Why does medication help some people with anxiety disorder?
If anxiety disorder isn’t caused by a biological or chemical imbalance in the brain, why do some people experience a benefit from medication?
It’s true that anxiety disorder is not caused by a biological problem with the brain or by a chemical imbalance in the brain. For more information:
- Myth: Anxiety disorder is caused by a biological problem with the brain
- Myth: Anxiety disorder is caused by a chemical imbalance in the brain
- What causes anxiety?
- What causes anxiety disorder?
Before I talk about why some people experience a benefit from medication, it’s important to understand that anxiety disorder is NOT caused by a chemical or biological problem. Anxiety disorder is NOT a medical condition either.
Anxiety disorder occurs when a person’s anxious behaviors interfere with a normal lifestyle. The root of anxiety disorder is overly anxious behaviors – the unhealthy ways we think and act. Since the root cause of anxiety disorder is overly apprehensive behaviors, we eliminate anxiety disorder by learning healthy ways—non anxious ways—of behaving.
The cure of anxiety disorder is through behavioral modification, and not through chemical or biological intervention. Identifying and addressing the unhealthy behaviors at the root of anxiety disorder is the ONLY way to achieve lasting success over problematic anxiety.
Unfortunately, many people equate anxiety disorder with its sensations and symptoms. But we have to keep in mind that being overly anxious stresses the body, and a body that becomes abnormally stressed can become symptomatic. So the sensations and symptoms associated with anxiety disorder are actually the sensations and symptoms of abnormal stress. We call them anxiety symptoms because being overly anxious is the main source of the stress that causes the body to exhibit sensations and symptoms.
When it comes to helping people feel better, this is usually associated with their sensations and symptoms of stress, and not the anxious behaviors that cause the stress.
That said, here are three main reasons why some people experience a benefit from medication:
1. Some medications are sedatives
Behaving apprehensively causes the body to activate the stress response. The stress response immediately secretes stress hormones into the bloodstream where they travel to targeted spots in the body to bring about specific physiological, psychological, and emotional changes that enhance the body's ability to deal with a threat - to either fight with or flee from it - which is the reason the stress response is often referred to as the emergency response or fight or flight response.
In addition to being powerful and the other functions stress hormones perform, stress hormones are stimulants. Consequently, stress responses stress the body.
As a part of the stress response changes, stress hormones accelerate the activity of the nervous system. This is why we feel ‘energized’ and on ‘high alert’ when stress hormones are flowing.
When stress responses occur infrequently, the body can recover relatively quickly from the physiological, psychological, and emotional changes the stress response brings about. After a stress response ends, it doesn’t take long for the ‘adrenalized’ feelings to end.
When stress responses occur too frequently and/or dramatically, however, the body has a more difficult time recovering, which can result in the body remaining in a semi emergency readiness state, which we call stress-response hyperstimulation. A body that becomes stress-response hyperstimulated can exhibit similar sensations and symptoms to that of an active stress response. The more anxious we are, the more overly stressed and symptomatic the body becomes.
Anti-anxiety medications that sedate the body, including the nervous system, such as benzodiazepines (Ativan, Xanax, Valium, Klonopin, etc.) can cause symptoms of hyperstimulation to diminish. This sedation effect can make a hyperstimulated body feel more calm and relaxed.
It’s the sedative effect that provides the benefit. Many people experience anxiety and stress symptom reduction when taking a sedative/tranquilizer.
But this benefit only lasts as long as the active ingredients are active. When the active ingredient agents begin to subside, many people see an increase in their symptoms again. So, relief is temporary.
2. The placebo effect
Medications that aren’t sedatives/tranquilizers have been shown to be relatively ineffective. For example, research has shown that only one third of people who take anti-anxiety and antidepressant medications experience any kind of benefit, with another one third experiencing no benefit, and the remaining third feeling much worse.
Research has also found that when people are given a placebo (a substance with no therapeutic effect), one third feel better. So anti-anxiety and antidepressants perform no better than placebo.
In fact, many researchers believe those that benefit from anti-anxiety and antidepressant medications do so solely because of the placebo effect.
The truth is, no one, not even the drug makers, know what anti-anxiety and antidepressant medications actually do in the brain. So it could be entirely possible that the placebo effect is the only reason some people feel better when taking them.
Since anxiety is caused by a troubled state of mind, if a person thinks his medication can help reduce his symptoms, naturally he will fret less, which all by itself can reduce anxiety and the stress impact on the body. This reduced anxiety and stress can make him feel better - sometimes right away, and sometimes over time as the person comes to believe that the medication could make him feel better (as his confidence increases, so can the positive effect).
3. Medications change how the brain functions, and some people experience a benefit as a result of these changes
As stated previously, at this time, no one, including the pharmaceutical companies, know what most of the anti-anxiety and antidepressant medications are actually doing in the brain. But these types of medications are changing brain chemistry and function in some way. These changes can affect some people in a positive way, some people in a neutral way, and some people in a negative way.
It’s not that the medication is ‘correcting’ anything, but that the changes caused by the medication will affect each person uniquely. Some people experience a benefit as a result.
You also have to keep in mind that many people feel better when they drink alcohol because of how alcohol affects the brain. The same is true with antidepressants. Some people feel better NOT because antidepressants restore a ‘faulty’ chemical balance in the brain, but because of the chemical and functioning changes the chemicals in the medication are causing in the brain.
Because psychoactive drugs are powerful, because no one is really sure how they affect the brain, because no one is sure what the long-term implications of antidepressants are, and because anxiety disorder is NOT caused by a chemical imbalance that needs ‘restoring,’ we aren’t advocates of anti-anxiety and antidepressant medications. Since similar (if not better) sensation and symptom relief can be achieved through natural means, such as through regular exercise, relaxed breathing, deep relaxation, containment, and having fun, to name a few, we are advocates of managing anxiety and its sensations and symptoms naturally and not chemically.
And since anxiety disorder, and its sensations and symptoms, can be completely eliminated by doing the right work, we prefer people deal with their anxiety issues correctly so that it can be eliminated for good and without introducing what could be harmful drugs.
Much more could be said, but the above explains why some people benefit from anti-anxiety and antidepressant medications.
Anxiety and its sensations and symptoms are caused by overly apprehensive behavior and the stress toll it takes on the body. Therefore, the most effective way to overcome problematic anxiety and its sensations and symptoms is to address the behaviors at the root of problematic anxiety and reduce the body’s stress so that it can eliminate its stress-caused symptoms.
The most effective way of achieving this is with the combination of good self-help information and professional therapy, preferably by a therapist who has experienced and successfully overcome problematic anxiety in his or her own life.
There is a vast difference between someone who has learned about anxiety and someone who has personally lived it and worked through to lasting recovery.
The combination of good self-help information and working with an experienced anxiety disorder coach, counselor, or therapist is the most effective way to address anxiety disorder and its many symptoms. Until the core causes of anxiety are addressed - the underlying factors that motivate apprehensive behavior - a struggle with anxiety disorder can return again and again. Identifying and successfully addressing anxiety's underlying factors is the best way to overcome problematic anxiety.
For more information about our Anxiety Counseling option; our Available Anxiety Therapists; to Book An Appointment with one of our anxiety therapists; common Anxiety Signs and Symptoms; common Anxiety Attack Symptoms; the symptoms of panic attack disorder; anxiety Recovery Support area; information about Anxiety; and our Anxiety 101 section; or click on the appropriate link or graphic below:
Return to our Anxiety Frequent Questions page.
Authors: Jim Folk, Marilyn Folk, BScN. Last updated January 1, 2019.