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Dr. K
Dr. K, Psychiatrist
Category: Mental Health
Satisfied Customers: 357
Experience:  15 years clinical experience in all areas of psychiatry. Holistic and practical approach.
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Ive had generalized anxiety disorder since February of 2007.

Customer Question

I’ve had generalized anxiety disorder since February of 2007. Paroxetine has worked well for me, but at times I will abuse controlled substances, but I have made a vow to never use them unless it’s an emergency. I have also comited to not drinking alcohol. With the death of my mother’s significant earlier this month due to amyotrophic lateral sclerosis, my depression and anxiety has struck back with a vengeance. Any suggestions?
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr. K replied 3 years ago.

Are you still on paxil? What dose (or what dose were you on in the past if not still on it)?


Any other meds tried?

Customer: replied 3 years ago.
20MG, but my doctor thinks I may be better on 30MG. I have tried alprazolam, but the side effects are brutal, such as disinhibition, fatigue and mild anterograde amnesia.
Expert:  Dr. K replied 3 years ago.

I agree with your doctor...the rule of thumb is instead of experimenting with a different medication, make the most of your current dose. You can go up to 30mg...and consider going up further if needed; the maximum dose is usually 60mg.

 

I am glad you have tried treating yourself holistically (exercise, nutrition, sleep hygiene, and comedy). However, you didn't mention psychotherapy which can be a powerful tool. Consider self help books like: The Relaxation & Stress Reduction Workbook (New Harbinger Self-Help Workbook) by XXXXX XXXXX. The Mindfulness and Acceptance Workbook for Anxiety: A Guide to Breaking Free from Anxiety, Phobias, and Worry Using Acceptance and Commitment Therapy by John P. Forsyth.

 

Also consider learning yoga, meditation, tai chi, etc....these are powerful tools for anxiety. Look for local bereavement groups if you can handle the group setting.

 

I would avoid alprazolam or any similar meds because they can be addictive. However, if there seems to be no lother option, lorazepam or clonazepam can be helpful, and are not nearly as additive as alprazolam (obviously you will need to watch out for the same side effects). Any of these are DANGEROUS to combine with alcohol.

 

I hope this helps. Let me know if you have other questions. Take care.

 

Customer: replied 3 years ago.
Thank you. I have been to a few AA meeting and a bereavement support group for people dealing with someone they love with amyotrophic lateral sclerosis. They do help, but can also be a tad depressing. Thanks for the advise.

Best,
Matt
Syracuse University
Expert:  Dr. K replied 3 years ago.

As the saying goes, no pain, no gain. Going to groups or individual therapy can be a little depressing. You're not going for coffee and to discuss news/weather/sports. This is part of the healing process.

 

Just have a plan to do some positive, distracting activity after the session (music, movie, hang out with friend/family, TV, etc.). Take care.

Dr. K, Psychiatrist
Category: Mental Health
Satisfied Customers: 357
Experience: 15 years clinical experience in all areas of psychiatry. Holistic and practical approach.
Dr. K and other Mental Health Specialists are ready to help you
Customer: replied 3 years ago.
One last note, I will follow your advise and it gives me great pleasure that I chatted with a practiioner of holitic medicine.

"A weak man is just by accident. A strong but non-violent man is unjust by accident." - Gandhi
Expert:  Dr. K replied 3 years ago.

My pleasure...good luck.

 

Dr. K, Psychiatrist
Category: Mental Health
Satisfied Customers: 357
Experience: 15 years clinical experience in all areas of psychiatry. Holistic and practical approach.
Dr. K and other Mental Health Specialists are ready to help you
Customer: replied 3 years ago.
I pray that our medical researches will one day find a cure for ALS (amyotrophic lateral sclerosis), and I hope I will one day stop fearing death. Thanks for advise from both worlds (East & West).
Expert:  Dr. K replied 3 years ago.
I hope so too. Fearing death is being human....it is part of the natural life cycle. We're not getting any younger. Live every day like its your last and enjoy it as much as you can.

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