Woman in distress

Getting Anxiety Right

Anxiety medications may help patients return to work, but they often do little to address the underlying problem. With many pharmaceutical companies raising a white flag, a new approach to treating anxiety may be needed, one that addresses both unconscious and conscious responses to stimuli.

NEW YORK – When researchers want to evaluate the efficacy of new anxiety treatments, the traditional approach is to study how rats or mice behave in uncomfortable or stressful situations. Rodents shun brightly lit, open spaces, where, in the wild, they would become easy prey. So their natural tendency in a test apparatus is to find areas that are poorly illuminated or close to walls. The longer a medicated animal spends in areas in which it is unprotected, the more effective the drug is judged to be in treating anxiety.

But the drugs that have resulted from this approach are not actually very good at making people feel less anxious. Neither patients nor their therapists consider the available options – including benzodiazepines like Valium and selective serotonin reuptake inhibitors like Prozac or Zoloft – as adequate treatments for anxiety. After decades of research, some of the big pharmaceutical companies are raising the white flag and cutting back on efforts to develop new anti-anxiety drugs.

But we cannot afford to give up on treatment for the so-called anxiety disorders, which encompass problems related to both fear and anxiety. Feelings of fear occur when a possible source of harm is nearby or likely to present itself, while feelings of anxiety usually involve the possibility of harm in the future. Worldwide, the lifetime prevalence of anxiety disorders is about 15%, and the cost to society is enormous. In the late 1990s, it was estimated that the economic burden of anxiety totaled more than $40 billion. The total cost is most likely significantly higher, because many anxiety disorders are never diagnosed.

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