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Doctor Blake
Doctor Blake, Psychologist
Category: Mental Health
Satisfied Customers: 146
Experience:  Ph.D., Ed.S., NCSP Clinical Psychologist; 15+ years of experience; dual licensure
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I have GAD and its getting worst not better. What do I need

Customer Question

I have GAD and it's getting worst not better. What do I need to do?
I have upper back muscle problems. Cold hands and feet. Just had a complete
blood panel done and everything was normal. Please help. I'm losing it.
Submitted: 7 years ago.
Category: Mental Health
Expert:  samuraimd1 replied 7 years ago.
If you have upper back muscle pain, then the best thing is to get on a muscle relaxer pill . This will help treat the myofascial pain and will help you relax as well. I'm not a huge fan of xanax, but if you truly need it then take it, but also add something like buspar twice a day for your GAD. It will help at least keep you at the same dose of xanax for longer and will help keep you more calm.
Customer: replied 7 years ago.

Pills pills and more pills that all I ever hear from doctors. I want reflief from this

since I've had it for over 40 years. I've been on Xanax for 20 years. What next?

Expert:  Doctor Blake replied 7 years ago.

Good morning!


Thanks for writing to JA.


Your symptoms may well be related to anxiety or GAD.


As an anxiety disorder, GAD has been described as the "catch all" term to describe an individual with nonspecific or global anxiety that can, at times, reduce functioning in certain areas. Folks with GAD are prone to develop more specific anxieties around specific events than the normal population, and may develop more "specialized" anxiety disorders over time. As one of the Anxiety Disorders, GAD is felt to be related to applying the wrong response to a given situation. That is, fear is an adaptive function that all animals (human and otherwise) are born with... it is an innate reaction - but can be learned in response to certain situations/events. When fear (the response) comes at the right situation (a hungry saber-toothed tiger standing in front of you), you're doing GREAT! Fear makes you move (fight or run for your life)! When fear (the response) comes at the wrong situation (at the grocery store or on an elevator or driving down the highway, for example), you're not doing so great - and you need to relearn when/how to apply fear as originally intended.


Research has consistently demonstrated that treatment plus medication is more effective than medication alone or treatment alone for anxiety. Further research has shown that Cognitive Behavioral Therapy (CBT) is the most effective form of psychological treatment/intervention - particularly in dealing with anxiety disorders (like GAD).


A licensed psychologist/psychotherapist with specific training in CBT modalities would be able to address your concerns. I would encourage you to find a licensed mental health professional with whom to work, employing CBT. Be sure when you speak to a possible licensed mental health professional that s/he employs CBT techniques - not just "influences from CBT" or "an eclectic approach."


With regard to medical treatment, many/most physicians appear to begin with a Selective Serotonin Reuptake Inhibitor (SSRI) to treat anxiety. Because I am not an MD, it is beyond my purview to address medication concerns, however.


Again, the mantra of years of research says: medication or treatment alone is not as effective as both working in tandem. Some research has also indicated that insight-oriented talk therapy is counter-productive with some forms of anxiety disturbance... it actually exacerbates the condition(s) So, seek out a CBT therapist who will provide targeted, efficient, and effective therapy - not someone who signs you as a "lifer." If you're going to a therapist for years, something about the therapy isn't working.


Your psychiatrist *may* know of a CBT licensed mental health professional. Please make certain, however, that they employ CBT practices.


Thanks. I hope you're well and that this was helpful.


* FEEDBACK ENCOURAGED. Please contact me prior to leaving negative feedback so that we can resolve the matter. I am eager to work with all JA clients to provide them with useful/helpful answers. Thanks again.

Customer: replied 7 years ago.

This was a vague answer and did not help me all. I have

heard this answer a hundred times.I am trying to get help

for my psysical symptoms, and medications would be

right. I am seeing my family doctor today.

Expert:  Doctor Blake replied 7 years ago.

I'm sorry you felt that way - but glad you will be seeking the support of your GP.


Best of luck to you.


Please press ACCEPT.

Doctor Blake, Psychologist
Category: Mental Health
Satisfied Customers: 146
Experience: Ph.D., Ed.S., NCSP Clinical Psychologist; 15+ years of experience; dual licensure
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