“Doctor, I am not as concerned about depression as I am about anxiety, can you recommend a non-benzodiazepine medication for my anxiety?”
Anxiety is a common problem for the people we see at Gateway Psychiatric, and some variation of request above is one of the most frequent questions people ask and yet it is also one of the most complicated to answer. It is puzzle. Patients feel anxiety in their bodies, so they naturally expect that a physical treatment like a medication will help. But anxiety disorders respond to our medications much less than other conditions.
Anxiety comes in many forms and means different things to different people. For example, it is common to hear someone say that they’re not anxious but they do worry a lot. To complicate things more, dread and hopelessness, which is one of the most common manifestations of depression, can also be confused with excessive anxiety.
So let’s begin by describing some of the types of anxiety that people experience.
Types of Anxiety
These are the most common types of anxiety that we see:
1. PTSD or Traumatic Anxiety: Intrusive fear or anxiety related to a traumatic event. There are often flashbacks, intrusive memories, or nightmares along with other symptoms.
2. Panic or Sudden Extreme Anxiety: Sudden overwhelming anxiety. Often associated with feeling as though you are going to die or go crazy.
3. Generalized Anxiety or Ongoing Worry about Many Things: Worrying about many different things over a long period of time.
4. Obsessional Anxiety or Recurring Worries: Worrying about one thing over and over.
5. Fearfulness or Paranoia: Fear that perhaps all is not as it seems, that perhaps people cannot be trusted.
6. Phobias: Anxiety linked to specific situations.
7. Agitated Anxiety and Racing Thoughts: Anxiety can also be a manifestation of what is called a “mixed state” and distinguishing this from other kinds of anxiety is both extremely important and very difficult.
Relationship between Anxiety and Other Mood Symptoms
in addition to various means of anxiety another important issue that has to be explored before making any recommendations for treating anxiety is the relationship between this symptom and other mood symptoms.
Treatment of Anxiety
Given the complexity of the various types of anxiety and the relationships between anxiety and mood symptoms, it may not be too surprising that the question of how best to treat anxiety is one of the most challenging questions we face in the practice.