What does a psychiatrist do to treat anxiety?

InMarch 2021, the Centers for Disease Control released a report showing a dramatic increase in the number of adults with symptoms of an anxiety or depressive disorder. While this increase is to be expected during major disease outbreaks, it is no less of a cause for concern. Fortunately, we live in a time when it is socially acceptable to talk about mental health and well-being, making it easier to seek treatment.

The two most common treatments for anxiety disorders include medication and psychotherapy. For many people, the greatest relief comes from a combination of both treatments. There are different types of health care providers who can provide treatment for anxiety, including psychologists, psychiatrists and general practitioners. Many people prefer to start with a psychiatrist because he or she is specially qualified to diagnose and treat symptoms of mental disorders, including anxiety disorders.

How do psychiatrists treat anxiety disorder?

Psychiatrists are doctors who specialize in mental health. They can treat anxiety with a variety of treatments, including many types of medications and psychotherapy. Choosing the best treatment for a patient depends on his or her specific needs. Here are some of the treatments that psychiatrists use to relieve symptoms associated with anxiety disorder.

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are often the first type of medication psychiatrists use to treat patients with anxiety disorders. SSRIs work by increasing serotonin levels in the brain. Serotonin helps regulate mood, sleep, appetite, and digestion. Low serotonin levels, which are often associated with behavioral and emotional disorders, can lead to depression, anxiety and suicidal behavior. Formally, SSRIs are classified as antidepressants, but they are also often used to treat anxiety and other disorders.

Examples of SSRIs are: Prozac, Paxil, Zoloft, Luvox, Celexa, and Lexapro.

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Serotonin-norepinephrine reuptake inhibitors (SNRIs) are similar to SSRIs in that they work to increase levels of certain neurotransmitters, including serotonin. But in addition to increasing serotonin levels, they also increase norepinephrine levels. Serotonin works on mental balance and creates feelings of well-being, while norepinephrine promotes feelings of alertness and energy. People whose symptoms of anxiety include low energy levels or poor concentration, or those who have not found relief with SSRIs, can be treated with SNRIs.

Examples of SNRIs are: Effexor, Cymbalta, Pristik, Fetzima, and Sewella.

Tricyclic antidepressants (TCAs)

Like SNRIs, tricyclic antidepressants (TCAs) affect the amount of serotonin and norepinephrine in the brain. TCAs are an older class of antidepressants that have been very effective in treating anxiety, depression, and other psychiatric disorders. In people with severe cases of depression or anxiety, TCAs can be even more effective than SSRIs. One disadvantage of TCAs is the increased risk of side effects and lower safety profile. But for many, they provide much-needed relief from distressing symptoms.

Examples of TCAs are: Tofranil, Elavil, Norpramin, Anafranil, Pamelor, and Vivactil.

Benzodiazepines

Benzodiazepines are a class of medications that treat symptoms of acute anxiety by acting on gamma-aminobutyric acid (GABA) receptors in the brain. GABA plays an important role in the body's response to stress, and research shows that it helps control fear and anxiety. Changes in the GABA system are associated with anxiety disorders. Benzodiazepines bind to the same receptors as GABA, slowing down the central nervous system and causing a calming effect. They are fast-acting and also fast-weaning.

Examples of benzodiazepines: Xanax, Librium, Klonopin, Valium, and Ativan

Psychotherapy

In addition to prescribing medication for people with anxiety, psychiatrists are also authorized to provide talk therapy and psychosocial interventions. Common psychotherapies related to anxiety treatment include cognitive behavioral therapy (CBT) and exposure therapy. CBT seeks to identify and address how the patient's thoughts and behaviors are calming or exacerbating anxiety symptoms. Exposure therapy involves creating a safe environment in which the patient is exposed to things he or she fears and avoids in order to lessen negative associations and cope with feelings of anxiety.

Some psychiatrists prefer to focus on medication for anxiety and refer their patients to a psychologist for additional therapy. Others prefer to work closely with patients using various forms of treatment. Patients can also choose a psychiatrist who does both, or work with different doctors. With the patient's permission, both therapists can share notes and information, working together to provide exceptional care.

Forthose who cannot find relief with standard anxiety treatments , intravenous ketamine therapy has also proven helpful. For more information, contact Telehealth today.