In this post I review the benefits and limitations of conventional treatments of anxiety disorders. Future posts in this series will discuss complementary and alternative approaches used to treat different anxiety disorders.
Conventional treatments of anxiety
Cognitive-behavioral therapy (CBT), supportive psychotherapy, and psychopharmacology are widely used conventional treatments of anxiety. Double-blind studies have established the efficacy of prescription medications such as benzodiazepines and serotonin-selective reuptake inhibitors (SSRIs) in the short-term treatment of recurring panic attacks and generalized anxiety. Certain prescription drugs are effective treatments of social phobia, however there are no effective psychopharmacological treatments of specific phobias such as arachnophobia (i.e., ‘fear of spiders,), fear of flying or others. Behavioral therapies including graded exposure and flooding are beneficial in social anxiety and performance anxiety. The conventional treatment approaches of obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) rely on both psychotherapy and medications.
Limitations of conventional treatments
Conventional treatments of anxiety are often beneficial but also have significant limitations. A meta-analysis of high-quality studies concluded that the efficacy of conventional treatments varies widely depending on the core symptom being treated. Panic attacks tend to improve and remain improved in response to medications like lorazepam and clonazepam, but patients who use these medications or other benzodiazepines chronically to control panic symptoms are at significant risk of dependence and withdrawal. Most individuals with generalized anxiety initially have positive responses to conventional treatments but remain symptomatic over the long-term. Phobias, obsessions and compulsions, and symptoms of post-traumatic stress are often poorly responsive to conventional Western treatments. This is complicated by the fact that many patients who experience chronic anxiety are too impaired to seek treatment and frequently have other mental health problems such as depressed mood, sleep disturbances and substance abuse.
Inter-individual differences and no standard care model
In general, anxiety is difficult to treat because of significant inter-individual differences in the type and severity of symptoms and incomplete understanding of medical, psychological, social and cultural factors that cause or exacerbate anxiety symptoms. Finally, standards of care for the acutely or chronically anxious patient are difficult to achieve because of differences in training, experience and skill of conventionally trained mental health professionals.
To learn more about complementary and alternative treatments of anxiety check out my e-book, “Anxiety: The Integrative Mental Health Solution.”