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Caffeine may cause or exacerbate panic anxiety. Anxiety can temporarily increase during withdrawal from caffeine and various other drugs.
Panic disorder can be effectively treated with a variety of interventions, including psychological therapies and medication with the strongest and most consistent evidence indicating that cognitive behavioral therapy has the most complete and longest duration of effect, followed by specific selective serotonin reuptake inhibitors. Subsequent research by Barbara Milrod and her colleagues suggests that psychoanalytic psychotherapy might be effective in relieving panic attacks, however, those results alone should be addressed with care. While the results obtained in joint treatments that include cognitive behavioral therapy and selective serotonin reuptake inhibitors are corroborated by many studies and meta-analysis, those obtained by Barbara Milrod are not. Scientific reliability of psychoanalytic psychotherapy for treating panic disorder has not yet been addressed. Specifically, the mechanisms by which psychoanalysis reduces panic are not understood; whereas cognitive-behavioral therapy has a clear conceptual basis that can be applied to panic. The term "anxiolytic" has become nearly synonymous with the benzodiazepines because these compounds have been, for almost 40 years, the drugs of choice for stress-related anxiety.
Antidepressant medications most commonly used to treat anxiety disorders are mainly selective serotonin reuptake inhibitors. Benzodiazepines, monoamine oxidase inhibitor, and tricyclic antidepressants are also sometimes prescribed for treatment of agoraphobia. Antidepressants are important because some have antipanic effects. Antidepressants should be used in conjunction with exposure as a form of self-help or with cognitive behaviour therapy. A combination of medication and cognitive behaviour therapy is sometimes the most effective treatment for agoraphobia.
Benzodiazepines, antianxiety medications such as alprazolam and clonazepam, are used to treat anxiety and can also help control the symptoms of a panic attack. If taken in doses larger than those prescribed, or for too long, they can cause dependence. Side effects may include confusion, drowsiness, light-headedness, loss of balance, and memory loss.
Eye movement desensitization and reprocessing (EMDR) has been studied as a possible treatment for agoraphobia, with poor results. As such, EMDR is only recommended in cases where cognitive-behavioral approaches have proven ineffective or in cases where agoraphobia has developed following trauma.
Many people with anxiety disorders benefit from joining a self-help or support group (telephone conference-call support groups or online support groups being of particular help for completely housebound individuals). Sharing problems and achievements with others, as well as sharing various self-help tools, are common activities in these groups. In particular, stress management techniques and various kinds of meditation practices and visualization techniques can help people with anxiety disorders calm themselves and may enhance the effects of therapy, as can service to others, which can distract from the self-absorption that tends to go with anxiety problems. Also, preliminary evidence suggests aerobic exercise may have a calming effect. Since caffeine, certain illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of anxiety disorders, they should be avoided.
Other prescription drugs are also used, if other methods are not effective. Before the introduction of SSRIs, monoamine oxidase inhibitors (MAOIs) such as phenelzine were frequently used in the treatment of social anxiety. Evidence continues to indicate that MAOIs are effective in the treatment and management of social anxiety disorder and they are still used, but generally only as a last resort medication, owing to concerns about dietary restrictions, possible adverse drug interactions and a recommendation of multiple doses per day. A newer type of this medication, Reversible inhibitors of monoamine oxidase subtype A (RIMAs) such as the drug moclobemide, bind reversibly to the MAO-A enzyme, greatly reducing the risk of hypertensive crisis with dietary tyramine intake.
Benzodiazepines such as clonazepam are an alternative to SSRIs. These drugs are often used for short-term relief of severe, disabling anxiety. Although benzodiazepines are still sometimes prescribed for long-term everyday use in some countries, there is concern over the development of drug tolerance, dependency and misuse. It has been recommended that benzodiazepines be considered only for individuals who fail to respond to other medications. Benzodiazepines augment the action of GABA, the major inhibitory neurotransmitter in the brain; effects usually begin to appear within minutes or hours. In most patients, tolerance rapidly develops to the sedative effects of benzodiazepines, but not to the anxiolytic effects. Long-term use of benzodiazepine may result in physical dependence, and abrupt discontinuation of the drug should be avoided due to high potential for withdrawal symptoms (including tremor, insomnia, and in rare cases, seizures). A gradual tapering of the dose of clonazepam (a decrease of 0.25 mg every 2 weeks), however, has been shown to be well tolerated by patients with social anxiety disorder. Benzodiazepines are not recommended as monotherapy for patients who have major depression in addition to social anxiety disorder and should be avoided in patients with a history of substance abuse.
Certain anticonvulsant drugs such as gabapentin are effective in social anxiety disorder and may be a possible treatment alternative to benzodiazepines.
Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine have shown similar effectiveness to the SSRIs. In Japan, Milnacipran is used in the treatment of Taijin kyofusho, a Japanese variant of social anxiety disorder. The atypical antidepressants mirtazapine and bupropion have been studied for the treatment of social anxiety disorder, and rendered mixed results.
Some people with a form of social phobia called performance phobia have been helped by beta-blockers, which are more commonly used to control high blood pressure. Taken in low doses, they control the physical manifestation of anxiety and can be taken before a public performance.
A novel treatment approach has recently been developed as a result of translational research. It has been shown that a combination of acute dosing of d-cycloserine (DCS) with exposure therapy facilitates the effects of exposure therapy of social phobia. DCS is an old antibiotic medication used for treating tuberculosis and does not have any anxiolytic properties per se. However, it acts as an agonist at the glutamatergic N-methyl-D-aspartate (NMDA) receptor site, which is important for learning and memory.
Kava-kava has also attracted attention as a possible treatment, although safety concerns exist.
Appropriate medications are effective for panic disorder. Selective serotonin reuptake inhibitors are first line treatments rather than benzodiazapines due to concerns with the latter regarding tolerance, dependence and abuse. Although there is little evidence that pharmacological interventions can directly alter phobias, few studies have been performed, and medication treatment of panic makes phobia treatment far easier (an example in Europe where only 8% of patients receive appropriate treatment). Medications can include:
- Antidepressants (SSRIs, MAOIs, tricyclic antidepressants and norepinephrine reuptake inhibitors): these are taken regularly every day, and alter neurotransmitter configurations which in turn can help to block symptoms. Although these medications are described as "antidepressants", nearly all of them — especially the tricyclic antidepressants — have anti-anxiety properties, in part, due to their sedative effects. SSRIs have been known to exacerbate symptoms in panic disorder patients, especially in the beginning of treatment and have even provoked panic attacks in otherwise healthy individuals. SSRIs are also known to produce withdrawal symptoms which include rebound anxiety and panic attacks. Comorbid depression has been cited as imparting the worst course, leading to chronic, disabling illness.
- Antianxiety agents (benzodiazepines): Use of benzodiazepines for panic disorder is controversial with opinion differing in the medical literature. The American Psychiatric Association states that benzodiazepines can be effective for the treatment of panic disorder and recommends that the choice of whether to use benzodiazepines, antidepressants with anti-panic properties or psychotherapy should be based on the individual patient's history and characteristics. Other experts believe that benzodiazepines are best avoided due to the risks of the development of tolerance and physical dependence. The World Federation of Societies of Biological Psychiatry, say that benzodiazepines should not be used as a first-line treatment option but are an option for treatment-resistant cases of panic disorder. Despite increasing focus on the use of antidepressants and other agents for the treatment of anxiety as recommended best practice, benzodiazepines have remained a commonly used medication for panic disorder. They reported that in their view there is insufficient evidence to recommend one treatment over another for panic disorder. The APA noted that while benzodiazepines have the advantage of a rapid onset of action, that this is offset by the risk of developing a benzodiazepine dependence. The National Institute of Clinical Excellence came to a different conclusion, they pointed out the problems of using uncontrolled clinical trials to assess the effectiveness of pharmacotherapy and based on placebo-controlled research they concluded that benzodiazepines were not effective in the long-term for panic disorder and recommended that benzodiazepines not be used for longer than 4 weeks for panic disorder. Instead NICE clinical guidelines recommend alternative pharmacotherapeutic or psychotherapeutic interventions.
Treatment options include lifestyle changes, therapy, and medications. There is no good evidence as to whether therapy or medication is more effective; the choice of which is up to the person with the anxiety disorder and most choose therapy first. The other may be offered in addition to the first choice or if the first choice fails to relieve symptoms.
Lifestyle changes include exercise, for which there is moderate evidence for some improvement, regularizing sleep patterns, reducing caffeine intake, and stopping smoking. Stopping smoking has benefits in anxiety as large as or larger than those of medications.
Panic disorder is a serious health problem that in many cases can be successfully treated, although there is no known cure. Identification of treatments that engender as full a response as possible, and can minimize relapse, is imperative. Cognitive behavioural therapy and positive self-talk specific for panic are the treatment of choice for panic disorder. Several studies show that 85 to 90 percent of panic disorder patients treated with CBT recover completely from their panic attacks within 12 weeks. When cognitive behavioral therapy is not an option, pharmacotherapy can be used. SSRIs are considered a first-line pharmacotherapeutic option.
Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants, are first choice medication for generalized social phobia but a second line treatment. Compared to older forms of medication, there is less risk of tolerability and drug dependency associated with SSRIs.
In a 1995 double-blind, placebo-controlled trial, the SSRI paroxetine was shown to result in clinically meaningful improvement in 55 percent of patients with generalized social anxiety disorder, compared with 23.9 percent of those taking placebo. An October 2004 study yielded similar results. Patients were treated with either fluoxetine, psychotherapy, or a placebo. The first four sets saw improvement in 50.8 to 54.2 percent of the patients. Of those assigned to receive only a placebo, 31.7 percent achieved a rating of 1 or 2 on the Clinical Global Impression-Improvement scale. Those who sought both therapy and medication did not see a boost in improvement.
General side-effects are common during the first weeks while the body adjusts to the drug. Symptoms may include headaches, nausea, insomnia and changes in sexual behavior. Treatment safety during pregnancy has not been established. In late 2004 much media attention was given to a proposed link between SSRI use and suicidality [a term that encompasses suicidal ideation and attempts at suicide as well as suicide]. For this reason, [although evidential causality between SSRI use and actual suicide has not been demonstrated] the use of SSRIs in pediatric cases of depression is now recognized by the Food and Drug Administration as warranting a cautionary statement to the parents of children who may be prescribed SSRIs by a family doctor. Recent studies have shown no increase in rates of suicide. These tests, however, represent those diagnosed with depression, not necessarily with social anxiety disorder.
In addition, studies show that more socially phobic patients treated with anti-depressant medication develop hypomania than non-phobic controls. The hypomania can be seen as the medication creating a new problem.
The following are two therapies normally used in treating specific phobia:
Cognitive behavioral therapy (CBT), a short term, skills-focused therapy that aims to help people diffuse unhelpful emotional responses by helping people consider them differently or change their behavior, is effective in treating specific phobias. Exposure therapy is a particularly effective form of CBT for specific phobias. Medications to aid CBT have not been as encouraging with the exception of adjunctive D-clycoserine.
In general anxiolytic medication is not seen as helpful in specific phobia but benzodiazepines are sometimes used to help resolve acute episodes; as 2007 data were sparse for efficacy of any drug.
There are many ways to treat phobophobia, and the methods used to treat panic disorders have been shown to be effective to treat phobophobia, because panic disorder patients will present in a similar fashion to conventional phobics and perceive their fear as totally irrational. Also, exposure based techniques have formed the basis of the armamentarium of behaviour therapists in the treatment of phobic disorders for many years, they are the most effective forms of treatment for phobic avoidance behavior. Phobics are treated by exposing them to the stimuli which they specially fear, and in case of phobophobia, it is both the phobia they fear and their own sensations. There are two ways to approach interoceptive exposure on patients:
- Paradoxical intention: This method is especially useful to treat the fear towards the phobophobia and the phobia they fear, as well as some of the sensations the patient fears. This method exposes the patient to the stimuli that causes the fear, which they avoid. The patient is directly exposed to it bringing them to experience the sensations that they fear, as well as the phobia. This exposure based technique helps the doctor by guiding the patient to encounter their fears and overcome them by feeling no danger around them.
- Symptoms artificially produced: This method is very useful to treat the fear towards the sensations encountered when experiencing phobophobia, the main feared stimuli of this anxiety disorder. By ingestion of different chemical agents, such as caffeine, CO-O or adrenalin, some of the symptoms the patient feels when encountering phobophobia and other anxiety disorders are triggered, such as hyperventilation, heart pounding, blurring of vision and paresthesia, which can lead to the controlling of the sensations by the patients. At first, panic attacks will be encountered, but eventually, as the study made by Doctor Griez and Van den Hout shows, the patient shows no fear to somatic sensations and panic attacks and eventually of the phobia feared.
Cognitive modification is another method that helps considerably to treat phobophobics. When treating the patients with the method, doctors correct some wrong information the patient might have about his disease, such as their catastrophic beliefs or imminent disaster by the feared phobia. Some doctors have even agreed that this is the most helpful component, since it has shown to be very effective especially if combined with other methods, like interoceptive exposure. The doctor seeks to convince patients that their symptoms do not signify danger or loss of control, for example, if combined with the interoceptive exposure, the doctor can show them that there is no unavoidable calamity and if the patient can keep themselves under control, they learn by themselves that there is no real threat and that it is just in their mind. Cognitive modification also seeks to correct other minor misconceptions, such as the belief that the individual will go crazy and may need to be "locked away forever" or that they will totally lose control and perhaps "run amok". Probably, the most difficult aspect of cognitive restructuring for the majority of the patients will simply be to identify their aberrant beliefs and approach them realistically.
Relaxation and breathing control techniques are used to produce the symptoms naturally. The somatic sensations, the feared stimuli of phobophobia, are sought to be controlled by the patient to reduce the effects of phobophobia. One of the major symptoms encountered is that of hyperventilation, which produce dizziness, faintness, etc. So, hyperventilation is induced in the patients in order to increase their CO levels that produce some of this symptoms. By teaching the patients to control this sensations by relaxing and controlling the way they breathe, this symptoms can be avoided and reduce phobophobia. This method is useful if combined with other methods, because alone it doesn't treat other main problems of phobophobia.
There are several options for treatment of scopophobia. With one option, desensitization, the patient is stared at for a prolonged period and then describes their feelings. The hope is that the individual will either be desensitized to being stared at or will discover the root of their scopophobia.
Exposure therapy, another treatment commonly prescribed, has five steps:
- Evaluation
- Feedback
- Developing a fear hierarchy
- Exposure
- Building
In the evaluation stage, the scopophobic individual would describe their fear to the therapist and try to find out when and why this fear developed. The feedback stage is when the therapist offers a way of treating the phobia. A fear hierarchy is then developed, where the individual creates a list of scenarios involving their fear, with each one becoming worse and worse. Exposure involves the individual being exposed to the scenarios and situations in their fear hierarchy. Finally, building is when the patient, comfortable with one step, moves on to the next.
As with many human health problems support groups exist for scopophobic individuals. Being around other people who face the same issues can often create a more comfortable environment.
Other suggested treatments for scopophobia include hypnotherapy, neuro-linguistic programming (NLP), and energy psychology. In extreme cases of scopophobia, it is possible for the subject to be prescribed anti–anxiety medications. Medications may include benzodiazepines, antidepressants, or beta-blockers.
The medical literature suggests a number of treatments that have been proven effective for specific cases of needle phobia, but provides very little guidance to predict which treatment may be effective for any specific case. The following are some of the treatments that have been shown to be effective in some specific cases.
- Ethyl Chloride Spray (and other freezing agents). Easily administered, but provides only superficial pain control.
- Jet Injectors. Jet Injectors work by introducing substances into the body through a jet of high pressure gas as opposed to by a needle. Though these eliminate the needle, some people report that they cause more pain. Also, they are only helpful in a very limited number of situations involving needles i.e. insulin and some inoculations.
- Iontophoresis. Iontophoresis drives anesthetic through the skin by using an electric current. It provides effective anesthesia, but is generally unavailable to consumers on the commercial market and some regard it as inconvenient to use.
- EMLA. EMLA is a topical anesthetic cream that is a eutectic mixture of lidocaine and prilocaine. It is a prescription cream in the United States, and is available without prescription in some other countries. Although not as effective as iontophoresis, since EMLA does not penetrate as deeply as iontophoresis-driven anesthetics, EMLA provides a simpler application than iontophoresis. EMLA penetrates much more deeply than ordinary topical anesthetics, and it works adequately for many individuals.
- Ametop. Ametop gel appears to be more effective than EMLA for eliminating pain during venepuncture.
- Lidocaine/tetracaine patch. A self-heating patch containing a eutectic mixture of lidocaine and tetracaine is available in several countries, and has been specifically approved by government agencies for use in needle procedures. The patch is sold under the trade name "Synera" in the United States and "Rapydan" in European Union. Each patch is packaged in an air-tight pouch. It begins to heat up slightly when the patch is removed from the packaging and exposed to the air. The patch requires 20 to 30 minutes to achieve full anesthetic effect. The Synera patch was approved by the United States Food and Drug Administration on 23 June 2005.
- Behavioral therapy. Effectiveness of this varies greatly depending on the person and the severity of the condition. There is some debate as to the effectiveness of behavioral treatments for specific phobias (like blood, injection, injury type phobias), though some data are available to support the efficacy of approaches like exposure therapy. Any therapy that endorses relaxation methods may be contraindicated for the treatment of fear of needles as this approach encourages a drop in blood pressure that only enhances the vasovagal reflex. In response to this, graded exposure approaches can include a coping component relying on applied tension as a way to prevent complications associated with the vasovagal response to specific blood, injury, injection type stimulus.
- Nitrous Oxide (Laughing Gas). This will provide sedation and reduce anxiety for the patient, along with some mild analgesic effects.
- Inhalation General Anesthesia. This will eliminate all pain and also all memory of any needle procedure. On the other hand, it is often regarded as a very extreme solution. It is not covered by insurance in most cases, and most physicians will not order it. It can be risky and expensive and may require a hospital stay.
- Benzodiazepines, such as diazepam (Valium) or lorazepam, may help alleviate the anxiety of needle phobics, according to Dr. James Hamilton. These medications have an onset of action within 5 to 15 minutes from ingestion. A relatively large oral dose may be necessary.
Flight experience with the use of anti-anxiety medications like benzodiazepines or other relaxant/depressant drugs varies from person to person. Medication decreases the person's reflective function. Though this may reduce anxiety caused by inner conflict, reduced reflective function can cause the anxious flier to believe what they are afraid will happen is actually happening.
A double-blind clinical study at the Stanford University School of Medicine suggests that anti-anxiety medication can keep a person from becoming accustomed to flight. In the research, two flights were conducted. In the first flight, though patients given alprazolam (Xanax) reported less anxiety than those receiving a placebo, their measurable stress increased. The heart rate in the alprazolam group was 114 versus 105 beats per minute in the placebo group. Those who received alprazolam also had increased respiration rates (22.7 vs 18.3 breaths/min).
On the second flight, no medication was given. Seventy-one percent of those who received alprazolam on the first flight experienced panic as compared with only 29% of those who received a placebo on the first flight. This suggests that the participants who were not medicated on the first flight benefited from the experience via some degree of desensitization.
Typical pharmacologic therapy is 0.5 or 1.0 mg of alprazolam about an hour before every flight, with an additional 0.5-1.0 mg if anxiety remains high during the flight. The alternative is to advise patients not to take medication, but encourage them to fly without it, instructing them in the principles of self-exposure.
Currently, scholarly accepted and empirically proven treatments are very limited due to its relatively new concept. However, promising treatments include cognitive-behavioral psychotherapy and combined with pharmacological interventions. Treatments using tranylcypromine and clonazepam were successful in reducing the effects of nomophobia.
Cognitive behavioral therapy seems to be effective by reinforcing autonomous behavior independent from technological influences, however, this form of treatment lacks randomized trails. Another possible treatment is "Reality Approach," or Reality therapy asking patient to focus behaviors away from cell phones. In extreme or severe cases, neuropsychopharmacology may be advantageous, ranging from benzodiazepines to antidepressants in usual doses. Patients were also successfully treated using tranylcypromine combined with clonazepam. However, it is important to note that these medications were designed to treat social anxiety disorder and not nomophobia directly. It may be rather difficult to treat nomophobia directly, but more plausible to investigate, identify, and treat any underlying mental disorders if any exist.
Even though nomophobia is a fairly new concept, there are validated psychometric scales available to help in the diagnostic, an example of one of these scales is the "Questionnaire of Dependence of Mobile Phone/Test of Mobile Phone Dependence (QDMP/TMPD)".
There are various treatments available to calm racing thoughts, some of which involve medication. One type of treatment involves writing out the thoughts onto paper. Some treatments suggest using activities, such as painting, cooking, and other hobbies, to keep the mind busy and distract from the racing thoughts. Exercise may be used to tire the person, thereby calming their mind. When racing thoughts are anxiety induced during panic or anxiety attacks, it is recommended that the person wait it out. Using breathing and meditation techniques to calm the breath and mind simultaneously is another tool for handling racing thoughts induced by anxiety attacks. Mindfulness meditation has also shown to help with racing thoughts by allowing practitioners to face their thoughts head-on, without reacting.
While all of these techniques can be useful to cope with racing thoughts, it may prove necessary to seek medical attention and counsel. Since racing thoughts are associated with many other underlying mental illnesses, such as bipolar disorder, anxiety disorder, and ADHD, medications used commonly to treat these disorders will help calm racing thoughts in patients.
Treatment for the underlying causes of racing thoughts is helpful and useful in order to calm the racing thoughts more permanently. For example, in people with ADHD, medications used to promote focus and calm distracting thoughts, will help them with their ADHD. Also, people with insomnia who have resulting racing thoughts will find Sleep Apnea treatment & Nasal surgery helpful to eliminate their racing thoughts. It is important to look at the underlying defect that may be causing your racing thoughts in order to prevent them long-term.
Heliophobia can be treated using talk therapy, exposure therapy, self-help techniques, support groups, cognitive-behavioral therapy, and relaxation techniques. For people who are severely heliophobic, anti-anxiety meditation is a recommended mode of treatment.
Phobias of this sort can usually be treated by different types of therapies, including: cognitive behavioral therapy (CBT), psychotherapy, behavior therapy and exposure therapy.
Practice may play an important part in overcoming fear. It may be helpful to sufferers to increase phone usage at a slow pace, starting with simple calls and gradually working their way up. For example, they may find it easier to start with automated calls, move on to conversations with family and friends, and then further extend both the length of conversations and the range of people with whom conversations are held.
The most common treatment for serious cases is behavior therapy—specifically, systematic desensitization.
Several other self-help treatments exist, mainly involving exposure therapy and relaxation techniques while driving. Additional driving training and practice with a certified teacher also help many to become more confident and less likely to suffer from anxiety.
One of the emerging methods of treating this fear is through the use of virtual therapy.
With repeated exposure, all of the subjects displayed significantly less variance from normal in heart rate acceleration, depression readings, subjective distress, and post-traumatic stress disorder ratings.
Autophobia is a form of anxiety that can cause a minor to extreme feeling of danger or fear when alone. There is not a specific treatment to cure autophobia as it affects each person differently. Most sufferers are treated with psychotherapy in which the amount of time that they are alone is slowly increased. There are no conclusive studies currently that support any medications being used as treatment. If the anxiety is too intense medications have been used to aid the patient in a continuation of the therapy.
It is not uncommon for sufferers to be unaware that they have this anxiety and to dismiss the idea of seeking help. Much like substance abuse, autophobia is mental and physical and requires assistance from a medical professional. Medication can be used to stabilize symptoms and inhibit further substance abuse. Group and individual therapy is used to help ease symptoms and treat the phobia.
In mild cases of autophobia, treatment can sometimes be very simple. Therapists recommend many different remedies to make patients feel as though they are not alone even when that is the case, such as listening to music when running errands alone or turning on the television when at home, even if it is just for background noise. Using noise to interrupt the silence of isolated situations can often be a great help for people suffering from autophobia.
However, it is important to remember that just because a person may feel alone at times does not mean that they have autophobia. Most people feel alone and secluded at times; this is not an unusual phenomenon. Only when the fear of being alone beings to interrupt how a person lives their daily life does the idea of being autophobic become a possibility.
Some desensitization treatments produce short-term improvements in symptoms. Long-term treatment success has been elusive.
For individuals prescribed anti-anxiety medications such as Alprazolam (Xanax), caffeine can introduce further problems by increasing rates of cytotoxicity and cell death by necrosis. This leads to these medications being essentially ruled out as viable treatments for caffeine-induced anxiety. Due to caffeine’s negative interaction with anti-anxiety medications such as benzodiazepines, treatments for caffeine-induced anxiety disorder tend to focus on abstinence from or a reduction of caffeine intake and behavioral therapy. Some doctors may recommend a continuance of caffeine consumption but with the provision that the patient actively takes note of physiological changes that happen after caffeine intake. The goal of this approach is to help patients better understand the effects of caffeine on the body and to distinguish threatening symptoms from normal reactions.
There have been a number of studies into using virtual reality therapy for acrophobia.
Many different types of medications are used in the treatment of phobias like fear of heights, including traditional anti-anxiety drugs such as benzodiazepines, and newer options like antidepressants and beta-blockers.
Cognitive therapy is a widely accepted form of treatment for most anxiety disorders. It is also thought to be particularly effective in combating disorders where the patient doesn't actually fear a situation but, rather, fears what could result from being in such a situation. The ultimate goal of cognitive therapy is to modify distorted thoughts or misconceptions associated with whatever is being feared; the theory is that modifying these thoughts will decrease anxiety and avoidance of certain situations. For example, cognitive therapy would attempt to convince a claustrophobic patient that elevators are not dangerous but are, in fact, very useful in getting you where you would like to go faster. A study conducted by S.J. Rachman shows that cognitive therapy decreased fear and negative thoughts/connotations by an average of around 30% in claustrophobic patients tested, proving it to be a reasonably effective method.