Anxiety (medical treatment)
Psychiatry clinic for anxiety disorders: diagnosis, medication where indicated, and coordination with psychotherapy.
When a psychiatrist gets involved
Not all anxiety needs medication. A psychiatry consultation makes sense when the intensity is high, when it's been going on for a long time, when it stops you functioning at work or at home, when it comes with depression, or when psychological treatment on its own isn't enough. Also when medication that's been carried on for years without review needs to be looked at.
What's assessed at the consultation
- The type of disorder: panic attacks, generalised anxiety, phobias, social anxiety, obsessive-compulsive disorder.
- Medical conditions that can cause the same symptoms â thyroid, arrhythmias, anaemia â which are worth ruling out with blood tests if that hasn't been done.
- Alcohol, cannabis, stimulant or caffeine use, which sustains and amplifies anxiety.
- Sleep, which is almost always disrupted and almost always makes everything else worse.
Treatment, without the myths
Antidepressants are today the main medication for most anxiety disorders: they take weeks to work, they don't create dependence and they don't change your personality. Benzodiazepines bring quick relief, but are used for as short a time as possible because of the risk of tolerance and dependence: that's one of the most common reasons for a consultation, coming off a course that's dragged on for years.
What works best
The combination. Medication lowers the intensity; psychological therapy teaches you to manage anxiety and stop avoiding everything, and is what sustains the result once the medication is withdrawn. At the appointment the full plan is set out, along with reviews to adjust the dose and decide when to reduce it.
Frequently asked questions
Are antidepressants addictive?
No. They take weeks to take effect, they do not create dependence and they do not change your personality. What does require monitoring are benzodiazepines, which give quick relief but are used for the shortest possible time because of their risk of tolerance and dependence.
I have been on anxiety pills for years, can I stop taking them?
Yes, and it is one of the most frequent reasons for consultation. Withdrawal is done gradually and according to a plan, accompanied by the psychological work that sustains the result. What is not advisable is stopping them abruptly on your own.
When do I need a psychiatrist and when a psychologist?
A psychiatry appointment makes sense when the intensity is high, when it has been going on for a long time, when it stops you functioning, when it comes with depression or when therapy alone is not proving enough. Usually the two work in a coordinated way.
What do psychiatrists usually prescribe for anxiety?
As baseline treatment, antidepressants âSSRIs above allâ, which take weeks to take effect and are not habit-forming. Benzodiazepines are reserved for short periods because of their risk of tolerance. The choice depends on your presentation, your history and the interactions with what you are already taking.
What is the safest medication for anxiety?
There is no single "safest" one for everybody: what is safe is the right drug for your case, at the right dose and with follow-up. What is best avoided is letting a benzodiazepine become long-term or self-medicating with what worked for someone else.
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Content reviewed by Dr Klejda Cibuku