Reader’s Question

I have been diagnosed with a Panic Disorder, Post-Traumatic Stress Disorder (PTSD), and obsessive-compulsive behaviors. I have been dealing with these disorders, I think, pretty well. I have been researching my conditions and educating myself on effective coping methods. I’ve also been seeing a therapist once a week.

I am very against medication, and I have been holding out for years on going that route. But recently my symptoms have me feeling rather scared. The obsessive/intrusive thoughts are beginning to worry me on a weekly basis. I am so afraid that I will lose control/go insane/let my guard down and just black out. Scary thoughts and images sometimes fly through my head, and I’m afraid that I will lose control and hurt someone. This fear is so paralyzing to me. I try positive self talk and reassurance. But it is just getting exhausting not being able to just ‘be’. My trigger for all of my anxiety issues is inactivity. When I get home from work, when all the cleaning and chores are done…when you are supposed to be relaxing — that’s when I get nervous and am left with my thoughts.

Do you think that the time has come to seek medicine as an option? If so, are there any safe, non-habit forming, options that you would recommend?

Our Clinical Psychologist’s Reply

You mentioned that you’ve been doing research on the topic of methods to cope with anxiety disorders. You also mentioned you’re seeing a therapist once a week. Hopefully, your therapist has specific training in the state-of-the-art methods to deal with your problem and is not merely providing psychotherapy. It’s important not merely to get help but the right kind of help. As you might know from your research, Cognitive-Behavioral Therapy (CBT) is the non-medical treatment of choice for anxiety-related disorders and has demonstrated effectiveness comparable to medical treatments. Sometimes, however, medication is necessary, especially in the short-term. And some classes of drugs (e.g., the benzodiazepines like Ativan and Xanax) have far more addiction potential than others. Many physicians prefer to prescribe medicines like Prozac (in the SSRI class of drugs) because they are not only effective in ameliorating anxiety with less dependency risk but also because they help with the depression that sometimes accompanies anxiety problems.

Fears like one might lose one’s mind or lose control are common features of an anxiety disorder not yet well-managed. But take heart, such fears represent a symptom of the disorder, not a reality about which you need to be terrified. It would be best to discuss all these issues with your therapist. And remember, you have every reason to hope that your anxiety issues will eventually be resolved.