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: Cognitive behavioral therapy for anxiety
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
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
- 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 mental health 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 CBT work?
In a cognitive behavioral therapy for anxiety 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 with cognitive behavioral therapy for anxiety
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.
Other options for support
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.
What is cognitive behavioral therapy (CBT)?
According to the American Psychological Association (APA), cognitive behavioral therapy (CBT) is a type of talk therapy that includes both behavior therapy and cognitive therapy techniques and is based on the interrelatedness of thoughts, feelings, and behaviors. The APA reports that CBT aims to help in “identifying and modifying the client’s maladaptive thought processes and problematic behaviors through cognitive restructuring and behavioral techniques to achieve change.” It can typically be conducted either in a therapist’s office or virtually.
How long does it take for CBT to work?
How long cognitive behavioral therapy (CBT) will take to make a meaningful difference in anxiety symptoms can vary significantly from person to person depending on their symptom severity and many other factors. That said, the UK’s National Health Service (NHS) suggests that it can take between six and 20 cognitive behavioral treatments (either weekly sessions or every other week) for a person to notice changes in negative thinking, uncontrollable worry, and other anxious patterns in daily life.
What are some CBT techniques for anxiety?
Several CBT skills and techniques may be used as self-help strategies—using a workbook like the ones available from Oxford University Press, for instance—and/or learned and practiced with a trained therapist guide. One example is cognitive restructuring, which is aimed at helping a person get a better understanding of their thinking patterns so they can learn to recognize and shift maladaptive thoughts.
Another example is mindfulness-based strategies, which come from the Buddhist tradition. When practiced over time, these may help a person notice when certain thoughts and feelings arise so they can choose whether to engage with them.
How do they influence behavior?
Influencing and shifting behavior is often a key part of therapeutic treatment for anxiety, specific phobias, chronic posttraumatic stress disorder (PTSD), and other forms of mental illness. For example, with interoceptive exposure therapy, a specially trained therapist helps a person confront feared stimuli and avoid any compulsive ritual or maladaptive behavior in response. Over time, this treatment may help the individual feel less anxiety when facing triggering situations, at least in part because it often equips them with coping and safety behaviors for difficult feelings.
Or, for PTSD, a therapist might use cognitive behavioral therapy to help the individual recognize distorted thoughts about themselves or the world. This may help patients confront triggering or stressful situations in real life that they may have previously avoided due to a fear memory. Some research published in J Clin Psychiatry also suggests that mindfulness-based cognitive therapy may be helpful in treating veterans with PTSD by helping in changing behaviors.
What gets rid of anxiety?
According to a meta-analytic review on the topic, the first-line treatment for anxiety disorders—including generalized anxiety disorder, social anxiety disorder or social phobia, and others—is typically some form of talk therapy, like cognitive behavioral therapy. It is sometimes recommended in combination with medication to help reduce symptoms.
How can I calm my anxiety fast?
Research from 2023 indicates that breathing exercises can often be an effective intervention for acute anxiety symptoms, as the right exercises may positively impact “neural circuit dynamics, cognition, and mood.” Visually picturing yourself in a calming place and going for a brisk walk to get out nervous energy may also be helpful.
Does CBD help anxiety?
Some recent studies suggest that CBD may be helpful in reducing anxiety symptoms in some people, though further research is needed. That said, CBD is not recommended as a replacement for professional treatment for symptoms of an anxiety disorder. Consult your doctor before taking CBD or another substance for anxiety.
How can I kill anxiety naturally?
While medication is recommended as part of treatment for some individuals with anxiety, it’s not in every case, and there are also natural approaches available. Talk therapy with a trained therapist is usually the first-line treatment. In addition, eating nutritious foods, exercising regularly, staying socially connected, and any other habit that may promote overall health could also be helpful in reducing anxiety. Finally, some natural remedies like CBD and chamomile tea may also be useful for some people, though these are not recommended as alternatives to professional treatment.
What foods trigger anxiety?
Certain foods may increase feelings of anxiety in some people. According to a randomized clinical trial, certain amounts of caffeine may cause heightened anxiety and trigger panic attacks in certain individuals. Refined sugar, energy drinks, alcohol, and highly processed foods might also trigger anxiety. In addition to limiting or avoiding these foods, practicing CBT protocols with a trained therapist, cultivating healthier habits, and engaging in regular self-monitoring through journaling or therapy sessions may help reduce anxiety too.
Are bananas good for mental health and anxiety?
Some research on the effects of banana pulp and peel on anxiety in mice suggests that certain compounds present in bananas may have anti-anxiety effects. However, more research is needed in humans. If you're looking for advice on eating patterns that may help reduce anxiety, speaking with a qualified nutritionist is generally recommended.
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