How to deal with anxiety and improve your mental health

• To deal with anxiety, most people need a combination of natural remedies, therapy, and medication.
• Cognitive behavioral therapy (CBT) can treat anxiety by exposing patients to anxiety triggers and helping them better manage their response.
• Medication may reduce anxiety in the short-term — and allow patients to effectively do CBT and implement lifestyle changes — but long-term use can result in dependency.
• This article was medically reviewed by David A. Merrill, MD, PhD, psychiatrist and director of the Pacific Brain Health Center at Pacific Neuroscience Institute at Providence Saint John's Health Center.
• Visit Insider's Health Reference library for more advice.

When anxiety begins to feel out of control or affects your quality of life, it's important to check in with a doctor and consider treatment, says Joseph Garbely, D.O, chief medical officer at Caron Treatment Centers in Pennsylvania.

Anxiety disorders affect about 18% of American adults each year. Common and effective treatments for anxiety can include lifestyle changes, therapy, and medications.

Here's what you need to know about each type of treatment and what might be best for you.

Natural remedies for anxiety

Lifestyle changes are an important part of calming anxiety, whether you have an anxiety disorder or not.

"If you find that you are not at risk of harm from the anxiety, you may prefer self-help at first," says Alessandro De Nadai, Ph.D., assistant professor of psychology at Texas State University.

Here are common treatments that you can use yourself to calm anxiety:

• Exercise: Regular exercise has been found to effectively relieve the symptoms of anxiety. Even 10 minutes of exercise each day can help reduce stress and boost mood.
• Nutrition: Eating a diet high in sugar and processed food is associated with increased anxiety. Instead, focus on eating wholesome foods and plenty of fruits and vegetables, says Dawn Jonas, NMD, with the Southwest College of Naturopathic Medicine.
• Mindfulness: Mindfulness meditation is a "proven and effective way to ease anxiety," Garbely says. Mindfulness apps can help you get started, and have been found effective at reducing anxiety when used for 10 minutes a day over two weeks.
• Biofeedback: Biofeedback is the process of monitoring your physical anxiety symptoms in order to better regulate them. For example, deep breathing techniques can lower a racing heart rate due to anxiety.

Cognitive behavioral therapy

Many people with anxiety disorders benefit from cognitive behavioral therapy (CBT).

During CBT, a therapist helps people confront their anxiety little by little, so they can learn to better control their reaction. Exposure therapy is one type of CBT that is particularly helpful for anxiety. De Nadai explains that these therapies focus on one main goal:

"The best treatments involve an element of practicing anxiety-provoking situations together with a therapist," De Nadai says. "With practice over time, the situation will make someone less and less anxious."

In fact, about 60% of people who finish CBT will have "substantial improvements" to their anxiety, according to research from the University of North Carolina. This typically happens within 12 to 20 sessions.

CBT can be delivered online or in person, and within group or individual sessions. A 2019 study also found that people with social anxiety, generalized anxiety, and panic disorders who had CBT online for a year experienced a significant reduction in their symptoms.

"Throughout treatment, tasks that once seemed impossible — such as public speaking — become less intimidating and are eventually conquered," says Garbely.

Most people get some relief from CBT between 12 and 16 weeks after they start sessions. Oftentimes, therapy will be used alongside medication.

Anxiety medications

Medications are the most effective treatment for quickly reducing anxiety, says Ryan Sultan MD, an assistant Professor of Clinical Psychiatry at Columbia University in New York.

In fact,roughly 50% of people who take medications will have a reduction in their anxiety symptoms.

"Anti-anxiety meds, such as benzodiazepines like Xanax, act as fire extinguishers for episodes of anxiety," Sultan says. "Shortly after taking the anti-anxiety medication, your anxiety rapidly reduces."

These medications are often prescribed as an on-needed basis, so people take them when anxiety spikes. But many people also take other types of daily medication to control anxiety symptoms and prevent episodes of intense anxiety.

Here are four common types of anxiety medications:

• Selective Serotonin Reuptake Inhibitors (SSRIs). This class of drugs, which includes Zoloft and Prozac, blocks the reabsorption of the neurotransmitter serotonin. As a result, people on SSRIs experience an increase of serotonin in their brains, which has been associated with improved mood. SSRIs are considered very effective at treating anxiety, but have possible side effects including insomnia and weight gain. SSRIs are taken daily.
• Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): SNRIs, which include Cymbalta and Effexor, function similarly to SSRIs, except they also increase levels of norepinephrine, a neurotransmitter that helps the body respond to stress. They are taken daily. SNRIs are effective, but have possible side effects such as stomach aches and insomnia.
• Tricyclic antidepressants: This type of medication increases levels of norepinephrine and serotonin. However, they're an older class of drugs and are generally only used if SSRIs and SNRIs fail, because they may have more severe side effects, including sudden drops in blood pressure.
• Benzodiazepines: Benzodiazepines, including valium and Xanax, act on the neurotransmitter gamma-aminobutyric acid (GABA), which helps calm the nervous system. They're often taken as-needed or on a short-term basis to relieve anxiety episodes, as they can cause dependency if used long-term. Benzodiazepines may also block memory formation in the brain, making it more difficult to benefit from CBT while on this type of medication.

Medication for anxiety should be overseen by a doctor and used alongside therapy. Eventually, your doctor may talk to you about weaning off medications, but this should only be done with medical oversight — because stopping anxiety medication suddenly can be dangerous.

"Medications help lower anxiety enough to allow you to successfully benefit from psychotherapy," Sultan says. "After completing the psychotherapy with the aid of the medicine, you may no longer need the medicine."

Overall, for most people, a combination of lifestyle changes, therapy, and medication can help them successfully manage anxiety.

"Research on the treatment of anxiety disorders overwhelmingly supports that people do best with a combined treatment approach with lifestyle, CBT, and medication at the same time," Sultan says.

Related articles from Health Reference:

• Does marijuana help with anxiety? Maybe, but reports are mixed
• How to stop a panic attack: 3 ways to deal with sudden anxiety
• How to lower your heart rate from anxiety, or a panic attack
• How to get better sleep with anxiety or stress, in 5 different ways
• Is anxiety genetic? Anxiety disorders are caused by a combination of both genes and your environment