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Dr John B
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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Ive been taking Zoloft for anxiety/worry for about 6 months

Customer Question

I've been taking Zoloft for anxiety/worry for about 6 months now and the constant worrying has gone away but I'm still very uncomfortable in groups and try to avoid going out at all. When I'm out I'm constantly thinking that other people are judging me or staring at me. Every so often I would have panic attacks so the doctor also prescribed me ativan. Zoloft helps but the only thing that I've taken that makes me feel 100% comfortable around people is when I had taken xanax. I've been told xanax is very bad for you and you become dependent on it so for me I just feel like I either have to choose becoming depend on a drug like xanax or live my life with anxiety. Is there any other way?
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr John B replied 2 years ago.

Hi,

Sorry to hear of the situation. Before I proceed can you provide some more detail on the kind of counseling you have received? Did it have a name? How many sessions? What happened during sessions?

Customer: replied 2 years ago.
Hi Dr. John. The counseling I received was for this issue was Hypnotherapy. I've also had family counseling and anger management when I was younger. The Hypnotherapy didn't work for me. There are days I feel completely normal, but it's rare.
Expert:  Dr John B replied 2 years ago.

Hi Donovan, thanks for the extra information. I have a few more questions I'd like to ask, it's help clarify your situation for me.

Firstly, have you experienced and significant trauma in your lifetime? For example, assault, motor accident, etc. You mention family counseling and anger management when younger, did you have the misfortune of being a victim of some sort when younger?

Second, you mention that your were having trouble with pervasive(?) worrying. Can you give me some examples of the kinds of things you used to worry about?

Lastly, can you give me some examples of social situations you've become highly anxious in? How long has the social anxiety been a problem?

Customer: replied 2 years ago.
Hi John. I'm not sure if these are considered significant trauma but it's been brought up in therapy before. When I was younger I was physically abused by my older brother. I think that was a major contributor to my anger. I don't feel the constant anger in me any longer but on rare occasions I do have outburst of anger. Around the age of 16 I started experimenting with acid and shrooms. No that I think about it during some of those I would think that I knew what other people were thinking about or that they knew my thoughts so I'm not sure if that's where that begun or if it begun because of those types of drugs. In 2001 I went to prison for 2 years and was put in solitary confinement for 6 months. While I was in there I had my first panic attack.

The worrying I have isn't about anything specific but I really worry for just about anything but it goes from one worry to the next. It's worst when I drink coffee or 5hours. It's hard to give up either one so I'm looking for alternatives to caffeine.

I'm not sure how long that I've been experiencing social anxiety but I think it was before or after prison. Right before I went to prison I was using coccaine, I had been using it for about 1 year before I went to prison as well as ectasy. John it's really hard to say what situations I have anxiety in because it's really for everything just interacting with people I'm uncomfortable, I hate being in groups or especially meetings where "all eyes are on me". I feel guilty for things that I haven't done for example if I was in a room of 4 people and a pen ended up missing and everyone was being questioned I would feel guilty even though I knew I didn't steal it, I would even began to feel uncomfortable and feel like people thought I took it.

I hope this helps John, I know I probably got alot of possibilities because of drug use, etc... just don't know what to do.
Expert:  Dr John B replied 2 years ago.

Thanks Donovan. Yes you're right the drug use, caffeine etc does complicate the situation as all these things impact upon anxiety in a profound way.

The current caffeine use will play havoc with your anxiety and if I was to give you one piece of straightforward advice it would be to stop consuming it. Easier said than done and something you already know......but I thought it important to emphasize it as a goal.

What is clear is that you describe diffuse and complex anxiety problems.... probably not surprising given some of your life history. Trauma has a powerful impact upon anxiety and we see people who have been victims of trauma become highly vulnerable to developing other anxiety disorders. I would presume that your early experiences have likely left you susceptible to the kind of difficulties you are having now.

Roughly speaking it seems that you have been experiencing difficulty in two anxiety areas: generalized anxiety (pathological worrying) and social anxiety with Panic Attacks. Both of these disorders/problem areas can be effectively treated using Cognitive Behavioral Therapy (CBT) and in fact CBT is recommended as a core part of the treatment of both of these problems. I usually describe specific treatment options foe both of these sets of problems but given that your situation is quite complex i think this is a little pointless. What I would strongly suggest is that you consult with an experienced CBT clinician who can conduct a detailed assessment of your anxiety processes and develop a tailored treatment plan. Suggesting you pursue treatment for only social anxiety (for example) at his stage would be pointless as the generalized anxiety and trauma will also be impacting on this area.

CBT is usually provided by Clinical Psychologists (although not exclusively) and you can contact the American Psychology Association (APA) for assistance with locating a Psychologist; take a look at the APA locator service here. You can use this to find Psychologists in your area and there is a phone number you can contact if you want a referral arranged for you. Also, take a look at an article published by the APA here. It's an interview with a senior Psychologist and covers some of the things you should consider when you looking for a Psychologist.

I'll pause here and wait for any response you may have so far.

Expert:  Dr John B replied 2 years ago.

Hi,

Did you still want my assistance with this question?

Customer: replied 2 years ago.
Hi John thank you for your help on this it's very much appreciated. I think I'm going to take your advice on the caffeine to start, actually haven't taken any of the meds that were prescribed to me for the past four days and caffeine for two days so we'll see how it goes. Thanks for the advice!
Customer: replied 2 years ago.
John I'm looking for the grade to click on but it's not there. Also wanted to send you a bonus.
Expert:  Dr John B replied 2 years ago.
Thank you very much! You should be able to make a rating now. If I can ever be of further assistance please don't hesitate to contact me directly. You can do this by simply putting for 'Dr John B' at the start of any question you post. Best of luck!
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
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Expert:  Dr John B replied 2 years ago.
Thank you very much for the extremely generous bonus. Highest I've ever received!

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Dr John B
Dr John B
Clinical Psychologist
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PhD in Clinical Psychology, registered clinical psychologist.