Treatment of Phobias
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For most medications that are prescribed to treat anxiety disorders, the doctor usually starts the patient on a low dose and gradually increases it to the full dose. Every medication has side–effects, but they are usually tolerable or diminish with time. If side–effects become a problem, the doctor may advise the patient to stop taking the medication and wait a week or longer for certain drugs – before trying another one. When treatment is nearing an end, the doctor will taper off the dosage gradually.
Research has also shown that behavioral therapy and cognitive–behavioral therapy can be effective for treating several of the anxiety disorders. Behavioral therapy focuses on changing specific actions and uses several techniques to decreases or stop unwanted behavior. For example, one technique trains patients in diaphragmatic breathing, a special breathing exercise involving slow, deep breaths to reduce anxiety.
This is necessary because people who are anxious often hyperventilate, taking rapid shallow breaths that can trigger rapid heartbeat, lightheadedness, and other symptoms. Another technique called ‘Exposure therapy’ gradually exposes patients to what frightens them and helps them cope with their fears.
Like behavioral therapy, cognitive–behavioral therapy teaches patients to react differently to the situations and bodily sensations that trigger panic attacks and other anxiety symptoms. However, patients also learn to understand how their thinking patterns contribute to their symptoms and how to change their thoughts so that symptoms are less likely to occur. This awareness of thinking patterns is combined with exposure and other behavioral techniques to help people confront their feared situations.
For example, someone who becomes lightheaded during a panic attack and fears he is going to die can be helped with the following approach used in cognitive–behavioral therapy. The therapist asks him to spin in a circle until he becomes dizzy. When he becomes alarmed and starts thinking, “I’m going to die”, he learns to replace that thought with a more appropriate one, such as “It’s just a little dizziness – I can handle it”.
Social phobia can be effectively treated with medications including, MAOIs, SSRIs and high potency benzodiazepines. People with a specific form of social phobia called performance phobia have been helped by drugs called beta blockers. There is no proven drug treatment for specific phobias, but certain medications may help reduce symptoms of anxiety before one faces a phobic situation. A type of cognitive–behavioral therapy known as “Exposure therapy” is also a very useful treatment for phobias. It involves helping patients become gradually more comfortable with situations that frighten them. Relaxation and breathing techniques are also helpful.