Treatment for anxiety

Anxiety disorders can be treated. Talk therapy, medicine, or both can ease symptoms and help you get back to daily life. The right plan depends on your needs, your health and what you prefer, and it can take some trial and error to find it.¹

This page explains the main talk therapies for anxiety, how much they help, and what treatment is like week to week. Medicines have their own page: medicines for anxiety.

Talk therapy or medicine?

Both talk therapy and medicine can work well for anxiety. A UK national guideline (from NICE, the National Institute for Health and Care Excellence) found no proof that one is better than the other for generalized anxiety. It says the choice should rest mainly on what the person prefers.²

Talk therapy has some extra benefits. It teaches skills you keep after treatment ends. It also has few side effects. In one U.S. trial, about 1 in 7 people in a mindfulness course reported a side effect, compared with about 4 in 5 people taking an antidepressant.⁴

Medicine may make sense if anxiety is severe, if therapy is hard to find, or if therapy alone has not helped enough. Some people use both. Talk with your doctor about what fits you.

Cognitive behavioral therapy (CBT) Strong evidence

CBT is based on a simple idea: thoughts, feelings and actions affect each other. Anxiety often comes with thoughts that predict danger, such as "Something bad will happen." It also comes with avoidance, like staying home or skipping a doctor visit.

In CBT, a therapist helps you:^1,8

• Notice anxious thoughts as they happen
• Check whether those thoughts are accurate or helpful
• See how the thoughts shape your feelings and actions
• Practice new ways of thinking and acting, step by step

CBT is active. You will usually have practice between sessions, such as keeping a worry log or trying a small task you have been avoiding. Our thought check tool and the six-week CBT lesson series show what this looks like.

How well does it work? A 2018 review pooled 41 trials with about 2,800 people. It compared CBT with a placebo (a pretend treatment, such as a pill with no medicine or a supportive talk without skills). People who got CBT had about 3 times the odds of improving.³ Results were strongest for obsessive-compulsive disorder and generalized anxiety. They were smaller but still clear for panic, social anxiety and PTSD.³

Exposure: facing fears in small steps Strong evidence

Avoiding what scares you brings quick relief. But over time, avoidance teaches your brain that the thing really is dangerous, so the fear grows. Exposure therapy helps you return to the things you have been avoiding.⁷

With a therapist's support, you face the feared thing in short, planned steps. You stay with the discomfort until the fear starts to fade. Each time, your brain learns that you can handle it.⁸ Most people start with a "fear ladder," a list of situations from least to most scary, and climb one rung at a time.

Exposure can be done in a few ways:

• Real life, such as riding an elevator or going to a busy store
• Imagined, picturing a feared scene in detail
• Interoceptive, bringing on body feelings that scare you, like a racing heart or dizziness, in a safe way. This is used for panic disorder.⁷

Exposure is a key part of treatment for panic attacks, phobias and social anxiety. Our page on exposure therapy shows how to build a fear ladder.

Acceptance and commitment therapy (ACT) Moderate evidence

ACT (said like the word "act") takes a different angle. Instead of fighting anxious thoughts, you learn to notice them without judging them and let them pass. Then you put your energy into what matters most to you, even when anxiety is present. ACT uses mindfulness and goal setting.¹

A 2021 review of 23 trials looked at ACT and mindfulness programs for anxiety disorders. ACT eased anxiety compared with usual care. In the few trials that compared ACT with CBT, the results were about the same.⁵ But the trials were mostly small, and long-term effects are less clear.⁵ U.S. health experts say research on ACT for generalized anxiety is still growing.¹

Learn more on our ACT page.

Mindfulness-based stress reduction (MBSR) Moderate evidence

MBSR is an 8-week group course. You meet once a week and learn mindfulness: paying attention to the present moment, on purpose, without judging it. Practices include breathing, gentle stretching and the body scan.

In a 2023 U.S. trial, 276 adults with anxiety disorders got either MBSR or a common antidepressant for 8 weeks. Both groups improved by about the same amount.⁴ People in the MBSR group had far fewer side effects, and none dropped out because of them.⁴

This was one trial, and reviews show that MBSR may help less than CBT.⁵ Still, it is a reasonable choice for people who prefer not to take medicine or who like learning in a group. See our page on MBSR.

Applied relaxation Moderate evidence

Applied relaxation is more than "just relax." Over several weeks, a therapist teaches you to relax your muscles deeply. You then practice until you can relax in seconds. Finally, you learn to spot the first signs of anxiety and use the skill right away, in daily life.

The NICE guideline lists applied relaxation as a main talk therapy for generalized anxiety, alongside CBT. It suggests about 12 to 15 weekly one-hour sessions.² In the 2021 review, ACT and applied relaxation did not differ clearly in how much they helped.⁵

You can start learning the basic skill with progressive muscle relaxation. Our page on relaxation training explains the full method.

How stepped care works

Stepped care means starting with the simplest treatment likely to help, and moving up only if needed. The NICE guideline for generalized anxiety uses four steps:²

At step 2, guided self-help usually means about 5 to 7 short sessions with a trained coach. A group class usually runs about 6 weeks.² For panic disorder, a full course of CBT is usually about 7 to 14 hours in total, finished within 4 months.²

You do not have to start at step 1. If anxiety is severe or you have tried self-help already, ask about therapy or medicine right away. Our self-help for anxiety page covers step 2 tools you can start today.

What to expect in treatment

Before therapy. A visit with your regular doctor is a good first step. The doctor can check for physical causes, such as thyroid problems or side effects of other medicines, and refer you to a therapist.^1,8 See what causes anxiety.

The first sessions. The therapist will ask about your worries, your health and your goals. Together you will agree on a plan. It is fine to ask questions like these:⁸

• What kind of therapy do you use, and what is the evidence for it?
• Have you worked with people my age who have this kind of anxiety?
• About how many sessions do you expect, and how will we track progress?
• Do you take my insurance or Medicare? Do you have a sliding scale?

How it feels. Feeling comfortable with your therapist matters a lot.⁸ Exposure work can feel harder before it feels easier. That is normal, and your therapist will set the pace with you.

How long it takes. A full course of CBT often lasts about 3 to 4 months.² If you are not improving after a reasonable time, talk with your therapist about a different approach or provider.⁸

In person or online. Therapy can happen in an office, by video or by phone. Apps and online programs can add to care.^1,8 See online therapy and apps.

Habits that help. Regular exercise, mindfulness, enough sleep and less caffeine can ease symptoms and make therapy work better. They are a support, not a replacement for treatment.¹

Treatment in later life

Anxiety treatment works for older adults too. A 2024 Cochrane review looked at 21 trials of CBT with 1,234 people aged 55 and older. CBT eased anxiety and worry more than usual care right after treatment, by a small to moderate amount.⁶ The benefit seemed to fade by 3 to 6 months, and the evidence was of low certainty.⁶ Ask your therapist about booster sessions or a plan to keep practicing after treatment ends.

Some older adults do well with slower pacing, written summaries and a family member's help with homework. Talk therapy is also useful because many older adults take several medicines, and some anxiety medicines raise the risk of falls and memory problems. Read more in anxiety in later life.

Paying for therapy

Medicare Part B covers individual and group therapy for anxiety. It covers visits with psychiatrists, psychologists, clinical social workers, nurse practitioners, marriage and family therapists and mental health counselors, among others. Telehealth visits are covered too.⁹ After the Part B deductible, you usually pay 20% of the Medicare-approved amount.⁹ Rules can change, so check with your plan. These facts are current as of October 2026.

For help finding care, see how to find a therapist and paying for therapy.

When to get help

See a doctor or therapist if worry, fear or panic:

• Lasts for weeks or keeps coming back
• Makes you avoid places, people or tasks
• Gets in the way of sleep, work, family life or caring for others
• Comes with low mood or drinking more to cope

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.