How to Find the Best Treatment for Anxiety and Why You May Need a Second Opinion

Anxiety is more than just occasional worry. Untreated anxiety can significantly and negatively impact one's daily life, relationships, and overall well-being. The Psychiatrists at Mental Health and Wellness Associates are experts in the diagnosis and treatment of all types of anxiety conditions. 

We frequently work with individuals who are struggling with the symptoms of anxiety. Some patients come in knowing they have anxiety and others do not. In this article, we will explore common manifestations of anxiety, the diagnostic process, treatment approaches, and why seeking a second opinion from a psychiatrist can be a valuable step for those dealing with untreated or undertreated anxiety.

Common Symptoms of Anxiety

A) Excessive Worry: Persistent and uncontrollable thoughts about various concerns, often involving catastrophic scenarios.

B) Physical Symptoms: Restlessness, muscle tension, trembling, increased heart rate, and sweating.

C) Sleep Disturbances: Difficulty falling asleep, staying asleep, or experiencing restless and unsatisfying sleep.

D) Irritability: Heightened sensitivity, impatience, and irritability in response to everyday stressors.

E) Difficulty Concentrating: Racing thoughts and an inability to focus on tasks due to preoccupation with worries.

F) Avoidance Behavior: Steering clear of situations that trigger anxiety, leading to social withdrawal or avoidance of specific activities.

G) Panic Attacks: Sudden and intense episodes of fear or discomfort, often accompanied by physical symptoms like chest pain and shortness of breath.

Diagnosing and Treating Anxiety

Psychiatric Evaluation: The first step is often a comprehensive psychiatric assessment by a psychiatrist. The clinical interview is extensive and covers all aspects of the biological, psychological, social and spiritual aspects of a person’s history, environment and daily life. 

The psychiatrist not only focuses on the past but also thoroughly assesses the nature, severity, and duration of anxiety symptoms. This evaluation considers any underlying medical conditions, co-occurring psychiatric and/or substance use disorder and life stressors. 

Anxiety rarely happens in a vacuum and unless you understand the whole person, you can only treat symptoms and not a comprehensive condition, like anxiety. That is why it is essential to work with a well-trained and experienced psychiatrist. 

Diagnostic Criteria: Anxiety disorders, as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), have well studied and understood symptoms and presentations that guide the diagnostic process, encompassing conditions like generalized anxiety disorder (GAD), panic disorder, obsessive compulsive disorder (OCD) and social anxiety disorder etc. A well trained and evidence-based psychiatrist will use DSM-5 diagnostic criteria when ruling in and/or ruling out anxiety disorders when making an accurate diagnosis. 

Therapeutic Approaches: Psychiatrists are trained in both medication management and therapy. They have the ability to refer to specialists when a patient needs a specialized type of treatment or psychotherapeutic approach. 

Psychotherapy, particularly cognitive-behavioral therapy (CBT), can be very effective in addressing thought patterns and behaviors associated with anxiety. In addition to therapy, medications, such as selective serotonin reuptake inhibitors (SSRIs), may also be prescribed based on the severity of symptoms. There are many other options, including other forms of therapy and other types of medication that a psychiatrist can guide a patient through, to find the most individualized and appropriate treatment plan.  

Lifestyle Modifications: Stress management techniques, regular exercise, and healthy diet and sleep habits can contribute to anxiety management. Behavioral modifications and stress reduction can play an important role in a comprehensive treatment plan. 

Holistic Care: Psychiatrists may also collaborate with other healthcare professionals, such as primary care physicians, specialists and existing treatment providers (i.e. like a therapist) to ensure a comprehensive approach to treatment.

The Value of Seeking a Second Opinion

In many cases, patient come to a psychiatrist feeling like their current treatment approach is failing or has not been as successful as hoped for. In these cases, a psychiatrist can provide a second opinion. The goal of which is to see if there are areas available to improve the current treatment approach. A well trained and experienced psychiatrist can help right the course of treatment in several ways: 

Confirmation of Diagnosis: Anxiety symptoms can be complex and overlap with other mental health conditions. Seeking a second opinion helps confirm the accuracy of the initial diagnosis and also explore the possibility of a misdiagnosis or missed co-occurring conditions that could be causing or making the current symptoms worse.

Exploration of Treatment Options: A new psychiatrist can bring a fresh perspective on treatment approaches, offering alternative therapeutic modalities or medication options or other forms of therapy that have not previously been tried. 

Validation of Concerns: Anxiety symptoms are hard to measure and can feel subjective. Because of this, family, friends and even some medical providers may doubt the severity of the symptoms or may simply have trouble quantifying them. A second opinion can provide validation, support and clarity.

Optimizing Treatment Plans: A primary care doctor or primary therapist does not have the training and experience of a top psychiatrist. Seeking a second opinion allows for the optimization of treatment plans tailored to individual needs. It may simply provide a road map that can be used by the existing team if that is preferred. 

Enhanced Patient-Doctor Relationship: Building a trusting relationship with any treatment provider is crucial for effective treatment. Seeking a second opinion allows individuals to find a psychiatrist with whom they feel comfortable and understood. This alone can improve outcomes and help you to reach treatment goals. 

Anxiety is a complex and often challenging condition both to accurately diagnose and treat. However, with the right treatment team in place, anxiety conditions are highly treatable. If you or someone you know is struggling with untreated anxiety, seeking the guidance of a psychiatrist is a vital first step. Additionally, considering a second opinion can offer valuable insights, ensuring that the diagnosis is accurate, and the treatment plan is optimal for long-term mental well-being.

Remember, you do not have to navigate anxiety alone. High quality professional help is available, and seeking care, or a second opinion, is a proactive step toward finding the most effective and personalized solutions for managing anxiety.

If you are interested in becoming a new patient, please schedule a time to speak with our practice manager (using the "book online" button above) or call our office today.

References:

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.

Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in Clinical Neuroscience, 19(2), 93–107.

Craske, M. G., Stein, M. B., Eley, T. C., Milad, M. R., Holmes, A., Rapee, R. M., ... & Wittchen, H. U. (2017). Anxiety disorders. Nature Reviews Disease Primers, 3, 17024.

Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.

National Institute of Mental Health. (2021). Anxiety disorders. Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml.