Top 25 treatments for anxiety

~ Carolyn Thomas

by Carolyn Thomas  ♥ @HeartSisters

Few things in life are as anxiety-producing as being told you have heart disease. Many heart patients become hypervigilant, on high alert to every new twinge that may or may not signal the start of another cardiac crisis. Is this something? Is it nothing? Should I call 911?  Even if symptoms are fleeting and benign, debilitating anxiety can remain.  And most remedies for easing these distressing feelings come in a pill bottle. But are there other treatments for anxiety that are as good as – or perhaps better than – pharmaceuticals? It turns out that, according to patients themselves, there very well may be.

Alexandra Carmichael is the co-founder of CureTogether, a site that collects patient-reported health data. I was intrigued by one of their reports called “6,100 Patients With Anxiety Report What Treatments Work Best”. Where did this data come from? Alexandra explains:

“CureTogether members have been anonymously sharing symptoms and treatments for three years. We analyze the data into infographic form to make it accessible.”

According to CureTogether’s crowdsourced data, here are the top 25 treatments for anxiety that thousands of other Real Live Patients – not drug reps for Big Pharma – say have worked for them:  

1. Exercise
2. Xanax
3. Yoga
4. Spending time with animals
5. Meditation
6. Cognitive Behavioral Therapy (CBT)
7. Inspiring music
8. Ativan
9. Clonazepam
10. Massage therapy
11. Acceptance and Commitment Therapy (ACT)
12. Deep breathing
13. Diazepam
14. Exposure therapy
15. Relaxation
16. Psychotherapy
17. Eye movement desensitization and reprocessing (EMDR)
18. Interpersonal therapy
19. Osteopathy
20. Zoloft
21. Lamictal
22. Bio-identical hormones
23. Avoid caffeine
24. Dialectical Behavior Therapy (DBT)
25. Prayer

Two facts immediately struck me about this list. First, that Spending time with animals was so highly ranked (fourth place) for reducing anxiety symptoms. (Are you surprised by this?)

Next, that out of the top 10 most effective treatments (as rated by real-life patients, not hired drug reps or industry-funded clinical trials), only three include pharmaceuticals.

So what about the effectiveness of those pharmaceuticals for depression and anxiety?

For those with debilitating mental health diagnoses, medications can indeed be lifesavers. In fact, many who could benefit from these meds may unfortunately consider taking any drugs to be a sign of weakness. It is not, of course – any more than it’s weak for a person living with diabetes to take insulin.

But as we know, pharmaceutical company hype promises the sun, the moon, the stars and freshly restored vitality by just taking a pill. Depression, for example, has gone from being what was described in the 1960s by leading medical experts as a self-limiting, episodic disorder showing spontaneous recovery without treatment after a few months to now being a more chronic, drug-managed illness. And as the CureTogether survey results suggest, there are many other remedies that are worth a try too.

Not coincidentally, this growth has paralleled that of the drug companies selling the meds.  In 1955, for example, only one in 468 North Americans was diagnosed with a mental illness; by 2008 it was one in 76. And since 1987 – the year Prozac hit the market –  the number of North Americans off work on disability benefits for mental health reasons has tripled.

This will be even more obvious any minute now once the 5th edition of The Diagnostic and Statistical Manual of Mental Disorders is published later this spring. The DSM is a reference text commonly known in the medical profession as the “shrink’s bible”.  This book has come under attack lately (even by such heavyweights as Dr. Allen Frances, himself the editor of the 4th edition of the DSM).

Dr. Frances told a Wired magazine interviewer last year:

“This gives drugmakers a new target for their hard sell and doctors, most of whom see it as part of their job to write prescriptions, more reason to medicate.”

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See also:

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Published by Carolyn Thomas

14 thoughts on “Top 25 treatments for anxiety”

  1. Hi I’ve been to 7 doctors all say I have anxiety I have constant chest pain fear of dying and haveing a heart attack I have arm pain leg pain face pain dry mouth and I’m pregnant now lighthead dizzy like I’m going to pass out and my eyes are blurry all the time I seem like I’m out of my own body at times I’ve never done brain scans or heart tests or anything I just believed my doctor when they told me that can this be true that its anxiety and nothing worst

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    1. Catherine, did any of the seven doctors recommend a treatment plan for anxiety? If so, please follow their advice. Meanwhile, review the list (in the article above) to see if you can start doing any of the non-medical suggestions on that list of 25 things to help calm yourself (these have each been shared by people living with anxiety who have already found these things did help them). This is important especially during your pregnancy when a “fear of dying” is not helpful for either you or your baby. Best of luck to you….

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  2. A decade ago, I started having anxiety issues that I believe were drug induced because I never had panic until after a period of hard drug abuse. I had severe panic several times a day, and it affected my ability to hold a job. My sleep was severely affected because I could only sleep for an hour or two before heavy anxiety woke me up. For a bit of time, I was given medication because the panic was so strong that I couldn’t manage it alone.

    It has taken me YEARS, but I have learned to manage anxiety without drugs. I have found that just getting outside almost immediately alleviates my anxiety, even if all I do is just stand outside my front door for a couple of minutes. Combined with getting outside, I find that deep breathing and resting when I need to averts severe panic episodes.

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    1. Congrats on finally getting to the point where your anxiety is being managed. Interesting that something as basic as getting outdoors seems to immediately start calming anxiety. Good luck to you…

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  3. What concerns me is how many women are told they have anxiety disorder and are not evaluated for cardiac etiology. There is a strong connection between anxiety and heart disease. Researchers found a very strong association between generalized anxiety disorder, or GAD, and the occurrence of cardiovascular events such as strokes, heart attacks, heart failure and death.

    The researchers looked at patients who experienced chest pain and other symptoms when they exerted themselves and engaged in certain other activities — a condition known as stable coronary heart disease.

    They found that people who had this type of heart disease, plus GAD, had a higher rate of cardiovascular events than did patients who did not suffer from GAD. The findings also showed that risk factors for heart disease such as smoking, physical inactivity and skipping meds did not play a role in the greater number of cardiovascular events. The anxiety may contribute to heart disease due to the high blood pressure and chemical effects of chronic stress that occur due to anxiety.

    In short, these findings suggest, GAD can predict whether people with stable coronary heart disease will have a stroke, heart attack or other serious heart problem. While an association between anxiety disorders and heart disease has long been suspected, doctors say this study is unique.

    Everyone responds differently to treatments, so if one treatment doesn’t work for you, try another and try multiple techniques for anxiety attacks. I find that first learning to use tools that give you a little control, deep breathing, relaxation, being in the present, are recommended first and if no relief then to the pharmaceuticals in combination with some sort of counseling. I try to counsel about using your control measures, like childbirth, it is terrifying and scary but if you can channel your thoughts and responses such as breathing think Lamaze methods you have a little more power or control over the attacks.

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    1. There is a strong link between heart disease and conditions like anxiety and depression. Many women are commonly misdiagnosed with anxiety even when presenting with textbook heart attack symptoms (see more here) and we know that living with anxiety/depression can result in poorer outcomes for those who do have heart disease. It’s a vicious cycle – but it can be broken by taking these steps.

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  4. Hi Carolyn,
    Actually, I count six pharmaceuticals on the list, seven if you include bio-identical hormones. (#s 2, 8, 9, 13, 29, 21, ?22)

    Is it any surprise to see so many drugs listed? Making life long changes is difficult for many if not most people. The medical profession doesn’t have the time to sit and talk long enough with patients to be effective so it’s much easier to write a prescription. This is compounded by the fact that many patients don’t want to make the commitment it takes to learn new skills i.e. practice daily yoga, meditation, etc, so they choose a quick fix pill instead. (I have my own bias about big pharma but that’s another response!)

    I have experienced some family tragedies and came up with a ‘thought stopping process’ on my own: when the terrible image, anxiety started, I would switch to positive life affirming thoughts. Little did I know that it’s an actual technique taught by therapists. It works.

    Love your blog Carolyn!

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    1. Hi Janet – yes, I was counting only the drugs in the Top 10 list as that’s where the biggest concentration of numbers were. I’ve been hearing the ‘no time to do lifestyle counselling’ excuse for some time – but when I saw the CureTogether list, I wondered just how many seconds it would take a doctor to say “Spend some time with pets!” to their patients?

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      1. “Spend some time with pets!” probably isn’t on the current medical school curriculum but it’s a positive step to see family pets being used as ‘therapy’ volunteers in hospitals and nursing homes.

        Last week, I met ‘Charlie’, a lovely Golden Retriever. He and his ‘volunteer’ handlers were visiting the rehab floor at a local hospital. Just seeing the smiles Charlie evoked was therapeutic. No drugs needed!

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        1. I’ve seen this reaction to therapy pets countless times during my years working at Hospice, too. We even had an official llama visit – now that kind of visitor enlists some smiles!

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          1. Beachwalking along the ocean or being near any body of water be it lake, river, creek, or table top fountain — water seems to put my mind at peace.

            . . . But I do rely on Xanax before calling the insurance company to resolve medical claim issues. It’s my #1 cause of anxiety since I have chronic illness and a lot of EOBs to track.

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            2. One thing I think that is missing from the top of the list is friends. I have had breast cancer and open heart surgery and was at total peace. My major stressor was trying to get my health insurance to pay the claims. I came so close to not having any health insurance before I had a heart valve replaced. I know that one day it will need to be replaced again and I have two aneurysms that are closely being monitor.

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