5 Types Of Therapy To Treat Anxiety

What is anxiety?

Some people might conflate anxiety with worry, whereas others may associate anxiety with nervousness. However, anxiety is an emotion separate from worry or nerves – it is characterized by immense fear, distress, and physical symptoms. Anxiety often involves a fear of a real or perceived threat. 

You do not have to have a severe anxiety disorder to feel anxiety. However, if anxiety frequently negatively impacts your life, it may indicate an anxiety disorder or underlying concern. 

Several anxiety disorders are listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), and anxiety can increase a person’s risk of developing an additional mental health condition, such as depression or borderline personality disorder. The most common anxiety disorders include the following: 

• Generalized anxiety disorder (GAD)
• Social anxiety disorder 
• Separation anxiety disorder 
• Specific phobias 
• Obsessive-compulsive disorder (OCD) 
• Panic disorder

Several factors can contribute to the development of these mental health conditions, including genetic and environmental influences. Individuals may be more likely to struggle with anxiety and other mental health disorders if they have a family history of mental illness. 

Symptoms

Anxiety symptoms can be both mental and physical and may differ depending on the person and their diagnosis. People with anxiety disorders may have specific symptoms, such as feeling nervous, experiencing racing thoughts, or having difficulty thinking logically about situations.

With panic disorder, individuals might experience panic attacks, periods of immense distress with accompanying physical symptoms: 

• Sweating
• Rapid heart rate
• Shallow breathing or hyperventilation 
• Shaking

Five types of therapy

With more than 400 types of therapy available in the US, there are many options to consider when treating anxiety disorder symptoms, including dialectical behavioral therapy (DBT), interpersonal therapy, psychodynamic therapy, psychoanalytic therapy, commitment therapy, eye movement desensitization and reprocessing (EMDR) therapy, acceptance and commitment therapy, and more.

Below are five common treatments used for reducing anxiety symptoms. However, the list is not exhaustive, and other options are available.

Animal-assisted therapies

Many animal-assisted therapies can bring emotional relief to people experiencing anxiety. Dogs, cats, and horses are often used in anxiety therapy due to their gentle nature and the possibility of allowing the client to form a connection with a loving animal. 

Animals often leave individuals feeling relaxed. Their presence might help clients ignore their fears and focus on an activity with the animal. For example, people participating in equine therapy may clean a horse, feed it, and go for relaxing rides.

It can also be helpful for people with anxiety to experience a bond with an animal. It can be lonely to experience mental health challenges, and animals may provide connection. 

Another type of animal-assisted therapy includes sessions with a therapy animal like a therapy dog. In these cases, the animal has undergone specific therapeutic training. They have calm temperaments and are often playful and cuddly. 

Note that therapy animals are not the same as service animals. Service animals are trained to complete one or more tasks to aid an individual handler with a disability. Service dogs are not allowed to complete tasks for people who are not their handlers or to provide therapy work unless they are specifically trained to do so. 

Art therapy

Art therapy can be a unique way to release anxiety-related emotions, as it can be challenging to express fear or worry verbally. Art therapy allows clients to use various mediums to showcase emotions or relieve tension. A randomized controlled trial found that art therapy is effective in reducing anxiety symptoms and enhancing quality of life and emotion control.

Art therapists use various art mediums, including paint, pencil, pastels, glass, jewelry, beads, papier mâché, clay, sculpting materials, and other art supplies to allow clients to express themselves or talk while focusing on another activity. The art therapist can offer prompts, talk to the individual about their creative process, or silently create art with them. 

Creating art may also build self-esteem. After you've finished a project, you might feel a sense of accomplishment or pride. Your therapist may compliment your pieces and ask you to describe them. 

Art therapy can take place in a group setting or in an individual one-on-one appointment with an art therapist. You can also create art at home on your own as a way to cope with distressing emotions or symptoms. 

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy (CBT) combines cognitive therapy and behavior therapy. It is one of the most effective types of therapy for anxiety because it focuses on the connection between a person's thoughts, behaviors, and feelings. 

When someone struggles with anxiety, their thoughts may be fearful or contain cognitive distortions. Cognitive distortions are unhelpful thoughts that may not be based on logic or reason.They can be hard to identify, but CBT therapists are trained to help clients restructure and rephrase these thoughts to make them more manageable. 

Exposure therapy is another common type of CBT used to treat anxiety disorders and phobias. Exposure therapy often uses a technique called systematic desensitization, in which mental health professionals can use tools such as virtual reality exposure to expose patients to anxiety-provoking stimuli and help gradually reduce their reaction.  

Cognitive-behavioral therapy can be short-term or long-term. Initially, clients may work with their therapist to recognize unwanted thought patterns and draw connections between their thoughts and their behaviors.

As the therapy progresses, the therapist may use exercises or homework assignments to help the client learn relaxation techniques or new ways of thinking. 

According to the American Psychiatric Association, cognitive restructuring practices can help people living with anxiety disorders decrease anxious feelings. 

Biofeedback therapy

Biofeedback therapy involves being hooked up to monitors and sensors that monitor bodily functions during counseling. During sessions, the therapist may monitor the client's breathing rate, brain waves, heart rate, skin temperature, and blood pressure. As clients discuss their symptoms or look at certain stimuli, they can watch how their body reacts. 

Allowing clients to see their physical progress may help demonstrate which coping skills are most effective. It can also help clients learn to identify signs of stress even when they are not hooked up to the monitors.

For example, if clients remember how it feels to have a racing heart, they might notice their heart rate speeding up when they begin to feel anxious out in public. 

Medications

In some cases, medication is used to treat anxiety. Several anxiety medications provide short-term relief or help suppress anxiety symptoms. Many people will also attend psychotherapy while taking medications. 

Medications are not always a long-term solution, and psychotherapy, like CBT or dialectical behavior therapy, can be as effective as medication in reducing anxiety symptoms. In addition, psychiatrists and medical doctors are the only providers able to prescribe long-term mental health medications.

Do not start, change, or stop medication without consulting your doctor or other mental health professionals. 

Lifestyle changes for anxiety 

Finding support from a mental health professional can be valuable when living with anxiety symptoms. However, you can make a few at-home lifestyle changes to care for yourself in conjunction with your therapy sessions. 

Breathing exercises 

Anxiety can cause hyperventilation, a shallow and fast form of breathing. Fast breathing impacts your heart rate, may lead to muscle tension, and can feel distressing. Learning deep breathing techniques can help you regain control when anxiety arises.

One common breathing exercise is box breathing, which involves breathing in, holding your breath, breathing out, and then holding your breath again. 

Mindfulness and meditation practices

Mindfulness is the practice of focusing on the current moment through guided exercises, such as breathing, focusing on your senses, or meditation. It can allow individuals to ground themselves, feel "inside" their body, and reduce distressing symptoms of anxiety or panic.

One quick way to practice mindfulness and ground yourself in the present moment if you are experiencing distress is to identify all of the items of a certain color in the room. 

Self-care activities

Self-care can include eating nourishing foods, practicing sleep hygiene, exercising regularly, participating in mindfulness activities, or engaging in hobbies. Self-care does not have to be effortful or expensive – even simply sitting outside can have mental health benefits.

Counseling options 

If you feel anxiety negatively impacts your life, you may benefit from counseling. Although the five forms of therapy described above can be effective in treating anxiety, they are not your only options for counseling. 

When looking for a provider, you can ask your doctor for a referral or do an online search for counselors in your area. If you struggle to afford treatment or can't find a therapist you connect with in your city, you can also try online therapy. 

Through an online therapy platform like BetterHelp, you can connect with a mental health provider from the comfort of your home. Online therapy offers individuals a cost-effective way to receive support. When you sign up for a platform, you can choose between phone, video, and live chat sessions and message your therapist any time before or after your appointments.  

If you're unsure about the effectiveness of online therapy, studies have found that certain forms of internet-based treatment, such as mindfulness-based CBT, have been found to be as effective as in-person therapy for treating conditions like anxiety or depression.

Online counselors are also required to have licensure and clinical experience to practice, just as traditional in-person counselors do.