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TherapistMarryAnn, Therapist
Category: Mental Health
Satisfied Customers: 5762
Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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I have been treated for depression/anxiety for about 2 year.

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I have been treated for depression/anxiety for about 2 year. Both therapy and medication

my treatment started when i had what felt like a 3 day long panic attack. I was not preforming at work and they had to fire me. I thought it was anxiety by my pcp said it was depression and anxiety... but mostly depression. I was in intense otpt therapy for 1 year. My dr but me on as high dose of celexa as was needed to manage my symptoms. i was eventually titrated to a lower dose. I was on a lower dose of generic zoloft for the last 6 months or so. I decided to go off of it with advice from my primary care Dr. I felt it was time and so did my Dr. I stopped medication about 1 1/2 months ago.

My current concern is that my acute symptoms are getting more and more acute. I wake up in the middle of the night panicked and sweaty. I have lower lows than i have had in the past. I am more irritated than i have ever been at really silly things. I am managing my symptoms now as best I can, but recently i have started having some real issues doing things i normally do. like go to the gym. it makes me so anxious to even drive there that i cannot go.

I work as an inpatient clinical social worker at a local Psychiatric hospital and the work is stressful.

Should I see a psychiatrist? or should i go back to my PCP and have them help me? I am trying to determine if the cost of the co payment is worth it?
Hello, I'd like to help you with your question.

Both anxiety and depression respond well to therapy. Medications can help to take the edge off if you feel it is too difficult to manage your day to day life, just as you are describing. But therapy is the most helpful treatment.

When you are anxious, your thoughts are causing your mind to think your in danger, such as when you are driving. Your body reacts by releasing adrenaline into your system. Adrenaline cause you to feel the body symptoms that are common with anxiety. It is much like after you have had a bad scare except with anxiety, there is no focus. The only thing you have to focus on is how you feel. And because your thoughts are probably always on alert, so is your body. This may be why you always feel anxious and scared. And why your symptoms continue to get worse. It is the mind/body reaction that gets into a loop and without treatment, it can get worse.

However, therapy can help you break that loop. It could be that the previous therapy was helpful but that you needed a different kind or a longer time in therapy to address the issues. Seeing a new therapist will help. In therapy, you learn to pay attention to what you are thinking to make yourself anxious. The therapist then can help you change your thoughts and therefore how your body reacts to your thoughts. You also can learn about how to let yourself float through your anxiety thereby gaining more control over how you feel. When anxiety comes on, you allow it to flow over you without tensing or panicking in response. This makes the anxiety reduce or go away faster. To find a therapist, talk to your doctor about a referral. Or you can search on line at A Master's level therapist, especially one experienced in anxiety and depression, is the best option.

You can also help yourself at home. There are numerous resources to help you learn more about anxiety. Here are some to get you started:

The Anxiety and Phobia Workbook by Edmund Bourne is excellent for any fears. It is self help and contains everything from supplements to relaxation techniques.

The Cognitive Behavioral Workbook for Anxiety: A Step-by-Step Program by Bill Knaus Ed.D. and Jon Carlson Psy.D. Ed.D.

From Panic to Power: Proven Techniques to Calm Your Anxieties, Conquer Your Fears, and Put You in Control of Your Life by Lucinda Bassett

You can find these books on or your local library may have them for you.

Also consider support groups either on line or in person. Talking to others that feel as you do can encourage you that you are not alone. You can also learn about what other anxiety sufferers use to help themselves which may help you.

I hope this has helped you,
Customer: replied 3 years ago.

I understand and appreciate what you are saying there.


I am however asking if i should go to a psychiatrist or my primary care physician for medication management.



You are best off going to a Psychiatrist for treatment. While a PCP can prescribe medications, they do not have the training in mental health that a Psychiatrist does.

TherapistMarryAnn and other Mental Health Specialists are ready to help you