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Dr. Rossi
Dr. Rossi, Psychotherapist
Category: Mental Health
Satisfied Customers: 4627
Experience:  PsyD, LPC, CHt
19260254
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Thank u for that... I need a therapist of the type u describe

Customer Question

Thank u for that...
I need a therapist of the type u describe as Im a emotional man..haha
But the problem is finding one on the Isle of Man...not easy.
The wife of 25 years can be strong and fixed in her views and that bothers me greatly...very little emotional support.
If I can get back to a reasonable work situation I can earn ok money and may be even willing to travel to UK for monthly sessions if I can find somebody really good.
I took part in a programme in Bards 20years ago into panic attacks and they told me my breathing was the worst on the trial...
What to do..to feel out of things so much is ..well undescribable.
We have money problem as well, 2 kids in Uni and falling behind on Mortgage payments, but as I say if I can get back to work (self employed Architect) things could be different.
One last thing..I recently met a really understanding women on line who gives me fantastic support and advice, but I feel guilty about this because Im married.
I know your not a marrage guidenc councellor but would be interested if u had any advice on this?
Thanks again better than I expected.

Iam very concerned that I may need to leave this marriage inorder to sort myself out???? Diffult

Eddie

Sorry dont mean to be funny but do I need to pay more for this follow up..if I do its fine just not sure thats all...
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr. Rossi replied 3 years ago.

Dr. Rossi :

Hi,

Customer:

no info received????

Expert:  Dr. Rossi replied 3 years ago.

It seems you were replying to a specific expert. If you do not put their name at the start of the post ex: For Dr. Soandso...., your question post in the general queue and there is no way to know which person you wanted to assist you.

Another option would be to carbon copy your question in the old thread (where the expert had initially replied to you) That usually goes to their box.

I ment to click IR not answer on my part.

Customer: replied 3 years ago.
OK Thanks for that, appreciated, did u read my previous question and answer? if so I may be interested in your reply..always interested in a Womens point of view as I have 5 sisters....
Expert:  Dr. Rossi replied 3 years ago.
I have access only to this post in this thread (no prior knowledge of what other info was exchanged with the other expert. If you want me to look at some question myself, let me knwo which one)
Customer: replied 3 years ago.

 

First Question.

 

I have suffered from panic attacks acute anxiety for the last 35 years.
The panic attacks have receded as Im taking Citalapram 40mg.

But im left in an AWFUL limbo of no feelings at all, for ANYTHING...just dead, I cant concentrate on my work or on anything for that matter...its just undescribable and its driving me insane....

I stopped drinking about 3-4 months ago....Im trying to come off a small addiction to codeine....but I have had these symptoms for as long as I can remember.........

 

Optional Information:
Gender: Male
Age: 49

Already Tried:
Citalpram, Some counselling, Diazipam small does 6mg/day. Dont have a lot of money...because I cant concentrate....

Customer: replied 3 years ago.

 

Reply received.

 

Hi! I believe I can be of help with this issue.


First let me say that I can imagine how overwhelming and frustrating this situation must be for you. On one hand you have experienced this for so long but on the other hand you have not found any relief and the symptoms seem to have gotten more extreme as the years have gone by.

And this is actually the key to my answer to you that you need to think about and consider and act on. That you are still hopeful and seeking help is a very good thing. My answer is going to focus therefore on three things: first, on HOPE itself, second on medications, and third on the the type of psychotherapy I recommend for you. I will also at the end of the posting give you a technique you can use on your own as well for when you are in the throes of depression, anxiety, or panic.

First, though, hope:

To bring you a measure of HOPE and some confidence, I'm going to take a moment to have you bookmark two videos that will give you just a moment's break from your own difficulties and will be inspiring. It's not to be curative; it's to give you a sense that we all live in the same world and we all have such different challenges and tests and we all have the ability to come to a good place in life:

Here's one about a young man who has a hard road in life but also had a dream:

http://vodpod.com/watch/1165857-walk-on-espn-video

The next is about a severely autistic girl. Let's see if she can help us here just a bit in the hope department:

http://www.youtube.com/watch?v=a1uPf5O-on0

 

Now on to the second point and something that is so important for you. I want to say that after this much time we have to reorient your focus from one that focuses on your symptoms exclusively. Remember: medications work on SYMPTOMS, not on what's going on with you as a human being. The problem with just focusing on symptoms is that we are human beings, not biological machines. So very often, when a medication treats one symptom, the underlying human condition that causes you depressed emotions pops up some other way and you are continually chasing after symptoms with your doctors. The research has shown (and my experience as a psychologist has certainly shown this) that psychotherapy WITH medications is much more effective than medication alone. Sometimes it can help the person reduce medications. And this is the tradeoff with medications when they are successful: they relieve SYMPTOMS but they relieve them while they are in your system. They don't actually TREAT the disorder. With pharmaceutical "solutions" you are getting relief from symptoms. That can be very important so that the anxiety from the symptoms doesn't overwhelm you. But if you want to treat the disorder itself--why it's happening, what is it telling me about myself, what changes do I need to make to not feel as I do?--to do that, you would need to explore yourself in a more human way.

So I need you to reorient your view of what's happening to you so that your emotions and to what might be a lifelong pattern of feelings and understandings in life which ARE after all, what is being talked about here with depression, anxiety, and the panic attacks that they are causing.

So I want you to reorient your focus from the medications being your main "work" on your anxiety and depression to your exploring your emotional reactions of feeling so anxious and being in such a depressed dark place as being your MAIN work and the meds as being the boost you need to help you not be so panicked and anxious and in a dark hole so that you CAN work on what's going on inside. Do you see this reorientation? The idea is that YOU ARE A HUMAN BEING and human beings don't just have emotions because they hit 49,000 miles like a car or like tires! We have emotions because they are part of how we grow and learn and become more fulfilled. But if we keep running from them and trying to get them just to go away without ever exploring what's going on, we NEVER get that chance to get anything from them. They just make us feel terrible year after year.

I know that was a long introduction to the discussion on medications but I wanted to make sure that after 35 years you will explore what this is all about as part of your life! But first, the meds themselves: I am not convinced that Valium is the best solution. I am concerned with that "deadening" feeling you refer to and I think that we have to suspect that the Diazepam (Valium) may be contributing to it after extended use. I would like to recommend you discuss with your doctor perhaps tapering off the Valium and replacing it with Xanax. Xanax is very short acting. It is not as pervasive as Valium. It can be used as needed as opposed to a regular regime as your symptoms improve. So, please discuss this and see if it helps to relieve that sense of deadening after a few weeks.

I have found that with your situation you will do better with a more introspective, humanistic approach in therapy. If we actually look inside, we can find great relief and meaning. And we can feel whole in ourselves in ways that we haven't for decades. However, you have to make sure that your psychologist is very experienced in Cognitive Behavioral Techniques (CBT) for anxiety and panic disorders as well. I don't know who's available in the Isle of Man, but I believe that this combination of experience with CBT and humanistic or psychodynamic therapy is very important for you. Because your symptoms are not just an anxiety disorder,

The idea here isn't that these types of therapy are magic. It's that I want you to find a therapist who will form a strong therapeutic alliance with you and will help you look at the sources of your emotions and panic reactions. You need to explore this if therapy will be ultimately worthwhile.

Now, I want to give you a tool to use for when the depression is overwhelming or there is anxiety panic. Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients suffering from depression or anxiety, when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. You will practice PMR at first when you don't wake up with an attack so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum. And this is good also for just general anxiety without panic attacks and for feeling as though you are in a dark hole of depression as well.

I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in a panic attack is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.

So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?


INSTRUCTIONS:

  1. After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.
  2. Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.
  3. Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.
  4. Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.
  5. Continue down your body, repeating the procedure with the following muscle groups:
    • chest
    • abdomen
    • entire right arm
    • right forearm and hand (making a fist)
    • right hand
    • entire left arm
    • left forearm and hand (again, making a fist)
    • left hand
    • buttocks
    • entire right leg
    • lower right leg and foot
    • right foot
    • entire left leg
    • lower left leg and foot
    • left foot
  6. for the shortened version, which includes just four main muscle groups:
    • face
    • neck, shoulders and arms
    • abdomen and chest
    • buttocks, legs and feet

Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation' poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.

What You Need:

  • A comfortable place.
  • Some privacy.
  • A few minutes.

Again:

 

Customer: replied 3 years ago.

 

Reply received.

 

Hi! I believe I can be of help with this issue.


First let me say that I can imagine how overwhelming and frustrating this situation must be for you. On one hand you have experienced this for so long but on the other hand you have not found any relief and the symptoms seem to have gotten more extreme as the years have gone by.

And this is actually the key to my answer to you that you need to think about and consider and act on. That you are still hopeful and seeking help is a very good thing. My answer is going to focus therefore on three things: first, on HOPE itself, second on medications, and third on the the type of psychotherapy I recommend for you. I will also at the end of the posting give you a technique you can use on your own as well for when you are in the throes of depression, anxiety, or panic.

First, though, hope:

To bring you a measure of HOPE and some confidence, I'm going to take a moment to have you bookmark two videos that will give you just a moment's break from your own difficulties and will be inspiring. It's not to be curative; it's to give you a sense that we all live in the same world and we all have such different challenges and tests and we all have the ability to come to a good place in life:

Here's one about a young man who has a hard road in life but also had a dream:

http://vodpod.com/watch/1165857-walk-on-espn-video

The next is about a severely autistic girl. Let's see if she can help us here just a bit in the hope department:

http://www.youtube.com/watch?v=a1uPf5O-on0

 

Now on to the second point and something that is so important for you. I want to say that after this much time we have to reorient your focus from one that focuses on your symptoms exclusively. Remember: medications work on SYMPTOMS, not on what's going on with you as a human being. The problem with just focusing on symptoms is that we are human beings, not biological machines. So very often, when a medication treats one symptom, the underlying human condition that causes you depressed emotions pops up some other way and you are continually chasing after symptoms with your doctors. The research has shown (and my experience as a psychologist has certainly shown this) that psychotherapy WITH medications is much more effective than medication alone. Sometimes it can help the person reduce medications. And this is the tradeoff with medications when they are successful: they relieve SYMPTOMS but they relieve them while they are in your system. They don't actually TREAT the disorder. With pharmaceutical "solutions" you are getting relief from symptoms. That can be very important so that the anxiety from the symptoms doesn't overwhelm you. But if you want to treat the disorder itself--why it's happening, what is it telling me about myself, what changes do I need to make to not feel as I do?--to do that, you would need to explore yourself in a more human way.

So I need you to reorient your view of what's happening to you so that your emotions and to what might be a lifelong pattern of feelings and understandings in life which ARE after all, what is being talked about here with depression, anxiety, and the panic attacks that they are causing.

So I want you to reorient your focus from the medications being your main "work" on your anxiety and depression to your exploring your emotional reactions of feeling so anxious and being in such a depressed dark place as being your MAIN work and the meds as being the boost you need to help you not be so panicked and anxious and in a dark hole so that you CAN work on what's going on inside. Do you see this reorientation? The idea is that YOU ARE A HUMAN BEING and human beings don't just have emotions because they hit 49,000 miles like a car or like tires! We have emotions because they are part of how we grow and learn and become more fulfilled. But if we keep running from them and trying to get them just to go away without ever exploring what's going on, we NEVER get that chance to get anything from them. They just make us feel terrible year after year.

I know that was a long introduction to the discussion on medications but I wanted to make sure that after 35 years you will explore what this is all about as part of your life! But first, the meds themselves: I am not convinced that Valium is the best solution. I am concerned with that "deadening" feeling you refer to and I think that we have to suspect that the Diazepam (Valium) may be contributing to it after extended use. I would like to recommend you discuss with your doctor perhaps tapering off the Valium and replacing it with Xanax. Xanax is very short acting. It is not as pervasive as Valium. It can be used as needed as opposed to a regular regime as your symptoms improve. So, please discuss this and see if it helps to relieve that sense of deadening after a few weeks.

I have found that with your situation you will do better with a more introspective, humanistic approach in therapy. If we actually look inside, we can find great relief and meaning. And we can feel whole in ourselves in ways that we haven't for decades. However, you have to make sure that your psychologist is very experienced in Cognitive Behavioral Techniques (CBT) for anxiety and panic disorders as well. I don't know who's available in the Isle of Man, but I believe that this combination of experience with CBT and humanistic or psychodynamic therapy is very important for you. Because your symptoms are not just an anxiety disorder,

The idea here isn't that these types of therapy are magic. It's that I want you to find a therapist who will form a strong therapeutic alliance with you and will help you look at the sources of your emotions and panic reactions. You need to explore this if therapy will be ultimately worthwhile.

Now, I want to give you a tool to use for when the depression is overwhelming or there is anxiety panic. Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients suffering from depression or anxiety, when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. You will practice PMR at first when you don't wake up with an attack so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum. And this is good also for just general anxiety without panic attacks and for feeling as though you are in a dark hole of depression as well.

I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in a panic attack is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.

So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?


INSTRUCTIONS:

  1. After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.
  2. Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.
  3. Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.
  4. Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.
  5. Continue down your body, repeating the procedure with the following muscle groups:
    • chest
    • abdomen
    • entire right arm
    • right forearm and hand (making a fist)
    • right hand
    • entire left arm
    • left forearm and hand (again, making a fist)
    • left hand
    • buttocks
    • entire right leg
    • lower right leg and foot
    • right foot
    • entire left leg
    • lower left leg and foot
    • left foot
  6. for the shortened version, which includes just four main muscle groups:
    • face
    • neck, shoulders and arms
    • abdomen and chest
    • buttocks, legs and feet

Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation' poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.

What You Need:

  • A comfortable place.
  • Some privacy.
  • A few minutes.

Again:

 

Expert:  Dr. Rossi replied 3 years ago.

The state of mind that you're describing - void of feelings, difficulty concentration, feeling dead generally is referred to as anhedonia. It is a state that is often experienced by individuals who are depressed (and depression often coexists with anxiety disorders).

 

Anti anxiety medication alone will not manage the depressive symptoms (you do not have to feel sad in order to deem yourself as depressed. The other symptoms are common in the disorder. Alcohol is a depressant, so that may have triggered some of the anhedonic mood. Poor concentration may be triggered not only by depression but also by stress, sleep disorder, low vitamin B levels (and stress, alcohol/drugs amongst other factors deplete the organism from vitamins and minerals. You can always supplement with b-vitamin complex and Omega 3 and another supplement is good for this is the one offered by Life Extension called Cognitex. If that is not available to you, you can supplement with pregnenolone. If you believe that the memory/concentration issue has more to do with ADD symtomalogy, then using hypnosis even if it is using self help CD

is one option. Another option would be medication (it does not have to be a stimulant because of your history of cocaine abuse)

 

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Dr. Rossi
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Mental Health Professional
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PsyD, LPC, CHt