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Penny Rayas, MFT
Penny Rayas, MFT , Therapist
Category: Mental Health
Satisfied Customers: 395
Experience:  I have 20 years experience in the mental health field
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Hello there, the answer to my questin wont be an easy one Im

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Hello there, the answer to my questin wont be an easy one I'm afraid. My son is 26 now and for 4 years he avoids nearly all social interactions with family and everybody. when people come to our house he is okay he comes out of his room and says hello. He hasnt gone to his first cousins' weddings 3 of them and when i pressure him he gets angry and bangs the doors. I am frustrated i dont know what to do, he hasnt got any friends and when men his age ring him up he usually doesnt answer the phone. Help
Submitted: 4 years ago.
Category: Mental Health
Expert:  Penny Rayas, MFT replied 4 years ago.
Hello I am sorry about your son. I wonder if he has any symptoms of depression such as low energy, not being able to sleep, depressed mood. I also wonder for how long he has been avoiding socializing.
Customer: replied 4 years ago.
We came from overseas 6 years ago. the first 2 years he was okay and then he started avoiding everybody, not going anywhere. i believe he sleeps alright even though he went to the doctor's a couple of times complaining about a fast heart beat and the doctor told him that he worries too much. i know he used cannabis overseas and i dont know if he is using anything now, but he just quit smoking which i hope is a good sign
Expert:  Penny Rayas, MFT replied 4 years ago.
I think the adjustment to a new country is a difficult one. I also think that your son sounds like he has an anxiety disorder.

The main symptom is the almost constant presence of worry or tension, even when there is little or no cause. Worries seem to float from one problem to another, such as family or relationship problems, work issues, money, health, and other problems.

Even when aware that their worries or fears are stronger than needed, a person with GAD still has difficulty controlling them.

Other symptoms include:

  • Difficulty concentrating

  • Fatigue

  • Irritability

  • Problems falling or staying asleep, and sleep that is often restless and unsatisfying

  • Restlessness, and often becoming startled very easily

Along with the worries and anxieties, a number of physical symptoms may also be present, including muscle tension (shakiness, headaches) and stomach problems, such as nausea or diarrhea.

Signs and tests

The health care provider will perform a physical and mental health exam. Tests will be done to rule out other conditions and behaviors that cause similar symptoms.


The goal of treatment is to help you function well during day-to-day life. A combination of medicine and cognitive-behavioral therapy (CBT) works best.

Medications are an important part of treatment. Once you start them, do not suddenly stop without talking with your health care provider. Medications that may be used include:

  • Selective serotonin reuptake inhibitors (SSRIs) are usually the first choice in medications. Serotonin-norepinephrine reuptake inhibitors (SNRIs) are another choice.

  • Other antidepressants and some antiseizure drugs may be used for severe cases.

  • Benzodiazepines such as alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan) may be used if antidepressants don't help enough with symptoms. Long-term dependence on these drugs is a concern.

  • A medication called buspirone may also be used.

Cognitive-behavioral therapy helps you understand your behaviors and how to gain control of them. Usually someone needs about 10 to 20 visits over a number of weeks. During therapy to will learn how to:

  • Understand and gain control of your distorted views of life stressors, such as other people's behavior or life events.

  • Recognize and replace panic-causing thoughts, decreasing the sense of helplessness.

  • Manage stress and relax when symptoms occur.

  • Avoid thinking that minor worries will develop into very bad problems.

Avoiding caffeine, illicit drugs, and even some cold medicines may also help reduce symptoms.

A healthy lifestyle that includes exercise, enough rest, and good nutrition can help reduce the impact of anxiety.

Support Groups

A support group allows you to talk to people who share common experiences and problems. This may help ease the stress related to a medical condition.

Support groups are not a substitute for effective treatment, but can be a helpful addition to it.

Expectations (prognosis)

How well a person does depends on the severity of the condition. GAD may continue and be difficult to treat. However, most patients get better with a combination of medication and behavioral therapy.


Depression and substance abuse may occur with an anxiety disorder.

Calling your health care provider

Call his health care provider if he constantly worry and feels anxious and it interferes with your daily activities.

What you can do is suggest that you son sees a therapist and receives treatment to learn how to cope. I hope that he is open to seeing a therapist. I think pressuring him to socialize does not help but he needs to learn how to reduce his anxiety.

I am glad that he stopped smoking but this will increase his anxiety. Both smoking siggaretes or pot reduces anxiety. I think your son was medicating an anxiety disorder by smoking.

Meditating and self help books will also help him reduce his anxiety.

Customer: replied 4 years ago.

i have tried before to tell my son that maybe he needs professional help but he doesnt want to hear it. would it be effective if i see his GP explain to him a few things and when my son goes to him again then the doctor will know what to do and how to help him? That means going behind his back trying to help him, but if he realises or finds out he will throw a tantrum, god help me


Expert:  Penny Rayas, MFT replied 4 years ago.
I understand that is hard to try to explain this to your son because he will not listen. I think having his GP explaining this to him will help. There several book that I like such as the book When Panic Attacks. You can do a search and get one for your son this book has all the methods to help him reduce anxiety. I also think you need some support in dealing with this. He will have a tantrum if he learns that you are trying to help. He may refuse to do anything so how do you take care of yourself if he will not get any help?
Penny Rayas, MFT, Therapist
Category: Mental Health
Satisfied Customers: 395
Experience: I have 20 years experience in the mental health field
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