Anxiety Disorder: Behavioural Therapy (CBT) is the First-line of treatment

✅ Verified by Mr. Bedanta Phukan, Clinical Psychologist.

Cognitive Behavioural Therapy (CBT) is widely recognised as one of the most effective treatments for anxiety disorders, including generalised anxiety disorder, panic disorder, social anxiety disorder, and specific phobias. CBT is considered a first-line therapy for anxiety disorders, followed by medications.

Cognitive Behavioural Therapy (CBT) is a structured, time-limited, evidence-based form of psychotherapy that aims to help individuals identify, understand, and modify unhelpful thought patterns and behaviours that contribute to psychological distress, like anxiety disorders. CBT is based on the idea that thoughts, feelings, and behaviours are interconnected and changing negative thought patterns can improve emotional state and behaviour.

How CBT helps in Anxiety Disorders

In anxiety disorders (e.g., GAD, social anxiety, panic disorder, phobias), people often:

Overestimate threats (“Something terrible will happen.”)
Underestimate their coping ability (“I won’t be able to handle it.”)
Engage in avoidance or safety behaviours that maintain the anxiety (e.g., avoiding public speaking, checking pulse repeatedly).

CBT targets these maladaptive thought patterns and behaviours. CBT identifies Negative Thought Patterns, helps individuals recognise and challenge unhelpful or distorted thoughts that fuel anxiety, such as catastrophizing or overestimating danger.

Components of CBT are:

Cognitive Restructuring: Identifies and challenges anxious thoughts (e.g., “What evidence do I have that I’ll faint during the meeting?”). This helps reduce catastrophic thinking.
Behavioural Experiments: Tests negative predictions (e.g., attending a party to see if embarrassment really occurs), helping correct false beliefs.
Exposure Therapy: Gradual exposure to feared situations reduces avoidance and desensitises the anxiety response over time.
Relaxation and Breathing Techniques: Helps control physiological symptoms like palpitations or hyperventilation.
Psychoeducation: Understanding how anxiety works biologically and psychologically empowers patients.
Thought Records: Gradual exposure to feared situations reduces avoidance and desensitises the anxiety response over time.

Examples by Anxiety Type

Panic Disorder: CBT helps patients reinterpret physical symptoms (e.g., rapid heartbeat is not a heart attack) and use interoceptive exposure to reduce fear of symptoms.
Social Anxiety: Patients challenge thoughts like “Everyone will judge me” and do behavioural experiments like speaking up in meetings.
Generalised Anxiety Disorder (GAD): Teaches how to break the worry cycle by challenging “what if” thoughts and using problem-solving over rumination.
Phobias: Gradual exposure to the feared object/situation reduces the fear response.

Efficacy

60–80% of patients experience a significant reduction in anxiety symptoms.
Effects are long-lasting, especially when CBT is done properly.

Numerous studies confirm that CBT is very effective with or without medications for many anxiety disorders. CBT equips individuals with lifelong tools to manage anxiety, reducing the risk of relapse.

If you’re experiencing an anxiety disorder, it’s important to seek professional help, as effective treatment is always available.

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