Can Taking An SSRI For Anxiety Help?
By: Michael Puskar
Updated May 12, 2020
Medically Reviewed By: Tanya Harell
Content Warning: Please be advised, the below article might mention topics that include prescription medication, abuse of medication, and addiction. The information found in the article is not a substitute for professional medical advice. Always seek the advice of your physician or other qualified health providers with any questions you may have.
Many people suffer from anxiety, and while therapies and coping methods are most effective, sometimes medication can make the problem more bearable. SSRIs were introduced in the 1980s, primarily to deal with depression. Their use has steadily skyrocketed as they've been found to be effective for a variety of conditions. The term "SSRI" stands for Selective Serotonin Reuptake Inhibitor, and these drugs work by stopping the neurotransmitter serotonin from being reabsorbed by the body. Serotonin is used in the process that transfers brain messages between the nerves of the body and is strongly linked to mood.
SSRIs help clarify messages between neurons, which can help reduce anxiety. Serotonin is released across the synapse (the space between neurons) and is then absorbed by the next neuron with the message. If there is not enough serotonin, only part of the information gets across, and the rest is lost, meaning that it is not interpreted at all, or it is garbled. When there is enough serotonin available, the body can better understand situations, making it less likely to trigger a false "fight or flight" response. It takes approximately 4-6 weeks for SSRI medications to be fully effective.
What Is Anxiety?
Anxiety is a natural response within the body, and it's the most common mental illness in America. When we experience danger, our senses become hyper-aware to help us survive. The problem is that rarely do we experience a survival situation these days, and our anxiety response becomes confused. In events that are stressful, or even ones that are not, our bodies perceive danger and react accordingly (or so it thinks). For example, nervousness or anxiety about making speeches or undergoing surgery has some rationality, while having a panic attack on an airplane does not. Having a specific fear about a thing or activity may not affect your daily life, but if your life is being affected by anxiety, it's important to get treatment.
Anxiety disorders do not simply "go away" and may even get worse without treatments. There are seven diagnosable anxiety disorders divided into three types, and many more that are connected to obsessive behaviors, trauma, and substance issues. Not all of them will be suitable for SSRI medications, so it's important to get the perspective of an expert before considering medication.
There are many anxiety quizzes available online to give you a basic understanding of anxiety disorders. Distinguishing an anxiety disorder means that your stress is extreme, exaggerated, and often unrealistic when it comes to what should be an ordinary event. If you're experiencing symptoms of anxiety, or you're encountering situations where your stress is affecting your ability to function, it's essential to seek help.
Benefits of SSRIs for Anxiety
While patients may see a temporary worsening of symptoms or flu-like symptoms at first, this is limited and quickly passes. Compared to other choices, SSRIs are better for long-term use in patients who do not react well to benzodiazepines. People taking SSRIs do not have the dependency risks of benzo patients, and unlike other anxiety medications, there's no weight gain. SSRIs also tend to have fewer side effects.
Commonly Prescribed SSRIs for Anxiety
- Prozac (Fluoxetine). This is used for depression and is the original SSRI, but it can be effective for social anxiety, OCD, generalized anxiety, and panic disorders. Research shows that it is well-tolerated and may also be useful for treating PTSD. The main issue with Prozac is that it can cause insomnia and may even increase anxiety in some patients.
- Zoloft (Sertraline). Similar to Prozac, Zoloft has a well-documented side effect of causing nervousness and agitation which can make anxiety worse. Usually, this is started as a low dose that is gradually increased until the effects are seen or until side effects are pronounced, and then it is scaled back. It also causes insomnia and may upset the digestive system.
- Paxil (Paroxetine). Used mainly for panic disorders and social anxiety it has some limited benefits for PTSD, OCD, and depression. It can cause nausea, weight gain, and sleepiness.
- Celexa (Citalopram). Celexa is prescribed for all the same conditions as other SSRI medications, but the digestive system side effects are more pronounced. Unlike other SSRIs, however, it has no sleep effects and should not be taken with alcohol as this can cause a depression in the respiratory system.
Are SSRIs Effective?
Until recently, it was common to prescribe SSRI medications for anxiety, but newer research shows that the average improvement is so slight that it almost matched placebos in trials. The large-scale study by Wayne State University published early in 2018 focused specifically on anxiety, whereas previous studies focused on depression with anxiety, looking at both disorders concurrently. The benefits of SSRIs were found to be less pronounced than most of the side-effects, meaning that SSRI medications are probably a poor first choice for treating anxiety.
An interesting part of the findings is that those patients given placebos experienced such similar results. It's clear that the drugs themselves may not be essential in treating anxiety. These patients still performed better than those given no medications, despite that the pills they were taking had no medicinal value.
What Are Other Treatment Options for Anxiety?
Many things can cause anxiety, but being able to calm your anxious mind is one of the easiest ways to cope. Meditation and grounding exercises are ideal because they don't require any special training or cost. Mindfulness meditation has been shown through various studies to be extremely effective in treating mood and anxiety disorders. Yoga may also help for the same reason, as it is meditative.
A study in 2016 suggested that writing or journaling can also be used to treat anxiety by giving the patient a way to think through their issues. By putting thoughts onto paper, the problem or danger is better understood, so the brain feels less threatened and anxious. This doesn't work for all types of anxiety, but for general anxiety disorder, it has shown to be effective.
Cognitive-behavioral therapies, like exposure therapy, have been shown to be especially effective. This type of treatment exposes a patient to the cause of their anxiety in controlled conditions and under the supervision of a therapist so that over time, they become less sensitive. This should not be done without a trained therapist.
BetterHelp Can Help
If you are looking for a therapist who is trained and experienced in helping people overcome anxiety, BetterHelp offers online sessions, which are convenient and usually more affordable than in-person meetings.
BetterHelp gives you access to licensed and professional counselors and therapists who can give you the skills to cope with anxiety, reducing its burden on your life. Read some of the following reviews to see how others have benefited from BetterHelp's services.
"I signed up for BetterHelp at a time where I felt my lowest. I was matched with Lenora and she has been nothing but wonderful. She has helped me learn how to control my emotions and identify when I am at risk for losing control. She always seemed to genuinely care about my feelings and well being. Because of her, I feel more confident and in control of my life. I am truly so grateful that I was matched with her as my counselor."
"Jennifer has helped me learn how to manage my anxiety so that I can enjoy life the way I used to. She always makes time when my schedule doesn't line up with hers. And she never makes me feel like I'm a burden to her."
Using SSRIs for anxiety is a common solution, but they should never be the first approach. Talk with your healthcare provider about alternatives and other possible medications that may work better for you. Living a fulfilling life free of anxiety is not only possible, but likely, with the right tools. Take the first step.