Anxiety disorders are among the most common of mental health problems and can have a significant impact on day to day functioning. They can lead to debilitating and worrying physical symptoms and prevent those with the anxiety disorder from living a full and happy life.

Because anxiety operates in a ‘vicious cycle’, symptoms can get progressively worse if left unchecked, becoming increasingly disruptive to your lifestyle. This is why, as with any mental health problem, the sooner you seek help, the better. Fortunately, anxiety is also one of the most treatable conditions. Here are three of the most effective psychological treatments available to tackle anxiety:

1. Cognitive Behavioural Therapy (CBT)

CBT is one of the most flexible treatment options for all manner of anxiety disorders, and it is likewise supported by a wide evidence-base¹. Its combination of practical, behavioural approaches with reflective, cognitive techniques offers a broad toolkit with which to tackle all kinds of worries, from unpleasant, intrusive thoughts to deeply ingrained avoidance patterns.

The benefits of CBT for anxiety disorders include:

Thoughts and actions:

The use of cognitive techniques can make CBT more palatable than behavioural therapies alone (see below), as the therapy does not simply rely on exposing you to your fears (although this is one of the tools that can be drawn upon).

Evidence based:

CBT is one of the most researched approaches to treating anxiety, and the evidence demonstrates that it is effective for a wide range of anxiety disorders.

Toolkit for life:

Once you have learnt the tools needed to help manage the feelings of anxiety, you can use them again and again and in all areas of life.

Widely available:

It is widely available on the NHS and privately, usually one hour per week for 12-15 sessions, depending on the complexity of the problem.

How does CBT help anxiety? – the Vicious Cycle

The cognitive behavioural model depicts anxiety as a vicious cycle:

1. A feared event happens, which triggers our flight or fight response and causes adrenalin to be released
2. We are automatically programmed to react to this rush of adrenalin and may act in a way to keep ourselves safe (such as not leaving the house)
3. This reaction can bring temporary relief and make us feel calmer and more in control.
4. By acting this way, we reinforce our initial, unfounded, fear.
5. Over time, we gradually become more sensitive to the triggers, and less able to inhibit our instinct to take evasive action when it occurs.

CBT aims to interrupt these feedback loops by providing evidence – through thought or behavioural experiments – that demonstrates that the avoidance is not actually necessary to keep us safe. Because interventions can target our thinking patterns as well as our behaviour patterns, CBT is easily tailored to your specific wants and needs, making it a little gentler than traditional behavioural therapy.

2. Behaviour Therapy

Behaviour therapy is one of the oldest psychological therapies for anxiety, and is likely the most effective in optimal circumstances. It refers to a range of practical, hands-on approaches to tackling fears, including systematic desensitization, flooding, and exposure therapy.

Of these, exposure therapy is the most widely used in practice, operating on the principles of habituation, where adrenaline reduces over time, lessening our anxiety; and conditioning, where we learn to make different associations about feared objects or scenarios.

Despite its strong theoretical rationale and clear evidence base, exposure therapy can be hard to stomach in practice. You will essentially be asked to face your fears in a very direct way, and to try to ‘ride out’ the anxiety that will inevitably follow.

This is often done gradually, working with less anxiety provoking stimuli first, before moving on to bigger, stronger fears; but nonetheless, a degree of discomfort is to be expected. The upside is that if you are able to endure it, and fully engage with the therapy, the success rate is near to 100%, and it is often quicker than talking-based approaches.

3. Mindfulness and applied relaxation

As the name suggests, mindfulness applied relaxation is about learning to apply relaxation techniques at times of stress: in short, teaching you to teach your body to calm down. The idea is that by using the techniques, we can manually override our brain’s automatic fear response (of increased heart rate, shortness of breath and so on), adjusting the feedback loop to teach our brains that actually, the triggering event doesn’t make us feel scared.

Common relaxation techniques include:

• Breathing exercises – such as breathing in for four counts, and out for eight.
• Progressive muscle relaxation – where you systematically tense and release the muscle groups in your body.
• Guided visualisation – a spoken story, guiding you on a peaceful journey.

Applied relaxation can be used in conjunction with other approaches, or as a stand-alone treatment.

The National Institute of Health and Clinical Excellence suggest attending 12–15 sessions, for one hour per week; although this can be adjusted up or down according to the complexity of the problem and the speed of clinical response.

There are many ways that people with anxiety disorders can be helped, talking therapies are just one of them. Lifestyle changes, exercise, diet and medication can all be key to abating the overwhelming sensations that are common with anxiety disorders. Anxiety is treatable, finding the right solution for you is key.

If you are suffering from anxiety and would like help deciding which therapy you are best suited to, call our knowledgeable triage team on 0203 326 9160.

Clinical Partners is the UK’s largest private mental health partnership, helping children, adults, families and organisations nationwide.

¹ Kaczurkin & Foa (2015). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence.