Mental Disorders and Treatment Anxiety Disorder

Introduction

Anxiety disorder is one of the mental disorders listed in the recent Diagnostic and Statistical Manual of Mental Disorders. Different scholars and institutions have advanced different definitions of anxiety disorder. However, the different definitions have similar meaning. DSM-5 (2013) describes anxiety disorder as extreme fear or worry that lasts for a period of six months or more. According to Traeger et al. (2012), anxiety disorder describes chronic or long-lasting anxiety that is not focused on a specific situation or object. In simple terms and in consideration of the advanced definitions, ‘anxiety disorder’ can be described as a condition in which an individual suffers from chronic fear and worry. As Traeger et al. (2012), explains, anxiety disorder does not refer to one particular disorder; rather, it encompasses various disorders that involve feelings of fear and anxiety. The different disorders that comprise anxiety disorder include panic disorder, separation anxiety disorder, social anxiety disorder, different forms of phobia, post-traumatic stress disorder, and generalized anxiety disorder. While anxiety is one of the normal experiences of human beings, prolonged anxiety may have severe impacts on the normal functioning of the brain and other parts of the body. In some cases, prolonged anxiety may be a cause of early death (Traeger et al., 2012). Therefore, there is need for timely diagnosis and effective treatment of the disorder. This paper gives a brief description of the diagnosis process for anxiety disorder and two of the proposed treatment strategies. In aIDition, the paper compares the recommended treatment strategies with scientific literature or findings of empirical studies.

Anxiety Disorder Diagnosis

Anxiety disorder can be diagnosed in various ways. The strategy that is used in most cases is exploration of symptoms of the disorder. Individuals suffering from the disorder have prolonged feelings of uneasiness and fear. In most cases, they also experience sleeping problems. An individual suffering from the disorder may also show symptoms such as headache, sweating, muscle tension and aches, nausea, dizziness, inability to stay calm, shortness of breath, dry mouth, hypertension, exhaustion and palpitations (Jacobsen & Heather, 2011).

In the process of diagnosing anxiety disorders, Health professionals should start by evaluating the symptoms that are evident. Precisely, a health professional should ask questions that are meant to understand the feelings of a patient, as well as his medical history. Next, a physical exam should be carried out to determine whether the patient has a physical illness that may be the cause of the symptoms. If no physical illness is found, the patient should be referred to a mental health professional, such as a psychologist or psychiatrist. The mental health professional should carry out thorough screening of mental illnesses on the patient using either interview method or questionnaires. Examples of clinical questionnaires that are commonly used are Zung Self-Rating Anxiety Scale and Taylor Manifest Anxiety Scale (Jacobsen & Heather, 2011).

Proposed treatment methods

There are various ways of treating anxiety disorders. As Jacobsen and Heather (2011) explain, the exact approach for treatment is determined by the type of anxiety disorder that a patient is suffering from and persistence of the problem. One of the recomended strategies used by health professionals is psychotherapy. In this approach, a mental health professional gives counseling to the patient on how to manage or respond to the illness. Usually, the strategy involves guiding the patient on how to deal with the causes of anxiety disorder or cope with anxiety (Jacobsen & Heather, 2011). Psychotherapy can be carried out in various ways. Firstly, a health profession can adopt a technique that focuses on reducing or eliminating behaviors of a patient that contribute to anxiety, and replacing them with behaviors that prevent anxiety or that enable a patient to cope with anxiety. For instance, a health professional may encourage a patient suffering from anxiety to engage in exercise, to meditate or pause when thinking. That strategy is called behavioral therapy (Jacobsen & Heather, 2011). A health professional can also adopt a cognitive therapy strategy, which focuses on connecting thoughts of a patient to realities and teach him how to adopt thought patterns that help to reduce anxiety. Also, health professional can adopt an approach that involves combining behavioral and cognitive strategies, called cognitive-behavioral therapy (CBT) (Jacobsen & Heather, 2011).

Anxiety disorder is sometimes treated using drugs, especially in cases where other strategies are not effective. The most recommended drug for treatment of the disorder is selective serotonin reuptake inhibitor, especially for children. Benzodiazepines can also be given to patients during the early stages of medical treatment (Jacobsen & Heather, 2011). In cases where anxiety symptoms persist, the disorder can be treated using monoamine oxidase inhibitors. Examples of such inhibitors are tranylcypromine and phenelzine. However, their use is limited by medical interactions and dietary restrictions. Another option that is also effective is Pregabalin. Atypical antipsychotic quetiapine has also been found to be effective, but it has more side effects than the aforementioned drugs. Olanzapine and risperidone have been invented recently, but evidence on their level of effectiveness is not yet conclusive (Jacobsen & Heather, 2011). Although it may be necessary to use medications in cases where anxiety disorder has become persistent or severe, it is always essential to make use of psychotherapy first. This is due to the fact that unlike the use of medications, psychotherapy does not have side effects. In aIDition, psychotherapy has long-term benefits while the use of medicines may not have long-term benefits. Medical treatment is usually more effective when applied together with psychotherapy and thus, the latter should always be used to augment the former (Jacobsen & Heather, 2011).

Scientific literature on treatment methods

There are numerous empirical studies that have been carried out to explore the extent of application and effectiveness of psychological therapy and use of medications to treat anxiety. Most of them have supported the treatment recommendations made in the previous section. In an examination of evidence-based literature, Traeger et al. (2012) found that medications and psychotherapy are the strategies mostly used to treat anxiety disorder. A study carried out by Mendlowicz and Stein (2014) carried out a systematic review to determine ways of improving quality of life of individuals suffering from anxiety disorder. The researchers found that psychotherapy is one of the methods of treating the disorder. Some studies have focused on CBT, which is a subset of psychotherapy. Stanley and Brown (2009) conducted a study to investigate the effectiveness of CBT in treating anxiety among adolescents. The researchers developed CBT based on the relapse prevention and risk reduction approaches. As well, the CBT was based on the dialectical behavioral therapy, cognitive behavior therapy and targeted therapies for individuals suffering from anxiety disorder. The researchers carried out the study on a sample of 110 young persons aged between 13 and 19 years who had anxiety disorders. They engaged young persons in 12 sessions that involved activities such as relapse prevention, psychoeducation, family intervention, skill development and safety plan development. After the administration of the CBT, cases of anxiety disorder reduced by 70 percent within the next six months among participants involved in the program (Stanley & Brown, 2009).

Just as recommended in the previous section, scientific studies have found that psychotherapy is and should be applied more than medications in treating anxiety disorders. The study carried out by Mendlowicz and Stein (2014) indicated that psychotherapy has been one of the core elements of a comprehensive treatment of anxiety, even in cases where medical treatment is used. However, Mendlowicz and Stein (2014) noted that psychotherapy can only be effective in cases where there is constant and effective communication between health care provider and patient. Also, the health care provider must have adequate training in treating mental illness.

Vega, Tarraf and Neighbors (2012) carried out a study to determine the impacts of both psychotherapy and medication in treating people with anxiety. The results indicated that psychotherapy does not have side effects, unlike the medical treatment strategy that has side effects. The researchers recommended that mild anxiety disorder should be treated using psychotherapy, rather than using drugs. The study showed that psychotherapy can help to treat or completely eliminate mild anxiety disorder. Among the psychotherapy strategies that have been found to be effective in treating depression include the CBT, behavioral activation, interpersonal therapy and cognitive behavioral analysis. However, the researchers found that the involved health practitioner should make a close follow-up of the patient. In case the problem persists, the health practitioner can aID medications. Also, the researchers proposed that the kind of medication offered to a patient with severe anxiety disorder should be based on the evaluation results of each individual.

Another study carried out by Guo et al. (2013) found psychotherapy to be the most effective strategy of reducing anxiety. The authors found that, apart from reducing anxiety in patients, psychotherapy also functions to improve the quality of life of the patients. However, they recommend different approaches for carrying out psychotherapy than those that are recommended in the previous section. According to the authors, psychotherapy can be carried out using strategies such as psychoeducation, cognitive behavior therapy and supportive-expressive therapy. In line with psychotherapeutic interventions, Guo et al. (2013) recognize the role of training in the delivery of psychological care.

Just ass recommended in the previous section, most of the past studies have found that medical treatment is more effective when it is augmented with psychotherapy. Roth and Massie (2007) investigated the effectiveness of medical treatment and psychotherapy in treating anxiety among patients with advanced cancer. The researchers found that most patients with cancer have persistent anxiety that that usually emerges from fear of death. The study indicated that the anxiety disorder was more persistent among patients with advanced cancer. According to the researchers, the best treatment for such persistent anxiety is the use of medications. The researchers found medical treatment to be effective when applied in palliative care settings. Despite this, the researchers found that intervention to the problem is more effective when medical treatment is augmented with psychotherapy (Roth & Massie, 2007).

Contrary to recommendations in the previous section, some researchers have recommended that psychotherapy should always be augmented with medical treatment. The study conducted by Greenhill and Wells (as cited in Mendlowicz & Stein, 2014), for instance, showed that the treatment of anxiety disorder is more effective when any of the psychotherapies is combined with medications. In aIDition to psychotherapy and medications, some scholars have proposed other methods that are suitable for application in specific situations. Some studies have found exposure therapy to be effective in treatment anxiety that results from phobia. Opris et al. (2011) conducted a quantitative meta-analysis that focused on determining the effectiveness of virtual reality exposure therapy in treating the problem of anxiety disorder. The researchers gathered data from 23 previous studies. The results derived from the studies indicated that the method is quite effective in treating anxiety disorders especially in cases where the problem is caused by phobia. However, the researchers found that exposure therapy is more effective in cases where it is used together with psychotherapy.

Other scholars have found acceptance and commitment therapy (ACT) to be effective in treating anxiety in situations where the cause of anxiety cannot be evaded. Arch et al. (2012) carried out a study that involved comparing the effectiveness of CBT and ACT strategies in treating anxiety disorders. The researchers carried out a quantitative analysis of data that was gathered from 28 participants with persistent anxiety disorders. The results derived from the study indicated that CBT led to similar effects as the effects of ACT in treating the disorder. The researchers proposed that in cases where causes of anxiety may not be easily aIDressed, ACT can be used in place of CBT. However, ACT tends to use almost a similar approach to the approach that is used in CBT since it involves use of strategies that are meant to change the behaviors of patients. This implies that ACT can still be grouped under psychotherapy. Other methods recommended by scholars for use in specific situations include interpersonal therapy and dialectical behavior therapy. However, all of them tend to integrate the strategies used in psychotherapy with other strategies in order to fit to specific situations. Thus, they can be regarded as modifications for psychotherapy strategies.

Conclusion

Overall, anxiety disorder is one of the mental disorders that many people experience today. Although feeling anxious is common for human beings, it becomes a disorder that can have detrimental effects to the brain and body when it lasts for a long time. Anxiety is diagnosed through conducting a thorough assessment of symptoms on patients. Although the disorder many be recognized by any health professional, a thorough assessment should be carried out by a trained mental health professional. Also, the role of treating patients with the disorder should be given to health professional with adequate training in treating mental disorders. The best method of treating the disorder is psychotherapy. However, medications should be administered to patients with persistent anxiety disorder, and it should be augmented with psychotherapy. Previous researches have also found the two methods to be the most effective in treating the disorder. However, a few studies have suggested that psychotherapy should be augmented with medication. Despite this, most studies have suggested that psychotherapy alone should be used for mild anxiety disorders that are not persistent since it does not have side effects, like most medications. The previous studies have also suggested other methods meant to treat anxiety in specific situations, such as ACT, exposure therapy, interpersonal therapy and dialectical behavior therapy. However, these therapy approaches seem to modify the strategies used in psychotherapy strategies in order to fit to the targeted situations.

References

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