Treatment
After a thorough evaluation (including interviews, tests, and maybe even imaging), your healthcare provider will talk to you about treatment options.
Choosing a treatment involves considering what you and your family prefer, as well as what kind of treatments are available where you live.
If treatment is recommended, it might involve psychotherapy/behavioral therapy alone or with medication.
Research shows that fewer than 50% of children and adolescents with anxiety receive appropriate care, despite effective treatments being available. Therefore, it’s crucial to utilize therapy options. If anxiety is left untreated, it can lead to significant long-term consequences in your life:
- – Struggling in school and falling behind academically
- – Feeling alone and isolated from others
- – Dealing with other anxiety disorders like depression
- – Engaging in self-harm
- – Turning to drugs or alcohol for relief
Types of Treatment
Behavioral Treatment
Psychological interventions can be provided to individuals through one-on-one or group sessions, both online and in-person. It’s important that you discuss with your healthcare provider what type of psychological treatment and setting is best for you. There is no one-size-fits-it-all approach to anxiety therapy.
The most common type of psychotherapy for anxiety is cognitive behavioral therapy (CBT).
What is CBT?
CBT is often the first line treatment for mild to moderate anxiety symptoms. A lot of research has shown its effectiveness in easing primary anxiety symptoms and helping individual’s to function better day-to- day.
CBT focuses on two main components:
- cognitive component: This component helps changing your thinking pattern. It helps you notice your self-talk, check your thoughts, and replace them with more better ones.
- behavioral component: Here, you learn different ways to change your behavior, like practicing social skills training, relaxing, and using exposure techniques where you are facing fears slowly.
Together, these parts can reduce emotional and physiological distress, like fast heartbeat or sweating. They also help change unhelpful beliefs and ease avoidance behavior. CBT is a focused therapy that usually lasts about 12-20 weeks, sometimes with occasional booster sessions later on. In CBT parents or caregivers might be included to some extent to support the treatment at home. Your therapist might also give you homework to practice what you have learned in your daily life.
CBT includes different elements:
- – learning about anxiety
- – setting goals for behavioral and rewarding yourself when you reach them
- – keeping track of how your worries, thoughts, and behaviors are connected
- – Using relaxation techniques like deep breathing, progressive muscle relaxation, or guided imagery.
- – Changing unhelpful thought through cognitive restructuring that challenges distortions such as catastrophizing, overgeneralization, negative prediction, all-or-nothing thinking
- – Learning problem-solving and social skills for dealing with anxiety triggering situations
Medical Treatment
If your anxiety symptoms are moderate to severe, or if CBT hasn’t helped enough, your healthcare provider might consider anti-anxiety medication.
The first choice of medication is usually selective serotonin reuptake inhibitors (SSRIs). Healthcare providers may also prescribe serotonin-norepinephrine reuptake inhibitors (SNRIs) or Duloxetine (Cymbalta) for generalized anxiety disorder in children aged 7 and older. Beta-blockers might also be used to manage specific physical anxiety symptoms. Benzodiazepines, once commonly prescribed, are now discouraged due to the risk of dependence. They are reserved for extremely limited and specific cases.
For up-to-date information on anxiety medication and treatment options, you can check out resources like the American Academy of Child and Adolescent Psychiatry (AACAP). They provide the latest updates on treatments.
Anxiety medication typically starts to show improvement 2 to 4 weeks after initiation, reaching peak effectiveness around 12 weeks. However, there’s no precise timeframe for treatment duration, and it’s essential to recognize that long-term use of anxiety medication poses no safety risks if well-tolerated.
Common side effects, occurring in less than 20% of individuals, include stomach pain and diarrhea, changes in appetite, sleep disturbances, and headache. Even more rare are side effects like irregular heartbeats, seizures, and self-harm. While suicidal thoughts and behaviors have been discussed in some studies, most SSRIs studies haven’t observed this risk. In studies reporting it, it was observed in less than 4% of children and adolescents, mainly at the start of medication intake.
Additional Treatment and Support
In addition to behavioral and medical treatments, there are other complementary approaches to help manage anxiety. Explore them here.
Prognosis
Research indicates that anxiety disorders in children and adolescents often improve, with remission rates of nearly 80% over a 3–4-year follow-up period. However, anxiety disorders can also fluctuate and vary over time in younger individuals. Early intervention and treatment significantly improve the prognosis, and caregiver support and coordinated care play crucial roles in long-term outcomes.