Anxiety Treatment in Spokane, WA

At Persona Mental Health, we provide individualized treatment plans tailored to your specific type of anxiety, symptoms, and personal circumstances. Research shows that the most effective treatment for anxiety disorders combines medication management with psychotherapy.

Medication Management for Anxiety

Psychiatric medications can significantly reduce anxiety symptoms and improve your quality of life. We carefully select medications based on your specific anxiety disorder, symptoms, medical history, and treatment goals.

Antidepressants (First-Line Treatment)

Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed first-line medications for most anxiety disorders. They work by increasing serotonin levels in the brain, improving mood and reducing anxiety.

Commonly prescribed SSRIs include:

• Sertraline (Zoloft) – effective for GAD, panic disorder, social anxiety, and PTSD

• Escitalopram (Lexapro) – highly effective for GAD and social anxiety

• Paroxetine (Paxil) – FDA-approved for GAD, panic disorder, and social anxiety

• Fluoxetine (Prozac) – effective for GAD, panic disorder, and OCD

• Citalopram (Celexa) – effective for GAD and panic disorder

Important considerations about SSRIs:

• Take 2-12 weeks to reach full effectiveness

• Start at low doses, especially for anxiety (to minimize initial activation)

• Require gradual titration to therapeutic levels

• Well-tolerated with manageable side effects for most patients

• Safe for long-term use

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are also effective first-line options for anxiety disorders:

• Venlafaxine (Effexor XR) – FDA-approved for GAD, panic disorder, and social anxiety

• Duloxetine (Cymbalta) – effective for GAD, especially when chronic pain is present

Other Antidepressant Options:

• Mirtazapine (Remeron) – helpful when sleep disturbance is prominent

• Bupropion (Wellbutrin) – may be used for some patients, though less common for primary anxiety

• Tricyclic antidepressants (TCAs) – effective but used less frequently due to side effects

Anti-Anxiety Medications (Benzodiazepines)

Benzodiazepines provide rapid relief of acute anxiety symptoms but are typically used short-term or as-needed due to potential for dependence.

Commonly prescribed benzodiazepines include:

• Clonazepam (Klonopin) – longer-acting, helpful for panic disorder and social anxiety

• Lorazepam (Ativan) – intermediate-acting, used for acute anxiety relief

• Alprazolam (Xanax) – shorter-acting, commonly used for panic attacks

• Diazepam (Valium) – longer-acting, used for GAD and muscle tension

When benzodiazepines are appropriate:

• Short-term use while starting an antidepressant (2-4 weeks)

• Acute anxiety episodes or panic attacks

• As-needed use for specific anxiety-provoking situations

• Adjunct treatment when antidepressants alone provide insufficient relief

Important safety considerations:

• Potential for physical dependence with long-term daily use

• Should not be combined with alcohol or opioids

• Require careful monitoring and gradual tapering when discontinuing

• May cause drowsiness, impaired coordination, or memory issues

Other Medication Options

Buspirone (BuSpar) – a non-benzodiazepine anti-anxiety medication particularly effective for GAD:

• No risk of dependence or withdrawal

• Takes 2-4 weeks to become effective

• Well-tolerated with minimal side effects

• Safe for long-term use

Beta-Blockers – medications like propranolol can help control physical symptoms of anxiety such as rapid heartbeat, trembling, and sweating:

• Particularly helpful for performance anxiety or social anxiety

• Used on an as-needed basis before anxiety-provoking situations

• Do not affect the psychological aspects of anxiety

Hydroxyzine (Vistaril) – an antihistamine with anti-anxiety properties:

• Rapid onset of action for acute anxiety

• No dependence potential

• Can be used as-needed or regularly

• May cause drowsiness

Psychotherapy and Counseling

Psychotherapy is highly effective for treating anxiety disorders and provides long-lasting benefits by teaching skills to manage anxiety symptoms.

Cognitive Behavioral Therapy (CBT)

CBT is the gold-standard psychotherapy for anxiety disorders, with extensive research supporting its effectiveness. CBT helps you:

• Identify and challenge anxious thoughts and beliefs

• Learn to recognize thinking patterns that contribute to anxiety

• Develop coping strategies for managing anxiety symptoms

• Gradually face feared situations through exposure therapy

• Practice relaxation and stress management techniques

CBT typically involves:

• 12-20 weekly sessions (may be shorter or longer depending on severity)

• Homework assignments to practice skills between sessions

• Gradual exposure to anxiety-provoking situations in a controlled way

• Learning to tolerate uncomfortable feelings without avoidance

Exposure Therapy

Exposure therapy, often a component of CBT, involves gradual, controlled exposure to feared situations or objects. This helps reduce fear responses and builds confidence in managing anxiety.

Exposure therapy is particularly effective for:

• Specific phobias

• Social anxiety disorder

• Panic disorder and agoraphobia

• OCD

• PTSD

Other Therapeutic Approaches

• Acceptance and Commitment Therapy (ACT) – teaches mindfulness and acceptance of anxious thoughts rather than fighting them

• Dialectical Behavior Therapy (DBT) – provides distress tolerance and emotion regulation skills

• Mindfulness-Based Therapies – reduce anxiety through present-moment awareness and meditation

• Psychodynamic Therapy – explores unconscious conflicts and past experiences that may contribute to anxiety

• Group Therapy – provides peer support and opportunity to practice skills in a supportive environment