Is Psychotherapy For Anxiety Disorders Effective?

Medically reviewed by Elizabeth Erban, LMFT, IMH-E
Updated August 12, 2024by BetterHelp Editorial Team
Please be advised, the below article might mention trauma-related topics that include suicide, substance use, or abuse which could be triggering to the reader.
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Fear is a common human emotion. Humans are biologically wired to experience fear and the fight-or-flight (or freeze) response when faced with a dangerous situation. However, if fear starts to get in the way of your daily functioning, it may indicate underlying physical or mental health conditions, such as anxiety disorders. 

Living in constant fear, stress, and apprehension can affect both brain and body emotionally, mentally, and physically, with symptoms ranging from high blood pressure and panic attacks to chronic pain or tension. For someone with an anxiety disorder, these symptoms can have a debilitating effect on life and hinder them from enjoying everyday activities. If you experience these symptoms, know you’re not alone.

Several mental disorders fall within the category of anxiety disorders in the DSM-5, and approximately 40 million adults in the United States live with an anxiety disorder.

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What is anxiety?

Anxiety, on its own, is a usually short-term state of increased alertness to potential dangers. Anxiety symptoms are typically brief, occurring in response to tangible, specific dangers or psychological worries.

People with anxiety disorders, however, feel anxiety on a frequent and intrusive basis—and often from stimuli that don’t typically warrant the amount of distress they feel. Someone with social anxiety, for instance, may be so unsettled by the prospect of saying hello to a stranger that they refuse to leave their home, are unable to get a job, or miss out on relationships that would be psychologically fulfilling for them.

There are several types of anxiety disorders. Each one differs in what the anxiety is about and how the symptoms manifest. The US Department of Health & Human Services lists the five most common types of anxiety disorders as the following:

Generalized anxiety disorder (GAD)

Generalized anxiety disorder, or GAD, is characterized by extreme or pervasive stress, fear, and anxiety on a daily and ongoing basis, with or without reason. General anxiety and worrying may become increasingly challenging to control, and can negatively impact an individual's ability to function in daily life. Symptoms of GAD include: 

  • Feeling persistently on edge 
  • Feeling that your thoughts are racing and that they can't stop 
  • Physical symptoms like a speedy heart rate or sweaty palms
  • Emotional distress 
  • Worrying thoughts 
  • Difficulty concentrating 
  • A feeling of impending doom or dread
  • Hypervigilance 

Obsessive-compulsive disorder (OCD)

The Mayo Clinic defines OCD as "a pattern of unreasonable thoughts and fears (obsessions) that lead you to repetitive behaviors (compulsions)." Over time, not giving in to a compulsion may cause distress and hamper a person's ability to function. Compulsions aren’t restricted to handwashing, which is a commonly depicted symptom. They can encompass counting rituals, cleaning, avoiding people or places, looking for patterns, and mentally or verbally repeating words or phrases, among many others. OCD may be caused by a combination of factors, including genetic predispositions and the environment. 

Post-traumatic stress disorder (PTSD)

PTSD can develop if an individual has experienced or witnessed a traumatic event. Per the release of the fifth edition of the DSM (diagnostic manual), PTSD is no longer considered an anxiety disorder. Instead, it is categorized as a stress-related condition. However, PTSD often involves symptoms similar to anxiety, such as hypervigilance, avoidance, and fear. 

It can take time for PTSD to develop, and what is traumatic for one person may not be for another. PTSD symptoms differ from other mental health conditions in that they are related to singular or multiple traumatic events. Those with this condition may experience intense flashbacks, anxiety, nightmares, and trouble functioning in response to their triggers.

Panic disorder

When an individual suffers from repeated, inexplicable, and unexpected panic attacks, they may qualify as having a panic disorder. People with panic disorder experience physical and emotional symptoms that are distressing or terrifying. Physical symptoms related to panic disorder include heart palpitations, difficulty breathing, sweating, shaking, and hyperventilating, among others. Panic attacks may be so intense as to be mistaken for heart attacks, and people experiencing them may believe they are dying. Genetics, psychological trauma, or environmental factors may all play a role in the development of this condition. 
Social anxiety disorder
Also known as social phobia, social anxiety disorder may occur when social interaction leads to fear, severe anxiety, or stress to the point that an individual avoids social situations. Those with this condition may avoid school, dates, work, family or social gatherings, or being out and about on errands at the mall or grocery store. This chronic mental condition can severely reduce quality of life and lead to other problematic states, such as depression.

Like with anxiety and other stress disorders, they can’t control these symptoms, but they can learn to manage them and are often able to enter remission with the right course of treatment.

Those with these conditions can’t control their symptoms. However, they can learn to manage them, and many go into remission with medication, therapy, or a combination of the two. Research shows that while medication can be helpful, psychotherapy or a combination of therapy and medication is typically more effective in the long term.

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Typical symptoms of anxiety disorders

It can be challenging to know if you are experiencing symptoms of an anxiety disorder, especially because some anxiety is healthy. Some recurring physical and psychological signs and symptoms that may indicate anxiety disorder include the following:

  • Difficulty sleeping
  • Fatigue
  • Breaking out in cold sweats
  • Bouts of dizziness or nausea
  • Feeling panicked, stressed, or fearful 
  • High blood pressure or heart palpitations
  • Inability to relax
  • Feeling unable to make decisions out of fear of being wrong 
  • Difficulty concentrating or focusing on tasks 
  • Lack of interest in activities that previously brought joy 
  • Thoughts of suicide or self-harm
If any of these symptoms sound or feel familiar to you and are causing you persistent distress, you might be showing signs of a mental health condition. Although most of us experience some of these symptoms independently from time to time, if they continue more often than not or occur on most days in a two-week period, consider reaching out to a mental health professional. They may recommend one of various types of therapy, such as cognitive behavioral therapy (CBT), or they may offer different options like anxiety medication and information on relaxation techniques.

Potential treatment plan for anxiety

If you’re taking the route of therapy but aren’t sure where to find a therapist, consider talking to your primary care physician for a referral. Be honest and truthful about your symptoms. The sooner you reach out for support, the sooner you can treat your anxiety. Your doctor can listen to you and run tests before referring you to the appropriate mental health professional. Even if you do not receive a diagnosis or referral, a therapist may work with you on a treatment plan and provide psychotherapy to help you ease your distress and return to a healthy balance.

Types of psychotherapy for anxiety disorders: Cognitive behavioral therapy, exposure therapy, and more

The most common types of psychotherapy used to treat anxiety are cognitive behavioral therapy (CBT) and exposure therapy, both outlined below. 

Cognitive behavioral therapy (CBT) for generalized anxiety disorders

CBT is one of the most effective therapies for anxiety, as demonstrated by various meta-analyses and other studies. Current evidence suggests that CBT may yield faster, more effective results while requiring less time than other types of treatment. CBT often follows a specific structure with a clear format. A therapist meets with a client and, based on the situation, creates an appropriate treatment plan outlining how often they should meet, how long the sessions should last, and what they want to achieve, focusing on a specific problem with a set goal to achieve.

CBT typically aims to change how a patient approaches thoughts and behaviors. It replaces cognitive distortions and negative beliefs with healthy, optimistic thoughts and research-backed coping mechanisms. 

There are usually four steps to achieving this positive outcome with CBT:
  1. Identifying and discussing your concerns 
  2. Becoming aware of your interpretation and feelings about your concerns 
  3. Identifying and recognizing the thoughts and patterns negatively impacting you and potentially worsening your situation
  4. Learning how to reshape these thoughts and perceptions so you can view the situation in a healthy way

For someone dealing with anxiety, CBT can provide an understanding of negative, fear-inducing thoughts in a unique way that provides healthy tools and techniques as alternatives for anxious behaviors. Over time, individuals often feel better able to manage situations in which they previously struggled.

While CBT is generally used to treat mental health conditions, anyone experiencing a stressful situation or concern may benefit from this method. It can provide you with tools to cope with stressful events or life anxiety regardless of whether your stresses reach the level of a disorder.

Exposure psychotherapy for anxiety

Exposure therapy exposes patients to feared stimuli to retrain the brain and reduce fear responses over time. Generally, when individuals fear something, they do their best to avoid it and stay far away.

With exposure therapy, you may work with your therapist to outline your specific fears or urges related to those fears. You can then create a plan to expose yourself to these fears and build resilience to them without causing you harm. 

For example, if you fear driving, part of your exposure therapy may be sitting in a car while someone drives, then taking a driver's test, followed by driving in an empty parking lot, driving on a quiet road, then driving through a busy intersection. Each step is a potential success in the treatment process. During each exercise, you may be asked to track your anxiety on a scale of one to ten or 100. A therapist may accompany you to each exposure activity or ask you to complete an exposure worksheet at home to discuss in your next session. 

Getting the most out of a therapy treatment plan

There are many treatments available for anxiety disorders. With timely action and support, you may be able to reduce symptoms and increase positive coping skills in your life. 

To get the most out of therapy for anxiety, be open and honest with your therapist about your successes and failures and follow through with the treatment plan to the best of your abilities. If they assign homework, try to complete it. It’s normal and okay to make a mistake or feel discouraged. If you find a bump in the road, let your therapist know so they can guide you through and past it. 

Recognizing you need mental health support

One of the first steps of your treatment may be recognizing an issue, understanding that you may require support, and finding the courage to seek the appropriate help. If your anxiety is hindering you from enjoying your life to its fullest or is affecting your relationships with family, friends, and other loved ones, consider speaking to a doctor or mental health professional.

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Counseling options for mental health

Seeing a psychotherapist can help you delve more profoundly into your symptoms and their causes. A therapist can provide research-based skills and tools to master emotions, conquer fears, and lead a healthy and prosperous life. If you're interested in starting, online counseling is one common option.

Online therapy can benefit those with anxiety and provide significant comfort. With online therapy, you can attend video, phone, or live chat sessions with a licensed therapist from your home. Plus, you can often reach out to your therapist 24/7 and receive assistance 

Studies indicate that not only do most people feel most comfortable at home, but also that online therapy can be highly effective. Additionally, one study found that 71% of its participants preferred online treatment to in-person methods and found it more effective. 

If you're interested in learning more about how online therapy might benefit you, consider signing up for a platform like BetterHelp, which offers over 30,000 therapists experienced in various specialties, including anxiety disorders. 

Takeaway

Anxiety disorders can affect your ability to function in your day-to-day life, and dealing with the symptoms on your own can be challenging. Reaching out for help is a brave first step toward reducing stress and anxiety in your life. If you're interested in getting started, consider reaching out to a counselor for further insight and compassionate guidance.

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