Writer’s Guide for the Treatment of Anxiety Disorders

Previously, we talked about what anxiety is, the different types of disorders, and now we’re going to talk about how each of them is treated. Keep in mind that none of these posts are to be used as a way to diagnose or treat people in real-life scenarios. It is merely a broad-overview of mental health disorders intended to help writers create as real-to-life characters as possible.
In a following post, I’m going to be bringing all of this information together to show how you can use the mental health diagnosis of anxiety together to create a plot and character arc. I try to post weekly on Mondays, so if consider following my page if you haven’t already.
In modern medicine, clinicians generally use a combination of medications as well as cognitive behavioral therapy. I am not going to focus on this medication aspect because it is not relevant to the point I’m trying to make.
Often, the first part of treating anxiety is to realize it is taking place. Sometimes it can be hard to admit that anxiety is causing that racing heart sensation, the nausea, and the heart palpitations. Often a person will show up at the ER thinking they are having a heart attack before showing up at their therapist’s office. Or a person with chronic anxiety might turn to less healthy alternatives of stress management such as binge eating or drinking. In cases like OCD, they may participate in ritualistic compulsion practices. In cases like agoraphobia, they may refuse to leave the house.
In this day and age, we are getting better as a society that does not demean people with mental health related illnesses, but we have a long way to go. If a person who previously perceived others with mental health illnesses as weak or crazy, when they develop symptoms themselves, they can be very hard to accept. A major hit to their self-esteem or self-perception can occur. Acceptance may not occur, so the person keeps presenting to the hospital with the same symptoms, but refuses to see a therapist. All this needs to be taken into consideration as it relates to treatments for anxiety. It’s also little details you can add into your character’s profiles to make them more real.
In a controlled environment such as a therapist’s office, the therapist will probably teach their client relaxation techniques to manage their anxiety symptoms when they arise. They will probably discuss different triggers that cause the anxiety to flare up. These triggers might phobias such as claustrophobia or the thought of eating in an anorexic patient. Together, the therapist and client will formulate a plan on how to face these triggers without having an anxiety related response.
For an example, we’ll us a woman with claustrophobia, specifically a fear of elevators. They are probably also afraid of closets, cars, and other tight quarters, but there’s an elevator down the hall so it’s the most convenient problem to deal with at the moment. The therapist may try ‘systematic desensitization’ where the therapist exposes the client to the threatening object in gradually increasing intensities (Videbeck p. 241). For example, they may spend a session looking at pictures of elevators on the computer. Next session, they may stand ten feet from the elevator and watch as it opens and closes while people get in and out. Then they take a peek inside the elevator. Basically, these steps are performed until the client is bored of them—which is the mind’s way of saying something is thoroughly processed. Finally, the client is able to step inside the elevator, not without fear, but without having a full-blown panic attack. They survive their small trip unscathed. This does not mean that elevator rides will be easy from now on. In fact, the client will still probably be scared of elevators, but they, themselves, will be braver. The key to this, however, is that the person must face the fear willingly. If the therapist drags them down the hall and shoves them into an elevator, the effects will be disastrous.
Often, this bravery translates into other parts of their life as well. They’re still scared to go to the grocery store, but they survived the elevator and are willing to give the shopping trip a try. They’re still afraid of their overbearing husband, but are willing to stand up to him for once. In the end (theoretically) the client become a braver person overall.
Thing is though, the overbearing husband might not like this change in their wife. They may have preferred being the strong, controlling man with the mouse-like wife. (Think Carol in the Walking Dead). Maybe she will have the courage to leave him. Or, perhaps the husband will have the courage to go to therapy themself to find out why they are the way they are. Who knows? It’s your story.
Next post I’m going to bring together all the elements of my previous posts on anxiety and show how you can use them to create a story/character arc.

Psychiatric-Mental Health Nursing, by Sheila L. Videbeck, fifth ed., Wolters Kluwer/Lippincott Williams & Wilkins, 2011.