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Anxiety and Stress Disorders

The Most Effective Medication

02/08/2007

Question:

I am a 20 year old female. I need some serious help or any information you can give me. I have been having panic attacks for the last 2 years. It has gotten to the point where I am scared to even leave the house. I live on the outskirts of the city and making a doctors appointment and the trip into town to actually get there seems like a nightmare! I literally feel if I leave my comfort zone I am going to die. I know that there is no apparrant danger and that heightens my panic because its all in my head and I can't control it. It has got to the point where I am constantly on edge. I cant do my school work, I can't work. And it's affecting all my relationships in my life. Please help me. I know that you are an online doctor but I think its a step. I guess now that you kind of know my situation I can ask you my question. I am really scared to take any medications after browsing the internet and seeing other peoples reactions to the drugs...I eat healthy and work out. I guess I am just wondering which kind of medication you would recommend. Which has the least amount of side effects and is least likely to cause weight gain...(i dont think that would help my situation much) Please get back to me!!

Answer:

It sounds like you need some serious and intensive mental health treatment.  While you may eat healthy and work out (and should continue to do so) this is not usually enough when there is a serious medical problem, as it appears you have.

While this forum is not set up to diagnose individuals, it certainly sounds like you have a significant anxiety problem, possibly panic attacks or social anxiety phobia (also called agoraphobia), where being around other people or in large, crowded or strange places leads to severe feelings of anxiety, which can include physical symptoms of nausea, weakness, dizziness, palpitations, headaches and chest pain.

Anxiety disorders are generally felt to be due to a chemical imbalance in the brain that then is made worse by the behaviors you choose, and the reactions you have to these behaviors.  Therefore, the most effective treatments are generally a combination of medication and therapy -- specifically a type of therapy called CBT (cognitive behavioral therapy).  CBT helps to reprogram the thoughts (cognitive) you have in response to the things you do and experience (behavior).  Medications, generally serotonin reuptake inhibitors like prozac, zoloft, lexapro and others, help to return the brain chemicals back to a normal balance.  The best results, with the longest lasting effects, are usually found when both medications and CBT are used together.

All medications have side effects, but the majority of people who take SSRI medications have no, or few, side effects.  Of course, they are not usually the ones who write a lot on the internet, so people rarely hear about the majority of people who get great benefit from medication with few side effects.  Only you will know what is right for you.  I encourage you to see your physician and a mental health professional as soon as possible.  Things will only get better when you decide to seek treatment.

Good luck.

Related Resources:

anxiety disorders of america
NIH NIMH anxiety

For more information:

Go to the Anxiety and Stress Disorders health topic, where you can:

Response by:

Nancy   Elder, MD Nancy Elder, MD
Associate Professor
College of Medicine
University of Cincinnati