If you have just been diagnosed with anxiety, this page is to help you choose what anxiety treatment will work best for you. If you have read my main page on anxiety, you will know that different experiences of anxiety need different types of treatment, and I am going to talk to you about that now.
In the video above, you can see two main ways that anxiety can be created. I shall discuss treatment for both amygdala-based anxiety and anxiety that occurs more through your thought processes.
Amydgala-based treatment for anxiety
Quick explanation: where you get anxious for seemingly no reason or in the same situations.
If you are currently working through my course, you will have come across a section explaining how your brain can learn to be anxious. This is primarily due to amygdala-based anxiety. This means that your amygdala has learnt to deliver a stress response in situations where you get anxious, and you need to teach your brain that there is no need for a stress response; you are not in danger.
If you have not come across the amygdala before, you can think of it like a fire alarm that sets off anxiety when your brain thinks you are in danger.
Treatment needed for this type of anxiety includes
Exposure Based Treatment
The rationale for exposure based anxiety treatment
If you are getting anxious in certain situations, you can think of this as your brain has developed a path where the situation triggers an alarm bell to give you anxiety.
The situation could be anything from speaking up in public or getting anxious when the focus of attention is on getting anxious in the same places, such as shopping or driving, anywhere you repeatedly feel anxious.
The exposure-based treatment allows you to correct this pathway and create new learning, where your brain no longer identifies these situations as being worthy of anxiety.
Why exposure based treatment is important
It creates new learning in your brain, which not only has an impact on how you feel but also on what you do; your behaviours.
Let’s take the example of someone getting anxious about giving presentations at work. If you get anxious every time you have to do this (or something similar), your amygdala is ringing an alarm bell to create anxiety.
I am guessing that you are affected emotionally, but you might have noticed that you have changed your behaviours. You might avoid meetings or situations where you feel you will be the focus of attention or might be judged somehow. At least three things are going on here.
- The automatic anxiety; coming from your amygdala
- Avoidance of situations that might trigger your anxiety, and
- The fear of being judged or other thought processes that are not nice to you. I will talk about this later, as this falls under a more conscious form of anxiety, which requires CBT.
To get over this, you need exposure-based treatment to give your brain a chance to learn that these situations are not threatening to you.
Anything you repeatedly do is like practice and helps your brain learn. The things you are doing at the moment could be keeping your anxiety going, for example.
- Repeatedly getting anxiety in the same situations
- Repeatedly avoiding those situations
- Repeatedly worrying about them before they happen
You want to create new learning where
You can be in the situation and remain calm without needing to avoid or worry about them.
How is this achieved
Repeat exposing yourself to the things that make you anxious (instead of avoiding them) and practising remaining relaxed or at least not running away from them.
I’ve noticed over the years that when I mention exposure-based treatment, some people understandably do not like this sound but hear me out.
You may not like the idea at present as it provokes an anxious response from you, but when you start with relaxation training or meditation, it becomes easier as you learn the skill to relax your body and quiet your mind.
This is why exposure-based treatment should also be combined with relaxation training.
Relaxation as an anxiety treatment
On my main anxiety page, you will read that the anxiety you feel comes from activating your sympathetic nervous system.
For example, continuing with the giving a presentation example above. When you walk into the room, and your heart is pounding, your face is beetroot, and your mouth is so dry that you can hardly speak, this is your sympathetic nervous system preparing you for danger.
This all occurs outside of your control; it is an automatic response, but you can learn to tame it by activating your parasympathetic nervous system, which will help you to relax.
This is why relaxation is essential in combination with exposure treatment, as you can voluntarily calm your body in situations which previously gave you anxiety.
Types of relaxation for anxiety treatment
Progressive Muscle Relaxation
With anxiety, your muscles can tense, and you are no longer aware of this. If you are getting anxious, this is your sympathetic nervous system preparing you for danger. Your muscles are prepared for fight or flight.
The problem with anxiety is that this can result in tight, painful muscles.
Progressive muscle relaxation encourages you to relax all your muscles from your head to your toes.
It also encourages the activation of your built-in relaxation response, the parasympathetic nervous system.
You can do this independently or use guided muscle relaxation like the Mp3’s in my course.
Relaxation using your breath
Using your breath as an anxiety treatment is often overlooked by people because they think it is too simplistic. But you are missing a gem.
As I mentioned before, you cannot control the automatic anxiety that comes from your amygdala, but you can counteract it with your relaxation response, and one of the ways to do this is to use your breath.
Again this can be guided or done by yourself. There are different ways to do this. You can use
- Diaphragmatic Breathing, or
- Controlled Breathing
In doing so, you are learning a new skill, which will become your automatic response with practice!
So far, I have been telling you about anxiety treatments that will help with more automatic forms of anxiety. Still, even these usually have a period of worry time before or leave you feeling like a failure, or not good enough, or in fear of being judged, and this requires an additional type of anxiety treatment known as CBT.
Even with amygdala-based anxiety, you probably need to do the following: you might start to worry about situations in the future where you might get anxious, and this has more to do with your thinking brain. This is more under your conscious control, and it is not an automatic response like amygdala-based anxiety; this is where talking therapies are useful.
Anxiety Treatment: Talking Therapy
Many people are referred to like myself, a psychologist, to undertake anxiety treatment using what is called ‘Talking Therapy.’
Talking Therapy is where you undertake treatment while talking to a professional who will use suitable therapy models to help you.
Cognitive Behavioural Therapy CBT
CBT is one of the best-known and widely researched anxiety treatments. I have a more detailed post on CBT here but the main points are below.
CBT helps to treat anxiety by;
- working with, and changing thoughts that are contributing to your anxiety,
- changing behaviours (you things that you do) that are contributing to your anxiety.
People also use different talking therapies to treat anxiety, but they are not NICE guidance. I am a psychologist trained in the UK and used the NICE guidance to reference what has been shown to work best.
I shall mention some other talking therapies below, but their efficacy as anxiety treatments is not as good as CBT.
Person-centred counselling is non-directive, which means the counsellor will not give advice, tell you what to do, or give strategies. This type of therapy allows you to talk without formal guidance from the therapist.
Psychoanalysis is a long-term therapy, often occurring 2 or 3 times a week and looks to things that may have happened in your early years that make you anxious now.
Self-Help Anxiety Treatment
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