Anxiety disorders: Guidelines for effective primary care therapy

Millions of Americans have anxiety disorders. Many with panic disorder, social anxiety disorder, and/or generalized anxiety disorder present initially to their primary care clinician. Effective treatment is possible in a busy primary care setting; therapy involves patient education and pharmacotherapy. Once other potential causes of symptoms of an anxiety disorder have been ruled out, the patient can be reassured that he or she has a psychological condition-a very common one-and that symptoms are not the result of an undiagnosed disease or "going crazy" or "losing control." Complete clinical remission is achievable, often with medication alone. Referral to a psychiatrist for psychotherapy may be indicated when a patient refuses or cannot tolerate drug therapy or when response to therapy is inadequate.