Anxiety, Anxiety Disorders, & Panic Attacks

16th October 2023

This page has been professionally reviewed and edited by a mental health
professional associated with the AYCNP who has a PhD in psychology.

Erin began experiencing anxiety from when she was a child. Her pediatric physician diagnosed her with generalized anxiety disorder (GAD). She began meeting with a therapist and continued to for about one year.

During that time, she learned techniques such as "positive self-talk," which literally talking herself out of anxiety. Every time she used positive self talk to come out of anxiety, it reinforced her self-confidence and reduced the severity of the anxiety. Her situation gradually improved over the next few years, to the point where she no longer needed the assistance of a therapist.

Natural remedies for anxiety: Regular exercise is one activity among many that can help overcome anxiety and anxiety disorders. Developing positive coping tools in your lifestyle can help you overcome anxieties and anxiety disorders. Prevention is also an important element of reducing anxiety.

One of the options that Erin and her parents decided not to pursue was the use of prescription drugs. She was determined to overcome her anxiety without — medication and she succeeded. (Geelan, R., N.J. Family, November, 2010. p.23)

What is Anxiety? Signs and Symptoms

While there are many different forms of anxiety, some of the general symptoms of anxiety can be described as follows:

·  Feelings of apprehension

·  A feeling of powerlessness

·  Sense of impending danger, panic, or doom

·  Increased heart rate

·  Breathing rapidly (hyperventilation)

·  Sweating

·  Trembling

·  Feeling weak or tired

Source: Based on Anxiety Symptoms, Mayo Clinic (2012)

Types of Anxiety Disorders
From a psychiatric perspective, major types of specific anxiety disorders include phobic disorders like agoraphobia; obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), acute-stress disorder, generalized-anxiety disorder (long-lasting and low-grade), Panic attacks (which are more acute and dramatic than generalized anxiety disorders), and separation anxiety disorder (a childhood condition).
Additionally, Anxiety disorder due to a medical condition and substance-induced anxiety disorder, are anxiety disorders due to a specific physical cause. For anxiety disorders that do not fit the above categories, the term “anxiety disorder not otherwise specified,” is used.

Anxiety disorders are diagnosed when anxieties become so pronounced so as to effect day-to-day activities.

Causes of Anxiety Disorders

The University of Maryland Medical Center states, "Most people with these disorders seem to have a biological vulnerability to stress, making them especially susceptible to environmental stimuli."

Environmental stimuli can include:

·  Trauma from events such as abuse, victimization, or the death of a loved one

·  Anxiety due to personal relationships, marriage, friendship, and divorce

·  Work related anxieties

·  School-related anxiety (e.g. stress over school workload, grades, bullying, peer pressure).

·  Anxieties about finances and money

·  Stress from a natural disaster

·  Watching distressing news events on television such as terrorism or crime

·  Reliving past traumatic events triggered by news events on television or conversations with others; repeatedly recalling past events

High recurrence rate with drug treatment of anxiety disorders

Prescription drug treatment is commonly used to treat anxiety disorders. While drug treatment for anxiety disorders may be effective in the short-term, long-term studies indicate a high recurrence rate with prescription treatment.

In an article entitled, Issues in the Long-Term Treatment of Anxiety Disorders, researchers Edward Schweizer, M.D.(Department of Psychiatry, University of Pennsylvania), Karl Rickels, M.D. (research psychiatrist), and Eberhard H. Uhlenhuth, M.D. (psychiatrist at Albuquerque New Mexico) report on the subject of short-term drug treatment of panic attacks :

Studies reporting outcome after short-term benzodiazepine therapy (anti-anxiety drugs such as Valium) find that many patients experience transient rebound anxiety symptoms to a level above their pretreatment baseline (38,56). By 1–3 years, approximately 50% or more of acutely treated patients have had a recurrence (34), and at least 50% have resumed treatment.

The same report indicates that approximately one percent of the adult population has currently or recently received long-term benzodiazepine therapy of one year or longer.

Recurrence rate of drug-treated anxiety:

·  Generalized anxiety disorder - 81% anxiety recurrence rate at one year after four-week treatment w/ benzodiazepine therapy

·  Generalized Anxiety Disorder - 63% recurrence rate within one year - w/diazepam, six-week treatment

The report concludes, "Overall, it appears that 60–80% of GAD patients (at least the ones applying for drug therapy) require additional treatment by 1 year."

·  Panic attacks - 50% recurrence rate w/benzodiazepine treatment

Rebound anxiety after discontinuing drug treatment
Based on scientific measurements, approximately 20% of persons treated with benzodiazepines had anxiety levels that were equal to or higher than their pretreatment baseline, indicating a rebound anxiety effect, or greater intensity of anxiety than before starting drug treatment.

The positive outcomes inherent in "well-established efficacy" of cognitive therapy (in conjunction with elements of behavioral therapy) and anxiety management strategies and therapies appear to be more acute (effective) and long-lasting than prescription drug treatment. Studies indicate the generalized anxiety disorder (GAD) treated with cognitive or anxiety management therapy may be unusually effective in sustaining improvement (italics added), with less than one-third of patients relapsing. (Schweizer, E., et al., 2000)
Lesson: Teach skills not pills.

Some of the issues related to benzodiazepine use are:

·  tolerance (of the drug) with long-term usage

·  attentional impairment

·  psychomotor impairment that may be relevant to the execution of complex real-world tasks.

·  impairment to cognitive tasks

·  impairment to short-term memory

·  potential for recreational abuse (for both the user and for others in the household)

·  physical dependence and withdrawal

·  psychological dependence

·  post-withdrawal craving for the drug

·  possible long-term medical or physiologically damaging effects

Effective Non-drug, Natural Remedies for Anxiety

Research also indicates that there are many effective therapies for anxiety disorders. In addition to exercise, relaxing activities, such as in Green Therapy or using Art as a therapy, and various other proven psychotherapies can be useful without the need for medications.

Evidence-based treatment studies reveal that:

  • Individual cognitive behavioral therapy,
  • Group cognitive behavioral therapy (GCBT),
  • GCBT with parents,
  • GCBT for social phobia,
  • And social effectiveness training for children with social phobia

are effective for both children, teens, as well as for adults.

These treatments are in the second tier of treatment efficaciousness, "probably efficacious," with very stringent standards for efficaciousness. This treatment plan need not include medication, according to the article, Journal Highlights Effectiveness of Research Based Psychotherapies for Youth, published in The Journal of Clinical and Adolescent Psychology, and as reported by NIMH.

Art is something to be considered for relief from anxieties, as is prayer and attention to
spiritual needs.

Doctor's Orders: Cecilia is an artist from Brazil who started painting when her doctor encouraged her to take it up to relieve anxiety. She started for the first time in February 2007, and since then has produced a couple of dozen of masterful works of art. Her intense anxieties were relieved, and without medication.

Conclusion: Anxiety and Anxiety Disorders & Panic Attacks: Symptoms, Natural Cures, and Prevention

As stated in this narrative, natural ways of combating anxiety appear to be feasible and viable, and most importantly, have been proven to be successful. Medicating anxiety with benzodiazepines and antidepressants has serious physical side effects, especially when discontinued. Many mental health professionals, such as the psychiatrists whose research has been cited in this discussion, advocate natural interventions. These include cognitive-behavioral therapy for treating anxiety and the basis for anxiety, in particular.

As alluded in this narrative, medication treats symptoms of anxiety rather than its causes. It is intuitively obvious that natural ways to treating anxiety are preferable. These interventions are non-invasive in the sense that they do not include treatment related to brain chemistry in controlling behavior. Moreover, such treatments for anxiety lack the effects, side effects, and rebound effects of a drug upon discontinuation. Overall, natural remedies for anxiety simply make sense.

References for Anxiety and Anxiety Disorders & Panic Attacks: Symptoms, Natural Cures, and Prevention

1. Anxiety - Symptoms. (June 30, 2012). Mayo Clinic.

2. Anxiety disorders - Highlights. (2011). University of Maryland Medical Center.

3. Journal Highlights Effectiveness of Research Based Psychotherapies for Youth. (April 15, 2008). NIMH.

4. Self-help treatments for generalised anxiety disorder. (2014, February 25). Britain: National Health Service (NHS) Choices.
This is a government health website resource of Great Britain.

5. Schweizer, E., Rickels, K., Uhlenhuth, E.H., (2000). Issues in the Long-Term Treatment of Anxiety Disorders

6. What Causes Anxiety? Medical News Today. Retrieved July 28, 2012.