What is Anxiety?
Anxiety is one of the most common mental disorders in America and comes in many different forms and levels of severity. It’s estimated that as many as 40 million Americans live with some form of anxiety disorder. Anxiety typically occurs when you are stressed or worried about an upcoming event, but it can also happen unexpectedly or with an environmental trigger.
The 5 most common types of anxiety disorders are generalized anxiety disorder, panic disorder, social anxiety disorder, post-traumatic stress disorder, and obsessive-compulsive disorder. Each type of anxiety disorder also has its signs and symptoms, and it’s important to note that anxiety is different from depression in that depression is a form of stress from an event that has already occurred.
About 30% of adults will at some point experience a form of anxiety, and just in the past year alone, nearly 20% of U.S. adults experienced an anxiety disorder. If anxiety is affecting your daily life, speak to your doctor or mental health provider to see if a medication treatment plan is right for you. Many people have also found using a mental health app to track your mood and monitor progress helpful to see overall change. Some apps, such as Youper, also allow you to speak with a mental health provider and receive medication treatment if prescribed.
Antidepressants are the most common class of medications used to treat anxiety. The two major sub-classes of antidepressants are selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRI). These drug classes are typically the first option used to treat anxiety and are effective for many disorders. Common medications that are used in the SSRI class include sertraline, paroxetine, citalopram, escitalopram, and fluoxetine. The SNRI class of medications includes venlafaxine and duloxetine. Antidepressant medications typically take about 2-4 weeks to start seeing an improvement of symptoms. Although SSRI and SNRI medications are similar, each medication has its indication for the different types of anxiety disorder.
Another popular medication for treating anxiety and tension is hydroxyzine. Hydroxyzine is an antihistamine that has two forms, hydroxyzine hydrochloride (Atarax) and hydroxyzine pamoate (Vistaril). Only hydroxyzine pamoate has the FDA indication for anxiety, but doctors can prescribe the hydrochloride form in place of the pamoate form. Both are widely used to treat anxiety, and some doctors may prescribe hydroxyzine with an SSRI or SNRI for 2-4 weeks to help with the symptoms while waiting for the effects of SSRI/SNRI to kick in. Hydroxyzine can make you drowsy and can be prescribed up to four times a day, so discuss with your doctor or mental health provider if it is appropriate for you.
Beta-blockers are commonly prescribed for high blood pressure. Propranolol and atenolol, however, can be prescribed for social performance anxiety. Examples of this type of anxiety include public speeches, debates, big presentations, interviews, and speaking to new people. Beta-blockers are usually taken 1-2 hours before you need them.
Benzodiazepines (BZDs) are also used to treat anxiety, however, they’re not the go-to choice for anxiety medication because it has addictive properties. BZDs are schedule 4 controlled substances, meaning they have the potential for abuse and dependence. BZDs are reserved for patients with severe anxiety or patients that cannot be on SSRI or SNRIs due to intolerance. It has fast-relieving symptoms but may cause cognitive impairment, slow or shallow breathing, or drowsiness. Some medications that belong to this class of medications include alprazolam, clonazepam, diazepam, and lorazepam. Because of their addictive properties, it’s best to consult with your doctor or mental health provider if benzodiazepines are appropriate for you.