Treatment Options From An Anxiety Psychiatrist

While feelings of anxiety affect all of us at certain points in our lives, if you are living with an anxiety disorder, this issue isn’t just an occasional problem, it’s a chronic condition that impacts every aspect of your life. Finding a qualified anxiety psychiatrist can be the first step toward taking control of your anxiety and starting the journey to a happier life.
 
Understanding Anxiety Disorders
Anxiety disorders encompass a range of mental health conditions characterized by excessive fear and anxiety. Here's a brief description of the different types:
 
Generalized Anxiety Disorder (GAD): People with GAD experience persistent and excessive worry about various aspects of daily life, such as work, health, or finances, often disproportionate to the actual source of worry.
 
Panic Disorder: Involves recurrent panic attacks—intense periods of fear or discomfort accompanied by physical symptoms like heart palpitations, chest pain, and dizziness.
 
Social Anxiety Disorder (Social Phobia): Features an intense fear of social situations and being judged or negatively evaluated by others, leading to avoidance of social interactions.
 
Specific Phobias: Involve an irrational fear of a specific object or situation, such as heights, flying, or spiders, that leads to avoidance behavior.
 
Agoraphobia: The fear of being in situations where escape might be difficult or help might not be available, often resulting in avoidance of places like malls, public transportation, or even open spaces.
 
Separation Anxiety Disorder: While commonly thought of as affecting only children, this disorder also can affect adults, causing distress when separated from home or from individuals to whom there is a strong emotional attachment.
 
Selective Mutism: A complex childhood anxiety disorder characterized by a child's inability to speak in certain social situations, such as at school or in the community, despite speaking in other settings.
 
Medication-Induced Anxiety Disorder: Anxiety or panic that is directly caused by taking or withdrawing from certain drugs or medications.
 
Each of these disorders can impact daily functioning significantly, but with proper diagnosis and treatment, individuals can manage symptoms and lead fulfilling lives. Keep in mind, that many people with an anxiety disorder also have a co-occurring disorder such as depression, ADHD, bipolar disorder, autism spectrum disorder, etc.
 
The Role Of An Anxiety Psychiatrist
My first goal as an anxiety psychiatrist is to spend time with a patient to determine a thorough diagnosis. As a psychiatrist, I am both a mental health professional as well as a medical doctor, and this unique perspective allows me to look at all of the facets of a patient’s life to determine what disorders and health conditions are reducing the quality of life.
 
As stated above, in many cases, a patient will have multiple diagnoses, and potentially even physical health conditions that are contributing to a decline in mental health. We must address all of these issues to truly improve a person’s life. Once we’ve completed a thorough evaluation and determined the correct diagnosis, we can begin to plan treatment.
 
Treatment Options
There are many different treatment options for those suffering from anxiety disorders. There are medications available as well as different types of therapy that can help patients manage their anxiety. While medications can be very beneficial, I typically recommend a combination approach that includes some type of talk therapy in addition to medication. Let’s take a look at some of the options.
 
Medication Management
Several different types of medications might be prescribed to a patient with an anxiety disorder. These include:
 

• Selective Serotonin Reuptake Inhibitors (SSRIs): Often the first-line treatment for anxiety disorders. Examples include fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro).

• Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Another class of antidepressants that can treat anxiety. Examples include venlafaxine (Effexor XR) and duloxetine (Cymbalta)
• Benzodiazepines: Used for short-term relief of acute anxiety symptoms. Examples include alprazolam (Xanax), lorazepam (Ativan), and diazepam (Valium).
• Tricyclic Antidepressants: An older class of medications that, while primarily used to treat depression, can be effective for anxiety as well. Examples include imipramine (Tofranil) and clomipramine (Anafranil).
• Buspirone: An anxiolytic that can be used for chronic anxiety. It's less sedating than benzodiazepines and doesn't cause dependence.
• Beta-Blockers: Primarily used for cardiovascular issues, beta-blockers like propranolol (Inderal) can help control physical symptoms of anxiety, such as trembling and rapid heartbeat.
• Antipsychotics: At low doses, some antipsychotic drugs like quetiapine (Seroquel) can be used to augment the treatment of anxiety disorders.
• Hydroxyzine: An antihistamine that can be used for short-term management of anxiety.
• Pregabalin (Lyrica) and Gabapentin (Neurontin): Originally developed to treat epilepsy, they also help to relieve anxiety in some people.
• Monoamine Oxidase Inhibitors (MAOIs): These include options such as phenelzine (Nardil), but MAOIs are less commonly used due to significant dietary restrictions and potential side effects but can be effective for some anxiety disorders.

 
Keep in mind that there is not a one-size-fits-all medication solution and, if a patient has co-occurring disorders, some of these medications might not be the best match. Additionally, many of these medications take time to work and with some medications, you cannot simply quit taking the medication at any given time but will need to taper on and off the medicine.
 
It is also crucial that you let your doctor know about any other medications and supplements you take, including any recreational drugs that may or may not be legal. Your doctor truly needs to understand all of the substances you use to find the best possible options for your needs. Keep in mind, if you are struggling with substance abuse, your anxiety psychiatrist often can provide you with the services of an addiction psychiatrist, as well, if that is an issue.
 
Psychotherapy Techniques
A psychiatrist for anxiety can provide you with a diagnosis and provide you with prescriptions for medication management, but these professionals usually don’t also provide you with psychotherapy or talk therapy. A therapist or psychologist is the professional you will need to contact for these services. Here are just a few types of therapy that could be beneficial to treat anxiety disorders as well as many other mental health issues.
 
Cognitive-Behavioral Therapy (CBT): CBT is highly effective for anxiety disorders and focuses on identifying, understanding, and changing thinking and behavior patterns. Techniques often include exposure therapy to gradually face feared situations in a controlled manner.
 
Exposure Therapy: A subset of CBT, this involves systematic exposure to the source of fear in a safe and controlled environment, which can help reduce the anxious response over time.
 
Dialectical Behavior Therapy (DBT): Initially developed for borderline personality disorder, DBT has been adapted for other conditions including anxiety, focusing on skills like mindfulness, distress tolerance, and emotion regulation.
 
Acceptance and Commitment Therapy (ACT): ACT helps patients accept their thoughts and feelings rather than fighting or feeling guilty for them. It encourages commitment to actions that enrich one’s life.
 
Alternative Treatment Options
While the aforementioned medications and therapy options have been utilized for many years, there are also some alternative treatment options to consider. In many cases, you might mix one of these treatments with talk therapy and/or medication to provide you with the best possible outcome.
 
Eye Movement Desensitization and Reprocessing (EMDR): This originally was designed to treat PTSD, but EMDR has been found to help with anxiety by changing the way negative memories are stored in the brain. 
 
Esketatmine: Ketamine is a drug that, for many years, served primarily as an anesthetic. However, in the last few years, this drug has been used to help those with treatment-resistant depression. Ketamine is not FDA-approved for the treatment of depression, although it is still utilized as an alternative treatment. It is imperative that ketamine be used only in a medical setting by trained medical professionals.
 
Esketamine, is a form of ketamine that is administered as a nasal spray. This option is FDA-approved for those with treatment-resistant depression. However, there is some evidence to suggest that this drug can be used to treat anxiety, OCD and other mental health conditions.
 
Exercise & Yoga: Exercise can be beneficial for anyone with a mental health condition. Regular physical activity has been shown to improve mood and reduce symptoms of anxiety due to the release of endorphins. Yoga, because it combines breathing exercises and medication, can be particularly beneficial.
 
Mindfulness & Meditation: These practices focus on present-moment awareness and have been shown to reduce symptoms of anxiety and stress. In addition to anxiety, meditation can be beneficial for many other mental health disorders including depression and ADHD.
 
Biofeedback: This therapy method teaches control over certain bodily functions, such as heart rate and breathing as well as promoting relaxation.
 
Again, a combination approach is typically the best course of action, and it can take time to find the best treatments and the best doctors and therapists to suit your individual needs.
 
Contact Dr. Jesalva Today!
If you need an anxiety psychiatrist, this is one of my areas of specialization. As a local psychiatrist, I provide in-person care as a psychiatrist in Westlake Village, Thousand Oaks and the surrounding areas. However, if you live outside that area or simply prefer to use an online psychiatrist, I also provide telepsychiatry services. In addition to treating anxiety, I also treat bipolar disorder, depression, ADHD, eating disorders, PTSD and more, and I can provide you with a diagnosis and treatment plan that drastically improves the quality of your life.