Recovery from anxiety

The conventional psychiatric drug approach
Benzodiazepines and antidepressants are commonly prescribed drugs for anxiety. Although these drugs are often helpful in reducing anxiety symptoms, increasingly, people are educating themselves on the risks and limitations of both classes of drugs. 
The following two graphics highlight evidence about these drugs, extracted from a number of peer-reviewed scientific studies.

First, benzodiazepines. These drugs can provide fairly immediate and effective relief from anxiety symptoms. They may be helpful for some people in severe psychiatric crisis or for people who do not want other approaches. However, they come with a host of troubling issues.

Many people have found the withdrawal difficulties especially debilitating. In addition to these downsides, benzodiazepines can more rarely cause paradoxical excitement - making anxiety worse, even producing mania.

Now consider antidepressants.

In addition to these issues, antidepressants are relatively slow to "kick in" and have a variety of other potential side effects that may persist after you stop using antidepressants. These include gastrointestinal issues, weight gain, cardiovascular issues, Parkinsonian-like involuntary movements, and more. [1]

The U.S. FDA clearly states that antidepressants work only slightly better than placebo (sugar pills). [2]  In fact, a massive review of 27,422 people on antidepressants led to the conclusion that, "the potential small beneficial effects (of antidepressants) seem to be outweighed by harmful effects." [3]  A recent analysis found that the effectiveness of antidepressants in treating anxiety has been overestimated, and in some cases is no better than placebo. [4]

On top of all of this, the FDA has issued a black box warning – the most serious type of warning for prescription drugs – for antidepressants, because of the doubling of the suicide risk for children and adults under age 25 on antidepressants. [5]

Your health, your choice
A growing number of doctors see antidepressants and bezodiazepines as flawed options, especially for the developing brain and personhood of a child.

They note drug withdrawal difficulties and the risk of benzodiazepine addiction, the long list of side effects, and the reality that our mind, body and emotions require a much more holistic and integrated approach than a pill can provide. 

Understanding these realities, many people are reevaluating the risk/reward profile of benzodiazepines and antidepressants, and are working to take a more holistic evidence-based approach to their recovery.

Before deciding to take psychiatric drugs - especially before agreeing to use benzodiazepines for more than a very short period of time - consider reviewing the above information with your practitioners. You may want to discuss the specific studies referenced below. 

The good news is that there are a number of non-drug approaches that often work as well as, or better than these drugs, without the many side effects and withdrawal difficulties. These non-drug approaches also leverage common sense approaches that can often lead to sustainable mental wellness.

Always work with trusted and licensed practitioners.  Any changes in psychiatric drug use should always be done under practitioner care. Please see disclaimer.

An integrated wellness approach
There are thousands of peer-reviewed gold-standard medical studies that support the use of non-drug approaches for mental health recovery. In fact, there are 27 broad non-drug approaches that have proven effective. Many are useful for anxiety (download free monograph).

It is often best to consider anxiety from a holistic perspective that includes many therapeutic options separated into four categories of care 

The "higher" in this diagram we operate (toward Preventive), the better, since these are the approaches that help us sustain mental wellness. However, once we develop anxiety symptoms, it may be helpful to use techniques in multiple categories simultaneously to maximize recovery. 

Preventive care
Preventive approaches include a number of common sense health practices we can adopt that often have a significant impact on mental health. Often called wellness basics, many of these approaches have been proven very helpful for anxiety including proper diet, exercise, mindfulness, controlled breathing, ensuring gut-health, social interaction, being in a bright natural light, mind-body disciplines (like yoga) and many more.

Restorative care
Restorative approaches address root-causes and direct influencers of mental health symptoms. They come in two varieties: biomedical and psychosocial. Since our body and mind interact so deeply, it is often helpful to address both simultaneously.

Biomedical practitioners can help identify an individual’s unique bio-individuality through blood/urine and other testing, using detailed biomedical test panels. This is important since over 25% of the time, mental health symptoms are caused by or significantly influenced by physical issues. These tests can uncover nutrient imbalances, hormonal issues, amino acid irregularities, food allergies, pathogens, inflammation, toxicities, or other root-cause physical conditions. 

Walsh-protocol nutrient therapy has been found to be particularly effective for depressive and anxiety symptoms: over 70% of people who use customized Nutrient Therapy for six months see a substantial decrease in symptoms, frequently allowing them to reduce or eliminate psychiatric drug use. [6To help you locate practitioners, review our practitioner finder

Psychosocial practitioners can help identify and address an individual's past trauma, stress, social challenges, emotional difficulties and unhelpful thinking patterns — common causes and influencing factors of anxiety.  A variety of psychosocial therapies are superior to drugs for generalized anxiety, obsessive-compulsive disorder, post-traumatic stress disorder and other anxiety-related situations, especially when considering side effects and extended risks.[7

In addition, peer support - from those who have experienced similar mental health challenges and recovered - offers a unique "been there" perspective and personal sensitivity that can be invaluable. Directories of therapists, psychologists, peer specialists and other psychosocial practitioners are usually available in your community.

Symptom relief care
Symptom relief approaches seek to address any residual symptoms that are not removed by preventive and restorative care. Although psychiatric drugs are by far the most common form of symptom relief prescribed, various herbs (e.g. kava), sensory therapies and very low charge electrical stimulation have been shown effective for anxiety.

Over-care avoidance
Over-care avoidance is limiting the use of psychiatric drugs and other medical interventions to only what is necessary. Increasingly, practitioners work to minimize the use of psychotropic drugs because of their side effects, withdrawal difficulties and inability to cure.

However, some people find psychiatric drugs helpful. When using drugs, they should be taken in minimum effective dosages - no greater than the amount needed to gain significant symptom relief and for no longer than is required. 

It is important since excessive drug use can not only be expensive, but harmful - particularly in the case of benzodiazepines. Over-prescribing of psychiatric drugs is an important issue, especially for children, the elderly and other vulnerable populations. The American Psychiatric Association and a variety of public health organizations are working to curb over-care practices.

Work with trusted integrative practitioners
Many practitioners are joining the paradigm shift to Integrative Mental Health - a discipline that embraces the best of both drug and non-drug treatments.

We are all different and require individualized paths to recovery. Integrative practitioners offer a variety of therapy options, and can advise you on the ones most appropriate for your bio-individuality, personal history, stressors, and preferences. Through experimentation, you can find the ones that work best for you. If your practitioners do not offer non-drug options, it is often best to engage practitioners that do. 

Dr. Kenneth Duckworth, Medical Director of the National Alliance on Mental Illness, is clear: "psychiatric medications... are rarely enough to promote recovery alone [8] ... many (people) report that a combination of treatments is most effective."[9]  In support of this outlook, NAMI advocates select non-drug options that can aid recovery [10] while Mental Health America articulates many more. [11]

Although non-drug approaches are not a universal panacea and they often take more work than popping a pill, many people have found that diligent use of non-drug options can significantly reduce or eliminate the symptoms of anxiety with little or no side effects, helping them realize mental health recovery.