If you’re someone who struggles with anxiety, whether you regularly find yourself having panic attacks or you simply find yourself feeling stressed from time to time, then you may have been recommended anxiolytics by your doctor. These are medications designed expressly for treating anxiety and they work in a number of ways to help combat both the psychological and physiological symptoms associated with it.

But how do they work? And should you take them?

Neuroscience

All anxiolytics work by changing the release of neurotransmitters and hormones that are associated with stress or anxiety. Stress is essentially caused by the ‘fight or flight’ response, which is our body’s chemical response to danger. When we think we’re under some kind of threat, we release adrenaline, norepinephrine, dopamine, cortisol and more and this leads to an increase in our heartrate, dilation of the pupils, dilation of the blood vessels and even increased blood viscosity. The muscles become stronger and we become more alert but the immune system and digestion are suppressed until we become safer.

Most anxiolytics work by increasing the amount of a substance called ‘GABA’ or gamma aminobutyric acid. This is an ‘inhibitory’ neurotransmitter, meaning that its purpose is to suppress activity in the brain and communication between brain cells. When it does this, it leaves us feeling less alert and less anxious which in turn causes those anxiety-related neurotransmitters to subside. Essentially it works by sedating us slightly.

Other anti-anxiety medication works by increasing serotonin. Serotonin is the ‘feel good’ neurotransmitter and when there’s lots of it in the brain, we feel happy and cheerful. Increasing this can therefore reduce feelings of anxiety and dread.

The Problems

The problem is that both these methods can lead to unwanted side effects as well as addiction. When you increase or decrease specific neurotransmitters, the brain responds by reducing its natural production of those chemicals, or by reducing its ability to respond to them (by removing ‘receptors’). Thus you can develop to the point where you need stronger doses of the medication to get the same results. Likewise, you can find yourself feeling even worse when you’re not using the medication. This is called ‘tolerance and dependence’.

Furthermore, using medication like this does not address the root cause of the problems – the thought processes that lead to that chemical change. While anxiolytics might be useful in the short term for preventing the on-set of an attack, it’s important to use other methods in the long term to solve the problem.