Reader’s Question

I am 19 years old, and I have been experiencing anxiety since I was 14, around the beginning of high school. Everything was fine for the first couple of days, but then I started feeling light headed and nauseous. My hands and neck went numb and I felt like I couldn’t move or I would vomit. That was the first time I experienced anxiety.

My doctor has put me on a generic form of Xanax, and I had been taking one each day before school throughout all of high school. Sometimes I would have to take another during the day if one wasn’t working for me. Other days I would just tell my parents I was sick. During my senior year my anxiety started to get so bad that I would have to take a pill when I went somewhere with friends. Then the summer after my senior year I got a job and was having to take up to 2-3 pills just to function at work.

Now my anxiety is worse then ever. The doctor started me on citalopram, but it doesn’t really seem to help me. I can’t hang out with friends anymore or even go to my grandpa’s house which is only one street away without having to be drugged up on Xanax (if it works). Now it’s just gotten to the point where I can’t leave the house. Even just going to the store for 10 minutes I feel very sick and can’t even take a pill with out throwing it up.

Honestly, I am not nervous about anything in particular or depressed. The anxiety just hits me whenever I try to do something outside my home. It feels more like a subconscious thing (if that’s the word for it).

Any idea what I should do? I really want to hang out with friends or do anything other than staying home all the time. I’ve tried talking to my doctors, but they say just stay on the meds, and my parents just shrug it off like they think I’m faking.

Our Clinical Psychologist’s Reply

I’ve posted about anxiety issues before, but your case illustrates so well some of the problems and misconceptions associated with the condition that I thought it warranted some special attention.

You are absolutely right when you say that you are not fearful of anything in particular. Most people who suffer from episodes of acute anxiety will report that their symptoms often “come out of the blue” or only in the kinds of situations in which they’ve experienced the anxiety before. Some folks experience a phenomenon called agoraphobia, which literally means fear of the marketplace. They don’t really fear the market, or the crowd, but what they dread is the symptoms that they experience when out in an atmosphere that takes them out of a safety zone. Although the symptoms of anxiety are really distressing, they are not dangerous (although their intensity can sometimes make a person feel like their health or well-being is in danger). Because of the dread of experiencing the symptoms, anxiety sufferers then start avoiding the situations that appear to bring the symptoms on. This creates a vicious cycle.

Although sometimes medication is a necessary component of treatment, some medicines (especially the anxiolytics like Xanax or the benzodiazepenes) can engender dependence and cause their own problems. As I have indicated in prior posts, the really good news is that there are very effective non-medical therapies available for anxiety which carry the added benefit of strengthening a person’s overall level of coping ability and self-confidence. These therapies are especially helpful in breaking the vicious cycle of avoidance caused by fear of the anxiety symptoms, and they also help teach a person how to gain mastery over their tendency to have the symptoms. Many individuals report a drastic reduction or a complete remission of symptoms (with occasional recurrences that can also be overcome).

Seek out an evaluation and care by a mental health professional trained in the state-of-the-art anxiety management strategies. Ideally, your prescribing physician should be aware of such treatments and should be able to give you a referral. If not, seek out such help on your own and be sure that your mental health services provider and your physician collaborate with respect to your treatment.