The most effective treatment of generalized anxiety disorder is probably one that combines psychotherapy, pharmacotherapy, and supportive approaches.

In terms of psychotherapy, cognitive approaches address an individual’s distorted thoughts, while behavioral approaches address somatic symptoms. The major techniques of used in behavioral approaches are relaxation and biofeedback. Supportive therapy offers patients reassurance and comfort. Insight-oriented psychotherapy focuses on uncovering unconscious conflicts and identifying ego strengths. Most patients experience a marked reduction in anxiety when given the opportunity to discuss their difficulties with a concerned and sympathetic physician or therapist.

The most effective prescription drugs for the treatment of generalized anxiety disorder are benzodiazepines, SSRIs (Zoloft, Prozac, Paxil, etc.), SNRIs (Effexor, Cymbalta, etc.), and buspirone (BuSpar). Other drugs that may be useful are tricyclic drugs (Nortriptyline, Amitriptyline, etc.) and beta-adrenergic antagonists or blockers (Propranolol).

What is Separation Anxiety Disorder?

Separation anxiety disorder is developmentally inappropriate and excessive fear or anxiety concerning separation from loved ones. The anxiety lasts at least 4 weeks in children and adolescents, and typically 6 months or more in adults. The diagnosis requires at least three of the following symptoms:

• Recurrent excessive distress when anticipating or experiencing separation from home or from loved ones.
• Persistent and excessive worry about losing loved ones or about possible harm to them, such as illness, injury, disasters, or death.
• Persistent and excessive worry about experiencing a negative event, such as getting lost, being kidnapped, having an accident, or becoming ill, causes separation from the loved one.
• Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere due to fear of separation.
• Persistent fear or reluctance about being alone at home or in other settings.
• Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a loved one. 
• Repeated nightmares involving the theme of separation. 
• Repeated complaints of physical symptoms (such as headache, stomachache, nausea, vomiting) when separation from loved ones occurs or is anticipated.
  The anxiety causes significant distress or impairment in social, academic, occupational, or other important areas of functioning.

What is Social Anxiety Disorder?

Social anxiety disorder is diagnosed when a person has excessive fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. Examples include social interactions, such as having a conversation, meeting new people, being observed while eating or drinking, and performing in front of others (e.g., giving a speech). In children, the anxiety must occur in peer settings and not just during interactions with adults.

The fear, anxiety, or social avoidance typically lasts for 6 months or more and causes significant distress or impairment in social, occupational, or other important areas of functioning. A diagnosis of social anxiety disorder cannot be explained by the physiological effects of a substance (e.g., a drug of abuse or medication) or another medical condition. If another medical condition (e.g., Parkinson’s disease, obesity, disfigurement from burns or injury is present) the fear, anxiety, or avoidance is clearly unrelated or is excessive. A social anxiety disorder may be diagnosed as “performance only” if the fear is restricted to speaking or performing in public.

Social Anxiety Disorder Epidemiology & Genetics

• Studies have reported a lifetime prevalence of social anxiety disorder ranging from 3 to 13 percent.
• The peak onset for social anxiety disorder is in the teens, although it can start at ages as young as 5 years and as old as 35 years.
• People who have relatives with social anxiety disorder are about 3 times more likely to be affected by the condition.

How is Social Anxiety Disorder treated?

Both psychotherapy and pharmacotherapy are useful in treating social anxiety disorder. Some studies indicate that the use of both pharmacotherapy and psychotherapy is more effective than either therapy alone.

The most effective prescription drugs for the treatment of social anxiety disorder are benzodiazepines, SSRIs (Zoloft, Prozac, Paxil, etc.), SNRIs (Effexor, Cymbalta, etc.), and buspirone (BuSpar). Other drugs that may be useful are tricyclic drugs (Nortriptyline, Amitriptyline, etc.) and beta-adrenergic antagonists or blockers (Propranolol).

Psychotherapy for social anxiety disorder usually involves behavioral and cognitive approaches, including cognitive retraining, desensitization, rehearsal during sessions, and a range of homework assignments.