Anxiety disorders

The recommended treatment for anxiety disorders is psychological treatment (usually cognitive behavioural therapy).

If this hasn't worked, or if you have very severe anxiety, your doctor might recommend medication as well.

It's best to try psychological treatments first. They can work just as well as medication. Discuss the options with your doctor.

Psychological treatment

The best type of psychological treatment for anxiety disorders is cognitive behavioural therapy (CBT).

When you do CBT you will start by learning about healthy anxiety and the way our brains handle anxiety. Then you will learn how to challenge your unhelpful thoughts and control your anxious thoughts and behaviours.

If the treatment is working you should see an improvement in 4–8 weeks.

Online CBT

You can get self-guided CBT online. It can be low cost or even free, and you can do it where and when suits you. Online CBT from these websites has been shown to work well for anxiety:

Face-to-face CBT

You can do CBT face-to-face with a qualified therapist – usually a psychologist or psychiatrist. Around 8–12 sessions are recommended.

More about psychological treatments

Exposure therapy

Exposure therapy is sometimes part of CBT. It's where you gradually confront a situation that makes you anxious.

First, you make a list of all the things you'd like to do, but currently can't. Then you start by doing the easiest thing, and gradually work your way up to the hardest.

For example, if you are anxious about train travel, your list might look like this:

1. Spend some time on the train platform.
2. Travel one stop with a friend.
3. Travel one stop alone.
4. Travel to the city alone at a quiet time.
5. Travel to the city alone at a busy time.

Medication

In general, you should only be treated with medication if psychological treatments haven't worked.

However, if you have a severe anxiety disorder or severe depression, your doctor will probably recommend both medication and psychological treatment from the start.

Types of medications used for anxiety

The best medications for anxiety disorders are antidepressants. Antidepressants work well for anxiety as well as depression.

The antidepressants most often used to treat anxiety are the selective serotonin reuptake inhibitors (SSRIs). Examples are fluoxetine and citalopram.

SSRIs aren't suitable for some people, so your doctor might recommend a different type of antidepressant instead – a serotonin and noradrenaline reuptake inhibitor (SNRI). Examples are venlafaxine and duloxetine. In some cases, your doctor might recommend other antidepressants.

Benzodiazepines (also called sleeping pills) are sometimes used to treat anxiety, but they are no longer recommended as an initial treatment. This is because they're addictive, and their effects don't last long.

More about antidepressant medications