Harvard Women's Health Watch

In the journals: Psychodynamic therapy is effective in treating chronic worry

In the journals

Psychodynamic therapy is effective in treating chronic worry

Occasional worries are normal, but if anxiety about everyday events and problems is dominating your life, you may have generalized anxiety disorder (GAD). In addition to excessive worry, people with GAD usually have other complaints, such as fatigue, insomnia, and poor concentration (see "Symptoms of generalized anxiety disorder").

Symptoms of generalized anxiety disorder

  • Persistent, excessive worry about events and activities occurring on more days than not for at least six months

  • Worry that is difficult to control

  • Heart palpitations

  • Being easily fatigued

  • Trouble concentrating or mind going blank

  • Irritability

  • Muscle tension

  • Restlessness or feeling keyed up or on edge

Anxiety disorders are treated with psychotherapy, medication, or both. In recent years, cognitive behavioral therapy (CBT) has edged out psychodynamic ("talk") therapy as the first-line psychotherapeutic approach to GAD. In CBT, patients are taught how to identify and change habits of thinking that lead to problems. Psychodynamic therapy is a less structured approach in which the past is explored to achieve insight into present problems and how to manage them. Many studies have shown that CBT, a relatively short-term technique, is effective in reducing generalized anxiety. Fewer studies have evaluated short-term psychodynamic therapy, and none have compared the two approaches head to head — until now.

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