Effective treatments for anxiety include cognitive behavioral therapy (CBT) or medications. The goal of both treatment approaches is to greatly improve patients quality of life.

CBT is goal-oriented and can assist your patients' to learn new ways of thinking, practice positive behaviors, and take active steps to move beyond their symptoms. Medications work in various ways to reduce the symptoms associated with anxiety disorders.

Cognitive Behavioral Therapy

One of the most effective treatments for anxiety is cognitive behavioral therapy (CBT). CBT is a short-term treatment that helps people understand the anxiety they experience, manage the distressful thoughts and feelings, and identify beliefs and thoughts that may prolong the distress. With CBT people learn more adaptive ways of thinking and coping that result in relief.

Two specific components of CBT are cognitive therapy and exposure therapy. Cognitive therapy focuses on identifying, challenging, and then neutralizing the unhelpful thoughts that are behind anxiety disorders. Exposure therapy focuses on often gradually confronting fears and overcoming avoidance with new skills and a sense of mastery. The overarching goal is for people to overcome anxiety problems and improve their quality of life.

Medication

Anti-anxiety medications help reduce the symptoms of anxiety. The most common anti-anxiety medications are called benzodiazepines, which can treat generalized anxiety disorder. For panic disorder or social anxiety disorder, selective serotonin reuptake inhibitors (SSRIs) or other antidepressants are more common.

With treatment and self-management skills, people with bipolar disorder can lead productive and fulfilling lives. Treatment for Veterans diagnosed with bipolar disorder does not follow a one-size-fits-all plan. That’s because each person’s symptoms, life circumstances, and other physical and mental health issues are unique. Veterans should work with their care providers to develop a personalized plan that fits their needs. Below are some options to consider together.

Medication

Medication is necessary in most cases of bipolar disorder. But no single treatment affects everyone the same way, so it is important for Veterans to work closely with their prescribers to find the right solution for them. At VA, programs and services are designed to treat each Veteran as an individual, including finding the treatments and programs that fit best for a Veteran’s personal needs and goals.

Psychological Treatments and Social Supports

Psychological and social interventions can help Veterans who have bipolar disorder learn new ways to process their thoughts and interact with others — an essential part of the recovery process. VA provides the following treatments and supports for bipolar disorder:

• Psychoeducation: This approach involves teaching Veterans with bipolar disorder about the condition, treatment, and signs of relapse that can help them know when to seek support, before an episode occurs. Psychoeducation is also available to family members to learn how they can support their loved one.
• Cognitive behavioral therapy (CBT): This therapy approach helps Veterans diagnosed with bipolar disorder learn to identify and change negative thought patterns and behaviors associated with the condition.
• Illness Management and Recovery (IMR): This program helps Veterans learn about bipolar disorder, acquire coping skills, and set meaningful goals to support their mental health and recovery.
• Peer Specialists: Peer Specialists have personal experience with bipolar disorder and recovery, and they have completed peer-counselor training. They can help Veterans navigate the VA mental health system, connect Veterans with community-based and VA resources, or advocate for their needs. As a Veteran who “has been there” in dealing with mental illness, a Peer Specialist can be a terrific ally in a fellow Veteran’s recovery journey. Ask your primary care or mental health provider whether Peer Specialist services are available at your facility.

Screening

The Mood Disorder Questionnaire is a 5-minute assessment to help people identify if they may have bipolar disorder. The questionnaire is designed for screening purposes only and is not meant as a diagnostic tool. Veterans should be sure to discuss the results with their mental health care provider.

No matter what is causing your patient's depression, effective treatments and resources are available. Medication and psychological counseling (psychotherapy) have proven very effective for most people, and many types of professionals treat depression.

Cognitive Behavioral Therapy for Depression (CBT-D)

CBT-D is a structure CBT-D is a structured, time-limited psychotherapy that helps people develop more balanced and helpful thoughts about themselves, others, and the future. This type of therapy modifies thought patterns to change moods and behaviors. CBT-D also helps people achieve personal goals and solve problems by learning and practicing new skills.

Acceptance and Commitment Therapy for Depression (ACT-D)

ACT-D is a psychotherapy that helps people overcome emotional pain and worry by encouraging them to take positive actions that are in line with their values. Based on the relationship between thoughts, feelings, and behaviors, ACT-D helps people recognize, commit to, and achieve what matters most to them in life.

Interpersonal Psychotherapy (IPT)

IPT is a form of treatment that focuses on the relationships that may be the cause or the result of depression, helping people understand the connection between their depression and current relationship problems. IPT also builds social skills that help people to deal with their problems, helping improve how people feel as well as their quality of life.

Screening

Your patients may be wondering if they have symptoms of depression. One way to determine this is by taking a brief, confidential, and anonymous screening offered by VA. Patients can choose to print a copy of the results to keep for their own records to to share with their physician or mental health professional.

Treatment for Traumatic Brain Injury (TBI) typically includes a mix of cognitive, physical, speech, and occupational therapy, along with medication to control symptoms such as headaches or anxiety. Treatments focus on the symptoms that cause the most problems in everyday life. These treatments may include:

• Strategies to deal with health, cognitive, and behavioral problems
• Rehabilitation therapies, such as physical therapy, occupational therapy, and speech-language therapy
• Assistive devices and technologies, such as electronic aids and learning devices
• Medications

Diagnosing TBI

Little research on blast versus nonblast TBI—A 2017 review of existing studies by researchers at the Minneapolis VA Health Care System found that little information is available about outcomes for TBIs caused by blasts versus those caused by other factors. The available research showed that blast and nonblast TBI groups had similar rates of depression, sleep disorders, alcohol use, vision loss, balance problems, and functional status.

Results were inconsistent about PTSD, headache, hearing loss, and neurocognitive functions. More research is needed, according to the researchers, on the differences between blast and nonblast TBI, along with consistent definitions of blast exposure.

Post-concussive symptoms after deployment—In a 2017 study by DVBIC, nearly half of soldiers who had an mTBI while serving in Afghanistan or Iraq had post-concussive symptoms such as sleep problems, forgetfulness, irritability, and headaches three months after their deployment. According to the researchers, this suggests that mTBI is associated with continuing problems for longer than has been generally recognized in the active duty population.

Advances in both medication and psychosocial (non-medication) treatments have led to better outcomes for individuals who develop schizophrenia and related mental health conditions. As with most mental health conditions, a combination of medications and psychosocial support and psychotherapy offer the best opportunity for reducing symptoms and regaining prior levels of functioning.

Medication

Medications play a crucial role in the treatment of schizophrenia and related conditions. Response to medications vary. Some individuals experience total or near total resolution of symptoms, and some notice smaller effects. For most individuals, symptoms are improved but are still present to some extent. Ongoing treatment with medications has been shown to provide the best protection from relapse of symptoms.

Assertive community treatment helps people with serious mental illnesses access treatment regularly by providing clinicians who visit clients in the home or in their local community on a frequent basis. This treatment has been shown to decrease hospitalizations and help people live independently and be employed. VA offers a version of assertive community treatment that has been modified for the VA system known as Intensive Community Mental Health Recovery (ICMHR) Services.

Supported employment, specifically the individual placement and support model, helps individuals with serious mental illnesses find and keep jobs. People who received these services more often found jobs, worked more hours, were employed longer, and earned more money.

CBT helps people understand relationships among their thoughts, feelings, and behaviors and learn new patterns of thinking to support positive feelings.

IMR helps those with serious mental illnesses set meaningful goals and learn skills to support their mental health and recovery.

SST was developed to help Veterans learn effective social skills that aid in their recovery. SST includes education, breaking skills down into simple steps, modeling, role-playing, and group support.