How long did it take for you to notice a difference in your anxiety treatment?

July 31, 2008 9:21 AM

Anxiety sufferers: how many sessions of therapy did it take to notice a difference?

I'm wondering specifically about CBT, which I've heard is a fairly effective treatment for generalized anxiety disorder. Should I expect it to take weeks? Months? Years? I'm mostly wondering so I have a barometer with which to gauge the effectiveness of the therapist, since it's pretty costly.

posted by saraswati to Health & Fitness (16 answers total)

Months (though not with weekly visits). It's very structured, and if it isn't sorted in less than about 15-20 sessions, it's not being done properly.
posted by different at 9:35 AM on July 31, 2008

I think it depends a lot on how hard YOU work at it and the pervasiveness of your anxiety.

For me, it took about 5 sessions of CBT - a few weeks in a row and then once-a-month for the last two - and there was a huge drop in my anxiety. Noticeable shift.

The treatment was fabulously effective - I feel totally in control, totally relaxed about a lot of things that normally would cause me a great deal of stress. The important part, though, is that I have to make the effort to use the techniques I learned - practice them, use them, refresh them. Just going to the sessions isn't enough.

Good luck!
posted by VioletU at 9:36 AM on July 31, 2008

Used to have pretty serious insomnia, until I tried SMR Neurofeedback. The therapist adminstering the procedure noted that she predominantly used it for patients with anxiety, but had been using it for insomnia as well. Some people consider this to be junk science, but it worked for me. It's may be no replacement for CBT done as noted above, but if that's not working for you, it may be another option.
posted by Debaser626 at 9:46 AM on July 31, 2008

I worked in psych hospitals when I was in college and was privilaged enough to sit in on a lot of CBT groups and I have seen it work wonders. There is a book called "Feeling Good - The New Mood Therapy" by Dr. David Burns that you might pick up. He is an expert in the field and says generally people take about 12 weeks for it to talk full effect. I am just starting to re-read it now, so it's funny that your question popped up. Lots of great info in the book on CBT.

I should say also, that along with how sever your anxiety is, another factor in the effectiveness of your therapist. If you aren't satisfied, please don't give up. Find a therapist that you feel you can work with because it can really change your life to get anxiety under control.
posted by inquisitrix at 9:48 AM on July 31, 2008

It really depends. Some people take months, and if they're lucky, even days. As inquistrix said, it depends on how severe your anxiety is; if you're sweating over every little thing and tensing up all the time, then that will take longer. Give yourself a couple of months (I didn't because unfortunately the sessions overlapped with school and I placed higher priority over the latter, although I'm doing a bit better than, oh, a year ago).

Good luck!
posted by curagea at 10:13 AM on July 31, 2008

It takes a few months to become really conscious of your thoughts in anxiety-producing situations and become effective at diffusing them. First you need to learn about anxiety itself, categorize your own situations and interactions that are difficult for you, and then get into the specifics of each experience and how you might try to think differently and reassure yourself in the future. Then you need to apply the techniques (can include lots of non-specific ones, like breathing, diet, and meditation). Sometimes you'll miss opportunities to combat anxiety, and just generally getting into the habit of mindfulness takes a few months. All through this time you're building trust with the doctor and talking through other emotions and general anxieties and trying to get a handle on things. I was assigned a workbook to read up on the condition and techniques. For me it was 2 months of weekly sessions before it was suggested that I come in monthly instead. At that point I had demonstrated that I could use the techniques effectively and felt better about future anxiety-producing situations.
posted by cowbellemoo at 10:38 AM on July 31, 2008

CBT is a form of exercise that makes you mentally more fit the same way that physical exercise builds physical fitness. Someone who hasn't exercised in a long time, and who embarks on an exercise program half-heartedly isn't going to see the same result as someone who adopts a daily fitness regimen.

The same applies to CBT. There's a lot you can do in between therapist visits to strengthen your mental fitness. A workout once a week is nice but daily training is probably a lot more effective.

And just as people start with differing levels of physical fitness, people come to CBT with varying degrees of anxiety. Someone who has a high-level of base anxiety is going to need more time than someone who has only occasional and mild anxiety.

I had a mild case of speaking anxiety once and I fixed it with the help of a CBT book called Mind Over Mood.... in a single day.
posted by storybored at 12:00 PM on July 31, 2008

I did talk therapy, rather than CBT specifically, so it was a good few months before I saw a difference. I have done CBT before but my anxiety was rooted in issues from childhood and I had to deal with that to treat the anxiety. So, it took a while. Definitely shop around for a therapist and find someone you gel with. Good luck!
posted by poissonrouge at 12:11 PM on July 31, 2008

CBT results can be "felt" in just a few sessions, as long as you're serious about using the exercises as often as possible.

For CBT to stick, yeah, 15-20 sessions is about right.

That said, some generalised anxiety symptoms may need help from anti-anxiety medication in addition to CBT until you're comfortable with the tools (and sometimes even on an ad hoc basis when a situation outstrips your ability to cope).

It's worth it, though. Completely worth it. Comparing my mindset post-CBT to before is like looking at a completely different person. A much happier, more effective person.
posted by batmonkey at 12:23 PM on July 31, 2008

My mother went to this kind of therapy. She said it took about 6 months (she would go weekly) before she started seeing a difference. It took almost year before she felt really better, and her therapist said she could come less often. She said the difference she felt was that she started sleeping better and being a little more confident. She went to this therapy at the recommendation of her cardiologist who said she was having heart palpitations and other problems probably due to her anxiety. By the end of her first year of therapy, she was able to go off the heart medication she was on. She still goes once every few months or so when she feels stressed.
posted by bluefly at 12:24 PM on July 31, 2008

I think the greatest thing about any type of therapy that does not involve sedatives or even beta-blockers is that you eventually learn to not perpetuate and re-inforce the thoughts and behaivors around your anxieties. It's all about practice. You have to continually test your limits until you don't have those limits anymore. Repeatedly immersing yourself in the activities that cause you anxiety is how you put an end to it. As far as CBT is concerned, make sure you go to someone who is reputable and that can convey the ideas to you clearly and effectively.
posted by captainsohler at 12:56 PM on July 31, 2008

I did CBT for anxiety and I would be hard pressed to say exactly when it was over. It could take 3 months but probably not longer than a year. A lot of your success with CBT has to do with your willingness to work on things the way your therapist suggests. I HATED thinking that I was "ill" so I worked my ass off to get better.
posted by kenzi23 at 3:13 PM on July 31, 2008

It took about a year, but then again, the first three months of therapy were spent cowering in the corner of my therapist's office.
posted by idiotfactory at 4:25 PM on July 31, 2008

I have complex, long-running PTSD, which is also an anxiety disorder. I am on a regimen of CBT and SSRIs to combat it. So far, it's been about 4 months, of weekly visits, and I'm starting to see an attitude shift. I'd say my progress has been fairly swift, relative to the severity of the problem.

I expect it to take another few months of weekly visits to straighten out all my mental kinks.
posted by ysabet at 5:13 PM on July 31, 2008

There's some anxiety on the list of things I'm working through. I'm nearly a year into therapy and noticed significant improvement after a month or two. I think it was at the two month mark that I could cry in the room.

I feel like I've had some cycles of rapid improvements followed by plateaus.

It's been worth it.
posted by bilabial at 9:30 PM on August 1, 2008

Yes, as many stated here you need to put to practice what your therapist is advising you. If you don't, you will tend to use them as a crutch in times of panic and that's not good. Because they will not be there for long at all. Make sure your therapist knows exactly what your needs are and take their suggestions and do them. It takes brain power and will to keep your mind open but it works in the long-run. You will be better able to handle stresses that happen more effectively. Generally people notice the difference within a few months. That is depending on what type of anxiety you have. With panic attacks and OCD, it could take a month to notice a difference but can take a full year sometimes to calm down the imbalance in your brain that sends the wrong messages of panic.
posted by InterestedInKnowing at 2:43 PM on September 27, 2008