Anxiety is the most prevalent mental illness in the United States. It affects nearly 14% of the population yearly. While new information on anxiety disorders has flourished over the last decade, little is being done to improve treatment options and enhance the care of patients with anxiety.
Although anxiety disorders are lesser known than other psychiatric conditions like schizophrenia, depression, and bipolar, they can be just as crippling. In a study conducted by Alexander Bystristky, Sahib. S. Lhalsa, Michael E. Cameron and Jason Schiffman, titled Current Diagnosis and Treatment of Anxiety Disorders, the roadblocks of anxiety found in 2013 was simply more mounting evidence of this mental health care issue’s complexity.
2013 Research Findings
1. Problems With Diagnosis
- Overlapping Symptoms
According to the National Co-morbidity Survey, there are extensive co-morbidities in patients with anxiety. Simply put, anxiety disorders frequently co-occur with other mental and physical health problems. It is not unusual for one person to have multiple diagnosable conditions. It’s possible a single person might have multiple different disorders emerge at different times in their lifetime.
Additionally, anxiety disorders and other mental health problems have many overlapping symptoms that make them difficult to distinguish. For example, if a patient experiences panic-like symptoms, it may be a symptom of panic disorder, or may be agoraphobia or social phobia. As a result, determining a diagnosis for a specific anxiety disorder can be a challenge.
2. Biology of Anxiety
In recent years, biological research in anxiety disorders has shifted to neurochemical and neuroimaging technology. Although there are new insights on the role genetics play in anxiety disorders, the exact interplay between genetic, biological, and stress factors is not well understood. However, a basic understanding of the brain regions reveals a close association between the following areas and the ABC’s of anxiety:
- (A) Amygdala: a quick response to threat and immediate alarm reaction is related to a disturbance of these circuits.
- (B) Basal Ganglia: these regions are associated with information processing during alarming situations.
- (C) Coping Cortex: coping mechanisms are related to a distribution of these difficult to distinguish circuitry systems.
Neurochemicals such as Serotonin, GABA, Dopamine, Neuroepinephrin, and many others have also recently been linked to anxiety disorders. Each chemical plays a very different, but equally important, role in anxiety regulation. Manipulating one or more of these chemicals with medication can combat specific aspects of anxiety.
3. Medication & Psychotherapy
The two most frequently used treatments for anxiety disorders arepsychopharmaceuticals and psychotherapy. Each case of anxiety is different, but most often the first line of treatment for a patient with anxiety is either medication, sessions of therapy with a trained professional, or a combination of both those methods. The most popular and effective form of therapy for anxiety is Cognitive Behavioral Therapy (CBT), as common medications for anxiety disorders include:
- Selective Serotonin Reuptake Inhibitor (SSRI): Usually the first medication prescribed to patients with anxiety disorders. Regulating serotonin is correlated with a reduction in anxiety.
- Serotonin Neuroepinephrin Reuptake Inhibitor (SNRI): Usually taken after an inadequate response to SSRIs. Combats effects to some symptoms of anxiety in some people but may exacerbate symptoms of anxiety in others.
- Benzodiazepine: Produces an immediate, effective anxiolytic response but has a high potential for overdose, dependence, withdrawal, and impaired cognition.
- Anti-seizure Medication: Has anxiety reducing properties similar to that of SSRI’s.
- Tricyclic Antidepressant: Is proven to be effective for anxiety reduction but has a number of associated adverse effects.
Anxiety research has provided a lot of useful information about the role of genetics and environmental influences. Although the available treatment options are numerous, they target very different symptoms of anxiety. In the future, more effective and perhaps hybrid treatments of several options need to be explored in order to increase the success and duration of anxiety relief.