system
How can severe anxiety be treated?
human
I have a 20-year-old daughter who is experiencing what I consider to be severe anxiety symptoms. We have a STRONG genetic predisposition for anxiety issues as well as depression. (Fortunately- this is the ONLY thing that runs in my family-- no cancer, no high blood pressure, no diabetes, serious illnesses, etc.)... Unfortunately, anxiety is NO SMALL THING. I have had the worst case of it in all of my immediate and extended family, and there are no adequate words to describe what it s like to deal this with disorder. It feels like MASSIVE amounts of adrenaline-- sometimes for long periods of time-- uncontrollably being produced by your body... and the worst part is that sometimes there are triggers that start these anxiety attacks or panic attacks-- but other times, both myself, 1/2 of my siblings --(a clue that this disorder has a genetic-base and biological root-- rather than an environmental trigger in our family or something to do with our upbringing or any dysfunction aspects of our family) -- have had absolutely TOTALLY random anxiety for ABSOLUTELY NO REASON. It is a miserable condition. Now... 1 or my 2 daughters (who has always had some anxiety)... is dealing with college, assignments & homework, a few professors that are extremely difficult for students to deal with, a part time job, a boyfriend, and she is currently about to do a mid-year/ (2nd semester of her Junior college year) transfer to a different University (not large-- mid-size) beginning in January and is preparing for that. Is it any wonder that she s having panic attacks...? Of course not-- this is a very stressful age of life-- I remember it like it was yesterday; however, her family doctor and I do not seem to be able to get a handle on helping her regardless of medications tried, a counselor/ talk-therapist, lots of immediate family support and extended family support... and I guess I just need some advice about the medications that we are trying right now-- the mixture of them -- and the possible side effects that we might run into... (did I mention that my daughter s worrying about the possible side effects of these new medications is causing her even MORE anxiety....?) She has been on 20 mg of Prozac for the past approximately 8 years. We found that Prozac works extremely well with my family members... Zoloft works okay, Paxil is a disaster, (the missing doses hell and the huge amount of possible weight gain!!), and Wellbutrin-- which many of our friends all seem to swear by -- seems to help the depression aspects that my family experiences -- but it also seems to have a rare side effect in my family -- which is that Wellbutrin causes EVEN MORE ANXIETY and makes it completely unmanageable (something about the fact that it works on the other neurotransmitters which help Dopemine levels-- wheras our deficiency seems to almost ALWAYS be in the Seratonin deficiency area... I have a psychiatrist for myself-- (since I ve had anxiety attacks since the age of THREE... And yes, I do remember them well & exactly when they started...and there were no triggers). I ve tried many meds over the years to try to best treat my anxiety as well as my depression (and I ve got some OCD mixed in there too! : / )... so I know a lot about many of them. My psychiatrist and I presently, and have found that the best thing for my biology/ chemistry of my body is 1) 60 mg of Prozac 2) Temazepam for anxiety/ insomnia at bedtime 3) GABA (Neurontin) - small dose - but to keep building it up in my bloodstream to help with the anxiety, and 4th ) Valium - 3 times per day for some serious life issues that I am currently dealing with -- including the recent death of my Father 4 months ago, trying to help my Mother, being a single parent to 1 young adult (the daughter that I am writing about) as well as 1 sixteen-year old daughter, and having gone through a horrible divorce about 2 years ago after a seemingly solid and happy marriage for 28 years. (We plan to take the Valium down to 2 X per day soon... and then to 1X per day after that - in order to avoid the addictive effects). ***I want my 20 year old daughter - with all of this college-age stress, (as well as after-effects of the divorce), to see my own psychiatrist-- since he understands the biology/ chemistry of my family-- however, he has a 6-month waiting list for Intakes/ New Patients ... We can t wait that long. As I said, this daughters is seeing a good counselor/ therapist-- and she is good and helpful, but the anxiety attacks are still serious & not manageable. So her family doctor/ personal physician has tried to prescribe appropriate medications for her. 1) He has upped her dose to 40 mg. 2) He has prescribed Ativan-- ONLY for when the panic attacks/ anxiety becomes EXTREME (he gives her a limited number, of course).... and now he just met with her, and wants to had Buspar(ine) ?? My question is: Does this sound like a good idea...? A good combination of medications-- given her current age, college status, life stressors (transferring colleges to 1 that is an hour away from home), part time work stress, massive amounts of homework, a boyfriend, and this horrible divorce that was just 2 years ago? Also, does this sound like a good combination of meds based on what I ve mentioned about my immediate family s predisposition for these disorders/ imbalances with serotonin and the way that the Family of Meds that include the Wellbutrin kind don t seem to be a good fit for us.....? (isn t Buspar(ine) in the same medication family as Wellbutrin? Thanks for your help, in advance! -Sherry YYYY@YYYY
gpt
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Anxiety disorders are a category of mental disorders characterized by feelings of anxiety and fear, where anxiety is a worry about future events and fear is a reaction to current events. These feelings may cause physical symptoms, such as a racing heart and shakiness. There are a number of anxiety disorders: including generalized anxiety disorder, a specific phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, and panic disorder among others. While each has its own characteristics and symptoms, they all include symptoms of anxiety. Anxiety medicines alone cannot cure anxiety disorders mainly because medicines do not alter behavior. Behavior change and Continuous practice of the changed behavior cure anxiety. I suggest anxiety education, progressive counseling and progressive psychotherapy. I assure you complete cure. I need to know more about your anxiety so that I will be able to diagnose it properly and provide you tips to overcome and manage your anxiety. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand