Why Do I Have Anxiety Even On Medication?

prozac for anxiety

Anxiety as an emotional state is an natural occurrence and something that an individual should expect to experience on a relatively regular basis throughout his or her life. Constant daily anxiety symptoms pertaining to the most trivial affairs and relentless rumination should not be accepted as a normal occurrence.

In cases like these it’s advised that the individual seek out professional treatment which usually involves medication.

But what if an individual still suffers from anxiety symptoms even when on medications like benzodiazepines or SSRI’s? What steps should an individual take if this is the case? In this article we will cover why this happens and how cope with this residual anxiety.

The Cause of Anxiety Symptoms Even When on Medication

Effectively managing your anxiety in a way that’s personalized for you can be a confusing pursuit which is why it’s important to make sense of any variables that you can.

Variables in this context are simply the factors that are allowing your symptoms to “breakthrough” despite taking an anxiety based medication.

Below are the most common causes of residual symptoms while on medication.

Recent Prescription

Medication can do wonders in terms acting as a tool to cope with anxiety symptoms but finding the right medication for you can be a tricky process. SSRI’s are commonly used to treat anxiety disorders but not all types will work well for all individuals. It’s simply not a one sized fits all approach.

Some popular SSRI’s indicated for anxiety disorders include Zoloft, Lexapro, and Prozac.

A common cause of a flare up of symptoms when on medication like an SSRI is the initial ramp up period. This is the time when a medication is working up to a steady level in the bloodstream in order to reach a therapeutic level (a level that will actually work to one’s benefit).

This ramp up period can subject an individual to additional anxiety but it is important to note that this should go away once a therapeutic level has been reached. How long does it take to reach a therapeutic level? It usually takes a few weeks for SSRI’s to produce their desired effect.

Drugs like benzodiazepines (Xanax, Valium, Klonopin, etc.) on the other hand work almost immediately although you should only rely on this class of medications on an as needed basis.

This class of medication is highly addictive and leaves an individual prone to dependency.

Not only is there a chance for additional anxiety and other side effects when first titrating up but there is also a very good chance that you won’t feel any anxiety relief at all during this period. As mentioned previously this period of time is meant to achieve a therapeutic dosage so you shouldn’t expect to feel any benefits before it has been reached.

Try to exercise patience, voice any concerns to your doctor or psychiatrist, and follow any advice given. Successful anxiety treatment and management is a marathon and not a sprint so by expecting instantaneous results you are setting yourself up for disappointment.

Breakthrough Anxiety

When undergoing treatment that consists solely of a medication regimen it is still likely for your anxiety to rear its ugly head or “breakthrough”. Breakthrough anxiety is anxiety that shows disregard for your medications clinical benefits and takes your symptoms and baseline to a level not usually experienced.

You may feel relatively calm and only mild anxiety symptoms that are very manageable while on medication but still suffer from these breakthrough symptoms on a regular basis.

What does this mean? This means that you should reevaluate your treatment approach as a whole and consult your psychiatrist or doctor about how to introduce techniques in addition to taking medication. We’ll discuss which coping techniques to consider in the section titled “How to Cope with Residual Anxiety”.

The Wrong Fit

The reason for your anxiety symptoms even when on medication could also simply be due to the fact that the medication you are currently on just isn’t the right fit for you.

We mentioned to be patient when just starting a drug like an SSRI but if you’ve been taking a medication for a few months and you aren’t happy with the results it may be time to change things up and/or add a new medication.

By doing this in addition to introducing other treatment options you’ll have a much better chance at reducing your anxiety than by sucking it up and sticking with the drug you are on. You’ll want to convey your unease to your psychiatrist and be specific concerning which symptoms are bothering you the most.

Progress on this front can only be attained if you are completely open with your psychiatrist. Make sure to jot down your troubles on a piece of paper or in a smartphone app so that you don’t forget something during your appointment. It’s very easy to forget a thing or two when relying on memory especially since an appointment can drum up anxiety which leads to a lack of focus and scattered memory.

How to Cope with Residual Anxiety

So you’ve come to realize that one or more of the reasons covered above are the culprit concerning residual anxiety on medication. Now what? It’s great to know a cause but without a solution it’s somewhat useless.

Below we will guide you through solutions tailored to each of the problems above.

Approaches Not to Be Dismissed

The first solution to residual anxiety encompasses several approaches of coping – that is, alternative anxiety treatment. These coping techniques are alternative in the sense that they do not involve medication.

Alternative approaches to anxiety are sometimes referred to as natural or holistic but the only identifier that really matters is that they don’t involve drugs. Four very popular and effective alternatives include talk therapy, exercise, mindfulness, yoga.

More of our anxiety content you might be interested in:

These approaches can be particularly helpful when it comes to breakthrough anxiety.

Using one or several of these options to your benefit can absolutely help take care of any anxiety while on medication. These are things you need to pursue because if you have a true anxiety disorder such as generalized anxiety disorder or social anxiety disorder then your anxiety will most likely stick with you for the rest of your life.

You need to learn how to live with your anxiety and cope with it so that it stays at a manageable level, a level that will not impede on your quality of life.

Talk therapy such as cognitive behavioral therapy is especially resourceful when it comes to finding the root cause of your anxiety issues and subsequently resolving and coping in an incredibly effective manner.

Dealing with anxiety is about coping in a way that allows you to live your life and methods such as these can bring you one step closer to doing so.

Medications that Work

The two issues discussed above related to medication can be resolved with patience and a strong relationship with your psychiatrist. You will also want to act on the alternatives discussed in the previous section, specifically talk therapy.

Non-medication based techniques should always be included in your treatment plan for the best results.

Finding the right medication(s) is always going to be a matter of trial and error which is why patience and a relationship with your psychiatrist forged on trust and open dialogue are so important.

Unfortunately, this isn’t always an enjoyable process but truth be told when you do find the right medication(s) you will see that the struggle was worth it.

Constant Coping

Anxiety disorders will always require an individual to be two steps ahead of the affliction. There are quirks that can pop up from time to time such as anxiety bleeding through even while on medication, but one thing remains constant; a multi-faceted treatment plan will always provide the most benefit and anxiety relief.

If you can work with your psychiatrist to incorporate medication alternatives then you will put yourself far ahead of the pack. It is all too common for individuals with anxiety (and any other mental health problems) to take medication and leave it at that.

True relief and quality of life requires due diligence, hard work, and legitimate coping techniques.

Anxiety Treatment Without Medication – Possible?

zoloft for anxiety

Anxiety is something that lies on a spectrum and as a result it is something that can be crippling (chest pains, panic attacks, etc.) or just a nuisance (minor elation). For those with Generalized Anxiety Disorder, Panic Disorder, and Social Anxiety Disorder it is something that genuinely puts a damper on quality of life and absolutely calls for treatment. And these disorders affect many, many people on a daily basis. Generalized Anxiety Disorder affects some 6.8 million adults or roughly 3.1% of the population. Without treatment many of these people can not go about their daily lives and not everybody wants to be shoehorned into treatment by medication. Which begs to question, is it possible to cope with anxiety without the use of medication?

you don't need medication to treat anxiety

Medication isn’t always necessary to treat anxiety. Read about some of the best alternatives below.

No Two Cases Alike

Everybody with this emotional issue experiences it differently and therefor each and every person needs treatment and coping skills tailored to their needs. There are different causes and triggers to be considered.

The disorders mentioned above are far from the only causes of a serious anxiety issue. People also find themselves in this emotional rut due to other mental health disorders such as bipolar disorder (type 1, 2, etc.), personality disorders, and depression.

The road of fear and inner frenetic turmoil can also be entirely situational but just as severe. A person may deal with intense anxiety, panic even, while driving, before taking a test, getting on a flight, and so on. There are an endless amount of scenarios where this fear and apprehension can take hold and change the course of a person’s actions, usually in a preventative fashion. The point is that this mental unease can prevent people from doing, from actually living life.

anxiety from driving

Each person is different as far as anxiety triggers go. Things that most people take for granted such as driving can cause intense anxiety and panic attacks for some people. 

While no two cases are alike there is one commonality between them all – the road to treatment often starts with the idea of taking medication or even a cocktail of medications in order to cope and live life. But are meds like benzodiazepines (Klonopin, Xanax, etc.) and SSRI’s (Zoloft, Prozac, etc.) the right way for everyone to start treating anxiety?

The short answer is that a person suffering from excessive worry should consider the alternatives before venturing into the world of pharmaceuticals (but always with the help of a professional). There are thousands of people who are able to manage their anxiety problems without having to take medications. The key is to find a method that works for you.

Treatment Techniques that Don’t Involve Medication

It’s great to want to break free from the status quo in terms of dealing with anxiety issues but it’s important to first become familiar with the options that are out there. Below you find some of the best non-medication based treatment options spelled out so that you can decide how to take action.


Talk therapy is a technique that has been used for decades with great success against a wide array of mental health issues – anything from depression to bipolar disorder. A certain type of therapy that is most popular when it comes to effectively treating anxiety issues is cognitive behavioral therapy or CBT for short.

The reason why CBT can be so effective against anxiety issues is because it aims to disrupt negative thought patterns that lead to an anxious state. Every single emotion that you experience is a direct cause of your thoughts and getting a handle on your thoughts will lead to better control of your emotions.

The key is cultivating thoughts that are grounded in reality. Extreme thoughts that are based on fear are certainly not healthy but it’s also not healthy to delude yourself into a state of mind detached from reality. A middle ground is the place to be.

prozac for anxiety

Medication such as Prozac has been proven to be effective for anxiety disorders but so have alternatives such as Cognitive Behavioral Therapy. Studies such as this one paint a very clear picture concerning CBT’s place as a form of treatment.

As a person with anxiety you may experience fear and apprehension related to starting therapy sessions and truth be told that it can take trial and error to find the right therapist for you, but you should also know that it’s completely normal to experience anxiety about starting therapy.

Just about everyone gets a little worked up over beginning talk therapy as stereotypes have been created about the experience by society and there is still somewhat of a stigma attached to it.

So, is it worth starting CBT or other types of therapy? If you can afford it, absolutely! While you may have read plenty of anecdotes pointing to the efficacy of this type of treatment, therapy is tried and true, a method that has been backed by scientific research time and time again (especially CBT).

Don’t have the money for therapy sessions? Don’t fret, there’s another option that is completely free should therapy not be something that fits your budget. Anxiety support groups are available at many locations and for the most part are completely free of charge.

A support group won’t offer you the exact experience of therapy but it will allow you to feel less isolated in your fight against anxiety through listening to others experiences as well as sharing your own should you choose to.

It can also be a great way to meet others who are going through some of the same struggles as you. You’ll want to search online using a website like the Anxiety and Depression Association of America to find out whether or not their are any groups near you. If you can’t find any groups tailored specifically towards anxiety there may be support groups that cover mental health issues in a broader sense.


Another method that can be incredibly effective when it comes to coping with anxiety without using medication is good ol’ fashion exercise. And just as with talk therapy exercise has tons of research to back up its efficacy in dealing with anxiety and anxiety disorders as well as thousands of anecdotes from people online.

Things like cardiovascular exercise (jogging, sports, cardio equipment, etc.) and weight lifting are able to help a person cope by the way they effect the brain chemistry during and after each sesssion. For example, regular aerobic exercise lowers levels of both adrenaline and cortisol. Cortisol is often referred to as the body’s stress hormone and adrenaline is responsible for states of fight and flight.

Adrenaline increases to very high levels when one is experiencing a panic attack for instance. That “surging” or “rush” feeling in the chest that one feels during panic or extreme states of anxiety is unadulterated adrenaline.

jogging to fight anxiety

Conventional exercises such as jogging can be a great way to combat anxiety but don’t think you have to do what everyone else is doing. Get creative! Find a type of exercise that gets your heart pumping to a moderate level that you also enjoy doing.

The cascade of neurochemical reactions in the brain due to working out leads to a state of relaxation. You will most likely notice that you’re anxiety level immediately after a lifting or cardio session is much lower than it was before you began. Over time, with consistent workouts, you will even notice that your baseline level of anxiety is lower at all times. No, you won’t abolish your anxiety but you will notice a marked improvement upon reflection, moreso if you are regularly charting your moods everyday.

There are entire communities dedicated to improving one’s mental health through exercise. One such community is called Exercise Out of Depression. Don’t be fooled by the name, the people of this community are not only about improving depression but also anxiety and other mental health issues. Browse the subreddit for yourself, they’re very supportive and friendly!

But it isn’t all about brain chemistry when it comes to exercise’s ability to help people cope. When a person is exercising they are able to direct their thoughts and energy to the task at hand and in this way it serves as a form of healthy distraction. Unlike unhealthy forms of escapism like recreational drug use and compulsive media consumption (TV, internet, video games, etc.) exercise provides outcomes that can further help the anxiety sufferer such as increased self confidence and energy levels.

Generally speaking, an exercise session is something that is going to tire someone out and this too is a beneficial side effect of the activity in relation to anxiety troubles. Getting rid of pent up mental energy leaves less room for constant worrying and rumination.

Getting better at dealing with anxiety is getting better at separating fact from fiction and burning through pent up mental energy allows a person to break the chain of looping thoughts and seprate themselves from obsessive worry unfounded in reality.

All of these side effects of regular exercise lead to a version of yourself that is more at ease and less likely fall into a pit of despair at the slightest hint of worry.

Mindfulness Meditation and Yoga

The last two methods of treating anxiety that don’t involve any pills or supplements are yoga and the practice of mindfulness. The reason we have grouped them together is that they are very much interconnected.

The essence of mindfulness is living in the present moment and experiencing everything that makes up the present such as how our bodies feel, the things that surround us in our environment, and our current thoughts.

Instead of getting caught up in thoughts and feelings you instead allow thoughts to simply be without imposing judgement of right or wrong. Mindfulness meditation has been found to be quite effective for generalized anxiety disorder, as well as other disorders like depression, through research but the reason it works is actually quite simple.

Mindfulness teaches a person with anxiety how to detach themselves from thoughts that are based on fantasy. Our thoughts form our emotions and so a person with an anxiety disorder will be less likely to experience a state of anxiety if they aren’t latching on to thoughts based on excessive worry.

mindfulness to treat anxiety

The verdict is out; research shows that mindfulness meditation is absolutely an effective treatment for anxiety.

Imagine you are standing on the side of a busy road with cars flashing by from both directions. Now suppose these cars are symbolic of the thoughts that flow through your mind on a moment to moment basis. With mindfulness meditation you can come to a place where you would no longer fixate on individual cars.

Instead you would simply exist in this scenario and allow yourself to see, hear, and smell all that is around you without any further judgement. It would be total immersion in the moment.

As you become better at practicing mindfulness you be able to eventually tune out most or even all unwarranted worry. By doing so you will be able to simply exist in the moment and choose more productive thought patterns. The end result is more control over your thoughts and your emotions as a byproduct of this.

How exactly does yoga enter the mix? Yoga is technically a form of exercise but it is much different than the forms of exercise we covered in the last section. It combines physical poses and stretches with mindfulness.

When a person does yoga they are not only performing poses but also paying very close attention to the sensations they are feeling in their body as well as focusing on breathing in and out in a rhythmic fashion. Sound familiar? That’s because these are two important components of mindfulness meditation.

Yoga is a great tool for many forms of anxiety and stress in this way and leaves most people feeling less tension and more relaxed after a session. Just as with mindfulness and the other forms of treatment we have discussed this effect compounds over time.

Use mindfulness meditation and yoga on a regular basis to create a killer one-two punch against your anxiety and reach a more content state of mind.

The Best Treatment Plan Going Forward

It goes without saying that if you have a serious anxiety problem such as generalized anxiety disorder, social anxiety disorder, panic disorder, or even anxiety as a symptom of major depression or bipolar disorder then you will always want to consult a professional such as a psychiatrist for the best outcome.

A psychiatrist will be able to point you in the right direction by telling you which coping techniques have worked best for his or her patients as well as giving you a referral for a suitable therapist.

As far as taking advantange of the coping techniques above for the best results you should aim to combine all three. At the very least give each treatment option a fair shot because you may find that one technique works better than another one.

Even though people suffering from anxiety disorders and anxiety in general share similar symptoms they all suffer more greatly from certain aspects of the affliction.

Finally, remember that this is a marathon not a sprint. You may never be able to totally get rid of anxiety but you will come to learn how to minimize its impact and improve your overall quality of life with continued effort.

Cognitive Behavorial Therapy as an Alternative to Antipsychotics?

For some individuals with schizophrenia, a mental illness that affects approximately 2.1 million Americans, modern treatment options can be more troubling than the actual symptoms of the illness itself. One of the main classes of drugs used to treat schizophrenia are antipsychotics. Medications that fall under the umbrella of antipsychotics include Risperdal, Seroquel, Geodon, and Abilify among quite a few others (for a comprehensive list of start here). These medications carry nasty and sometimes very serious side effects. However, recent research suggests that for some individuals cognitive behavioral therapy could act as a replacement for such medications.

A Much Milder Option

Cognitive behavioral therapy (CBT) is aimed at correcting flawed emotions and thought patterns that a patient might have through talking to a professional such as a psychotherapist. And since one is not ingesting any foreign substance through this process there are no side effects. As a result it’s a great option for individuals with schizophrenia who are hesitant to take pills for their illness.

According to the study, published in The Lancet, it was found that after 18 months (the final assessment) 41% of the 17 who participated in cognitive behavioral therapy showed a minimum of a 50% improvement. For comparison, only 18% of the 17 who did not participate in CBT and only received normal care showed improvement.

The way the researchers measured the improvement of the patients was by using a metric known as the Positive and Negative Syndrome Scale (PANSS). It was first developed in 1987 and it is a way of measuring the severity of the symptoms of schizophrenia. Positive refers to the positive symptoms of schizophrenia which include hallucinations, delusions, and grandiosity. The negative refers to the negative symptoms which include anhedonia, social withdrawal, and emotional withdrawal.

While the study used a small sample size and a much larger size would be needed to draw definitive conclusions this is still a great finding. This isn’t to say that this is the end of the use of antipsychotics in the realm of schizophrenia treatment. This just isn’t true. There will always be those that absolutely require this type of medication for any type of stability much less remission.

For those that could take part in CBT as an alternative this is absolutely astonishing considering the side effects that antipsychotics as a class of medications bring to the table. It’s a sad reality for some that this class of medications can actually worsen some of the symptoms of schizophrenia, namely the negative symptoms.

Paving the Way for CBT

At the very least cognitive behavioral therapy certainly seems to be a very worthy adjunct treatment option for individuals with schizophrenia. CBT has a proven track record and it could very well be what people need. It’s not just a superb option for individuals suffering from schizophrenia but for those suffering from all types of mental illness. This includes (but is not limited to) anxiety disorders, major depression, drug addiction, OCD, and even ADHD.

The only drawback to CBT is the cost. Even if one has health insurance it can still be a burden. The cost is especially disheartening when you consider the fact that around 60-80% of people with mental illness are unemployed. That number is very worrisome. When one can barely afford to breath air, drink clean water, and eat food how will they be able to pay for therapy?

Nonetheless, cognitive behavioral therapy is without a doubt proven to be an effective treatment option for all types of folks. It may not work for everyone but there is a significant chance it will work for a large amount of the population.

Real Time Web Analytics
Scroll To Top