DBT for Anxiety: How It Works, Techniques, and Effectiveness

More often than not, anxiety can feel like it’s taking control of your life. You may feel excessive fear, worry, and even physical symptoms that significantly impact your daily life. Fortunately, dialectical behavior therapy (DBT) for anxiety is a treatment option that many have found to be particularly helpful.

Here, we’ll explore the different aspects of DBT for anxiety, including how it works, the techniques it uses to equip you with coping skills, and its effectiveness in managing symptoms. If you want to feel more in control of your life and combat anxiety, then keep reading.

DBT for Anxiety

To understand how DBT and anxiety go hand in hand, it is crucial to define what anxiety is.

Anxiety is actually a normal reaction to stressful situations [*]. It can alert us to potential dangers and help us be more alert. However, too much anxiety can lead to anxiety disorders, which are characterized by significant feelings of fear or worry regarding real or perceived threats. Common symptoms include excessive worrying, panic attacks, restlessness, rumination, avoidance behaviors, disturbed sleep, and other physical symptoms like aches and pains.

Whether anxiety in children or adults, this condition can be debilitating and negatively impact one’s quality of life.

There are several treatment methods for anxiety, but the one we will focus on in this article is dialectical behavior therapy or DBT.

Initially, DBT was developed by Dr. Marsha Linehan in the 1980s to support patients with borderline personality disorder who had suicidal ideations and behaviors. Since then, it has become an option for treating other mental health conditions.

“Dialectical” in DBT means accepting and holding space for two opposite truths. This way of thinking (dialectical thinking) gives individuals a helpful framework to counteract ways of thinking that normally characterize anxiety. These include all-or-nothing thinking, which is a cognitive distortion that can intensify anxious thoughts.

DBT typically involves individual therapy, group skills training, phone support, and a consulting care team.

How DBT Works for Anxiety

DBT works for anxiety by allowing an individual to recognize their triggers and develop coping mechanisms to manage their anxiety. The treatment focuses on changing behavior patterns rather than talking someone through their anxiety.

DBT as a therapy teaches emotional and cognitive skills while encouraging you to learn how to apply said skills in real life. This therapeutic process can improve emotional regulation to help you gain better control over your feelings, which can be extremely helpful in managing anxiety. Studies have shown that the coping skills learned in DBT can successfully reduce symptoms of anxiety [*].

DBT Skills for Anxiety

DBT teaches individuals skills that can help them with difficulties in their emotions and other distressing experiences in life, including anxiety. This is called DBT skills training, and it is made up of four modules:

Mindfulness

Mindfulness is a fundamental skill in DBT. It teaches self-awareness and how to be present in the current moment. This technique is especially useful for individuals who worry excessively about past events and fear the future. By learning how to be grounded in the present, you can filter out past trauma and, instead, focus on the moment.

Distress Tolerance

Fear and anxiety can often seem unbearable to experience. This is where distress tolerance skills come in. This set of skills helps people with anxiety learn how to tolerate these intense emotions and avoid behavior that may aggravate them.

Distress tolerance teaches people with anxiety to apply skills that can be used instead of unhealthy or destructive behaviors. One example is radical acceptance, which means completely recognizing and accepting your reality, even when it includes pain and discomfort. By practicing this skill, it becomes easier to break the cycle of anxiety.

Emotion Regulation

Emotion regulation is the third DBT module, and it teaches people with anxiety how to deal with overwhelming emotions. It teaches you how to understand your emotions, reduce emotional vulnerability, and decrease emotional suffering. This module emphasizes that negative emotions are not necessarily harmful and are not always meant to be avoided. However, it is important to acknowledge negative emotions and let them go. By doing so, you will no longer be controlled by them.

Interpersonal Effectiveness

The last module, interpersonal effectiveness, teaches you how to interact with others. For instance, your anxiety may make it difficult for you to tell others “no.” Focusing on interpersonal effectiveness allows you to practice healthy responses to everyday situations, including anxiety, so you can handle them better in real life. This is especially helpful for anxiety in teens.

Is DBT Effective for Treating Anxiety?

Studies have shown that DBT can be effective in treating anxiety. One showed that DBT was able to reduce symptoms of both depression and anxiety in people with generalized anxiety disorder [*].

However, there isn’t that much research examining DBT on specific types of anxiety disorders. Instead, exposure and response prevention (ERP) is considered the gold standard of anxiety treatment, especially for specific phobias. That said, DBT may still be helpful for people who wish to feel more in control of their emotions and the responses to them.

Compared to CBT, which aims to help patients recognize when their thoughts might be unhelpful, DBT focuses on acceptance and feeling safe. This can be especially useful for DBT for kids, which focuses on kids with big emotions and how they can feel safer during treatment.

How Long Does it Take to See Results from DBT for Anxiety?

While DBT can be very effective, it typically takes time to see results. Most people start to see some improvement in their anxiety symptoms within a few months of starting treatment, but it can take up to a year or longer to see the full benefits of DBT.

Here are some factors that can affect how long it takes to see results from DBT for anxiety:

• The severity of your anxiety symptoms
• How long you have been experiencing anxiety
• Your commitment to treatment
• Whether you are also dealing with other mental health conditions

If you are struggling with anxiety, DBT can be a helpful treatment option. It is important to be patient and committed to treatment to see results.

Are There Risks and Side Effects Associated with DBT for Anxiety?

While there are no significant risks and side effects that one can expect from engaging in DBT for anxiety, it can be helpful to set expectations. Here are some things you can expect from DBT:

DBT will require a significant time commitment, both for the patient and the clinician.

• There are many skills to learn in DBT, which can be overwhelming.
• DBT follows a structured approach with strict boundaries
• DBT requires homework, which may not be well suited for everyone.

Ultimately, there are no risks and side effects involved. However, DBT for anxiety may be better suited for some people than others. For instance, DBT for teens may help deal with the intense emotions that come with adolescence, including feelings of anxiety.

The Bottom Line

So is DBT good for anxiety? DBT isn't a quick fix, but it offers powerful strategies for managing anxiety and living a happier life. Through DBT, you'll learn skills to handle difficult emotions, build strong relationships, and find lasting calm. If anxiety is a burden, consider talking to a DBT therapist – it could be the first step to feeling better emotionally.

Don’t forget to check out our DBT worksheets to learn more about this treatment method for anxiety. Furthermore, our anxiety worksheets can offer additional support to individuals struggling with anxiety.

References:

1. Muskin P. What are Anxiety Disorders? June 2023.
2. Peprah K & Argáez C. Dialectical Behavioral Therapy for Adults with Mental Illness: A Review of Clinical Effectiveness and Guidelines. 20 October 2017.
3. Afshari B, Dehkordi F, Farid A, et al. Study of the effects of cognitive behavioral therapy versus dialectical behavior therapy on executive function and reduction of symptoms in generalized anxiety disorder. 2022.