Woman suffering an anxiety attack alone in the night on a couch at home

Dr. Akmal Makhdum Looks at the Pros and Cons of Managing Anxiety through Medication

Anxiety affects an increasing number of people across the world, but particularly in modernized areas such as the United States or the UK. 1 in 6 adults experiences some type of ‘neurotic health problem’ each week. In England, the rate of anxiety in the population has increased by 12 percent since 1993. 10 percent of the population is said to experience a disabling anxiety disorder at some time in their lives.

Dr. Akmal Makhdum explains these anxiety disorders and the pros and cons of treating them with medication.

Causes of Anxiety
Anxiety is related to the natural instinct toward “flight or fight” that is built into all human beings. In anxiety, the symptoms of “flight or fight” are triggered by non-life-threatening events. Anxiety disorders have a variety of genetic and environmental causes. Stress is a major contributor to anxiety disorders and can exacerbate existing difficulties. Physical problems like thyroid disorders can worsen anxiety.

Stress and upheaval during childhood can lead to anxiety later in life. Biochemical imbalances in the brain cause many mental health disorders. These conditions can also be inherited. Anxiety often appears in a combination of depression and other mental health difficulties.

Symptoms of Anxiety
The symptoms of anxiety can be highly uncomfortable and can prevent a person from doing their normal daily activities. Chest tightness, shortness of breath, racing heartbeat, nausea, tremors, pins and needles, the feeling of a lump in the throat, and sweating are some of the bothersome physical symptoms of anxiety.

Psychological symptoms include feelings of tension and agitation. People feel a strong sense of dread. They fear losing control or experiencing a blackout, heart attack, seizure, or death. People are often highly irritable and feel detached from what is going on around them.

Treatment of Anxiety Using Medication
Many psychiatrists choose to treat anxiety disorders with medication. There are several good options on the market today, with different types of drugs being used for complementary effects. However, there can be cons to treating anxiety with medication. Dr. Mahkdum explains these different courses of treatment and how they can affect the patient.

Different Types of Anxiety Medications
Anxiety medications fall into three main categories. These categories are benzodiazepines like Valium and Xanax, antidepressants like Prozac and Effexor, and antihistamines like Atarax. Anxiety medications are often sedating, helping the body relax by removing the physical symptoms of the disorder.

Benzodiazepines are depressants that work by blunting the body’s “flight or fight” reflex. They suppress anxiety symptoms like a racing heart, sweating, and feeling like the patient is about to lose control.

Antidepressants treat the root cause of anxiety, especially when anxiety and depression go hand in hand. The advantage of treating patients with antidepressants is that these are generally not sedating. They will help the patient feel more like themselves without interfering with their ability to drive or care for other family members.

Antihistamines are a less common way to treat anxiety, since they are also sedating. Antihistamines like Atarax are especially helpful to treat anxiety attacks that occur in the middle of the night. They help people sleep better and reduce feelings of stress and panic.

Advantages of Treatment with Medication
With medication, it is possible to stop an anxiety attack in its tracks. It helps a great deal in the short term. Medication for anxiety can help the patient feel more in control and able to handle life’s daily responsibilities.

The Drawbacks to Treatment with Medication
Studies show that there is little to no difference in outcomes when a patient is treated with therapy versus medication. It is possible to avoid the side effects of anxiety medications when the disorder is treated with therapy.

Many anti-anxiety medications, especially benzodiazepines like Xanax, are habit-forming and frequently abused. Patients should be carefully evaluated for their potential for addictive behavior before a prescription for benzodiazepines is given.

Antidepressants also have unwelcome side effects, and they cannot be stopped without careful titration downward to avoid withdrawal symptoms. Antihistamines have fewer side effects, but they can cause lingering daytime drowsiness and the inability to drive safely. Also, the use of these medications over a long period of time can lead to resistance to their effects.

Alternatives to Medication
Therapy is a highly effective treatment for anxiety. When patients are treated with therapy alone, they can avoid the potential of becoming addicted to, or dependent upon, their medication. One of the most helpful types of therapy is called cognitive-behavioral treatment or CBT. This type of therapy helps the patient to build life skills to cope with anxiety and presents a new way of thinking about their disorder.

Yoga, meditation, and relaxation exercises are also helpful in dealing with stress and anxiety. These complementary activities should be practiced along with therapy or medication.

Effective Treatment of Anxiety
Patients may find that the most effective treatment for anxiety involves both medication and therapy. This can help to combine the advantages of each type of therapy. Using medication to treat anxiety can be helpful, but the side effects and addictive potential of these drugs should be carefully monitored.

Dr. Akmal Makhdum encourages all patients with anxiety to carefully consider both avenues for treatment. Patients should be open and honest with their care providers about their symptoms and the ways in which they manage them. Anxiety is a treatable disorder, and people should know that there is help available.