’s also important to consider drug interactions with prescribed anxiety medicines. For example, some OTC cough and cold remedies may interact with certain antidepressants.
In order to figure out which medication is going to best treat your anxiety and alleviate symptoms, you must speak with your healthcare provider.
The best anxiety medication and treatment depend on individual factors. Your provider will recommend a prescription based on your medical history, taking into account any other medications or conditions you may have. They’ll also be able to monitor your progress and alter treatment according to your response.
Best medication for anxiety
This is not an exhaustive list of anxiety medications. Always ask your healthcare provider for the best treatment for anxiety based on your health condition and medical history.
Common side effects of anxiety medicine
As with most medications, the drugs most commonly prescribed for anxiety disorders have a risk of some side effects. These can include:
This, of course, is not a full list of side effects of all medications your healthcare provider may prescribe. For more specific information, talk with your healthcare provider, who can advise you on any potential adverse reactions or drug interactions of the specific medicine you take.
Home remedies for anxiety
If you’d like to complement your treatment with natural options, your doctor may suggest some other strategies. Some natural remedies patients may find effective include:
Meditation and mindfulness practices
Physical exercise
Hypnosis
Dietary changes, such as increasing the amount of fresh fruit and vegetables
Reducing alcohol and illicit drug consumption
Vitamins and supplements, such as magnesium
Acupuncture
Before starting any natural treatment or trying home remedies for anxiety, be sure to speak with your healthcare provider and get their professional medical advice.
Expert takeaway
"Anxiety is very common, and fortunately, there are many treatment options available," says Karen Berger, Pharm.D., member of the SingleCare Medical Review Board. "Talk to your healthcare provider to determine the best plan of action."
Frequently asked questions about anxiety
Which SSRI is best for anxiety?
Some popular SSRI medications are Zoloft (sertraline), Prozac (fluoxetine), and Lexapro (escitalopram). However, given the many contributors to anxiety disorders, and your own personal medical history and lifestyle, only a healthcare provider can determine which SSRI is best for you. Your provider can make a recommendation based on your particular type of anxiety, symptoms, and any other health concerns you may have, as well as monitor your progress and response to treatment.
How do antidepressants help anxiety?
Antidepressants work by preventing the brain from absorbing certain neurotransmitters, or chemical messengers. This can help stabilize a person's mood, decrease anxiety, and improve sleep.
What over-the-counter medicine can you take for anxiety?
There are no recommended over-the-counter (non-prescription) drug treatments available for anxiety disorders. Your healthcare provider, however, may recommend some specific vitamins or supplements to complement your treatment. Always check with a healthcare provider before adding any OTC medicine to your regimen, even if it is labeled as a natural remedy.
What does it feel like to be on anti-anxiety medications?
Some anti-anxiety medications work within 30 minutes, while others take days to build up in your system and become effective. Once working, patients often feel a physical sense of relief and a decrease in worry and stress. That said, how it feels is different for each individual.
It’s not uncommon to feel some side effects, such as headaches, nausea, and fatigue, in the first few weeks of taking anti-anxiety medications. However, many patients find they eventually subside. If you think you’re experiencing any side effects, talk to your healthcare provider.
Does anxiety medication cause weight loss?
It depends on the medicine. Some medicines may be associated with a small gain or loss, while others do not typically affect weight. Talk to your healthcare provider if weight changes are a concern.
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