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Treating Anxiety With Psychopharmacology and Cognitive Behavioral Therapy

Abstract

Despite the success of both cognitive-behavioral and pharmacologic interventions for the therapy of anxiety illnesses, the combination of these modalities in adults has not reached significant improvements in results relative to either approach. Consequently, there have been questions about whether there are interfering impacts that attenuate the magnitude of combination treatment importance. In this article, an accounting of the potential employment of the two therapy methods is introduced and whether they can be used to successfully conduct treatment and benefit a patient. Similarly, the research indicates the types of anxiety and their effects on particular individuals and their symptoms. The recent studies on the effects of mental disorders have further enabled the introduction of various methods of treating the disease. Furthermore, the implications of treatment methods and medical drugs on patients with mental disorders have further been discussed.

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Introduction

Depression is normally witnessed as a fatal psychological issue that may be observed in individuals at various stages of life. It is characterized by moderate, severe, and mild deficiencies that impact a person’s ability to finish their daily tasks. According to studies conducted by the National Institute of Mental Wellness, it is estimated that about 17.3 million grown-ups and 3.2 million youths have at least one significant depressive episode, with a high prevalence amongst women (Villabø et al., 2018). Consequently, numerous treatment options for patients suffering from depression have been established, and the decision relies on a myriad of aspects, comprising resources, personality, and expertise of the healthcare physician. In this paper, the focus will be put on psychopharmacology and cognitive behavioral therapy (CBT) and how these two treatment methods can be utilized in depression management.

Background and Literature review

There are several types of anxiety disorders, including panic disorder, generalized anxiety disorder, separation anxiety disorders, agoraphobia, and social anxiety disorder. In the United States, in every given year, adults have the following types of anxiety illness; panic disorders 2 to 3 percent, separation anxiety disorder 1 percent to 2 percent. Similarly, the numbers of grown-ups with agoraphobia are 2 percent, while social anxiety disorder is 7 percent, generalized anxiety disorders are at 2 percent, and the number with a specific phobia is between 7 to 9 percent (Villabø et al., 2018). The statistics show that women are more prone to experience anxiety disorders as compared to men. Individuals with this disorder tend to anticipate future occurrences. The muscles experience tension, and one tends to have a behavior of avoidance. It means that they tend to avoid situations that accelerate or trigger their symptoms.

If a person can be diagnosed with anxiety disorder, the symptoms, which include anxiety and fear, have to be hindering their normal functionality in day-to-day activities. Moreover, in generalized anxiety disorder, people show fear and worry in excess most days for at least six months. These symptoms significantly interfere with the patients’ daily livelihood (Salza et al., 2020). The symptoms include the following factors: having difficulty concentrating, being irritable, being easily fatigued, having muscle tension, feeling restless, difficulty with sleeping, and having difficulty with feelings control.

Problem

The main problem of the current research is the effectiveness of treating anxiety using psychopharmacology and cognitive-behavioral therapies. A panic occurrence is an abrupt instant of profound fear that attains its limit within a significantly short time. Persons with anxiety illnesses have numerous incidents of panic attacks that are unanticipated or, at times, instigated by a trigger. Panic attack signs and symptoms include; sweating, shortness of breath, palpitations, trembling, and feeling of being out of control of your situation (Salza et al., 2020). These people tend to be cautious of their situation and try to avoid situations, things, places, or even people they associate with panic attacks. These reflex actions cause much bigger problems in the future, for example, agoraphobia. A phobia is defined as intense fear and subsequent avoidance of a specific situation or object. This is not the normal fear that people experience (Salza et al., 2020). It is fear that is out of proportion that people with phobia show symptoms of taking steps to evade the objects or situations they fear; they are irrational and worry too much about facing those situations or objects.

Phobias can be categorized into various categories; first, specific phobias or simple phobias occur in people, and the individuals usually display fear of specific situations and objects, blood, heights, and specific animals, such as spiders or snakes.

Second, social anxiety disorders are known as social phobia before (Bandelow et al., 2017). These people have an intense fear of social gatherings or performances. These people constantly feel they are in the spotlight, and therefore they are prone to scrutiny. Therefore, they try by all means to avoid places with social gatherings. These places include even schools, workplaces, and religious grounds. Conversely, agoraphobia is a situation where people experience fear due to two or more of these situations; being in an open space, using public transport, being outside of the home alone, being in an enclosed space, or being in a crowd (Bandelow et al., 2017). In separation anxiety disorder, people experience a deep sense of fear of being parted from someone. It mostly occurs in children, but adults too suffer from this disorder. These people might even have nightmares of them being separated from the people they are attached to. When they are being parted with these people, they even experience physical symptoms.

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Hypothesis

After conducting an assessment with patients diagnosed with depression, the results should be checked to determine the risk factors that cause anxiety illnesses. These aspects include both environmental and genetic. Different types of anxiety disorders have different risk factors, but there are common risk factors that apply to all. These factors include; a history of mental illness among the relatives, especially anxiety disorders, temper problems, physical health conditions for example thyroid problems and heart problems, some medications or substances that can also cause anxiety disorders, and childhood experiences that are related to a negative and stressful life may aggravate such disorders (Buckner et al., 2019). An anxiety disorder is diagnostic and entails the doctor performing a physical exam while taking records. The medical practitioner asks questions about the symptoms in detail to appropriately conduct a complete analysis. Furthermore, a blood test is also recommended in order to assess thyroid functions since hyperthyroidism causes almost similar symptoms (Buckner et al., 2019). Inquiry on the previous medications is also taken since some drugs cause anxiety symptoms. Some of these drugs include; cyclosporine, an immunosuppressant used in patients with rheumatoid arthritis and psoriasis, and levodopa, a drug used in the management of Parkinsonism. Anxiety might also be an accompaniment symptom to some diseases, such as schizophrenia, systemic lupus erythematosus, or sleeping problems. It means that a physical exam is carried out first to eliminate any systemic disease before carrying out a psychological test.

Experiment

A psychological examination is conducted by a therapist to assess the patient’s condition. The evaluation includes inquiring whether the person has a family history of mental illness like depression and anxiety. The specialist asks about the symptoms, that is, when they began, what period they have lasted, how serious the symptoms get, how often they occur, if they had ever occurred before, whether they were treated and how often they were treated (Bajbouj et al., 2018). He or she should also ask how the symptoms affect the person’s life. There are other psychological diseases that accompany this disorder. They include; eating disorders and post-traumatic stress disorder. The specialist also inquires further to make sure there are no other psychological disorders that are affecting this person.

The evaluation can also be accompanied by an open-ended questionnaire. It helps to examine the severity of the symptoms or even the specific type of anxiety disorder the person is suffering from. Anxiety disorder symptoms might overlap with symptoms of other psychological disorders, thus causing differential diagnosis. The specialist is hence supposed to distinguish those symptoms in order for them to rule out the other differential diagnosis and remain with the ideal diagnosis (Bajbouj et al., 2018). There are situations where the anxiety disorder is accompanied by another psychological disorder. It means that more than one diagnosis is possible.

Data

According to a survey that I conducted among college students, the study results were satisfactory on the number of anxiety issues among young adults in contemporary society. The study was conducted among 40 participants, 20 male and 20 female, all of who were college students of different social and ethnic diversities. In one of the conclusions made from the survey, some students concluded that their anxiety was instigated by the pressure to be accepted by their friends who were from a different social status than theirs. Similarly, a small group had been bullied based on their ethnicity and social background. The incident significantly affected their mental health and even compelled them to shift from their former schools. Finally, a fraction of the students claimed that they are usually nervous whenever they are approaching their exams period. Some complained of developing fever whenever they approached their semester exams.

Results

Despite the issues faced by the students, most of them agreed to use psychopharmacology to treat their mental illnesses. From my survey, approximately 55 percent of the participants, both male and female, overwhelmingly supported the use of the treatment method. From the ratio, 30 percent admitted to their successful experience with the treatment, while the other 25 percent attested to having a relation who successfully underwent psychopharmacological therapy. Finally, 40 percent of the contributors stated that they had talked about their anxiety issues to their counselors, whereas 15 percent usually discussed their problems with their parents and guardians.

Discussion

Anxiety disorders can be treated in various ways depending on the patient’s choice. The common treatments used are cognitive behavioral therapy and psychopharmacology medications. They can be used together, or either can be used alone. Thus, anxiety disorders can be managed pharmacologically (Dunlop et al., 2019). Medications help relieve the symptoms of anxiety disorders. These medications are known as anti-anxiety drugs. These drugs include; antidepressants, benzodiazepines, and beta-blockers. Benzodiazepines are an old class of drugs that have been used for a long time to treat general anxiety disorder (Dunlop et al., 2019). They have the advantage of having a rapid onset of action, and a maximum effect is achieved within two weeks of treatment. However, patients experience high tolerance after using them for a long time.

This means that over some period of time, these patients may need an increment of the dose to achieve the desired effect. They also become dependent on these drugs so that when not taken, the patients experience withdrawal symptoms. Therefore, the specialist should prescribe small doses per time. When the patient and the doctor decide that the treatment is over, the doctor should not suddenly withdraw this treatment but rather do so progressively to avoid those withdrawal symptoms (Dunlop et al., 2019). Antidepressants are also another group of drugs used to treat anxiety disorders. They are commonly used to treat depression and usually take significant time to respond and display the desired results in patients. Particular classification of drugs is the first-line treatment for anxiety disorders. They are classified into serotonin-norepinephrine reuptake inhibitors SNRIs) and selective serotonin reuptake inhibitors (SSRIs). These, too, have withdrawal symptoms when the patient suddenly stops taking them (Külz et al., 2019). Therefore, the doctor should ensure they withdraw it progressively.

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There are other types of antidepressants that are less commonly used, like; monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants. Beta-blockers, mostly used in the treatment of hypertension, are also used in the treatment of anxiety disorders. They help to relieve the physical symptoms that accompany anxiety disorders like trembling, rapid heartbeat, and blushing (Külz et al., 2019). Different drugs work differently on different people. Therefore, the patient and doctor need to work hand in hand to find a medication that works for them. This means that one may be required to use several medications before finding the right one. Therefore, patients may be required to show a huge sense of patience.

The other treatment is Cognitive Behavioral Therapy (CBT) which is a type of psychotherapy where the patient works hand in hand with a health counselor or a therapist in a way that the patient attends various scheduled sessions. The therapist is supposed to bring the patient to understand and be aware of negative thoughts so that he or she can couch them to deal with situations more effectively (White et al., 2017). It is the most preferred psychotherapy as it helps one point out and deals with challenges faster than other therapy. The therapist helps one unwind their thoughts and enables one to change their bad thoughts or behaviors. The sessions also equip one with positive ways of dealing with situations.

The types of CBT include exposure therapy, behavioral experiments, role-playing, guided discovery, journaling and thought records, cognitive restructuring or reframing, relaxation and stress reduction techniques, and activity scheduling and behavior activation. Some of the advantages of CBT are that it takes a short period, can be used where medications cannot, and it can be done in different formats like in groups (White et al., 2017). There are also some disadvantages like it might not be convenient for people with more complex disorders, it requires one to confront the anxiety itself, so at first, it might be triggering, it needs commitment, it deals with behavior change so if there are external problems like in the family, they might not be addressed.

Conclusion

Anxiety disorder is a mental disorder that should be addressed with the seriousness it requires. The illness has posed a significant challenge to a section of persons in the current society. Some of the victims are individuals in the community; some of them stay silent and live a traumatic life, while others are bold enough to seek treatment. Since the illness is treatable, people experiencing anxiety symptoms should seek medical treatment and work closely with the doctor to find the solution to it. These treatments should be observed keenly to note the side effects earlier rather than later to avoid irreversible situations. Furthermore, anxiety is both psychological and an overall medical concern that should be investigated further by experts to develop more appropriate ways that can be used to treat patients and regulate them.

References

Bajbouj, M., Aust, S., Spies, J., Herrera-Melendez, A.-L., Mayer, S. V., Peters, M., Plewnia, C., Fallgatter, A. J., Frase, L., & Normann, C. (2018). PsychotherapyPlus: Augmentation of cognitive behavioral therapy (CBT) with prefrontal transcranial direct current stimulation (tDCS) in major depressive disorder—study design and methodology of a multicenter double-blind randomized placebo-controlled trial. European Archives of Psychiatry and Clinical Neuroscience, 268(8), 797–808.

Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in Clinical Neuroscience, 19(2), 93. Web.

Buckner, J. D., Zvolensky, M. J., Ecker, A. H., Schmidt, N. B., Lewis, E. M., Paulus, D. J., Lopez-Gamundi, P., Crapanzano, K. A., & Bakhshaie, J. (2019). Integrated cognitive behavioral therapy for comorbid cannabis use and anxiety disorders: A pilot randomized controlled trial. Behaviour Research and Therapy, 115, 38–45.

Dunlop, B. W., LoParo, D., Kinkead, B., Mletzko-Crowe, T., Cole, S. P., Nemeroff, C. B., Mayberg, H. S., & Craighead, W. E. (2019). Benefits of sequentially adding cognitive-behavioral therapy or antidepressant medication for adults with nonremitting depression. American Journal of Psychiatry, 176(4), 275–286.

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Külz, A. K., Landmann, S., Cludius, B., Rose, N., Heidenreich, T., Jelinek, L., Alsleben, H., Wahl, K., Philipsen, A., & Voderholzer, U. (2019). Mindfulness-based cognitive therapy (MBCT) in patients with obsessive–compulsive disorder (OCD) and residual symptoms after cognitive behavioral therapy (CBT): A randomized controlled trial. European Archives of Psychiatry and Clinical Neuroscience, 269(2), 223–233.

Salza, A., Giusti, L., Ussorio, D., Casacchia, M., & Roncone, R. (2020). Cognitive behavioral therapy (CBT) anxiety management and reasoning bias modification in young adults with anxiety disorders: A real-world study of a therapist-assisted computerized (TACCBT) program Vs.“person-to-person” group CBT. Internet Interventions, 19, 100305, 1097-2025. Web.

Villabø, M. A., Narayanan, M., Compton, S. N., Kendall, P. C., & Neumer, S.-P. (2018). Cognitive–behavioral therapy for youth anxiety: An effectiveness evaluation in community practice. Journal of Consulting and Clinical Psychology, 86(9), 751.

White, L. K., Sequeira, S., Britton, J. C., Brotman, M. A., Gold, A. L., Berman, E., Towbin, K., Abend, R., Fox, N. A., & Bar-Haim, Y. (2017). Complementary features of attention bias modification therapy and cognitive-behavioral therapy in pediatric anxiety disorders. American Journal of Psychiatry, 174(8), 775–784.

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