Treatment options for anxiety

There are various treatments available for anxiety problems. And you don't always have to see your GP.

I realise I had to educate myself, seek help and learn techniques to help me deal better with situations that make me feel anxious or low.

Self-help courses for anxiety

A self-help course might be the first treatment option your GP offers you. This is because it's available quite quickly. And it may help you to feel better without needing to try other options.

Self-help could be delivered through:

• Workbooks. For example, your GP might recommend books from a scheme called Reading Well. This offers Books on Prescription. Most local libraries support this scheme, so you can go and check the books out for free. You don't actually need a prescription from a doctor.
• Online cognitive behavioural therapy (CBT) programmes. There are several online CBT courses to treat anxiety and panic attacks. You may be offered a course that you do on your own. Or you may have check-ins with someone to support you while you complete the course. See our page on CBT to find out more.
• Psychoeducation courses. Your GP may recommend that you attend a psychoeducation course. These involve going to a group session every week for several weeks. At the sessions you'll learn about different ways to manage your mental health.

If you live in Wales, you can self-refer to SilverCloud. SilverCloud has online self-help programmes for anxiety, and other mental health problems.

Find lots more self-help tips in our page on how to manage anxiety and worry.

Talking therapies for anxiety

Your doctor should offer you a talking therapy if self-help resources aren't likely to help. Or if you've already tried self-help and it hasn't worked.

There are 2 types of talking therapy recommended for anxiety and panic:

• Cognitive behavioural therapy (CBT). This focuses on how your thoughts, beliefs and attitudes affect your feelings and behaviour. And teaches you coping skills for dealing with different problems.
• Applied relaxation therapy. This involves learning how to relax your muscles in situations where you normally experience anxiety.

Our pages on talking therapy and counselling and CBT have more information on these and other kinds of therapy.

These professional guidelines for treating anxiety disorders have more details on what your doctor might offer.

Medication for anxiety

Your doctor might offer to prescribe you medication to help manage your symptoms. They should offer medication if you'd prefer this to talking therapies. Or if talking therapy wasn't helpful for you. But medication shouldn't be the only treatment they offer.

Some people find it helpful to try talking therapies and medication at the same time.

Here are some medications you might be offered:

Antidepressants

The most common type of medication offered for anxiety is antidepressants. Being offered antidepressants doesn't mean that you have depression.

Usually if you're offered an antidepressant it will be a type called a selective serotonin reuptake inhibitor (SSRI). For some people SSRIs can cause side effects, such as sleep problems. Or feeling more anxious than you did before. If they don't work, or aren't right for you, you may be offered a different kind.

Our pages on antidepressants have more information. This includes a page on side effects of antidepressants.

Pregabalin

In some cases, your doctor may decide to prescribe you a drug called pregabalin. For example, if you have a diagnosis of generalised anxiety disorder (GAD). Pregabalin is an antiseizure drug. It's normally used to treat epilepsy, a neurological disorder that can cause seizures. But it's also licensed to treat anxiety.

See our pages on anti-anxiety medication and pregabalin for more information.

Beta-blockers

Beta-blockers are occasionally used to treat the physical symptoms of anxiety. Such as a rapid heartbeat, palpitations and tremors (shaking). But they're not recommended as a treatment for the psychological symptoms of anxiety.

Benzodiazepine tranquillisers

If you experience very severe anxiety that has a significant impact on your day-to-day life, you may be offered a benzodiazepine tranquilliser.

But these drugs can cause unpleasant side effects. And they can become addictive. So your doctor should only prescribe them at a low dose for a short time. This is to help you through a crisis period.

See our page on benzodiazepines for more information.

Medication helped me move forward in my life. Professional help is available and my advice is that you should not hesitate to take it if you feel you need to.

How do I access treatment for anxiety?

To get treatment on the NHS, the first step is normally to visit your GP.  For advice on what to say to your doctor, and what might happen next, see our page on how to get help from your GP.

Your GP should explain your treatment options to you. And you can decide together what might suit you best.

In England, you can also self-refer for talking therapy, without seeing a GP.  The NHS website can help you find NHS talking therapy services.

An assessment might include asking you to fill in a questionnaire about how often you feel worried, anxious and nervous.

Our page on how to find therapy and counselling explains how to access therapy step-by-step.  This also covers options for getting therapy through the private sector.

What if my anxiety stops me from seeking help?

If you have anxiety, making or attending appointments may be difficult. And this can make it harder to get the support you need. For example, you might not feel able to talk on the phone or leave the house.

Here are some things you could try:

• Ask your doctor if they offer home visits or telephone assessments. If not, they might be able to book you an appointment at a time when the surgery tends to be quiet.
• Some GP practices will allow someone else to ring up and book appointments for you (with your consent). It could also help to have someone come with you to the appointment for support.
• Make adjustments to therapy to suit you better. Our page on getting the most from therapy has lots of suggestions.

That first step of speaking up, though terrifying, started me on a new path.

What if I don't feel better?

Your doctor should offer you regular appointments to check how you're doing. And see how well any treatment is working for you.

Different things work for different people. If a particular medication doesn't work for you, your doctor should offer an alternative. If a type of talking therapy or a particular therapist isn't right for you, then again your doctor should offer an alternative.

If you've tried a range of treatments and none of them have helped, your doctor might refer you to a community mental health team (CMHT). This is made up of a number of different healthcare professionals. For example, psychiatrists and clinical psychologists. Your CMHT can assess you separately and offer you a personalised treatment plan.

Your doctor might consider a CMHT referral if:

• Your symptoms are making it hard for you to keep yourself safe or take care of your basic needs
• You have a serious physical health problem
• You have another mental health problem
• There's a risk of you self-harming
• You're having suicidal thoughts

Recovery won't always be straightforward. For example, it might help to focus on learning more about yourself and developing ways to cope, rather than trying to get rid of all your anxiety symptoms.

See our pages on recovery and what to do if your GP doesn't help for more information.