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Bill
Bill, LCSW, Consultant, Expert Witness
Category: Mental Health
Satisfied Customers: 3705
Experience:  35 years treating individuals, couples, families with mental health and substance abuse prob's
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I have a strong family history of anxiety and depression.

Resolved Question:

I have a strong family history of anxiety and depression. I am a 57 year old professional male.

1). I have been on Clonazepam for a sleep disorder for ~~15 years.

I have never had a sleep study. My sleep disorder is pretty simple. In spite of how physically tired I am I cannot turn my mind off at night. Sometimes I am thinking about work projects but often it seems anxiety related . It is typically a mixture of both. I am somewhat OCD, like many successful people. I can occasionally get so focused on a minor-major issue until I have to get it off my plate before I move on.

But those that know me well would not tell you my OCD traits really interfere with my life.

My dosage of Clonazepam has never changed. I have not required a higher dose.

I sleep very well with Clonazepam, I feel very rested each morning and do not feel hung over.

2). I have probably had mild anxiety and depression most of my adult life but not to the point that it has interfered with personal relationships (Happily married to the same wonderful women for 25 years with no infidelity) ,work, enjoyment of hobbies, etc. In my profession I am considered by my peers as one of the best at what I do. I teach academic courses and seminars for colleagues, etc.

When the Columbine shooting occurred, I lived 45 minutes from the school. I had a severe panic attack. A friend of mine was a physician. I called him and he prescribed Ativan. I was on this for a few weeks and all seemed well.

When 9-11 occurred I had a very severe panic attack and once again started using Ativan.

My father had mild anxiety most of his adult life. As he got older it became worse and worse and ultimately he was put on a small daily dose of Valium. (1960'-70's) This helped him tremendously. He died in 1974 of an M.I.

As I am getting older my Anxiety seems to also be getting worse and more frequent. There are some days when I do not take any Ativan. On bad days I will take two under my tongue and I calm down within 15 minutes and can continue to function at a very high level.

3). We do not have any family history of addictive disorders.

4). Right now I sleep well on the Clonazepam ( again for almost 15 years w/o a change in dosage). The anxiety I have is becoming a nuisance but again I am capable of functioning at a very high level.

My question is should I continue the status quo? It seems to be working well. If it ain't broke don't fix it???????

Or should I try medications like cymbalta, Efexor, Luvox?

I have had a knee replacement and both ankles reconstructed due to years of sports activities. So I have to watch my weight very closely. I am on a long term low carb eating pattern ( not a diet) and my main form of exercise is bicycling, elliptical and walking.

So I do not want to take anything that will make me gain weight.

I would appreciate any and all suggestions.

Thank you
Submitted: 1 year ago.
Category: Mental Health
Expert:  Bill replied 1 year ago.

Bill :

Hello- Thank you for asking the question. I have over 30 years of experience working with individuals, couples and families & am happy to reply.

Bill :

I am sorry to hear about this anxiety related disorder you have suffered.

Bill :

These Disorders are very treatable when evaluated and diagnosed properly. In reading what you have written- it does not sound like you have had the proper evaluation and diagnosis to achieve lasting relief.

Bill :

We know that anxiety disorders will worsen in time if not properly treated and this is what I sense from what you have written.

Bill :

I am attaching detailed information on Anxiety and Panic Disorders and their treatment from Harvard University as well as the protocol for treating anxiety and Panic from the Department of Psychiatry at University of Michigan which is a Center of Excellence in the treatment of Anxiety Disorders.

Bill :

Review the information and address this with your Doctor who ideally, should be a Psychiatrist.

Bill :

Treatment Protocol:

Bill :

Getting the right medication in addition to Cognitive Behavioral Therapy is the recipe for lasting relief. I trust this will help you get on track.

Bill :

If you have additional questions, feel free to ask- I am happy to help.

Bill :

Kindest regards, Bill

Bill :

I appreciate your Positive Rating so that I receive credit for my time.

Bill :

Thank you.

Expert:  Bill replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

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Customer: replied 1 year ago.

This is very generic information one can get from any source.

Expert:  Bill replied 1 year ago.

Thomas-

I respect your sense that this is generic information which to a degree, it is.

That said- it is directed to your unique situation in that:

1) I believe you have an anxiety Disorder that requires proper treatment evaluation, diagnosis and evaluation.
2) This needs to be conducted by a Psychiatrist that can determine the proper medication regimen for your unique needs. (a friend who is a physician is not going to be able to adequately evaluated your comprehensive Psychiatrist needs nor be willing to write prescriptions medications that you may been,
3) What medication you may need would be determining by the Psychiatrist----most often these conditions are treated with an SSRI class of medication - Zoloft ,Paxil etc. Additionally, patients are often treated with a small dose of benzodiazepine as you have taken .

4) The answer to your question regarding whether to "fix " the problem I tried to answer above in stating: "We know that anxiety disorders will worsen in time if not properly treated." I don't believe you have ever had proper evaluation of this disorder and that is what is suggested and recommended.


If you require assistance locating an Expert to evaluate and treat you- respond with your Zip Code and I will be happy to identify Experts who can help in you specific geographic area.


I trust this will provide the specific and individualized plan you deserve.

I look forward to hearing from you.

Kindest regards, Bill

Bill, LCSW, Consultant, Expert Witness
Category: Mental Health
Satisfied Customers: 3705
Experience: 35 years treating individuals, couples, families with mental health and substance abuse prob's
Bill and other Mental Health Specialists are ready to help you
Expert:  Melanie Barton replied 1 year ago.
I am a holistic psychotherapist who uses regular Western medicine and some Eastern techniques as well. I have over 25 years experience working with clients experiencing anxiety disorders.

Here are some things to consider:
1. Have you had your thyroid checked?
2. Have there been events that increased your cortisol levels that have affected your adrenal glands which would cause stress hormones to be released and potentially increase your anxiety?
3. Do you drink caffeine and if so how late in the day?
4. Under what circumstances does your anxiety increase besides tragedies that happen outside of your personal life?
5. Have you tried meditation and yoga?

Some of the antidepressants you mentioned can affect your ability to respond sexually so that is something that could increase your anxiety. You can become immune to the dosage of medications over time. If you get some illness that requires you to go on antibiotics it can make anxiety medication less potent.

If you wish to discuss this further, come back to this page and I will periodically check back. Thank you, XXXXX XXXXX opportunity to be of help to you, Dr. Melanie Barton

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