<unk>  is a serious health problem that in many cases can be successfully treated, although there is no known cure. Identification of treatments that engender as full a response as possible, and can minimize relapse, is imperative. Cognitive behavioral therapy and positive self-talk specific for<unk>  are the treatments of choice for<unk> . Several studies show that 85 to 90 percent of<unk>  patients treated with CBT recover completely from their<unk>  attacks within 12 weeks. When cognitive behavioral therapy is not an option, pharmacotherapy can be used. SSRIs are considered a first-line pharmacotherapeutic option. Psychotherapy<unk>  is not the same as phobic symptoms, although phobias commonly result from<unk> . CBT and one tested form of psychodynamic psychotherapy have been shown efficacious in treating<unk>  with and without agoraphobia. A number of randomized clinical trials have shown that CBT achieves reported<unk> -free status in 70–90% of patients about 2 years after treatment. A 2009 Cochrane review found little evidence concerning the efficacy of psychotherapy in combination with benzodiazepines such that recommendations could not be made. Symptom inductions generally occur for one minute and may include: *Intentional hyperventilation – creates lightheadedness, derealization, blurred vision, dizziness *Spinning in a chair – creates dizziness, disorientation *Straw breathing – creates dyspnea, airway constriction *Breath holding – creates sensation of being out of breath *Running in place – creates increased heart rate, respiration, perspiration *Body tensing – creates feelings of being tense and vigilant Another form of psychotherapy that has shown effectiveness in controlled clinical trials is<unk> -focused psychodynamic psychotherapy, which focuses on the role of dependency, separation anxiety, and anger in causing<unk> . The underlying theory posits that due to biochemical vulnerability, traumatic early experiences, or both, people with<unk>  have a fearful dependence on others for their sense of security, which leads to separation anxiety and defensive anger. Therapy involves first exploring the stressors that lead to<unk>  episodes, then probing the psychodynamics of the conflicts underlying<unk>  and the defense mechanisms that contribute to the attacks, with attention to transference and separation anxiety issues implicated in the therapist-patient relationship. Comparative clinical studies suggest that muscle relaxation techniques and breathing exercises are not efficacious in reducing<unk>  attacks. In fact, breathing exercises may actually increase the risk of relapse. Appropriate treatment by an experienced professional can prevent<unk>  attacks or at least substantially reduce their severity and frequency—bringing significant relief to 70 to 90 percent of people with<unk> . Relapses may occur, but they can often be effectively treated just like the initial episode. vanApeldoorn, F.J. et al. (2011) demonstrated the additive value of a combined treatment incorporating an SSRI treatment intervention with cognitive behavior therapy (CBT). Gloster et al. (2011) went on to examine the role of the therapist in CBT. They randomized patients into two groups: one being treated with CBT in a therapist guided environment, and the second receiving CBT through instruction only, with no therapist guided sessions. The findings indicated that the first group had a somewhat better response rate, but that both groups demonstrated a significant improvement in reduction of<unk>  symptomatology. These findings lend credibility to the application of CBT programs to patients who are unable to access therapeutic services due to financial, or geographic inaccessibility. Koszycky et al. (2011) discuss the efficacy of self-administered cognitive behavioural therapy (SCBT) in situations where patients are unable to retain the services of a therapist. Their study demonstrates that it is possible for SCBT in combination with an SSRI to be as effective as therapist-guided CBT with SSRI. Each of these studies contributes to a new avenue of research that allows effective treatment interventions to be made more easily accessible to the population. Cognitive behavioral therapy Cognitive behavioral therapy encourages patients to confront the triggers that induce their anxiety. By facing the very cause of the anxiety, it is thought to help diminish the irrational fears that are causing the issues to begin with. The therapy begins with calming breathing exercises, followed by noting the changes in physical sensations felt as soon as anxiety begins to enter the body. Many clients are encouraged to keep journals. In other cases, therapists may try and induce feelings of anxiety so that the root of the fear can be identified. Comorbid clinical depression, personality<unk> s and alcohol abuse are known risk factors for treatment failure. As with many<unk> s, having a support structure of family and friends who understand the condition can help increase the rate of recovery. During an attack, it is not uncommon for the sufferer to develop irrational, immediate fear, which can often be dispelled by a supporter who is familiar with the condition. For more serious or active treatment, there are support groups for anxiety sufferers which can help people understand and deal with the<unk> . Current treatment guidelines American Psychiatric Association and the American Medical Association primarily recommend either cognitive-behavioral therapy or one of a variety of psychopharmacological interventions. Some evidence exists supporting the superiority of combined treatment approaches. Another option is self-help based on principles of cognitive-behavioral therapy. Using a book or a website, a person does the kinds of exercises that would be used in therapy, but they do it on their own, perhaps with some email or phone support from a therapist. A systematic analysis of trials testing this kind of self-help found that websites, books, and other materials based on cognitive-behavioral therapy could help some people. The best-studied conditions are<unk>  and social phobia. Interoceptive techniques Interoceptive exposure is sometimes used for<unk> . People's interoceptive triggers of anxiety are evaluated one-by-one before conducting interoceptive exposures, such as addressing palpitation sensitivity via light exercise. Despite evidence of its clinical efficacy, this practice is reportedly used by only 12–20% of psychotherapists. Potential reasons for this underutilization include "lack of training sites, logistical hurdles (e.g., occasional need for exposure durations longer than a standard therapy session), policies against conducting exposures outside of the workplace setting, and perhaps most tellingly, negative therapist beliefs (e.g., that interoceptive exposures are unethical, intolerable, or even harmful)." Medication Appropriate medications are effective for<unk> . Selective serotonin reuptake inhibitors are first line treatments rather than benzodiazapines due to concerns with the latter regarding tolerance, dependence and abuse. Although there is little evidence that pharmacological interventions can directly alter phobias, few studies have been performed, and medication treatment of<unk>  makes phobia treatment far easier (an example in Europe where only 8% of patients receive appropriate treatment). Medications can include: * Antidepressants (SSRIs, MAOIs, tricyclic antidepressants and norepinephrine reuptake inhibitors) * Antianxiety agents (benzodiazepines): Use of benzodiazepines for<unk>  is controversial. The American Psychiatric Association states that benzodiazepines can be effective for the treatment of<unk>  and recommends that the choice of whether to use benzodiazepines, antidepressants with anti-panic properties or psychotherapy should be based on the individual patient's history and characteristics. Other experts believe that benzodiazepines are best avoided due to the risks of the development of tolerance and physical dependence. The World Federation of Societies of Biological Psychiatry, say that benzodiazepines should not be used as a first-line treatment option but are an option for treatment-resistant cases of<unk> . Despite increasing focus on the use of antidepressants and other agents for the treatment of anxiety as recommended best practice, benzodiazepines have remained a commonly used medication for<unk> . They reported that in their view there is insufficient evidence to recommend one treatment over another for<unk> . The APA noted that while benzodiazepines have the advantage of a rapid onset of action, that this is offset by the risk of developing a benzodiazepine dependence. The National Institute of Clinical Excellence came to a different conclusion, they pointed out the problems of using uncontrolled clinical trials to assess the effectiveness of pharmacotherapy and based on placebo-controlled research they concluded that benzodiazepines were not effective in the long-term for<unk>  and recommended that benzodiazepines not be used for longer than 4 weeks for<unk> . Instead NICE clinical guidelines recommend alternative pharmacotherapeutic or psychotherapeutic interventions. When compared to placebos, benzodiazepines demonstrate possible superiority in the short term but the evidence is low quality with limited applicability to clinical practice. Other treatments For some people, anxiety can be greatly reduced by discontinuing the use of caffeine. Anxiety can temporarily increase during caffeine withdrawal.
Panic disorder
Hyperthyroidism
Depression 
Cardiovascular disease
Late life depression
Hypochondriasis
Blood phobia
Anxiety disorder