Reader’s Question

Several years ago, my primary care doctor diagnosed me with an anxiety disorder and prescribed me Paxil. I took the medication for a while, but never felt it was truly helping. I have also taken several other anxiety medications throughout the years. I still got very anxious at job interviews, doctor appointments, and when talking to a coworker about something important or personal. I can feel my heart rate increase, I get really warm and even sweat, but worst of all, I start to cry. When others see me crying, they panic and think something is seriously wrong. After 2-3 minutes, I can calm myself down and resume whatever I was doing or need to do. I have tried not thinking of the event about to happen, counting down from 100, and taking deep breaths, none of which seemed to help. I have developed tricks to duck out of situations that will cause me to have an anxiety attack, such as sitting closer to a speaker in a large group so I can be first to introduce myself instead of waiting to be the last to speak, or scheduling interviews/appointments first thing in the morning so I don’t have to wait all day. I am concerned that as I get older, people will be less understanding of my anxiety issues, especially when I cry, and I will lose out on jobs for which I am qualified. I can deal with the increased heart rate and sweating, but the crying really bothers me. Sometimes, it’s the fear of having an anxiety attack that actually causes the attack. Is there other medicine that I can take that will calm my anxiety and/or would a psychologist be able to help me develop some tools to deal with the anxiety attacks?

Our Clinical Psychologist’s Reply

Anxiety disorders are among the mental health conditions that research indicates are very amenable to treatment. Success rates in effectively managing anxiety are among the highest in the mental health field. That said, it’s important that your treating professional be well-versed on the most effective treatment regimens.

Medications can be particularly helpful, especially during initial stages of treatment, as well as in situations where the optimal reduction of anxiety symptoms does not follow non-medical interventions. Often, medical practitioners prefer the use of Selective Serotonin Reuptake Inhibitors (SSRIs) like Paxil because they carry less risk of unhealthy dependency or abuse compared to other anxiolytic (anti-anxiety) drugs such as the benzodiazepenes (e.g., Valium, Xanax).

Individuals who suffer from anxiety disorders frequently get caught up in a vicious cycle that prevents them from brushing off the harmless but distressing symptoms they experience and ridding themselves of them. This is because the symptoms themselves are both distressing and frightening. So, the symptoms evoke excessive and unhealthy emotional responses, and those responses only intensify the symptoms. For someone not versed in the techniques of anxiety management, the only option appears to be escape from anxiety-evoking situations, which in itself is a reinforcer of the anxiety response.

There is a variety of safe and effective treatment for anxiety, and a psychologist versed in that area of specialty should definitely be able to help. So, don’t dismay. Effective treatment for anxiety can not only help you rid yourself of the distressing symptoms, but also help you acquire other general coping skills and an increased sense of self-efficacy and self-mastery.