Treating anxiety and stress disorders with therapy

When anxiety is tied to a medical condition or substance use, treatment usually concentrates on that underlying cause. For other anxiety disorders, care rests on three main approaches: psychotherapy, medication, and complementary treatments.

Psychotherapy, especially cognitive behavioral therapy (CBT), exposure therapy, or insight-oriented therapy, plays a central role in helping people manage anxiety. Each approach involves working with a mental health professional to understand what drives the anxiety and to learn strategies for controlling symptoms. Sessions can take place in settings from doctors' offices to schools, and therapy works best when you feel a strong connection with your therapist.

Cognitive behavioral therapy (CBT)

CBT, the leading form of psychotherapy for anxiety, aims to correct ingrained patterns of negative thought and behavior. As its name suggests, the treatment has two parts. Cognitive therapy helps people change ways of thinking that keep them from overcoming their fears, while behavioral therapy works to change their reactions in situations that set off anxiety. A person with social anxiety disorder, for example, may assume others will inevitably think whatever they say sounds stupid; that is negative thinking. As a result, they may avoid being with or talking to others; that is negative behavior. CBT's goal is to break this chain of thoughts and reactions.

Exposure therapy

Exposure and response prevention, a type of exposure therapy for anxiety, brings you into contact with the object of your fear in gradual, increasing steps until the fear subsides. Under a therapist's guidance, you first imagine your fears and then confront them.

Studies show that a course of eight to 12 exposure sessions produces significant, long-lasting results: symptoms improve in 60% to 80% of people, and the benefits persist for two to six years. Virtual reality exposure therapy (VRET) is now being explored for PTSD, social anxiety disorder, and panic disorder.

Insight-oriented psychotherapy

This traditional form of "talk" therapy explores how life events, desires, and past and present relationships shape your feelings, create discomfort, and feed anxiety. During treatment, you and your therapist uncover the unconscious reasons behind your anxiety and consider how unresolved conflicts from your past may contribute to your current distress. The goal is greater self-awareness and more acceptance of feelings or thoughts that might otherwise cause discomfort or inner conflict.