Is Cognitive Behavioral Therapy For Anxiety An Effective Treatment Type?
Living with anxiety can present significant challenges in various areas of life. Your anxiety may constantly tell you, “Look out!”—without really telling you what to look out for or why. Instead, it can keep you in a state of tension and distress and cause uncomfortable physical sensations that prevent you from engaging in the activities you’d like to pursue. Over time, anxiety can grow so severe that you may feel incapable of going to work, making a phone call, or connecting with your friends. You might also experience physical symptoms, such as shortness of breath, nausea, and insomnia. No matter how your symptoms manifest, there are evidence-based treatments available for anxiety. Below, we’ll learn more about cognitive behavioral therapy (CBT) and how this common form of treatment for anxiety can improve your quality of life.
What is anxiety?
According to the American Psychological Association, anxiety is defined as “an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure.” Anxiety can present itself in a variety of mental health conditions, with some of the most common including:
Generalized anxiety disorder (GAD)
Generalized anxiety disorder is persistent and uncontrollable worrying, fear, or dread. Everyday activities often trigger anxiety for people experiencing GAD, such as work, school, family, health, or money.
Social anxiety disorder
Social anxiety disorder is characterized by social interactions causing someone to feel anxious. They might fear embarrassment or rejection when speaking to others and could lead to avoiding social situations entirely.
Panic disorder
Panic disorder consists of overwhelming distress, leading to panic attacks. In addition to psychological distress, panic attacks can also consist of physical symptoms such as rapid heart rate, chest pain, nausea, and trembling.
Post-traumatic stress disorder (PTSD)
Post-traumatic stress disorder often develops after a person has experienced a traumatic, shocking, or dangerous event. PTSD symptoms can include distressing thoughts, being easily startled, intense negative thought patterns, and flashbacks. Long term, this disorder can become complex or chronic post-traumatic stress disorder.
Obsessive compulsive disorder (OCD)
Obsessive-compulsive disorder is characterized by unwanted intrusive thoughts or urges that can lead to distress. Common obsessions include fear of germs, fear of loss, or taboo thoughts, while common compulsions include handwashing, organization, counting, or repeating words.
Treating anxiety disorders
If you’re experiencing anxiety, you’re not alone. According to the Anxiety and Depression Association of America, “Anxiety affects 6.8 million adults, or 3.1% of the U.S. population, in any given year.”
Getting the right psychological treatment, such as therapy, may help to treat the symptoms of anxiety. Hundreds of studies have proven that CBT can be very effective in helping to manage cognitive distortions and their symptoms.
What the research says about CBT as a treatment
Extensive studies show that Cognitive Behavioral Therapy (sometimes called cognitive behavior therapy, cognitive behavioural therapy, or CBT) can be effective in treating anxiety. One study titled "Cognitive Behavioral Therapy for Adult Anxiety Disorders," which was a meta-analysis of randomized placebo-controlled trials, proved that CBT therapy is effective in treating anxiety disorders in adults.
Another systematic review titled “Cognitive Behavior Therapy in Anxiety Disorders” stated, "Overall, CBT demonstrates both efficacies in randomized controlled trials and effectiveness in naturalistic settings in the treatment of adult anxiety disorders." The conclusion reiterates the findings by saying "despite some weaknesses of the original studies, the quantitative literature review of randomized placebo-controlled trials and trials in naturalistic treatment settings provides strong support for both the efficacy and effectiveness of CBT as an acute intervention for adult anxiety disorders."
Medications for anxiety disorders
- Selective serotonin reuptake inhibitors (SSRIs)
- Tricyclic antidepressants
- Monoamine oxidase inhibitors
- Benzodiazepines
There are pros and cons of taking medications for mental health conditions. About half of the people who use medications for mental health or mental illness report experiencing at least some relief from their symptoms. Medication is often readily available, and physicians and psychiatrists commonly prescribe them.
On the flip side, not everyone responds well to medication. About half the people who take them don't experience any relief at all. Many patients who experience improvement with medications only receive a mild (20-40%) improvement in their symptoms. Some people experience uncomfortable side effects from the medication, although they're usually fairly mild. Also, those who opt to take medication to control the symptoms of anxiety may need to stay on it long term. Once they stop taking the medication, their symptoms may return.
Working with a specialist
Causes
Research and clinical neuroscience indicate that CBT is based on the notion that maladaptive patterns of thinking and avoidance behaviors can cause anxiety. Typically, people with anxiety have prolonged exposure to thought patterns in which they tend to think bad things are sure to occur and that they will be more severe than most other people would think they'd be. They also commonly have experienced a traumatic event. When anxiety surfaces, a person may try to avoid certain situations or practice compulsive rituals as a means of coping. In many cases, those who suffer from chronic post-traumatic stress disorder can be at a much higher risk of getting stuck in these thought patterns.
People living with anxiety may try to escape and avoid situations that make them feel uncomfortable. Since they often have difficulty experiencing certain situations without feeling anxious, they can get stuck in a cycle of feeling fear and trepidation, and they may try to cope by avoiding the situation that causes them to become anxious. Cognitive and behavioral therapies can play a role in helping the person think about the situation in a new way, potentially leading them to behave differently.
How does cognitive behavioral therapy work?
In a CBT therapy session, a client will learn to identify and change the cognitive aspects of their anxiety, such as unhelpful thoughts, behaviors, and emotions. CBT differs from other types of treatment, such as exposure techniques or relaxation techniques, although it may include aspects from each.
CBT for anxiety tends to consist of a set of therapeutic techniques. The client has to actively participate in the treatment for it to be successful. It can also help if the client understands what's involved in their treatment and why they need to practice coping skills. The better the therapist and client understand the origin of the anxiety, the easier it may be to treat it.
Gaining insight into personal history
At first, a CBT therapist tends to take a personal history and assess a person’s psychological functioning. If needed, the therapist may refer the client for a medical or psychiatric consultation to rule out any possible medical reasons for the anxiety. Most people can start CBT right away. People with serious anxiety may need a psychiatric consultation to assess whether they're at a point where therapy and medication will be helpful.
Learning more about your feelings and behaviors
As part of the therapy, the therapist typically helps their clients learn more about anxiety and how it manifests in their lives. Clients may be encouraged to document their positive or negative feelings, thoughts, and behaviors and try to identify situations that trigger their anxiety. Therapists may also use cognitive treatments and techniques such as exposure exercises/therapy, applied relaxation, deep breathing, progressive muscle relaxation, and/or cognitive processing therapy. Exposure therapy techniques are often used for those who experience phobias or anxiety that is based on fear.
Working together, the client and therapist can map out the client’s symptoms, identify the specific thinking and behavior habits that need to be changed, work on behavioral experiments, and determine the best techniques to relieve the symptoms. These techniques may include short-term strategies for acute anxiety, such as controlled breathing and muscle relaxation.
Examining your inner dialogue and other interventions
The treatment often entails the therapist coaching the client to question themselves about the inner dialogue they have about situations that make them anxious. This is often combined with other psychological and pharmacological interventions, depending on the provider and the needs of the patient. The client may learn how to identify anxious thoughts and replace them with healthier thoughts that are based on rational appraisals of the situation. This is called cognitive restructuring, which is based on the ability to form logical thoughts. Many studies, including this 2022 randomized controlled trial, have demonstrated positive results from cognitive restructuring.
Bringing new techniques to real-world situations
Once a person learns to adapt their thinking and behavior based on the cognitive techniques that were used, the therapist may have them test it in the real world. They may do this by exposing the person to their fears in small doses under the guidance of the therapist. As they are better able to practice coping skills, the therapist may guide them through more challenging situations. The person may also be encouraged to practice their coping skills at home in between sessions, and they may gain more control over their anxiety the more they practice CBT treatments.
Seeking therapy for anxiety
If you’re experiencing anxiety but don’t feel comfortable with traditional in-person therapy treatments at this time, you might consider online therapy. Online therapy offers several advantages, such as not having to leave the comfort of your home and having a larger pool of therapists to choose from to ensure you find the right fit for your needs.
CBT has been proven to be effective for treating anxiety, and research has found that online CBT can be just as effective as in-person therapy for this condition. One study published in 2017 found that online CBT was effective for generalized anxiety disorder, social anxiety, phobias, and panic disorders, among other mental health challenges.
Takeaway
Cognitive behavioral therapy (CBT) is a widely used treatment for various anxiety disorders. CBT tends to help people learn to recognize and replace negative thoughts with more positive thoughts, which may lead to more desirable emotions and behaviors. With BetterHelp, you can choose from among thousands of therapists to find someone experienced with CBT for anxiety. Take the first step to addressing anxiety and reach out to BetterHelp today.
Frequently asked questions
Cognitive behavioral therapy (CBT) is a leading form of therapy for anxiety. CBT can be helpful because it may allow you to play an active role in your treatment process by replacing negative thought patterns and coping mechanisms with positive ones. CBT can help you control your thought process, learn positive coping skills, and develop a sense of confidence and control. CBT is also used as a psychological treatment for obsessive compulsive disorder (OCD) and panic disorder.
Therapy is a highly personal and individual process, so the time it takes to experience relief can vary from person to person. On average, however, people who are experiencing generalized anxiety disorder typically need to see a counselor weekly for 6-12 weeks before they make progress. Most studies have found that courses of CBT are most effective when they last for 12-16 weeks.
What are some CBT techniques? How do they influence behavior?
At its core, CBT tends to focus on identifying and challenging the thought patterns that contribute to your anxiety. CBT typically uses a wide variety of strategies to accomplish this goal, and these techniques may include journaling, completing therapeutic worksheets, practicing relaxation techniques, and engaging in thought exercises. The techniques you and your therapist use will likely be tailored to your individual needs, but you might expect a combination of these strategies to help you identify the cognitive distortions that perpetuate your anxiety.
Current advances in science and psychology have not yet shown a way to eliminate anxiety once and for all. However, there are a few things you can do to decrease your mental and physical symptoms of anxiety. For example, medical and psychological research has proven that alcohol and caffeine can increase anxiety. As a result, most therapists recommend that you avoid both of these substances, and many people have experienced significant relief from their anxiety after abstaining from caffeine and alcohol. Regular exercise and a healthy sleep schedule have also been proven to alleviate symptoms of anxiety.
How can i calm my anxiety fast?
If you are experiencing a panic or anxiety attack, there are a few coping mechanisms you can implement to decrease your anxiety. For example, you can employ some deep-breathing exercises to center yourself and decrease your heart rate, blood pressure, and anxiety levels. For maximum effectiveness, you might try using the rule of four: hold your breath until a count of four, breath out to a count of four, and hold empty to a count of four.
You may have noticed that many people use CBD products because they claim it helps their anxiety. The Anxiety and Depression Association of America has conducted research to evaluate the validity of these claims and reported the following: “There is insufficient scientific evidence to support the claim that CBD is an effective treatment for depression or anxiety. That does not mean it would not help, but there simply haven’t been properly controlled clinical trials to support an indication of CBD for treating anxiety or depression. Considerably more research is required to evaluate CBD as a potential treatment for anxiety and depression.”
Some people prefer to treat anxiety with natural remedies. For example, many people find that chamomile tea helps to take the edge off. A study at the University of Pennsylvania Medical Center tested the effectiveness of chamomile supplements in patients with generalized anxiety disorder (GAD). The study found that patients who took chamomile supplements for eight weeks had a significant decrease in anxiety symptoms compared to patients who took placebo pills. So, chamomile tea may be an option for treating anxiety naturally. Many people also prefer to make changes to their lifestyle and diet by increasing their amount of exercise and restful sleep and eliminating substances such as caffeine and alcohol.
Researchers at Harvard Medical School have observed that processed foods and foods that are high in sugar can increase symptoms of anxiety. They have even noticed that a sugar rush can mimic the symptoms of a panic attack. To avoid diet-triggered anxiety symptoms, most medical professionals recommend avoiding processed foods that are high in sugar and avoiding anything that can trigger a hypoglycemic state. Your blood sugar can also affect your anxiety, so it may help to eat regular, well-balanced meals. This may help both your mental health and your physical health.
You may have heard that bananas can be good for anxiety, but it’s important to understand the research behind this popular theory. Bananas may be considered a “serotonin superfood,” but they aren’t a cure for anxiety. This is in line with research showing that the serotonin from bananas cannot cross the blood-brain barrier.
How much CBD should I take for panic attacks?
Micro-dosing on your own without the advice of a mental health professional can be risky. Scientists are currently unsure if CBD helps with panic attacks and anxiety. Also, most CBD products are largely unregulated, so the dosage of each product is not universal. If you are experiencing panic attacks or anxiety, you might consult a licensed mental health professional and get their advice about medication and therapy that may alleviate your symptoms.
As noted above, chamomile may help relive anxiety. However, if you would like to try an herbal supplement to help with anxiety, it’s best to consult your doctor or a licensed mental health professional to find a safe and helpful supplement. Because many herbal products are unregulated by the FDA, more research is needed to identify the risks and benefits they pose. It’s especially important to consult your doctor if you are taking any other medications because certain herbal supplements can have adverse reactions when paired with other medications.
Researchers at Harvard Medical School have observed that processed foods and foods that are high in sugar can increase symptoms of anxiety. They assert that a healthy, well-balanced diet— including lean meats, fruits, vegetables, and unprocessed foods—may help reduce anxiety symptoms. So, you might try avoiding fast food, junk food, and sugar!
What can I eat to calm my nerves?
There is no such thing as a superfood that instantly calms your anxiety. However, eating healthy, well-balanced meals that include lean meats, fruits, vegetables, and unprocessed foods can promote mental and physical well-being. When you put these foods into your body and eliminate processed foods that are high in sugar, you may create a healthy environment for your mind and body and decrease the likelihood of a diet-triggered anxiety attack. Studies also show that salmon and chamomile can promote brain health, and this may decrease your levels of anxiety.
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