From the Guidelines
For a patient with chronic anxiety, Cognitive Behavioral Therapy (CBT) is a highly beneficial non-medication treatment option. This is based on the most recent evidence from 2023, which suggests that CBT, among other options, is a recommended treatment for patients with moderate symptoms of anxiety 1. According to the guideline update, individual or group therapy with CBT, Behavioral Activation (BA), structured physical activity and exercise, or psychosocial interventions with empirically supported components (such as relaxation and problem-solving) are all viable options.
Some key benefits of these non-medication treatments include:
- Reduced symptoms of anxiety
- Improved emotional regulation
- Enhanced stress resilience
- Better overall quality of life
In terms of specific recommendations, CBT is a strong option, as it helps patients identify and challenge negative thought patterns, develop coping strategies, and gradually face anxiety-provoking situations through exposure techniques. Other beneficial approaches include:
- Structured physical activity and exercise, which can help reduce physiological arousal and improve mood
- Psychosocial interventions with empirically supported components, such as relaxation techniques (e.g., progressive muscle relaxation, deep breathing exercises) and problem-solving skills
- Behavioral Activation (BA), which focuses on increasing positive behaviors and activities to improve mood and reduce anxiety symptoms
It's essential to note that these approaches work best when practiced consistently, and patients should consider combining multiple approaches based on personal preference and symptom patterns. Professional guidance through therapy can be beneficial, especially for patients who are new to these techniques. As stated in the guideline update, the evidence quality is intermediate, but the strength of recommendation is strong, indicating that the benefits of these non-medication treatments outweigh the harms 1.
From the Research
Non-Medication Treatments for Chronic Anxiety
- Cognitive Behavioral Therapy (CBT) is considered the psychotherapy of first choice for anxiety disorders, as it has been shown to be effective in reducing anxiety symptoms 2, 3
- Mindfulness-based interventions, such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), have also been found to be effective in reducing anxiety and mood symptoms 4, 5, 6
- Exercise, particularly aerobic training, has been studied as an adjunctive treatment for anxiety and can be recommended as a complementary therapy 2
- Psychoeducation, which includes information about the psychophysiology of anxiety reactions and the rationale of available treatment possibilities, can also be beneficial for patients with anxiety disorders 2
- Deep breathing, exposition, cognitive restructuring, problem solving, relaxation, and mindfulness practices can be taught to patients in a self-help format to help manage anxiety symptoms 2
Comparison of Non-Medication Treatments
- CBT and adapted MBSR have been found to be equally effective in reducing principal disorder severity, but CBT may be more effective at reducing anxious arousal, while adapted MBSR may be more effective at reducing worry and comorbid disorders 5
- MBSR and MBCT have been found to have broad-spectrum antidepressant and antianxiety effects and decrease general psychological distress 6
- Zen meditation has also been found to be beneficial for pain management and general psychological health 6