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Anxiety Non-pharmacologic Management
Aka: Anxiety Non-pharmacologic Management, Anxiety Counseling, Anxiety Psychotherapy, Anxiety Behavioral Techniques, Anxiety Cognitive Techniques
- See Also
- Anxiety Pharmacologic Management
- Anxiety Disorder
- Anxiety Secondary Cause
- Anxiety Symptoms
- Generalized Anxiety Disorder
- Obsessive Compulsive Disorder
- Body Dysmorphic Disorder
- Panic Disorder
- Social Anxiety Disorder (Social Phobia)
- Acute Stress Disorder
- Post-Traumatic Stress Disorder
- Excessive Worry
- Anxiety Non-pharmacologic Management
- Management: General
- Offer Reassurance
- Not a serious physical disease
- Not insanity
- Not a sign of weakness or failure
- Not childishness or overdependency
- Not life-threatening
- Encourage Acceptance of anxiety as a life-long problem
- Innate response with years of reinforcement
- Complete calm always is unrealistic goal
- Set Goals for Therapy
- Decrease level of anxiety and maintain at low level
- Modulate future symptom responses
- Increase functioning
- Management: Lifestyle Modification
- Daily Physical Exercise (e.g. Walking, Tennis, Aerobics, Bicycling)
- Likely effective, although less than with Major Depression, and with inadequate evidence to date
- Jayakody (2014) Br J Sports Med 48(3): 187-96 [PubMed]
- Stonerock (2015) Ann Behav Med 49(4): 542-6 [PubMed]
- Improve sleep quality
- Establish good Sleep Hygiene
- Consider new hobbies
- Avoid harmful intakes (See Anxiety Secondary Causes)
- Avoid Alcohol use
- Avoid Tobacco use
- Avoid Caffeine
- Avoid Substance Abuse
- Management: Psychotherapy
- Background
- Optimal effects are after 8 weeks of weekly sessions
- As effective as medication for the treatment of Generalized Anxiety Disorder and Panic Disorder
- Goals
- Increase self confidence
- Increase self control
- Promote emotional growth
- Specific areas of education
- Teach coping skills and Conflict Resolution
- Encourage patient to express themselves
- Practice goal directed behavior
- Redirect energy and creativity
- Identify a new source of fulfillment
- Cognitive Behavioral Therapy
- Systematic Desensitization with exposure therapy (most effective single measure)
- Recognize, Reexamine and replace anxious thoughts
- Management: Mindfulness and relaxation
- See Relaxation Training
- Mindfulness-based Interventions (including stress reduction)
- Appears effective, but variable benefit in studies to date
- Goldberg (2018) Clin Psychol Rev 59:52-60 [PubMed]
- Khoury (2013) Clin Psychol Rev 33(6): 763-71 [PubMed]
- Progressive Muscle Relaxation
- Relaxation Training
- Meditation
- Yoga
- Likely offers benefit, but effects appear small, adjunctive
- Hoffman (2016) J Evid Based Med 9(3):116-24 [PubMed]
- Self-Hypnosis
- Tai Chi
- Effective in older adults with anxiety (symptom control with less relapse)
- Song (2014) J Physiol Pathophysiol Pharmacol 6(1): 55-60 [PubMed]
- Biofeedback
- Breathing retraining (arousal reduction)
- Take a deep breath
- Let breath out through pursed lips
- References
- Saeed (2019) Am Fam Physician 99(10): 620-7 [PubMed]