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Dr. Rossi
Dr. Rossi, Psychotherapist
Category: Mental Health
Satisfied Customers: 4627
Experience:  PsyD, LPC, CHt
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Ive had an alcohol problem of and on for 3 yrs. Im 34 yrs.old

Customer Question

I've had an alcohol problem of and on for 3 yrs. I'm 34 yrs.old and started drinking due to social anxiety and secondary depression. I also went through a divorce and was laid off from my job...this caused my drinking to become worse. I have found that I need to drink to be in social situations, if I don't I will have panic attacks. This has affected my life to the point where I don't really even want to leave my house. I've never had a DUI, done anything to endanger others or ever used alcohol at work. I been to Dr's, had bloodwork, xray's, prescribed anti-depressants and xanax. My anxiety has only worsened and I've found that I have a hard time making eye contact with people with out my head shaking rapidly in a no-no tremor. This has made me very depressed and self-conscious. I see a psychiatrist one a month and a counselor once a week. I've had several med changes but nothing has seemed to work!! The xanax does help control the symptoms, but only at high doses. I don't drink everyday and even went 3 months without any alcohol and my symptoms never got any better. The only thing that seems to help is having a few beers to relax me and the anxiety stops completely. I know this is not a good long-term solution! I am very desperate for any kind of answers or suggestions as to what is going on. I've had social anxiety my entire life but never to this extreme. Any ideas as to what could be causing this?
Submitted: 4 years ago.
Category: Mental Health
Expert:  Dr. Rossi replied 4 years ago.

Hi,

 

Anxiety and depression are in most cases caused by neurochemistry (unless you are making a connection b/w the events - divorce/laid off) after which you notice a worsening of your symptoms. The latter would be seen as psychological and emotional triggers (even suppressed ones) affecting your well being. Something else to look into would be a sleep study to rule out nocturnal seizures, sleep conditions i.e. REM sleep disorder and sleep apnea as these can cause neurological changes and affect your mood/anxiety level during the day. Many antidepressants suppress one's REM sleep cycle and you're on multiple different ones.

 

**Psychotropic meds that work on the norepinephrine levels can also cause increase in the dopamine levels which relates to the fight or flight response. In that case, you may perceive an increase in anxiety/irritability/agitation and difficulties sleeping.

 

You've mentioned that your anxiety responds to a higher dosage of the medication and a question for your prescribing psychiatrist would be if you've reached a threshold where the medication at the current dosages is not effective. You may want to speak with your MD about what your base line is according to him/her.

 

In addition to medication and talk therapy, other therapeutic modalities to look into would be biofeedback/neurofeedback and hypnotherapy.