Recently, I’ve become very intrigued with combined forms of treatment for anxiety disorders and phobias. Until recently, the most beneficial treatment for social anxiety disorder was thought to be a combination of both therapy and medication. However, a recent study published by Nordahl et al. (2016) suggests that cognitive therapy is the most effective treatment approach compared to those involving either medication or a combination of medication and therapy for treating social phobia. In this study, researchers examined self-reported social anxiety in those diagnosed with social anxiety disorders in three treatment conditions: cognitive therapy, medication, and a combination of both cognitive therapy and medication. The results, which showed that cognitive therapy as a standalone treatment was the most effective form of treatment, seemed surprising to me, as medication has become the most mainstream form of treatment.
In order to understand the implications and impact of this specific study on contemporary treatment for social anxiety disorders, an understanding of prevalence rates of mainstream medication for these disorders is needed. One example of a type of medication used for anxiety disorders are selective serotonin reuptake inhibitors (SSRIs). This form of medication prevents the reuptake process of serotonin in the neurons. Jenkins, Nguyen, Polglaze, & Bertrand (2016) discuss the role serotonin plays in influencing both mood and cognition. Generally, low serotonin levels are related to a lowered state of mood. Additionally, lower serotonin levels are related to lowered cognitive facets such as verbal reasoning and both episodic and working memory. Granted, other medications exist that are used to treat anxiety disorders and associated psychopathology. However, this study only examines participants currently taking Paxil for their treatment conditions.
IMS Health published information on prevalence rates of different types of drugs in the United States as well as different countries. Not surprisingly, over 40,000,000 people in the United states are currently taking antidepressant medication as of April 2014. While research has shown that medication and therapy has been the most effective form of treatment for anxiety disorders and other psychopathology, clearly other forms of treatment need to be considered for specific anxiety disorders. Below is a breakdown of antidepressant medication prevalence in the United States, reported by the Citizens Commission on Human Rights from IMS Health.
Antidepressants 0-5 Years 110,516
0-1 Years 26,406
2-3 Years 46,102
4-5 Years 45,822
6-12 Years 686,950
13-17 Years 1,444,422
18-24 Years 2,860,537
25-44 Years 12,400,129
45-64 Years 16,185,388
65 Year + 8,566,579
Grand Total 41,226,394
Although this study does not guarantee generalizability across other anxiety disorders and psychopathology, it presents an interesting finding regarding the effectiveness/efficacy of therapy for a specific type of anxiety disorder. More long-term studies of this nature need to be conducted that examine the differences of self-reported measures of symptoms based on the following treatment conditions: medication only, therapy only, and medication combined with therapy.