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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5439
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Hi, im a 22 year old student. Ive been suffering from extreme

Resolved Question:

Hi, im a 22 year old student. I've been suffering from extreme anxiety / depression for about 4 years now, it seems to come and go in cycles, where by I'll be bed ridden for 2-3 weeks at a time but would eventually lift and I could carry on with normal life for 6 months or so.

I recently split up with my girlfriend of 6 months and this triggered extreme anxiety / depression. I experence what I believe to be panic attacks frequently, and they always seem to be triggered by little things such as seeing a couple together on holiday, this would make me feel extremely anxious and sad bring up lots of memories of me being in a relationship.

Not only was the break up quite bad as she basically told me that she resents me, but she was also my first love. After the split up we decided to try and keep in contact and remain friends but I would get an urge to message her when I had a panic attack and ask if we could meet and try again or that I loved her and missed her, and this I believe drove her away and told she didn't want me to messeage her as much and to give her space.

Becuase of my anxiety issues I continued to bombard her with messeages, after which she told me to stop contacting her. I deleted her phone number and blocked her on Facebook as a means by which to prevent myself from contacting her. I told myself that this would also help me to get over her, but when I haven't checked her profile for a while I have extreme anxiety and have to give in to temptation. If I read or see something on her profile which might trigger more anxiety I begin t have panic attacks, "what she up to?" "Does she not care about me?" "Does she still love me?".

I was originally prescribed setriline as an antidepressant but I've been taking up to 150mg for a month now and I don't feel any benefits at all. The only hope I've had for the past few weeks was to take zopiclone (sleeping pills) in the day time as they actually work for effective as an antidepressant.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

Dr. Z. :

Hello I believe I can help you with your concern

Dr. Z. :

I am so sorry that you have been exhibiting these symptoms associated with anxiety and depression, I can imagine how distressing this is for you.

Dr. Z. :

First off concerning the Setraline, it usually takes around 4-8 weeks to achieve the maximum benefits of that medication. But if that does not work you also may want to try Escitalopram at 10-20mg as this is a more effective SSRI antidepressant for anxiety and depression. Also adding a benzodiazepine (e.g. Ativan, Xanax, or Klonopin) can help reduce your anxiety very fast and can be used as needed.

Dr. Z. :

Now I would like to ask, have you ever seen a therapist to help with your anxiety and depression? And if so, was this a Cognitive Behavioral Therapy (CBT) therapist?

Dr. Z. :

CBT has a premise that your symptoms are caused by negative thoughts, so if we change your thought process to be more positive and objective as well, then your symptoms will lessen, thus no more symptoms of anxiety and depression

Dr. Z. :

Cognitive therapists do not usually interpret or seek for unconscious motivations but bring cognitions and beliefs into the current focus of attention and through guided discovery encourage clients to gently re-evaluate their thinking.Therapy is not seen as something “done to” the client. CBT is not about trying to prove a client wrong and the therapist right, or getting into unhelpful debates. Through collaboration, questioning and re-evaluating their views, clients come to see for themselves that there are alternatives and that they can change.Clients try things out in between therapy sessions, putting what has been learned into practice, learning how therapy translates into real life improvement.

Dr. Z. :

Here are a few good CBT techniques that are very effective that can help you. So this link may help you, it contains a technique I use with patients called a thought record. It will help you keep track of any negative thoughts you have. You put the negative thought on paper, the emotion accompanying, the evidence to support it, and the evidence against it. Then I want you to come up with an alternative thought for the situation (more objective and plausible). This will help you change your way of thinking to be able to think more positive and not automatically go to a negative type of thinking.

Dr. Z. :

In addition, these two worksheets are very good at helping lessen anticipatory anxiety and helping you focus on the big picture and the objective/positive thoughts and outcomes.

Dr. Z. :

Also individuals with severe anxiety also have a poor coping mechanism, so this worksheet will help you develop a better coping strategy to manage your anxiety better.

Dr. Z. :

In addition, I believe these books can be helpful as well for you as well in addition to the medications and possibly therapy if you choose that route

Dr. Z. :

Also this technique called Progressive Muscle Relaxation can help you create a long term calm by using muscle tension and release techniques; it can help manage your anxiety better and is very similar to a style of meditation.

Dr. Z. :

I see that you are online right now, so I will let you read over what I wrote and all the links I provided and if you have any questions or concerns, please feel free to ask them at anytime.

Customer:

hello sorry for the delay

Dr. Z. :

No worries, take your time.

Customer:

what you've mentioned sounds amazing, I'd be happy to try all of the above mentioned ideas, I am currently on a waiting list in the UK to see a psychotherapist

Dr. Z. :

I am glad that you like the CBT techniques, they are very effective and CBT is the most evidence based therapy out there currently.

Dr. Z. :

Good, a psychotherapist will be able to help you with your anxiety and depression. While the medications can lessen your symptoms, only therapy will be able to cure you

Customer:

and i recently went to my doctor and mentioned that the setraline was working and he actually procribed me escatalopram

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5439
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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