Can Anxiety Be Treated Without Medication?

Yes, anxiety can be treated without medication. This question regarding non-medication treatment for anxiety is important, as people with anxiety and doctors are quick to take an inventory of symptoms, and then the person walks away from the doctor’s office with a prescription in hand. The issue in our society is that we want the quick fix for our anxiety, and medication fits the bill…it is our magic bullet. We are a society of pill-poppers (patients) and pill-pushers (doctors and pharmaceutical companies). And with direct pharmaceutical advertising to consumers and pharmaceutical-sponsored education (marketing) to doctors, it’s no wonder that prescription medications are inappropriately prescribed for many people with anxiety.

The problem with prescription medications is that they have significant side effects. In theory, the doctor weighs the risks of treatment versus the benefits of treatment. For severe anxiety and for anxiety that does not respond to psychotherapy, it is more warranted to prescribe a medication for anxiety, given that the benefits outweigh the risks of treatment. The problem is that many people with milder forms of anxiety are prescribed medication, and in these cases, the risks most likely outweigh the benefits of treatment, given that more conservative (non-medication) treatment options are effective for milder anxiety and do not have the side effects of the medications. In addition to direct consumer advertising of prescription medication and physician enticements by pharmaceutical companies, other influences to the expansion of prescription medications for milder forms of anxiety include decreasing physician time with patients (due to decreasing reimbursement from each patient), the necessity of including a DSM diagnosis for reimbursement, and the shortage of therapists to see patients with anxiety, just to name a few. When insurance companies reduce or refuse reimbursement for a patient visit with the doctor, then the doctor is forced to spend less time with the patient. So when a doctor had more time with patients, this would be spent gathering more information, honing the diagnosis, and spending time counselling their patients. With the average doctor visit now only lasting for less than 7 minutes, the quickest and easiest solution is to check off symptoms from the DSM, give an anxiety disorder diagnosis, and reach for the prescription pad to prescribe the anxiety medication. An ideal evaluation for anxiety should last at least 1 hour, and include time for counselling. When adequate time is spent seeing patients, there is less likelihood of overdiagnosis of anxiety, and less reliance on prescription medications. Oftentimes, the patient is only stressed out and worried, and only needs to talk through their problems with the doctor, or can be referred to a therapist for further work.

Medications are only indicated for anxiety when a person fails treatment with psychotherapy, or if the anxiety symptoms are severe. Primary treatment for anxiety is psychotherapy, with cognitive behavioral therapy (CBT) having the most evidence for anxiety disorders. Self help treatments based on CBT can also be utilized by people with milder forms of anxiety. Furthermore, for more severe anxiety, self help treatments can be used concurrently with psychotherapy and medication treatment, as they complement one another.

Certainly, there is a revolt occurring against prescription medications for anxiety, given there are more natural ways to deal with anxiety. The newer generations appear to be more health-conscious, and want treatments for anxiety that do not involve prescription medication. In addition to psychotherapy, there are adjunctive treatments that have been shown to be effective in anxiety, like exercise, yoga (mind-body exercises), visualization/relaxation, progressive muscle relaxation, meditation, acupuncture, massage, rest/sleep, healthy eating, and addressing the cause of the worry/anxiety. Furthermore, studies show that self-help interventions and natural supplements (herbal and dietary) are effective for anxiety. As discussed here, anxiety can be treated without medication. The only role for medication in anxiety is for severe cases, or for those who do not respond to psychotherapy.