Should I see a therapist or psychiatrist about anxiety?

Diagnosis

You can start by going to your doctor to see if your anxiety is related to your physical health. He or she can check for signs of an underlying condition that may need treatment.

However, you may need to see a mental health professional if you are very anxious. A psychiatrist is a doctor who specializes in the diagnosis and treatment of mental illness. A psychologist and some other mental health professionals can diagnose anxiety and provide counseling (psychotherapy).

To help diagnose an anxiety disorder, your psychotherapist can:

• Conduct a psychological evaluation. This involves discussing your thoughts, feelings and behaviors to help make an accurate diagnosis and check for co-occurring complications. Anxiety disorders often occur along with other mental health problems - such as depression or substance abuse - which can make diagnosis difficult.
• Compare your symptoms with the DSM-5 criteria. Many clinicians use criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association to diagnose anxiety disorder.

Treatment

The two main methods of treating anxiety disorders are psychotherapy and medication. You may benefit most from a combination of these two methods. It may take some time of trial and error to determine which treatments work best for you.

Psychotherapy

Psychotherapy, also known as talk therapy or psychological counseling, involves working with a therapist to reduce symptoms of anxiety. It can be an effective method of treating anxiety.

Cognitive Behavioral Therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Typically a short-term treatment, CBT focuses on teaching you specific skills to improve your symptoms and gradually return to the activities you have been avoiding because of your anxiety.

CBT involves exposure therapy, in which you gradually confront the object or situation causing your anxiety so that you have the confidence to deal with the situation and the symptoms of your anxiety.

Medications

Depending on the type of anxiety disorder and if you have other mental or physical health problems, several types of medications are used to relieve your symptoms. For example:

• Some antidepressants are also used to treat anxiety disorders.
• The anti-anxiety drug buspirone may be prescribed.
• In limited circumstances, your doctor may prescribe other types of medications, such as sedatives, also called benzodiazepines, or beta-blockers. These medications are intended for short-term relief of anxiety symptoms and are not intended for long-term use.

Talk to your doctor about the benefits, risks, and possible side effects of medications.

Clinical trials

Examine telemedicine research that tests new treatments, interventions, and tests as a means of preventing, detecting, treating, or managing this condition.

Lifestyle and home remedies

While most people with anxiety disorders need psychotherapy or medication to get their anxiety under control, lifestyle changes can also make a difference. Here's what you can do:

• Keep yourself physically active. Develop a daily routine so that you are physically active most days of the week. Exercise is a powerful stress reliever. They can improve your mood and help you stay healthy. Start slowly and gradually increase the amount and intensity of exercise.
• Avoid alcohol and recreational drugs. These substances can cause or worsen anxiety. If you can't quit smoking on your own, see a doctor or find a support group to help you.
• Quit smoking and reduce or eliminate caffeinated beverages. Both nicotine and caffeine can increase anxiety.
• Use stress management and relaxation techniques. Visualization techniques, meditation, and yoga are examples of relaxation techniques that can alleviate anxiety.
• Make sleep a priority. Do everything you can to make sure you get enough sleep and feel rested. If you don't sleep well, see a doctor.
• Eat healthy foods. Eating healthy foods - such as an emphasis on vegetables, fruits, whole grains, and fish - may be associated with reduced anxiety, but more research is needed.

Alternative Medicine

Some herbal remedies have been studied as a treatment for anxiety, but more research is needed to understand the risks and benefits. Herbal and dietary supplements are not controlled by the Food and Drug Administration (FDA) in the same way that drugs are. You can't always be sure what you're getting and whether it's safe. Some of these supplements may interact with prescription drugs or cause dangerous interactions.

Before taking herbal remedies or dietary supplements, consult your doctor to make sure they are safe for you and will not interact with the medications you are taking.

Treatment and support

To deal with an anxiety disorder, here's what you can do:

• Learn about your disorder. Talk to your doctor or mental health professional. Find out what may be causing your particular condition and what treatments may be best for you. Involve your family and friends and ask for their support.
• Stick to your treatment plan. Take your medicines as prescribed. Attend therapy appointments and do any tasks your therapist may give you. Consistency can make a big difference, especially when it comes to taking your medications.
• Take Action. Find out what is causing your anxiety or stress. Practice the strategies you have developed with your therapist to be prepared to deal with feelings of anxiety in these situations.
• Keep a journal. Keeping notes about your personal life will help you and your psychiatrist identify what is causing you stress and what is helping you feel better.
• Join an anti-anxiety support group. Remember that you are not alone. Support groups offer compassion, understanding, and shared experiences. The National Alliance on Mental Illness and the American Anxiety and Depression Association provide information on finding support.
• Learn time management techniques. You can reduce anxiety by learning how to carefully manage your time and energy.
• Socialize. Don't let worries isolate you from loved ones or activities.
• Break the cycle. When you feel anxious, take a brisk walk or take up a hobby to take your mind off your worries.

Preparing for Admission

You can start by talking to your doctor. He or she can refer you to a mental health specialist.

What you can do

Before your appointment, make a list:

• Your anxiety symptoms. Pay attention to when they occur, whether anything improves or worsens them, and how much they affect your daily activities and interactions.
• What causes you stress. List any major life changes or stressful events that you have recently experienced. Also note any traumatic events you have experienced in the past or as a child.
• Any family history of mental health problems. Note if your parents, grandparents, siblings, or children have struggled with any mental health problems.
• Any other health problems you have. Include both physical conditions and mental health problems.
• All medicines you are taking. List all medications, vitamins, herbs, and other supplements and doses.
• Questions to ask your doctor to get the most out of your appointment.

Some basic questions to ask your doctor include:

• What is the most likely cause of my anxiety?
• Are there other possible situations, psychological problems, or physical health issues that may be causing or exacerbating my anxiety?
• Do I need any tests?
• Should I see a psychiatrist, psychologist or other mental health professional?
• What kind of therapy can help me?
• Will medication help? If so, is there a generic alternative to the medicine you prescribe?
• Besides treatment, is there anything I can do at home to help?
• Do you have any tutorials that I could get? What sites do you recommend?

Feel free to ask other questions during the appointment.

What to expect from your doctor

Your doctor is likely to ask you some questions, such as:

• What are your symptoms and how serious are they? How do they affect your ability to work?
• Have you ever had a panic attack?
• Do you avoid certain things or situations because they make you anxious?
• Was your feeling of anxiety episodic or constant?
• When did you first start noticing your anxiety?
• Does something in particular seem to be provoking your anxiety or exacerbating it?
• What, if anything, improves your sense of anxiety?
• What traumatic experiences have you had recently or in the past?
• What, if any, physical or mental illnesses do you have?
• Do you take any prescription medications?
• Do you regularly use alcohol or recreational drugs?
• Do you have any blood relatives who suffer from anxiety or other mental illnesses, such as depression?

Preparing and anticipating questions will help you make the most of your time.