Almost everyone gets nervous at times. Usually it’s not only a perfectly normal response to something, it’s a healthy one. Sometimes, however, and for some people anxiety happens for seemingly no reason at all—or for what may seem like a good reason to them at the time, but in retrospect turns out not to be. It is estimated that more than 18 percent of American adults have some kind of anxiety disorder.

Anxiety comes in a variety of forms. The most basic is called generalized anxiety disorder. Panic disorder, obsessive-compulsive disorder, post-traumatic stress, and phobias—including social phobia—all fall under the anxiety banner. Often people have more than one of these conditions at the same time, and they interact. For example, a panic attack is sometimes the reaction a person with a phobia has to the object of that phobia.

Treatment for anxiety generally involves cognitive-behavioral therapy, in which the patient and the therapist work together to identify negative and maladaptive thought patterns, so that the patient can learn to change them. Medications can help, but the long-term effectiveness is generally limited except in conjunction with therapy. Drugs called beta-blocker, developed for heart disease, can be used off-label to temporarily reduce anxiety when it’s not a chronic problem, or a a way to jump-start the therapeutic process.

In September, researchers in Boston found a way to use functional magnetic resonance imaging to help create individualized anxiety treatment plans on a per-patient basis. By having a social phobic patient look at faces while in the fMRI machine and seeing the brain’s response, the study showed, doctors can predict whether cognitive-behavioral therapy alone will prove to be a better approach than medication for that patient.

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