10 Best-Ever Anxiety- Management Techniques: There Are Effective Alternatives to Medication

By Wehrenberg, Margaret | Psychotherapy Networker, September/October 2005 | Go to article overview
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10 Best-Ever Anxiety- Management Techniques: There Are Effective Alternatives to Medication


Wehrenberg, Margaret, Psychotherapy Networker


10 Best-Ever Anxiety- Management Techniques

There are effective alternatives to medication

By Margaret Wehrenberg

"I don't think I want to live if I have to go on feeling like this." I hear this remark all too often from anxiety sufferers. They say it matter-of-factly or dramatically, but they all feel the same way: if anxiety symptoms are going to rule their lives, then their lives don't seem worth living.

What is it about anxiety that's so horrific that otherwise high-functioning people are frantic to escape it?  The sensations of doom or dread or panic felt by sufferers are truly overwhelming--the very same sensations, in fact, that a person would feel if the worst really were happening. Too often, these, literally, dread-full, sickening sensations drive clients to the instant relief of medication, which is readily available and considered by many insurance companies to be the first line of treatment. And what good doctor would suggest skipping the meds when a suffering patient can get symptomatic relief quickly?

But what clients don't know when they start taking meds is the unacknowledged cost of relying solely on pills: they'll never learn some basic methods that can control or eliminate their symptoms without meds. They never develop the tools for managing the anxiety that, in all likelihood, will turn up again whenever they feel undue stress or go through significant life changes. What they should be told is that the right psychotherapy, which teaches them to control their own anxiety, will offer relief from anxiety in a matter of weeks--about the same amount of time it takes for an SSRI to become effective.

Of course, therapists know that eliminating symptomatology isn't the same as eliminating etiology. Underlying psychological causes or triggers for anxiety, such as those stemming from trauma, aren't the target of management techniques; they require longer-term psychotherapy. However, anxiety-management techniques can offer relief, and offer it very speedily.

The unpleasant symptoms most likely to be helped by medication are the very ones that the 10 best-ever anxiety-management techniques are intended to correct. They fall into three typical clusters:

- the physical arousal that constitutes the terror of panic;

- the "wired" feelings of tension that correlate with being "stressed out" and can include pit-of-the-stomach doom;

- the mental anguish of rumination--a brain that won't stop thinking distressing thoughts.

A therapist armed with methods for addressing these clusters can offer her anxious client the promise of relief for a lifetime, if she knows which of these "10 best" techniques work for which symptoms, and how to use them.

Cluster One: Distressing Physical Arousal

Panic is the physical arousal that sends many clients running for Xanax. Sympathetic arousal causes the heart-thumping, pulse-racing, dizzy, tingly, shortness-of-breath physical symptoms that can come from out of the blue, and are intolerable when not understood. Even high levels of acute anxiety that aren't as intense as outright panic attacks can constitute very painful states of arousal. Physical symptoms of anxiety include constant heightened physical tension in the jaw, neck, and back, as well as an emotional-somatic feeling of doom or dread in the pit of the stomach. The feeling of doom will always set off a mental search for what might be causing it.

Bad as these symptoms are, there are methods that, when followed regularly as lifelong habits, offer tremendous relief.

Method 1: Manage the Body. Telling anxiety-prone clients to take care of their bodies by eating right, avoiding alcohol, nicotine, sugar, and caffeine, and exercising is a strikingly ordinary "prescription," but not doing these things can undermine the effectiveness of other antianxiety techniques. During the summer before Ellie went off to college, for example, she'd almost eliminated her anxiety by practicing deep, calm breathing and learning to stop her catastrophic thinking.

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