Not infrequently we’re asked about the effects of medication on anxiety. While medication has a place in treatment, it should not be seen as a magic bullet that will erase all anxiety symptomology. In fact, for some issues medication may inhibit one’s long-term recovery.
Our patients often describe that medications prescribed for anxiety (often selective serotonin reuptake inhibitors, or “SSRI”, such as Zoloft and Prozac) “turns down the volume” of the intrusive anxious thoughts, and/or reduces the intensity of panic attacks. They are also very clear that the medications do not get rid of the anxious thoughts or the panic attacks, but rather reduce their intensity. One potential reason for this is that the medication does not address the underlying thought processes related to the anxiety: if I’m worried about the plane crashing, medication will make me less physiologically panicky, but does not stop or help me think through my concern about the plane crashing.
The approach we use focuses on addressing the underlying thought processes, as well as the panicky sensations and related behaviors. The reason one gets anxious is based on how one thinks about the situation (e.g., “I know this plane is going to crash”). If I didn’t think the plane wasn’t going to crash, then I wouldn’t be anxious about flying. We help people to think through the issue and examine the data that either supports, or contradicts, their anxious thought (“How often do planes crash? Are all these other passengers foolish for getting on the plane?”).
Medication can be helpful on the short run, “turning down the volume” of the anxious thoughts so a person can attend to treatment without being overwhelming by the scary thoughts. Over time, we hope that people can rely on their newfound cognitive skills, rather than medications to deal with worry thoughts and panic attacks.
