The two main treatments for anxiety disorders are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.
Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for anxiety.
Cognitive behavioral therapy is one of the most effective forms of psychotherapy for anxiety disorders. Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to gradually return to the activities you’ve avoided because of anxiety. Through this process, your symptoms improve as you build upon your initial success.
Several types of medications are used to treat anxiety disorders, including those below. Talk with your doctor about benefits, risks and possible side effects.
-Antidepressants. These medications influence the activity of brain chemicals (neurotransmitters) thought to play a role in anxiety disorders. Examples of antidepressants used to treat anxiety disorders include fluoxetine (Prozac, Sarafem), imipramine (Tofranil), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and venlafaxine (Effexor XR). Citalopram (Celexa) and escitalopram (Lexapro) also can be effective, but dosages of 40 milligrams (mg) a day of citalopram or 20 mg a day of escitalopram warrant discussion of risks versus benefits. Your doctor also may recommend other antidepressants.
-Buspirone. An anti-anxiety medication called buspirone may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective.
-Benzodiazepines. In limited circumstances, your doctor may prescribe one of these sedatives for relief of anxiety symptoms. Examples include alprazolam (Niravam, Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), diazepam (Valium), and lorazepam (Ativan). Benzodiazepines are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these medications aren’t a good choice if you’ve had problems with alcohol or drug abuse.
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As with many mental health conditions, the exact cause of anxiety disorders isn’t fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to becoming anxious. Inherited traits also can be a factor.
Medical causes
For some people, anxiety is linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order lab tests and other tests to look for signs of a problem.
Examples of medical problems that can be linked to anxiety include:
-Heart disease
-Thyroid problems
, such as hypothyroidism or hyperthyroidism
-Drug abuse
or withdrawal
Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications
-Irritable bowel syndrome
-Rare tumors that produce certain “fight-or-flight” hormones
-Premenstrual syndrome
Sometimes anxiety can be a side effect of certain medications.
It’s more likely that your anxiety may be due to an underlying medical condition if:
-You don’t have any blood relatives (such as a parent or sibling) with an anxiety disorder
-You didn’t have an anxiety disorder as a child
You don’t avoid certain things or situations because of anxiety
-You have a sudden occurrence of anxiety that seems unrelated to life events and you didn’t have a previous history of anxiety
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This troubling sleep disorder is a condition called REM behavior disorder. This disorder causes the sleepers to physically act out their dreams by kicking, screaming and even falling out of bed. Unfortunately, this disorder is usually not noticed until it causes an injury either to themselves or others.
Dr. Nabeela Nasir, MD, sleep specialist, assistant professor of neurology at Loyola University Medical Center, would like to raise awareness of this disorder because those who endure this condition can be treated successfully with medications.
“I don’t think we have a clear idea how prevalent it is.” “Patients don’t report it, and doctors don’t ask about it,” says Dr. Nasir in a news release.
Sleep involves transitions between three different states; wakefulness, REM sleep (rapid eye movement associated to dreaming) and N-REM sleep (non-rapid eye movement).
Normally muscles do not move during REM but this temporary paralysis does not occur in patients with REM behavior disorder. The patients will physically act out their vivid dreams they are having, for example, running, fighting and warding off attackers.
REM behavior disorder belongs to a class of sleep disorders called parasomnias, which include the sleep disorders of sleep walking and sleep related eating disorder (person eats while asleep).
This disorder affects an estimated one in every 200 adults with nine out of ten men suffering from this disorder with the vast majority being over 50 years. Many patients eventually develop Parkinson’s disease and other neurodegenerative disorders.

Mayo Clinic researchers found that people with REM sleep behavior disorder have twice the risk for developing mild cognitive impairment or Parkinson’s disease. Their study appeared online January 12, 2012 in Annals of Neurology.
Many patients are treated with Clonazepam, which is in a class of medicines called benzodiazepines, which curtails or eliminates the disorder 90% of the time. Melatonin a hormone that regulates sleep and wake cycles is used for insomnia and being looked at for as a treatment for REM behavior disorder.
Dr. Nasir recommends to safe-proofing the bedroom such as clear the room of furniture and objects that could cause injury and sleep alone if necessary.
The main symptom of REM sleep behavior disorder is dream-enacting behaviors. At times they can be violent causing self-injury or injury to the bed partner. These behaviors can include punching or jumping out of bed while still asleep. Other actions of REM behavior disorder include; kicking, grabbing and sitting up in bed.
If any of these behaviors occur during sleep seek medical attention.