Eight Types Of Therapy To Manage Anxiety

According to the Anxiety and Depression Association of America, over 40 million US adults have been diagnosed with an anxiety disorder. With so many Americans experiencing this condition, many treatments are available. Untreated anxiety can affect your physical health, relationships, and career, so reaching out for help can be beneficial. Additionally, over 47% of people diagnosed with anxiety in the US already see a therapist.

Depending on your specific symptoms and any co-occurring mental health conditions, therapists may use several therapeutic techniques and strategies for reducing anxiety. These techniques may help you cope with anxious reactions. People respond differently to specific methods, so find an approach that works for you and discuss your treatment goals with your provider. You may cycle through several options before you find one that helps you.

What is anxiety?

Anxiety is a normal human emotion, but for some people, chronic anxiety interferes with their daily tasks. Excessive fear and anxiety with no obvious cause could be an indicator of an anxiety disorder. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists a number of anxiety and anxiety-related disorders, including: 

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

Note: although post-traumatic stress disorder (PTSD) was once considered an anxiety disorder, it is now listed in the DSM-5 as a stress-related condition.  

Generalized anxiety disorder and social anxiety disorder

Two of the most common forms of anxiety are GAD and SAD. Each year, 3.1% of US adults experience GAD, and 7.1% experience SAD.  

Anxiety symptoms

According to studies, symptoms of various anxiety disorders may include:

• Feeling restless
• Difficulty focusing
• Irritability
• Fatigue 
• Frequent worrying 
• Uncontrollable anxious feelings
• Experiencing a panic attack
• Insomnia or other sleep complications
• Physical symptoms such as headaches, muscle tension, and stomach aches

Clinical anxiety can manifest differently, leading to a variety of psychological and physical symptoms. Therefore, not everyone will experience the same symptoms, highlighting how anxiety may involve various factors.

Types of therapy for anxiety disorders

Studies have shown that with the aid of treatment options, including psychological treatment, support groups, and medical interventions, people with anxiety can see symptom improvement. Therapy for anxiety can involve talking therapies, skills training, psychodynamic therapy, mind-body therapies, relaxation techniques, and desensitization techniques, among others. Different types of therapy for anxiety can be experienced via individual or group therapy sessions. Clinical neuroscience and psychological research have determined several psychotherapies or talk therapy approaches suitable for the treatment of anxiety.  

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a type of therapy that falls under the umbrella of cognitive therapy. During CBT therapy sessions, the therapist can help the client understand negative thought patterns that may be contributing to their anxiety. However, in addition to helping patients identify negative thoughts, CBT helps promote behaviors to challenge and change those negative thoughts, leading to healthier emotional responses and actions.

CBT therapists also teach coping skills for emotional control that can aid in reducing anxiety symptoms and improving interpersonal relationships, and relaxation techniques such as deep breathing for the physical symptoms of anxiety. As you work through the full scope of negative thoughts that may cause anxiety, you can develop a more positive outlook to face anxiety-provoking situations with ease and comfort. 

Acceptance and commitment therapy 

Acceptance and commitment therapy (ACT) is designed to help anxiety patients learn and practice mindfulness to accept their present reality and commit to well-being. Healthy acceptance may mean considering a realistic, non-judgmental perspective. In mindfulness practice, you can focus on the information you receive from your five senses to help you stay grounded in the present. 

ACT may also help individuals challenge the feelings of intense dread that anxiety often provokes. If you can convince your mind that you are not actually in danger, you may be able to prevent future anxiety attacks from seeming overwhelming. 

Biofeedback

Biofeedback is a type of mind-body therapy in which you learn to recognize and control your physiological responses to stress. With biofeedback therapy, a trained therapist places sensors on your skin to record your body's responses to stressful stimuli. 

With practice, you can learn to identify indications that you are becoming anxious, and then work to slow your heart rate and breathing and practice progressive muscle relaxation. This type of therapy may take time, but it can be beneficial for reducing stress and anxiety in the long term. The goal is not to cure anxiety and get rid of it completely but to reduce how anxiety interferes with our daily lives.

Dialectical behavior therapy 

Commonly used to treat borderline personality disorder, dialectical behavior therapy (DBT) may be effective in teaching people to face overwhelming emotions that may lead to anxiety. It is often used to treat social anxiety, separation anxiety, and other anxiety disorders. 

Dialectical behavioral therapy involves modules and worksheets on mindfulness, distress tolerance, emotional control, and interpersonal connectedness. In each module, you may learn new coping mechanisms for various symptoms of emotional distress and anxiety. It can be done in both individual and group therapy sessions. Group skills sessions may allow you to connect with others who experience similar symptoms. 

Exposure therapy

Exposure therapy allows you to face the causes of your anxiety. It is often particularly effective in treating obsessive-compulsive disorder (OCD) and PTSD. Types of exposure therapy can include systematic desensitization, exposure and response prevention (ERP), and virtual reality therapy.

Systematic desensitization involves intentional and controlled exposure to the least frightening aspects of what you fear, increasing exposure over time. A therapist may track your anxiety levels and progress during this exercise.  

Imaginal exposure may also be used in exposure therapy. As the name implies, imaginal exposure involves imagining your triggers and fears and focusing on them until your anxiety symptoms decline. 

Another technique, in-vivo exposure, involves the client facing their fear directly in a real-life situation. In-vivo exposure may be one of the final steps in exposure therapy. A trained therapist will help the client through the experience, including working through difficult feelings or setting up a safety plan. 

Although it may be scary to face your fears, your therapist can work with you to ensure you are not overwhelmed. Instead, you may increase your ability to endure exposure with each minor step. You may feel that systematic desensitization is successful when you can face the object you fear without losing your ability to function appropriately. 

Another type of exposure therapy for anxiety disorders is virtual reality therapy. Virtual reality therapy is a new form of exposure therapy involving sitting in front of a computer display and wearing virtual reality equipment. During therapy sessions, you may be virtually exposed to a situation that causes you anxiety, so you can learn to tolerate it in a safe setting. 

You might also partake in this therapy in a CAVE environment. The CAVE room has screens on each side, allowing clients to target fears through an immersive environment that feels like a real-life situation. This virtual reality exposure may be effective for treating phobias of heights or flying. 

Eye movement desensitization and reprocessing therapy

Eye movement desensitization and reprocessing (EMDR) is a therapy that helps your brain learn to process information in a new way. By engaging in eye movements similar to REM sleep, your brain patterns can be shifted, so the feared object, situation, or event is far less distressing to you. 

During an eye movement desensitization and reprocessing therapy session, a mental health professional will direct the client to move their eyes rhythmically back and forth while thinking or talking about a traumatic memory. This therapy has been helpful for people with post-traumatic stress disorder, panic disorder, or phobias such as social anxiety disorder.

The National Institute of Health found that in 24 randomized controlled trials, EMDR therapy had positive outcomes, including decreased depression, fewer visual flashbacks, and other memory effects. EMDR has the potential to be an effective treatment for anxiety symptoms related to traumatic memories. Some experts have even suggested that EMDR could be used preventatively in the period following a traumatic event to prevent future PTSD or anxiety symptoms. 

Interpersonal therapy

Interpersonal therapy is a shorter form of anxiety therapy. Treatment may last no more than 16 weeks and primarily focuses on resolving conflicts within current interpersonal relationships.

Interpersonal therapy might be advantageous for you if your anxiety is most evident in your platonic, family, or romantic relationships. Additionally, if you are experiencing symptoms of depression, this method may be effective for your depressive symptoms. This therapy has been used for mood disorders, eating disorders, substance dependency, and bipolar disorder.

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

There are many ways to treat anxiety

Get anxiety help online

Choosing an anxiety therapy modality

With many options available, you may use a trial-and-error process to determine what works best for you in your treatment of anxiety. Give each process a few sessions before deciding. You can also discuss your options with your potential therapist to understand them more.

Medication options to treat anxiety disorders

For some people, the most effective treatment option is a combination of therapy and anti-anxiety medication. According to the American Psychiatric Association, selective serotonin reuptake inhibitors (SSRIs) are most commonly used for treating anxiety disorders. SSRIs increase the level of serotonin in your brain. Other medications used for treating anxiety disorders include serotonin and noradrenaline reuptake inhibitors (SNRIs) and pregabalin.

Any treatment plan involving medication is supervised by a primary care provider or mental health specialist. You typically need to attend periodic appointments to check in on the effectiveness of your medication and adjust your dosage as needed.

Counseling options 

If you are experiencing overwhelming or debilitating anxiety symptoms, you may struggle with seeing a therapist in person. Additionally, making appointments, commuting, and organizing billing can be challenging for many. In these situations, online therapy may function as a beneficial alternative. You can consider an affordable online therapy platform like BetterHelp to connect with thousands of licensed mental health professionals with various specialties, methods, and treatment styles. 

A study published in 2016 found that internet-based therapy for anxiety is as effective for children and adolescents as traditional therapy. A randomized controlled trial published in 2018 found that 70% of individuals who participated in internet-delivered cognitive behavioral therapy (iCBT) reported a significant reduction of adverse symptoms and high levels of recovery and satisfaction with the program. Around 60% of the participants completed the program, and half of the participants noted that therapeutic mindfulness techniques were as effective as CBT.

Counselor reviews

"I have been working with Rebecca for a couple of months now. When I signed up for counseling, I was going through anxiety, panic attacks, and depression and had hit a real low point. I had become overwhelmed by a complex life situation that I couldn't figure out and felt I needed professional help. Rebecca has made a huge difference and continues to make a positive impact on my recovery. She is able to both listen and prompt with thought-provoking and challenging questions to help us get to the heart of the matter and start to unpick things from there. She emphasizes and encourages self-care and I feel so much more healthy and balanced as a result. We chat once a week, and the flexibility of phone sessions and a wide variety of appointment times means I can fit around my schedule. Rebecca also encouraged me to journal regularly and will respond to messages promptly so I know I have support there when I need it. I regularly receive articles that relate to my situation or techniques of dealing with stressful situations. I feel Rebecca understands and cares and would be happy to recommend her."

"I have had many therapists in past 10 years and they have all been helpful, but my experience with Lauren has been transformative. She is bold when necessary and honest, but she always wants to let you make the choices you choose. She always wants you to be healthy first and foremost. She provides goal settings, cognitive behavioral therapy, help with anxiety and will be honest if more support is needed than just online therapy."