Anxiety is one of the most common mental health conditions, but it is also one of the easier ones to treat. With a combination of medication, therapy, and other resources, it is generally possible to manage all of the different forms of anxiety, often providing a significant and sometimes complete reduction in symptoms.
But when you are seeking out psychiatric treatment for anxiety for the first time, there can be several questions about the process and what you can expect from your psychiatrist. While the process can differ slightly depending on your specific doctor and the type of anxiety condition you are diagnosed with, this is what you can expect during anxiety treatment in Dallas at Aware Behavioral Health.
What is Anxiety Understanding When You Should Seek Treatment?
Anxiety takes what is a normal mental and physical response to stimuli and exacerbates it, causing your anxiety response to occur in the moments where it is not necessary or to an extreme that does not match the intensity of the situation. The anxiety response will cause you to experience different physical and mental sensations.
Mentally, anxiety can cause feelings of fear, panic, stress, and lack of focus. It may cause you to catastrophize situations and picture worst case scenarios. Physically, you may feel rapid heart rate, sweating, rapid breathing, tensing, and restlessness.
Mental and physical symptoms are a result of adrenaline and other neurotransmitters released in the brain. When you are in a situation where there is actual danger or where increased performance is necessary, such as a presentation at work or a walk home at night alone, these symptoms are helpful because they will make you more alert and increase your capabilities.
But with an anxiety disorder, you will feel these symptoms when they are not helpful. How you experienced them will differ by the disorder, but they are usually a frequent enough occurrence that they can quickly become exhausting as you find yourself always living with stress and an excess of adrenaline. Anxiety may occur in ways that interrupt your day to day life.
The most common types of anxiety that people seek treatment for in Dallas include:
- Generalized Anxiety Disorder – With generalized anxiety, you will feel anxious a good deal of the time without necessarily having an identifiable cause. You may also be dealing with a stressful situation simultaneously, but the anxiety you feel is disproportionate or over aspects of the situation that you cannot control.
- Post Traumatic Stress Disorder – PTSD occurs after a person has lived through or witnessed a traumatic event. PTSD is the body’s and brain’s response to triggers that seem to indicate that a similar event may be about to occur. Common signs and symptoms of PTSD include panic attacks, flashbacks, nightmares, hypervigilance, and depression.
- Panic Disorder – Panic attacks are a short, but extreme physical and mental anxiety response. They can come on suddenly in response to different triggers and cause an overwhelming feeling of terror. Physical symptoms, like increased heart rate, shortness of breath, hyperventilation, faintness, nausea, profuse sweating, and dizziness, are often strong enough that those experiencing a panic attack may mistake it for a heart attack. Because of how extreme they are, panic attacks can be debilitating and leave you in fear of when the next one will occur.
- Obsessive Compulsive Disorder – Also called OCD, this can present in different ways. Patients will often experience obsessive thoughts for which they must then act on a compulsion to get rid of. But OCD often comes so extreme that obsessive thoughts and or compulsions will interrupt other more important thoughts and activities. It is also possible for obsessions or compulsions to occur separately with OCD.
- Social Anxiety – Social anxiety is a specific type of phobia that can cause extreme anxiety or panic attacks in situations where the patient has to interact with others. This could include giving speeches or presentations, being in crowded areas, or some other type of social situation, and is generally extreme enough that the person with anxiety will choose to forego these situations altogether.
- Other Phobias – Phobias can be for a wide range of things, and may cause panic attacks or extreme anxiety from simply thinking about the phobia. When the subject of a phobia is something that you will regularly encounter, it becomes important to get treatment for this phobia so that coming into contact with the object of your phobia does not continue to interrupt your life.
The difference between any of these anxiety conditions and more benign, short term stress or fear is how intrusive the thoughts are, how severe they are, and whether they accurately match the severity of the situation in which you are experiencing anxiety.
Many of our patients at Aware Behavioral Health come to us for Dallas anxiety treatment after reaching a point where anxiety has become disruptive enough to their life or the stress of dealing with anxiety has become a stressor on its own.
Getting an Anxiety Diagnosis
The first step with anxiety treatment is to give you a diagnosis. You may already have a relatively good idea of what disorder you are experiencing or you may simply have a sense that something is wrong. Either way, anxiety treatment will begin with history taking in order to provide a diagnosis and start designing a treatment plan.
During your initial appointment at Aware Behavioral Health, Dr. Sehdev will ask a number of questions about all of the following:
- Your symptoms and experiences as they relate to mental health.
- Your family mental health history.
- Your physical health history.
- Current medications for physical and mental conditions.
- Other forms of treatment you may be undergoing.
This process will be an in-depth one as we get to know you during the first visit. This is partially because more information enables us to make a more accurate diagnosis, but also because Dr. Sehdev believes in the importance of truly getting to know his patients in order to deliver a high level of individual care.
The right knowledge at this stage will enable us to make a diagnosis for an anxiety condition if appropriate. Because Aware Behavioral Health also treats a range of other mental health challenges, your diagnosis can also include any other concerns that you may be dealing with. Depression, addiction, Insomnia, and other issues have a correlation of occurring alongside anxiety. If you are experiencing both simultaneously, the full picture we get of your mental health during this initial stage makes it possible to often treat issues simultaneously for the most effective solution to anxiety.
The Treatment Process for Anxiety
Once we have your diagnosis and a full understanding of who you are, we can move forward with treatment. The treatment plan we use here will look different for every client based on the questions you answered and the background you provided during the initial intake.
As a psychiatrist, mental health medication plays a significant role in our treatment plans and we will generally begin by prescribing one or more of the following medications to treat anxiety:
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are a type of antidepressant that are also commonly recommended for generalized anxiety and OCD. Serotonin is a neurotransmitter that causes feelings of happiness when your brain releases it. SSRIs work by keeping the brain from reabsorbing serotonin, therefore increasing the overall concentration of serotonin so that you feel more content and calm.
One of the reasons that SSRIs are so often recommended for anxiety is that they often have limited side effects. When side effects do occur, they can include:
- Feeling Anxious
- Dry Mouth
- Weight Loss
- Loss of Appetite
- Reduced Sex Drive
- Erectile Dysfunction
- Easier Bruising
- Easier Bleeding
Other rare, but serious, side effects are serotonin syndrome which occurs when serotonin levels get too high, and hyponatremia where sodium levels fall, both of which are a reason to contact us, your physician, or seek emergency treatment if severe.
There are several types of SSRIs that are effective in treating anxiety. Some of the most common types are the generics escitalopram, citalopram, paroxetine, fluoxetine, and sertraline. When taking these, you will have a daily dosage and will usually start to feel the effects after 2 to 5 weeks. Most patients will take SSRIs for at least 6 months or longer. These drugs are not habit-forming, although we will still work with you to manage your prescription.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
SNRIs work similarly to SSRIs. They were initially designed as an antidepressant, but are also now prescribed for generalized anxiety, panic disorder, and social phobia. A physician may also prescribe them for chronic pain.
SNRIs inhibit the reuptake of serotonin as well as the reuptake of norepinephrine. Norepinephrine contributes to energy and focus, so SNRIs can also boost your energy levels in addition to your mood.
The side effects of SNRIs are largely similar to SSRIs, although specific prescriptions may have additional side effects. For instance, venlafaxine can increase blood pressure and duloxetine can negatively impact existing liver problems, which is part of the reason we take into account your medical history. SNRIs will take several weeks to start working, but are non-habit forming for long term management of anxiety symptoms.
While antidepressants for anxiety are a medication that you will take daily for the overall management, benzos cause immediate relaxation and are a prescription you can take when needed. They work by increasing the neurotransmitter GABA in the brain, which relaxes your muscles and reduces psychological symptoms of fear, making you feel calmer overall.
Benzodiazepines are best known by several brand names, including Valium, Xanax, and Klonopin. Each of these has similar effects with some differences, and we can decide which is best suited to your anxiety.
At Aware Behavioral Health, we may prescribe benzodiazepines to help manage short term anxiety, such as panic attacks and phobias. They do, however, come with more significant side effects than antidepressants. They can cause drowsiness, confusion, disorientation, breathing challenges, and depression.
But the leading reason that we only prescribe benzos when necessary is that they can be addictive. They will also become less effective the longer they are taken. For this reason, if benzodiazepines are part of your anxiety treatment, we will carefully monitor your symptoms and side effects to avoid any additional health challenges.
Other Medications for Anxiety
Antidepressants and benzodiazepines are the most common medications for anxiety, but not the only options. Some of these are considered off-label use, meaning that they are not necessarily marketed for anxiety treatment, but have treated a variety of anxiety conditions successfully. These include:
- Beta-Blockers – Although usually for high blood pressure, these can block the effects of adrenaline to help you feel calmer and less stressed.
- Tricyclic Antidepressants – These are a type of antidepressant that was widely used before SSRIs and SNRIs. They also block the reuptake of norepinephrine and serotonin. They often cause more side effects than newer antidepressants, but can work where SSRIs or SNRIs have not.
- Buspirone – Research on the functioning of buspirone is ongoing, but it is known to successfully treat both long- and short-term anxiety. It works somewhat slower than benzodiazepines, but not as slow as SSRIs. It is also less likely to lead to dependence and has fewer side effects than benzos.
- Monoamine Oxidase Inhibitors (MAOIs) – These are the earliest form of antidepressants, and can still be prescribed for anxiety conditions like social phobia and panic disorder. They may be effective when other medications have not been, but they may have more side effects and can react poorly with other medications, food, and drink.
The specific medication we prescribe will be based on the type of anxiety disorder you have, your symptoms, experiences you have had with anxiety medication in the past, and any medications you are currently taking. Our goal is to give you as much of a reduction in symptoms as possible without causing unwanted and unmanageable side effects. This also impacts how we choose the initial dosage for your anxiety meditation.
During this part of the process, we can also answer any questions you have about medically assisted treatment, your diagnosis, what you should expect from the treatment, and if there are any side effects that you should be aware of.
Treatment After the Initial Prescription
The next step is to schedule a follow up appointment. As long as you are receiving treatment from Aware Behavioral Health for anxiety, you should expect regular follow up appointments. How often these occur will depend on the anxiety diagnosis, the severity of it, and the type of medication you are on.
As treatment goes on and you start to feel more in control of your anxiety, we may also be able to space these follow up visits further apart. During a follow up visit, Dr. Sehdev will inquire about any symptoms you are experiencing, any side effects from medication, and other changes that have occurred since the last visit. This is also a great time to bring up questions or concerns that may have come to you since your intake or previous discussions with Dr. Sehdev.
It is during these visits that any changes can be made to your medication and other aspects of your treatment plan where necessary, such as increasing the dosage of a current medication or switching to a new medication. We can also consider other sources of treatment in addition to medication if you need additional ways to manage anxiety.
Other Techniques for Treating Anxiety
In addition to medication, many cases of anxiety can also be improved through additional strategies. Working with a psychiatrist gives you access to these solutions as well, and depending on what we discover about your condition, we can provide further support or refer you to the correct services. As a result, your treatment can involve any of the following:
- Psychotherapy – While psychiatry uses medication, psychotherapy uses various discussion-based methods to help manage symptoms and alter thoughts. These can include Cognitive Behavioral Therapy (CBT), positive psychology, and several other strategies. This can be useful for teaching methods to cope with stress or come down from an anxiety or panic attack as it is happening. Talk therapy will also often focus on the underlying cause of anxiety, helping you get to the root of the issue. For this reason, it works especially well alongside medication, which can help manage symptoms in the short term. Dr. Sehdev can provide talk therapy techniques, or can make the recommendation to refer you out to a psychotherapist who will be able to work with you on a regular schedule while we continue to handle your medication needs for anxiety at Aware Behavioral Health.
- Lifestyle Changes – Different habits can exacerbate anxiety and stress, such as not getting enough sleep, consuming caffeine, relying on alcohol, eating a poor diet, and other concerns. We can help you identify if any of these may be negatively impacting you and suggest opportunities for improvement that will work alongside your medication to help reduce symptoms.
- Skill Building – Different skills can help you manage symptoms of anxiety. These can include improving speaking abilities or building confidence to cope with social anxiety, time management techniques to reduce stress related to work or school, or mindfulness techniques for reducing feelings of panic.
- Other Forms of Treatment – In some instances, working with additional health professionals may be necessary to provide additional treatment. This may mean meeting with a physician for any physical health conditions that could be contributing to anxiety or additional care for those coping with addiction, either as a result of or because of their anxiety.
As with medication, these treatment solutions may change over the course of your treatment plan, particularly as you begin to see improvement in your condition and your needs change.
We will continue to discuss progress and available options throughout your anxiety treatment program in Dallas with aware behavioral health so that we are always working towards the right combination of solutions to meet your needs.
Continuation of Anxiety Treatment
Depending on the type of anxiety and the person, you may find that anxiety goes away eventually. Alternatively, it may be a lifelong condition that rather than curing, we will work with you to manage it appropriately.
Aware Behavioral Health is able to support you as long as you require it with personalized care that continuously works towards the goal of reducing your anxiety symptoms so that you can remain focused on what is most important to you.
Get Started with Dallas Anxiety Treatment – Make an Appointment at Aware Behavioral Health Today
Living with anxiety is stressful. From the mental and physical symptoms you experience as a result of anxiety, to having to worry when the next panic attack or anxiety attack may strike, fear can hold you back. Yet even when anxiety feels overwhelming, it is treatable. Dr. Sehdev at Aware Behavioral Health aims to make that treatment process as straightforward as possible, both to get you the assistance you need, and to help you feel reassured throughout.
If you still have questions after reading this guide or are ready to get started with treatment for anxiety, we encourage you to contact our team by phone or by sending us a message through our online form. At that point, we can provide the answers and information that are specific to your situation and start moving forward to help you overcome anxiety.