What kind of therapy is the right kind to help with anxiety? And can you treat yourself, or do you have to see a therapist for anxiety therapy?
Anxiety and anxiety disorders
Anxiety means you have worried and increasingly illogical or fear-based thoughts that you can’t control. These thoughts are causing you more and more tension. This tension create symptoms such as sleep issues, a racing heart, sweatiness, and muscle aches (read our article on anxiety symptoms for more).
An anxiety disorder means that your anxiety has been present for at least six months or more, and is now at the level that it directly affects your capacity to cope on a daily basis. This includes things like your career and your social life.
There is quite a range of disorders that fit under the category ‘anxiety disorders’, including:
Anxiety is one of the conditions which can really benefit from self-help. So much so that it’s now the first line of recommended treatment by both the national health service (NHS) and the National Institute for Health and Care Excellence (NICE), the authority health practitioners refer to.
NICE divides self-help into things you do by yourself (non-facilitated self-help’), or self-help that is a program, ‘guided self-help’.
Non-facilitated self-help includes educating yourself about anxiety, or perhaps joining a support group. It also can include things like exercise, relaxing techniques like yoga and pilates, and lifestyle changes such as avoiding drinking and smoking.
If you go to see your GP about anxiety, one of the first things you may be offered is a guided self-help course you do yourself. This means a course you do in your own time, over the internet or using a workbook. It will last six weeks or more.
You might also be offered the option of group therapy. This means that once a week you’d go work with a therapist-led group of people, all learning how to manage anxiety together.
Cognitive Behavioural Therapy (CBT)
CBT is currently the most recommended therapy for anxiety in the UK and one of two recommended psychological interventions suggest by the NICE anxiety and anxiety disorder guidelines. It is generally the therapy you will be given if you use the NHS to deal with your anxiety.
Cognitive behavioural therapy is a short-term, structured and time-limited (up to four months) therapy. It doesn’t delve into your past but focuses on how to improve your present-day life by learning to recognise and control the connection between your thoughts, feelings, and actions.
So relaxation can really help deter anxiety. Applied relaxation is the second psychological intervention recommended by NICE and offered by the NHS. It is a systematic and controlled way of learning how to quickly and deeply relax your body. Like CBT, it’s a short-term therapy, where you’ll see a therapist on a weekly basis for up to four months.
There are several other therapies to help you with your anxiety, some of which are evidence-based.
These are not, however, usually available on the NHS and will involve seeking private treatment at your own expense. On the other hand, you can avoid long waiting lists and choose the therapist you work with.
A small but promising 2018 study published in the journal “Frontiers in Psychology” found that MBCT was helpful in reducing symptoms in adults with social anxiety, confirming research from an earlier 2010 study that found MBCT helped young people with social anxiety.
Behaviour Therapy/ Exposure therapy
This involves pushing yourself to take certain actions in order to challenge your anxious thoughts, ‘exposing’ yourself to the very thing you fear in a managed, controlled and safe way. It is a controversial therapy, sometimes offered for OCD and phobias, more commonly used in the United States than in the UK.
Note that exposure therapy does not mean you have to go and directly approach what you fear. To take a simple example of a fear of public speaking, you are not going to be forced to immediately sign up to make a speech.
Instead exposure therapy can involve things like imagining what you fear, or role-playing with your therapist, or even using virtual reality, noticing how you respond and talking through things with the therapist, or using relaxation exercises to change your response.
Clinical hypnotherapy is not like stage hypnosis. You don’t ‘lose control’ at any time, this is just one of many myths about hypnotherapy. Instead, hypnotherapy for anxiety is a process of deep relaxation that helps you access and mange your unconscious thoughts.
An overview on research studies of hypnotherapy published in ‘The Expert Review of Neurotherapeutics” suggests that hypnotherapy requires more research, but is “an efficacious treatment for state anxiety (e.g., prior to tests, surgery and medical procedures) and anxiety-related disorders”.
Will I be offered medication to treat my anxiety?
Here in the UK medication might be offered for anxiety if things like guided self-help have had little effect. You might be offered a serotonin reuptake inhibitor (SSRI) or tricyclic antidepressant (TCA).
Note that it is always your choice whether to take medication or not and your medical professional should always throughly explain what it would entail, including side effects and withdrawal symptoms if the treatment is stopped suddenly.