Best Treatments Anxiety Disorders
What are anxiety disorders?
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Anxiety disorders are a group of mental disturbances characterized by anxiety as a central or core symptom. Although anxiety is a commonplace experience, not everyone who experiences it has an anxiety disorder. Anxiety is associated with a wide range of physical illnesses, medication side effects, and other psychiatric disorders. The revisions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) that took place after 1980 brought major changes in the classification of anxiety disorders.
Prior to 1980, psychiatrists classified patients on the basis of a theory that defined anxiety as the outcome of unconscious conflicts in the patient’s mind. DSM-III (1980), DSM-III-R (1987), and DSM-IV (1994) introduced and refined a new classification that considered recent discoveries about the biochemical and post-traumatic origins of some types of anxiety. The present definitions are based on the external and reported symptom patterns of the disorders rather than on theories about their origins.
Anxiety disorders are the most common form of mental disturbance in several countries. It is estimated that 28 million people suffer from an anxiety disorder every year. These disorders are a serious problem for the entire society because of their interference with patients’ work, schooling, and family life. They also contribute to the high rates of alcohol and substance abuse in the United States.
Anxiety disorders are an additional problem for health professionals because the physical symptoms of anxiety frequently bring people to primary care doctors or emergency rooms.DSM-IV defines 12 types of anxiety disorders in the adult population. They can be grouped under seven headings:
Who Suffers From Them?
I know I do. My anxieties controlled me. I was afraid to even ask a girl who I knew liked me, for a dance at my Public school graduation dance. I was afraid to ask her if she would be my partner to celebrate our graduation. Someone else asked her. There she was looking so very beautiful, my heart was broken. That was a long time ago.
Job interviews are another source that causes us to feel anxious. For most people that is quite normal. For me, it was a great fear. Was it caused by a fear of rejection for me? Quick, the answer is, Yes. Where did it come from? I know I lost out on a lot of opportunities in life because of this anxiety disorder.
Anxiety disorders are the most common form of mental disturbance in several people. So don’t ever feel you are alone. It is estimated that 28 million people suffer from an anxiety disorder every year. These disorders are a serious problem for the entire society because of their interference with patients’ work, schooling, and family life. They also contribute to the high rates of alcohol and substance abuse in the United States.
Anxiety disorders are an additional problem for health professionals because the physical symptoms of anxiety frequently bring people to primary care doctors or emergency rooms.DSM-IV defines 12 types of anxiety disorders in the adult population. They can be grouped under seven headings:
- Panic disorders with or without agoraphobia. The chief characteristic of panic disorder is the occurrence of panic attacks coupled with a fear of their recurrence. In clinical settings, agoraphobia is usually not a disorder by itself but is typically associated with some form of panic disorder. Patients with agoraphobia are afraid of places or situations in which they might have a panic attack and be unable to leave or find help. About 25% of patients with panic disorder develop obsessive-compulsive disorder (OCD).
- Phobias. These include specific phobias and social phobias. A phobia is an intense irrational fear of a specific object or situation that compels the patient to avoid it. Some phobias concern activities or objects that involve some risk (for example, flying or driving) but many are focused on harmless animals or other objects. Social phobia involves a fear of being humiliated, judged, or scrutinized. It manifests itself as a fear of performing certain functions in the presence of others, such as public speaking or using public lavatories.
- Obsessive-compulsive disorder (OCD). This disorder is marked by unwanted, intrusive, persistent thoughts, or repetitive behaviors that reflect the patient’s anxiety or attempts to control it. It affects between 2-3% of the population and is much more common than was previously thought.
- Stress disorders. These include post-traumatic stress disorder (PTSD) and acute stress disorder. Stress disorders are symptomatic reactions to traumatic events in the patient’s life.
- Generalized anxiety disorder (GAD). GAD is the most commonly diagnosed anxiety disorder and occurs most frequently in young adults.
- Anxiety disorders are due to known physical causes. These include general medical conditions or substance abuse.
- Anxiety disorder not otherwise specified. This last category is not a separate type of disorder but is included to cover symptoms that do not meet the specific DSM-IV criteria for other anxiety disorders.
All DSM-IV anxiety disorder diagnoses include a criterion of severity. The anxiety must be severe enough to interfere significantly with the patient’s occupational or educational functioning, social activities or close relationships, and other customary activities. Anxiety disorders vary widely in their frequency of occurrence in the general population, age of onset, family patterns, and gender distribution.
The stress disorders and anxiety disorders caused by medical conditions or substance abuse are less age- and gender-specific. Whereas OCD affects males and females equally, GAD, panic disorder, and specific phobias all affect women more frequently than men. GAD and panic disorders are more likely to develop in young adults, while phobias and OCD can begin in childhood.
Anxiety disorders in children and adolescents:
DSM-IV defines one anxiety disorder as specific to children, namely, a separation anxiety disorder. This disorder is defined as anxiety regarding separation from home or family that is excessive or inappropriate for the child’s age. In some children, separation anxiety takes the form of school avoidance. Children and adolescents can also be diagnosed with panic disorder, phobias, generalized anxiety disorder, and post-traumatic stress syndromes.
Causes and symptoms:
The causes of anxiety include a variety of individual and general social factors and may produce physical, cognitive, emotional, or behavioral symptoms. The patient’s ethnic or cultural background may also influence his or her vulnerability to certain forms of anxiety. Genetic factors that lead to biochemical abnormalities may also play a role.
Agoraphobia — Abnormal anxiety regarding public places or situations from which the patient may wish to flee or in which he or she would be helpless in the event of a panic attack.
Compulsion — A repetitive or ritualistic behavior that a person performs to reduce anxiety. Compulsions often develop as a way of controlling or “undoing” obsessive thoughts.
Obsession — A repetitive or persistent thought, idea, or impulse that is perceived as inappropriate and distressing.
Panic attack — A time-limited period of intense fear accompanied by physical and cognitive symptoms. Panic attacks may be unexpected or be triggered by specific cues. Anxiety in children may be caused by suffering from abuse, as well as by factors that cause anxiety in adults.
What are Anxiety Disorders Symptoms?
Specific symptoms vary by type of anxiety disorder, but typically, anxiety disorders are defined by:
- Feelings of being on edge or restlessness
- Feelings of being fearful or powerless
- Physical symptoms such as muscle tension, sweating, or heart palpitations
- A sense of doom or impending danger
- Difficulty concentrating or mind going blank
- Sleep disturbances
The definition of an anxiety disorder also includes an impairment of day-to-day functioning. A person with an anxiety disorder often experiences a significantly reduced quality of life and anxiety disorders are associated with possibly fatal heart conditions.
Types of Anxiety Disorders:
Several types of anxiety disorders are identified in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).
- Obsessive-compulsive disorder (OCD)
- Generalized anxiety disorder (GAD)
- Panic disorder
- Posttraumatic stress disorder (PTSD)
- Social phobia also referred to as social anxiety disorder
- Specific phobia (also known as a simple phobia)
- Adjustment disorder with anxious features
- Acute stress disorder
- Substance-induced anxiety disorder
- Anxiety due to a general medical condition
Social phobia is the most common anxiety disorder and typically manifests before the age of 20. Specific, or simple phobias – such as a fear of snakes – are also very common with more than one in ten people experiencing a specific phobia in their lifetime.
Anxiety Disorder Treatment:
Anxiety disorder treatment is typically in the form of psychotherapy and is sometimes combined with medication. Anxiety disorders often occur with other disorders such as substance use disorder, so anxiety disorder treatment often includes the treatment for those disorders as well. Education about mental illness, anxiety disorders in particular, and lifestyle changes are often crucial to the success of anxiety disorder treatment.
Several herbal remedies have been studied as a treatment for anxiety, but more research is needed to understand the risks and benefits. Here’s what we know — and don’t know:
- Kava appeared to be a promising treatment for anxiety, but reports of serious liver damage — even with short-term use — caused the Food and Drug Administration to issue warnings about the use of dietary supplements containing kava. While these initial reports of liver toxicity have been questioned, use extra caution, and involve your doctor in the decision if you’re considering using products containing kava.
- A few small clinical trials suggest that passionflower might help with anxiety. In many commercial products, passionflower is combined with other herbs, making it difficult to distinguish the unique qualities of each herb. Passionflower is generally considered safe when taken as directed, but some studies found it can cause drowsiness, dizziness, and confusion.
- In some studies, people who used valerian reported less anxiety and stress. In other studies, people reported no benefit. Valerian is generally considered safe at recommended doses, but since long-term safety trials are lacking, don’t take it for more than a few weeks at a time, unless your doctor approves. It can cause some side effects such as headaches, dizziness, and drowsiness.
- Limited data shows that short-term use of chamomile is generally considered safe and can be effective in reducing symptoms of anxiety. However, chamomile can increase the risk of bleeding when used with blood-thinning drugs. The use of chamomile can cause allergic reactions in some people who are sensitive to the family of plants including chamomile. Other members of this family are ragweed, marigolds, daisies, and chrysanthemums.
- Some evidence suggests that oral lavender or aromatherapy with lavender can reduce anxiety; however, the evidence is preliminary and limited. Oral lavender can cause constipation and headaches. It can also increase appetite, increase the sedative effect of other medications and supplements, and cause low blood pressure.
- Lemon balm.
- Preliminary research shows lemon balm can reduce some symptoms of anxiety, such as nervousness and excitability. Lemon balm is generally well-tolerated and considered safe for short-term use but can cause nausea and abdominal pain.
- Gotu kola is another of the natural anxiety supplements that have been used for thousands of years. It has an effect on producing mental clarity. It is called the fountain of life in China because of its many uses and the legend of a herbalist who lived for 200 years by consuming the herb. This herb is also used to treat insomnia due to its calming effect. It was shown to reduce the startle response to loud noise in clinical trials. The startle response is an indicator of anxiety level. Gotu kola is available as a dried herb for making tea, powder in capsules, and as a liquid tincture.
Ashwagandha or Withania somnifera is among a group of herbs called ‘adaptogens’. Adaptogens affect systems and Hormones in the body that regulate a person’s stress response. Ashwagandha has a long history of use in traditional Indian, or Ayurvedic, medicine. A small 2019 clinical trial investigated the efficacy of ashwagandha for stress and anxiety.
The 8-week study involved 58 participants with perceived stress. Each participant randomly received one of three treatments: Ashwagandha extract at doses of either 250 milligrams (mg) per day or 600 mg per day, or a placebo. The participants who took ashwagandha showed less of the stress hormone cortisol than those in the placebo group. They also experienced improved sleep quality. Participants who took 600 mg of ashwagandha reported significantly reduced stress levels. However, participants who took the lower dose of ashwagandha did not report a reduction in stress.
In another 2019 study, 60 participants with mild anxiety received 250 mg of ashwagandha or placebo for 60 days. Those taking the herb showed a significant reduction in some measures of anxiety but not others. People can take ashwagandha as a tablet or in liquid tincture form.
Chamomile is a flowering herb similar in appearance to a daisy. There are two types of chamomile that people can use medicinally: Roman chamomile and German chamomile.
Some people use chamomile in the following forms to help relieve stress and anxiety:
- skin cream
A 2016 clinical trial investigated the efficacy and safety of chamomile as a long-term treatment for generalized anxiety disorder (GAD).
All 93 participants received 1,500 mg of chamomile daily for 12 weeks. Some then continued taking chamomile for the next 26 weeks, while the remainder switched to a placebo.
Researchers observed that those participants who continued taking chamomile were no less likely to experience a relapse of GAD symptoms than those switching to placebo. However, when relapse did occur, the symptoms were less severe.
Some people may experience allergic reactions to chamomile, particularly if they experience reactions to the following plants:
Chamomile may interact with certain drugs, including the blood thinner warfarin, and the anti-rejection drug cyclosporine.
Anyone taking any type of medication should check with their doctor before consuming chamomile teas or supplements.
Valerian or Valeriana officinalis is a plant native to Europe and Asia. For many centuries, people have used the root to help treat sleep problems, anxiety, and depression.
Valerian root is available in the following forms:
To date, there have only been a few high-quality studies on the effects of Valerian. The National Center for Complementary and Integrative Health (NCCIH) states, that there is insufficient evidence to determine whether Valerian can alleviate anxiety or depression.
Studies suggest that Valerian is generally safe. However, the NCCIH notes that there is no information on the long-term use or safety of Valerian in the following groups:
- pregnant women
- nursing mothers
- Children under 3 years of age
People should also be aware that Valerian may have a sleep-inducing effect. Taking the herb with alcohol or sedatives will add to this effect and could be dangerous.
Lavender is a flowering plant belonging to the mint family. Many people use lavender to help calm their nerves and alleviate anxiety.
People may use lavender in the following ways:
- Making tea from the leaves
- Using the oil in aromatherapy
- mixing the essential oil into a base oil for massage
- adding the oil or flowers to baths
Lavender essential oil (LEO) contains chemicals called terpenes. A 2017 review article suggests that two of these terpenes called linalool and linalyl acetate may have a calming effect on chemical receptors in the brain.
The review suggests LEO may be an effective short-term treatment for anxiety disorders. However, studies of the long-term effects of LEO are lacking.
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5. Galphimia glauca
Galphimia glauca is a plant species native to Mexico. People traditionally used it as a tranquilizer to reduce anxiety.
A 2012 clinical trial investigated the efficacy of G. glauca as a treatment for GAD. Participants received either G. glauca or the prescription anti-anxiety medication lorazepam for 12 weeks. Researchers continued to monitor the participants for a further 3 weeks to test for withdrawal symptoms.
Results showed that participants who received a daily dose of 0.175 mg of G. glauca showed a greater reduction in GAD symptoms compared with those who took lorazepam. Both treatments were safe.
According to a 2018 review, the evidence for G. glauca as a treatment for anxiety is promising. However, medical companies have not exploited their potential due to a lack of available plant material.
Passionflower or Passiflora is a family of plants with around 550 different species. Some studies show that a particular species, P. incarnata, may be effective in treating restlessness, nervousness, and anxiety.
According to an older 2010 review of complementary treatments, some evidence suggests that the anti-anxiety effects of P. incarnata are comparable to those of benzodiazepines. Benzodiazepines are a class of drugs that doctors may prescribe to treat anxiety.
People can take P. incarnata in tablet form or as a liquid tincture.
7. Kava kava
Kava kava, or simply kava, is a shrub that is native to the islands of the Pacific Ocean. Its scientific name is Piper methysticum. In the Pacific Islands, people use kava as a ceremonial beverage intended to relieve stress and alter their mood. A 2013 placebo-controlled trial investigated the efficacy of kava as a treatment for GAD. The 6-week study involved 75 participants. Each person received one of three treatments: Kava extract at doses of either 120 mg or 240 mg per day, or a placebo.
Participants taking kava showed a significant reduction in anxiety compared with those who received the placebo, suggesting kava may be a moderately effective short-term treatment for GAD.
The study also found kava to be safe.
In 2002, the Food and Drug Administration (FDA) advised that taking supplements containing kava could result in severe liver injury. However, the World Health Organization (WHO) has since indicated that the link between kava and liver toxicity is unclear, saying that scientists need to re-evaluate the data.
Cannabidiol (CBD) is one of the active ingredients of the cannabis plant.
Research from 2019 suggests that CBD may have a calming effect on the central nervous system.
Although the FDA does not currently approve the use of CBD, in some countries this natural chemical, is widely available in the following forms:
- liquid extract
- vape liquid
- topical cream
The study above investigated whether CBD could help to treat anxiety and sleep disorders. Researchers retrospectively analyzed data from 103 adults taking CBD as an additional therapy for anxiety and sleep disorders.
Of the 72 adults they included in the final sample, 57 experienced a decrease in their anxiety scores within the first month of taking CBD. These scores remained low for the 3-month study period.
The researchers concluded that CBD may be beneficial for people with anxiety-related disorders. However, clinical trials are necessary to confirm these results.
9. Other supplements that might help
Other supplements that may help to alleviate symptoms of anxiety include:
- A combination of the amino acids L-lysine and L-arginine: These amino acids may influence brain neurotransmitters that are involved in stress and anxiety.
- Magnesium: Taking magnesium in combination with herbs such as kava and St John’s Wort may help to alleviate anxiety.
- Essential fatty acids: These may reduce stress in females who are premenstrual, pregnant, or menopausal.
- High dose sustained-release vitamin C: Females who take this supplement may experience reduced anxiety and a less drastic increase in blood pressure in response to stress.
Many herbs can interact with over-the-counter (OTC) and prescription medications. Some can increase or reduce the effects of certain drugs, potentially causing serious health effects. People taking any kind of medication should consult their doctor or pharmacist before beginning herbal supplements. They should also be aware that herbal remedies can take longer to start working than prescription medications.
If a person needs more advice about a herbal product, they should consult a qualified herbalist about brand, strength, and quantity. The FDA does not monitor herbal remedies, so there are potential safety concerns for herbs that have mislabeling or contamination with heavy metals.
People have been using herbs for thousands of years to treat many health conditions. Scientific studies indicate that certain herbs may help to alleviate the symptoms of anxiety. As with prescription medications, some herbal products can cause side effects. Herbal products may also take longer to begin working. People must consider these factors when weighing up the pros and cons of a particular treatment. There can be serious interactions between certain herbs and medications. A person who is taking any kind of medication should consult their doctor before they begin taking herbal products.
Exercise for Anxiety
Of course, inactivity is not the cause of anxiety for everyone. Some people are genetically prone to anxiety. Others have had experiences that shaped their anxiety symptoms. Whether inactivity causes your anxiety or not, there is also reason to believe that exercise alone can be one of the best ways to manage it. Anxiety management is about performing behaviors that fight anxiety, and exercise – of all possible behaviors – is potentially one of the best anxiety cures.
Evidence suggests all the following:
- Preventing Inactivity First and foremost, of course, is that exercise is the opposite of inactivity. If you’re exercising, then the effects of inactivity on anxiety will no longer be present. Even if inactivity doesn’t cause your anxiety, it often makes it worse. Exercise reduces the likelihood that inactivity-related anxiety affects you.
- Releasing “Relaxation” Neurotransmitters Still, the primary reason that exercise works as an effective anxiety management solution is that exercise actually has some of the same effects as some anxiety medications. Exercise releases endorphins in your brain, which are your body’s natural painkillers. They’re technically released to prevent exercise from causing pain, but they also play a role in regulating mood and relaxing the mind.
- Burning Cortisol Nearly everyone living with anxiety likely has excess cortisol in their body, as a result of the stress that anxiety places on them. Exercise depletes that cortisol, preventing many of the symptoms that lead to further anxiety, such as concentration problems and fatigue.
- Improved Sleep Exercise also tires the body enough that it becomes easier to sleep with anxiety – something that many anxiety sufferers struggle with. Sleep is crucial for anxiety management, to the ability for exercise to improve sleep is incredibly valuable.
- Healthy Activity Finally, exercise represents a healthy coping tool in general. Coping is about making sure that you’re spending time in ways that are good for your mental health, and exercise is most certainly a way to do that.
There are countless other reasons why exercise may also help with anxiety. Exercise improves confidence. It ensures that your body is healthy, and good health is important for every mental health issue. It also helps your body run more efficiently and prevents any “misfiring” that may be causing persistent anxiety.
What Exercises Will Improve Your Anxiety Symptoms?
People hear “start exercising” and they immediately zone out. When you haven’t exercised, picking up exercise can be pretty hard. It should be noted that exercise always is hard first before it gets easier – your body needs to get used to breathing and exertion, and within a few weeks it usually does – but there is no denying that starting to exercise can feel like a grueling task.
There’s good news – you don’t need to exercise intensely. You simply need to get out and get moving.
That’s not to say that you shouldn’t try to ramp your way up to more intense exercises. For some of the benefits of exercise on anxiety – especially endorphin release – you need to exercise as intensely as possible. But the most important thing you can do is get up and move, and if you simply go play some basketball or go for a bike ride once a day, you’ll see a noticeable difference even without added intensity.
Regular yoga practice can help you stay calm and relaxed in daily life and can also give you the strength to face events as they come without getting restless. Yoga practice ideally includes the complete package of asanas (body postures), pranayamas (breathing techniques), meditation, and the ancient yoga philosophy, all of which have helped several anxiety patients recover and face life with new positivity and strength.
Shares Sushama Goyal, homemaker, “I would always remain tense and worried about little things in life. Every small or big event would shake me up. My husband decided to consult a doctor who told us that I had a generalized anxiety disorder. I underwent anxiety treatment, along with the regular practice of yoga and meditation for about six months. And today I feel I have got a new birth. My thinking has changed, I feel much settled from within, and I have faith that whatever will happen will be for the good. I’m not scared of the future anymore! Yoga gave me this strength.”
Like Sushama, even you can say hello to a positive life and overcome fear with yoga. The following yoga techniques can help calm an unsettled mind.
- Dhanurasana (Bow Pose)
- Matsyasana (Fish Pose)
- Janu Shirsasana (One-Legged Forward Bend)
- Setubandhasana (Bridge Pose)
- Marjariasana (Cat Stretch)
- Paschimottanasana (Two-Legged Forward Bend)
- Hastapadasana (Standing Forward Bend)
- Adhomukha Shwanasana (Downward-Facing Dog)
- Shirshasana (Headstand)
- Shavasana (Corpse Pose)
Note: At the end of the yoga posture session, lie down in Yoga Nidra to give your mind and body a few minutes of thorough relaxation. The technique is helpful in flushing out body toxins, a primary cause of stress, from the system.
2: Breathe right with pranayamas to relieve anxiety
Taking your attention to the breath can help free the mind of the unnecessary clutter of thoughts that breed anxiety. Try the following breathing practices:
Kapal Bhati Pranayama (Skull-Shining Breathing Technique)
Nadi Shodhan Pranayama (Alternate Nostril Breathing) – effective in releasing stress from the system (where the exhalation is longer than the inhalation)
Bhramari Pranayama (Bee Breath)
Meditation can be an excellent technique to relax a distracted mind, give you a sense of calm and peace, and also observe with daily practice how your mind works to keep you involved in small, petty things around. It can also help you not worry too much or get anxious about the unknown future.
You might have often heard the term ‘adrenalin rush’. This happens when we get too anxious about a potential threat. For instance, while taking an adventure ride. At such a time, the level of the adrenalin hormone goes higher, leading our hearts to beat faster, making the muscles tense and our bodies sweat profusely. Scientific research has shown that regular meditation practice can help significantly reduce the level of this stress hormone.
4: Apply yoga philosophy in your life; stay happy and enjoy every moment
Knowing and applying ancient yoga knowledge in daily life, which talks about some simple yet profound principles (Yamas and niyamas) of yoga, can be the secret to happy and healthy living. For instance, the Santosha principle (niyama) teaches the value of contentment. The Aprigraha principle can help us overcome greediness or the desire to keep possessing more, which can be a reason for stress and anxiety. Also, the Shaucha principle talks about the cleanliness of the mind and body. This rule can particularly help if you tend to get too anxious about catching infectious diseases.
The Yamas and niyamas of yoga will also help us eat nutritious food and live a healthy lifestyle which greatly helps to overcome anxiety and stress. To understand the yoga philosophy, you may consider reading Sri Sri Ravi Shankar’s Commentary on Patanjali Yoga Sutras.
5: Pray, keep the faith, and smile!
Prayer is the best form of reassurance and support to keep your anxiety-free. Developing habits of daily prayer, chanting, or singing bhajans (devotional songs) fills you with positive energy and also helps the mind. They also instill a sense of deep faith that all happens for the best and that there is a higher divine power that takes care. Moreover, make a conscious effort to smile more and more. It will instill confidence, calmness, and positivity instantaneously. Try it out right now!
6: Think about what you can do for others
When we constantly remain stuck in ‘me and mine’, it makes room for stress and anxiety. We keep worrying about what will happen to us. Rather, shift your attention to how you can be of some use to others around you. Energizing yourself with some service activity can give you deep satisfaction and immense joy.
7: Know the impermanence of the world
When this realization sets in that everything around us is temporary and will change, we become relaxed and settled from within. A feeling of ‘this too shall pass and not remain forever’ arises in us and frees us from anxiety. Meditation can help us see this founding principle of life.
8: Remember a similar past situation when you could overcome anxiety
This fills you with immense courage that you can pass even this situation. Keep reminding yourself often.
9: Keep positive company around your
When you spend more time with positive-minded people, you are influenced by similar thoughts, which reflects in your overall attitude to life. Only a positive mind can breed joy, peace, and relaxation.
If you feel anxiety is stopping you from doing the things you would like to do. You are not alone. Anxiety may lead to other depressive states. I like to rely on natural remedies and natural ways of dealing with certain issues I have to deal with. I have been on prescription medications for over fifteen years. Unfortunately, they were accompanied by some nasty side effects.
Most of these prescription medications may cause withdrawal effects if you try to stop taking them suddenly. They need to be weaned off, most of the time under medical supervision.
Please Always consult with a medical professional if you feel that anxiety or any other disease is robbing you of a beautiful fulfilled life. You are your best friend for life, treat yourself accordingly.
Thank you for reading,
Comments are welcome.