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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4037
Experience:  MD Psychiatry
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hello, I am a 39 year old male. I have been suffering with

Customer Question

hello,
I am a 39 year old male. I have been suffering with anxiety issues and need to direction or advice. I have had anxiety since I was a child. I think it all started with my asshole father making me anxious as a child. My brother also suffers from anxiety. I smoked marijuana daily from the age of 17 till 7 months ago. Over the years I always had anxiety but it was mild and I could live just fine. Since I quit smoking 7 months ago my anxiety has been difficult to deal with. At first I thought it was just withdrawal but it still persists now 7 months into quitting. The most annoying thing it that the anxiety is over really silly things that make no sense to me. When I first quit my anxiety was at its highest and I seemed to fear everything. I would get fears of everyday things in my environment. I got this thought about noticing colors and now I can stop noticing all the colors around me. It is almost like anxious obsession right now and it is getting me down because I know it is really silly but the thought just keeps coming back to me. I function fine in my daily routine and I can get a break when I keep busy but just keeps coming back into my mind. Ocd I suppose. I have tried to not get worked up about it because I know the worked up I get the more the thought will stick to me.I have had silly thoughts many times but they always faded away. I need advice of how to get past this issue. Do you think I am still in withdrawals after 7 months of not smoking after smoking for 22 years or do you think this is just the real me without smoking. By brother doesn't smoke and he has had obsessive problems where he worries a lot. My life is great beside this issue. Should I go back to smoking as maybe it masks my natural issues or could you offer me technique to get past this silly recurring thought.I really don't want to smoke anymore. Thank you.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 2 years ago.

Dr. Kaushik :

Hi there,

Welcome to Just answer !

Well are you open to use of medication for relief from anxiety as you see anxiety is definitely treatable but there are two approaches , one is use of anti anxiety agents/ medication and the other approach is use of therapy that is counseling .. Both of these approaches to deal woth anxiety are effective in their own way but drug therapy is much faster to act to relieve anxiety , however best approach is to mix the two and use it for a stipulated period ..

Dr. Kaushik :

so please let me know if you are willing to try drug therapy so that i can provide you the various drug options for relief from anxiety besides mentioning to you about the type of therapy that will suit your anxiety most..

Dr. Kaushik :

i will get back to you once you reply to my query so please hang on as this conversation is still in progress..

Customer :

Hi,

I am trying some natural therapies such as theanine to increase gaba and tryptophan to increase serotonin. I am also trying Nac as I read that it modulates glutamate which has been found in to be involved in anxiety and ocd. I am scared of benzos and was hoping to not have to take an ssri but I would if it is strongly recommended. How long do you think it takes for neurotransmitters to balance out after quitting weed . Thanks

Dr. Kaushik :

Thanks for the reply..

Dr. Kaushik :

Well, yes i agree here that it is your marijuana withdrawal which is still weighing on your mind and contributing to your anxiety issues and it will take abstinence from marijuana for atleast 1 yr for you to start feeling control over your anxiety and ocd symptoms.. But i strongly suggest that instead of trying natural supplements which are good only for mild anxiety with not much of an effect over ocd symptoms, it will better that you get started on a formidable drug therapy and yes it will include an ssri and a benzodiazepine for a short period, but ssri shall be continued for atleast 4 -6 months ..

Dr. Kaushik :

I understand and respect your reservations about getting started on drug therapy but believe me if there had been any ohter option as effective as this , i would have told you that, but unfortunately drug therapy is still considered as a treatment of choice for anxiety and ocd which once controlled will make it easier for you to remain abstinent from marijuana abuse.

Dr. Kaushik :

So, kindly consult a psychiatrist ( preferrably ) or your MD physician and get the below mentioned drugs prescribed and started ..

1) Lexapro ( escitalopram ) at dose of 10 mg / day , to be taken in the morning only or as an alternative zoloft ( sertraline ) at dose of 50 mg/ day in the night only dose.

Dr. Kaushik :

2) Klonopin ( clonazepam ) at dose of 0.25 mg in the morning and 0.5 mg in the night..

Dr. Kaushik :

This two drug regime shall form the basis of treatment.

Dr. Kaushik :

While lexapro (ssri) shall be continued for 4-6 months but klonopin to be continued for 3-4 weeks only as this drug shall only be used to allay the anxiety initially while lexapro takes this time to reach steady state plasma levels which are required to produce the anti anxiety and anti ocd effects and once the lexapro starts acting to it's full potential and then klonopin , the benzodiazepine shall be brought off.

Dr. Kaushik :

So this way you will not have to bear with benzodiazepine for too long a period.

Dr. Kaushik :

Also i will like to add here that before starting on these two drugs you shall have to come off theanine and tryptophan as these two may interfere with the proper functioning of these two drugs mentioned above , but Nac may be continued ..

Dr. Kaushik :

If possible you shall also try to consult a clinical psychologist and get started on counseling such as CBT , that is cognitive behaviour therapy , which will help you to alter your thinking pattern and modify your behaviour which includes ocd and anxiety traits. Besides this therapy will help you to learn some mental strengthening exercises which will help you to remain abstinent from marijuana by exerting self control through the day to day practise of these mental strengthening exercises.

Dr. Kaushik :

So to summarize there are two appraches that you ahve to combine to get total reprieve / control over your anxiety and ocd symptoms plus to remain free from marijuana addiction and these two approaches are drug therapy comprising of lexapro and klonopin and CBT as a special counseling technique which is a very flexible therapy done in one to one sessions between the psychologist and the patient , once a week , lasting about 3-4 months ..

Dr. Kaushik :

I hope this gives you some insight into how you should deal with your current conditions..

Wish you all the best..

Please give me a psoitive rating if you are satisfied with the answer as only then will i be credited for my service.

Regards..

Expert:  Dr. Kaushik replied 2 years ago.
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Expert:  Dr. Kaushik replied 2 years ago.

Please give me a Positive Rating if you are satisfied with the answer as only then will i be credited for my service.

 

Please use reply button if you have any remaining doubt or query to ask, i will be more than happy to answer.

 

Regards..

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