CBT without medication for anxiety

[benthic_man]

Hi All,

    I'm curious to hear from anyone else who practices Cognitive Behavioral Therapy for their anxiety, and how effective it may be long-term without medication- I've been using CBT for about 2 years, and it's been a godsend as far as reducing the severity and frequency of debilitating anxious moments, but I still feel that my baseline anxiety level is higher than it could be.  I can not take any medication because of the nature of the work I do, so I'd really like to hear about any success stories or alternatives and supplements to CBT that have been effective. Thanks!

[RuthAllen]

CBT is a powerful way to address anxiety.  CBT skills take practice.  Oftentimes, worry and fear start in childhood and adolescence.  CBT skills work for young people too, and gives them a way to manage anxiety as they mature.  

[mammo]

The FAA does not allow pilots to fly while on medication.  Once diagnosed with anxiety and/or depression they can return to flying after being off medication and symptom free for 90 days. However, herbal remedies are not banned and they suggest a week of ground use before flying to determine what side effects they may have from something like St. Johns Wort. There are other professions who have strict guidelines as well, like Air Traffic Controllers, the DOT, etc.  I agree that we always recommend therapy as a first effort in controlling anxiety, but it can be a lengthy process.  I also believe that a lot of how well we do with CBT depends on the therapist, and if one feels they're not getting anywhere with their current one, should find another.  Exercise is great for anxiety, as well as the deep breathing exercises.

[benthic_man]

DJ it sounds like what you're doing is what used to be called a biofeedback exercise. I don't suppose that the name matters much- it's a combination of deep breathing and meditation, anyhow, and that usually works very well for me too.
         As I mentioned earlier, for professional reasons I am unable to take any current anti-anxiety medications that are available, so I've had good incentive to see how far I could take non-medical treatment for mediation purposes. My own anxiety manifests as general anxiety for the most part, and a strong aversion to crowds that is more controllable under normal circumstances.  My primary care physician AND my psychologist both push exercise and relaxation techniques to supplement the CBT. Deep breathing is my go-to exercise, though.

[DJ873]

I am finding success with a combination, the CBT is very valuable, but learning how the brain works and meditating have become my go to when I am anxious. I am not sure what I call meditating is the traditional sense of the word, but more of a body control and how to focus awareness. Focus out of thought to being and accepting what is.  I just got a Eckart Tolle CD and really like it, I have used his book for a couple of years. While I am absolutely not saying that the medication is not important, and I do have it on hand, I maybe at this point take 4 xanax a year-ish. I did take the time on medication to learn read and practice alot of things before I took them out of the daily arena. But as they have said each person and each situation is different but that is what seems to be working for me.

[Julie359]

Just to add there are numerous people in professions of high status and skill that take anit-depressants, my own GP explained that even surgeons, psychiatrists, pilots, construction workers etc take these types of drugs. It normally won't interfer with occupational health assessment as long as the person is fit and healthy to perform their job.  

[Julie359]

Hiya, well I had roughly 6 months of CBT and like youself found it a god send, it taught me so much about myself.  Sadly it didn't take the anxiety away but it made me understand why i was having panic attacks etc, it brought a lot of issues to light.  We also worked on being more assertive to gain more of a sense of control over situations as this is my problem mostly and is my trigger.  I didn't do as much exposure work as I would of liked due to limited resorces and a long waiting list, I felt like I was dumped like a sack of potatoes.  I do feel if I was given more time with a support network I would of acheived more than I did.

As for medication, there are numerous different types of anxiety control. There are a lot of drugs that don't cause sleepiness, it is mainly drugs like Benzodiazepines ie: Valium that has this effect, so maybe you could talk to ur doctor about a good alternative.  

[nursegirl6572]

While I can certainly understand those professions not allowing their members to take meds like benzos, are antidepressants permitted?  If not, that surely is a shame as it could limit potential progress that a person could have with both meds and therapy.

I think if you do some more searching you'll find that therapy is suggested all the time, as a matter of fact, most of us, whether we're anti-med, pro-med, or somewhere in between...agree upon the importance of theray as an adjunct anxiety treatment.

Many people who come to us are seeking info about medications, so you will definitely see a lot mentioned in regards to meds.  Even with myself being a proponent of meds in the treatment of anxiety, I stress all the time to people that there is something for everyone when it comes to anxiety treatments.  We have such a diverse group here, with some people being knowledgeable in medications, some with more natural approaches, meditation, biofeedback, nutrition and lifestyle changes, you name it!  That's one great thing about this forum.  While you may notice more threads about medications, we offer advice on how to treat the underlying anxiety with descriptions of so many types of treatment modalities.  Not too many people would argue the fact of needing to address the anxiety, the anxious thinking, etc...whether meds are involved or not.

I hope you stick around.  This forum has so much to offer...and I think you will find a wealth of info about ways to help better control your anxiety if medications aren't an option for you!

[benthic_man]

Thanks for the comment- One thing that is worth mentioning in this community is that people who can't take drugs for professional or religious reasons (airline pilots, surgeons and ship captains among others) are often in high-anxiety positions. I found my doctor through my primary care physician, who told me that he practices CBT for anxiety, and sent me to the same guy he goes to.

       I'm a little surprised that there isn't more mention of CBT in the archived questions. Medication only ameliorates the symptoms- I don't see a lot of folks writing about treatment so much as the medication.

[nursegirl6572]

Hello and welcome to the Anxiety Community!  Glad you found us!

I have personally never utilized CBT, but have known scores of people that have and most people report great success.  I think a large part of that depends on the therapist himself.  The greatest success stories seem to involve the ones where the therapist is much more hands on and allows for a lot more "real life" practice with coping skills. Some therapists who practice CBT aren't as willing to "go the extra mile" outside the office environment.

That's where CBT can differ a lot from traditional "talk therapy", in that people can actually navigate through tough situations (ie driving, bridges, crowded stores) WITH the therapist there, helping, and guiding the person throughout the process of coping.  Both forms of therapy are helpful in their own right, but CBT can offer anxiety sufferers (especially ones with some level of agoraphobia) something much different, much more customized to each unique situation.

Again, in either form of therapy I feel that the success (or lack thereof) depends greatly on the quality of the therapist, and the level of comfort a patient has with that therapist.  While one therapist may be a perfect fit for ME, you may find him or her completely unhelpful.  We're all different in the attributes we find important in a therapist.  Some need a tougher, more direct approach, some need more caring and compassion, more "hand holding", if you will.  It just depends on the person, which is why we always tell people that it sometimes takes a few trial runs with therapists until they find the "right" one.

CBT is a wonderful form of treatment for anxiety sufferers, whether medications are used or not.  The only negative feedback I've seen was either from people who are resistant to the idea of therapy to begin with (which makes therapy not so effective for those people)...or again, the people who just haven't found the right therapist.

I'm glad it seems to be working well for you...I hope you share with us some of your therapy experiences and how they helped you!  Welcome again!