The treatment for anxiety disorders can be broadly classified under non-pharmacological and pharmacological.

Non-pharmacological Treatments for Anxiety Disorders

Cognitive-behavioral therapy (CBT)
Cognitive-behavioral therapy or CBT is a form of psychotherapy or talk therapy. CBT involves meeting with a mental health therapist to make the patient aware of any irrational, negative or inaccurate thought processes they may have developed. This awareness helps patients view situations in a clearer way and respond to them more effectively. This is how CBT creates effective anti-anxiety mechanisms for patients. Unlike other forms of psychotherapy, CBT is very structured and involves a limited number of sessions so it can be completed quickly.

During the sessions, the patient discusses their feelings and thoughts related to their disorder. If patients are shy or unable to share their feelings and experiences, the therapist can help the patient open up. The therapist often has the patient perform activities outside of the sessions to supplement skills learned during the session.

CBT involves four steps, the first is to identify the situation causing anxiety and set a goal for therapy. The treatment then shifts to making the patient aware of their patterns of thought during anxiety-provoking situations including interpretations of events. What patients tell themselves about the situation is crucial. Using this information the therapist can encourage patients to pay attention to their responses and irrationality of thoughts. Lastly, the patient is encouraged to view these anxiety-provoking situations objectively. Since these beliefs may have been held for years or decades, this can be difficult. CBT typically takes 10 to 20 sessions to complete.

Family-based therapy
Family-based therapy is based on the idea that an illness can be a result of some issue in the patient’s family unit. The illness is seen as a symptom problems within the and tries to influence changes in the whole family dynamic. The whole family needs to be involved in the solution and that is how the therapy proceeds.
Family-based therapy involves showing the family how they function and how a typical family functions. The focus is taken off the patient and put on the collective family condition. Through this familial focus, issues within the family can be identified and resolved to help the family deal with problems in a more effective way.
Like in standard CBT, specific goals are set and the family may be given assignments to complete outside of the session to bolster what they have learned during the session. How long treatment lasts depends on the family and the issue.

Play therapy
Play therapy is a type of psychotherapy for children which allows them to express themselves through play rather than with words. Because children are more familiar with expressing themselves through playing, this form of therapy may help them articulate their feelings better than traditional talk therapy.
Children typically act out any personal issues they are experiencing through inappropriate behavior. Play therapy provides another avenue for children to act out their concerns. During the session, the child is allowed to play with very few restrictions and with toys specifically chosen to help the child express their feelings and develop better behavior. In the first few sessions, children play with a toy of their choice. In later sessions the therapist introduces specific toys and activities to coax the child to express specific issues they may be experiencing.
This therapy is primarily used for children younger than 12 years. Sessions only last for 30 to 45 minutes and may occur one-on-one or in groups.

Exposure therapy
Exposure therapy is a type of CBT that involves exposing the patients to their anxiety-provoking triggers in a controlled environment to improve the response to the situation in everyday life. This could involve being exposed to a similar situation on a smaller scale or reliving a traumatic situation. The therapist helps the patient remember or experience the situation and work through any negative responses that may arise. Through repeated exposure, the patient learns how to deal with the situation and their anxiety reduces overtime.

Applied relaxation
Applied relaxation helps patients recognize early signs of anxiety and cope with them before they get overwhelmed. To recognize signs of anxiety early, patients are told to observe and record how they respond to anxiety-inducing situations while in the situation. It may take weeks for patients to become fully aware of their response. Patients then learn progressive relaxation— a technique that involves tensing up and then releasing different muscle groups in the body, a couple of times a day. To increase the time it takes to relax, patients then undergo release-only relaxation, where they relax each muscle group without tensing them up beforehand. The next stage is simply being in a state of relaxation through cue-controlled relaxation. This practice reduces the time it takes to relax to 2-3 minutes over 1-2 weeks of practice. In order for patients to be able to use this technique in any situation, they practice differential relaxation, where they are told to relax while also doing different movements and actions. Patients then undergo rapid relaxation where they learn to relax in non-stressful situations within 20-30 seconds. Finally, Patients undergoes application training which involves relaxing in anxiety-provoking situations.

Pharmacological Treatments for Anxiety Disorders:

On a molecular level anxiety disorders have been associated with chemical imbalances involving neurotransmitters. These chemicals are released from nerve cells and bind to receptors on other cells to influence their activity. The neurotransmitters serotonin, norepinephrine, and gamma aminobutyric acid or GABA influence feelings of well-being and the capacity to relax. Many of the medications used to treat anxiety disorders target these neurotransmitters. Because there are many similarities in the neurochemical imbalances associated with anxiety and depression, antidepressants target similar processes to treat depression, and antidepressants may often be prescribed to treat anxiety.

Selective serotonin reuptake inhibitors (SSRIs)
First line treatments for anxiety often target serotonin or 5-hydroxytryptamine (5-HT) imbalances. Serotonin modulates several behaviors including mood. Although it is not completely understood how serotonin contributes to anxiety, it is thought that serotonin reduces anxiety by suppressing hyperactivity of the amygdala.

Once released, serotonin modulates the activity of different brain regions by binding to receptors on cells in that region. Unbound serotonin is reabsorbed by the releasing (presynaptic) cell using reuptake transporters and degraded in order to reduce serotonin concentration in the brain. Anxiety medications typically modulate or inhibit this process to increase serotonin concentrations in the brain and increase serotonin signaling. Common anxiolytics, therefore, include selective serotonin reuptake inhibitors (SSRIs), which prevent the uptake of unbound serotonin and increase serotonin concentrations.

Commonly used SSRIs include:
· fluoxetine (Prozac)
· fluvoxamine (Luvox)
· sertraline (Zoloft)
· paroxetine (Paxil)
· escitalopram oxalate (Lexapro)
· citalopram (Celexa)

Serotonin and noradrenaline reuptake inhibitors (SNRI)
Like SSRIs, serotonin and norepinephrine reuptake inhibitors (SNRIs) target serotonin concentrations by blocking the uptake of both serotonin and norepinephrine.
Common SNRIs for anxiety disorders include:
· venlafaxine (Effexor)
· venlafaxine XR (Effexor XR)
· duloxetine (Cymbalta)

Monoamine oxidase inhibitors (MAOIs)
MAOIs were the first antidepressants ever developed. MAOIs work by preventing clearance of multiple neurotransmitters including norepinephrine, serotonin and dopamine by blocking the activity of a neurotransmitter clearing enzyme called monoamine oxidase. They are rarely prescribed now because they interact with many foods and other medications.
Common MAOIs prescribed for anxiety disorders include:
· phenelzine (Nardil)
· tranylcypromine (Parnate)

Benzodiazepines
Benzodiazepines were originally designed to specifically treat anxiety disorders. They are psychoactive medications that work as a mild tranquilizer to reduce anxiety and other symptoms. However, they are not typically prescribed because they can be addictive.
Common benzodiazepines used to treat anxiety disorders:
· alprazolam (Xanax)
· clonazepam (Klonopin)
· diazepam (Valium)
· lorazepam (Ativan)
· oxazepam (Serax)
· chlordiazepoxide (Librium)

Beta Blockers
Beta-blockers work by reducing blood pressure through inhibiting the activity of neurotransmitter epinephrine and opening up blood vessels, which causes the heart to slow down. Beta-blockers are used for a variety of conditions, but in treating the anxiety disorders, they are used to treat social phobia.
· propranolol (Inderal)
· atenolol (Tenormin)

Tricyclic Antidepressants
Like many other antidepressants, tricyclic antidepressants or TCAs work by blocking the removal of norepinephrine and serotonin from the brain. However, these therapies may also affect other neurotransmitters which can have some major side effects.

Common TCAs prescribed to treat anxiety disorders include:
· imipramine (Tofranil)
· desipramine (Norpramin, Pertofrane and others)
· nortriptyline (Aventyl or Pamelor)
· amitriptyline (Elavil)
· doxepin (Sinequan or Adapin)
· clomipramine (Anafranil)

Antipsychotics
Antipsychotics are typically used to treat schizophrenia, dementia and manic-depressive disorder. However, they have shown to be beneficial in treating anxiety as well. Although it is not fully understood how antipsychotics work, they are known to regulate the levels of several neurotransmitters.

Commonly prescribed antipsychotics for anxiety disorders include:
· ziprasidone (Geodon)
· risperidone (Risperdal)
· quetiapine (Seroquel)
· olanzapine (Zyprexa)

Antihistamines
Some antihistamines are also capable of reducing anxiety in addition to treating allergic reactions. They work like other antihistamines by blocking histamines in the body from inducing an allergic reaction.

The most commonly prescribed antihistamine for anxiety disorders is hydroxyzine (Vistaril, Atarax).

Anticonvulsants
Anticonvulsants are typically used to treat epilepsy and seizures. However, there is some evidence that they may also be effective against anxiety. They work by reducing excessive electrical activity in the brain by targeting specific ion channel proteins.
Commonly used anticonvulsants for the treatment of anxiety disorders include:
· Valproate (Depakote)
· Pregabalin (Lyrica)
· Gabapentin (Neurontin)

Side effects of the treatments:
Some of these pharmacological therapies may be associated with side effects. Some are more severe than others and these effects vary for each patient.
Common side effects include:
· Lightheadedness
· Dry mouth
· Nausea
· Weight gain
· Suicidal thoughts
· Sexual dysfunction
· Addiction
· Drowsiness