How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Z Your Own Question

Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 6029
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
74815544
Type Your Mental Health Question Here...
Dr. Z is online now
A new question is answered every 9 seconds

I am a fireman and have been through some traumatic incidents.

Resolved Question:

I am a fireman and have been through some traumatic incidents. Lately I have been having a lot of flashbacks of the horrific incidents I've been to. I have been depressed and I've been losing sleep and it's now affecting my wife and family. A very close friend and coworker has been on some of the same calls and he was prescribed Valium for this. Would that work for me? And should I tell my doctor this and ask for the Valium? I have basically no good memories of my wife and kid or other good times but I remember EVERYTHING from the "bad" things
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

Dr. Z :

Hello

Dr. Z :

I believe I can help you with your concern

Dr. Z :

Please give me a couple minutes to read over your question carefully to assist you better

Dr. Z :

I am so sorry that you have been experiencing these symptoms, I can imagine how distressing this is for you

Dr. Z :

What you are actually describing is most likely Post-Traumatic Stress Disorder (PTSD) which is not uncommon for your occupation. Medications are not typically a cure for PTSD, but they can lessen the symptoms greatly for you, although therapy is the only true way to cure it

Dr. Z :

I can recommend some good therapy techniques and medications you can ask your prescribing physician about if you like.

Customer:

Ok

Dr. Z :

By the way PTSD is usually mix of anxiety and depression, but your symptoms seem more anxiety related. Here is a good link describing PTSD in more detail for you

Dr. Z :

So these techniques take root in Cognitive Behavioral Therapy (CBT) which is the most evidence based treatment for PTSD. 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.

Dr. Z :

So this link may help you, it contains a technique I use with patients called a thought record. It will help him keep track of any negative thoughts he has. He puts the negative thought on paper, the emotion accompanying, the evidence to support it, and the evidence against it. Then I want him to come up with an alternative thought for the situation (more objective and plausible). This will help him change his 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 PTSD symptoms. It can help you focus on the big picture and the objective/positive thoughts and outcomes.

Dr. Z :

Also individuals with symptoms of PTSD have a poor coping mechanism, so this worksheet will help you develop a better coping strategy to manage your symptoms better.

Dr. Z :

In addition these books can be helpful as well

Dr. Z :

Now regarding medication, Valium is very good and it is a benzodiazepine, so this can be physically addicting if you take it too often, which is why you want to take it as needed. But in addition, you may also want a SSRI antidepressant to take regularly. I would recommend Lexapro at 10-20mg as it is fast acting, more effective than most antidepressants, has great anti-anxiety effects, and has less side effects.

Dr. Z :

But for a complete list of appropriate medications, I will suggest this link.

Dr. Z :

So the combination of medication and CBT therapy is the best treatment protocol to "cure" these symptoms for a sustained period of time.

Dr. Z :

Also the Valium is the easiest of the benzodiazepines to not be physically addicted to as well, so it is good to start with that if you choose to use a benzodiazepine

Dr. Z :

Do you have any questions or concerns?

Customer:

Ok would I go to my doctor or a specialist?

Dr. Z :

You can get this from your general practitioner, but if you would like a specialist you can go to a psychiatrist although it is not necessary

Customer:

The reason I ask about the medication is because I already work shift work and have a horrible sleep schedule, but lately my off nights sleeping at home have been just as bad with the flashbacks. I'm having another baby soon and I don't want to be so phyisally and mentally drained that it further affects my family.

Dr. Z :

Then the benzodiazepine will help with your sleep as it has a sedation effect and will prevent the flashbacks to help you sleep too, so take it before you fall asleep.

Dr. Z :

The SSRI antidepressants do not cause you to fall asleep and actually can disrupt sleep, so you want to take that during the daytime

Customer:

I always get nervous asking for a specific medication because I don't want the doctor to think the wrong thing.

Customer:

Do you know what I mean?

Customer:

I don't think the doc has enough time to hear everything that is making this happen but I want him to understand that things are just not OK anymore

Dr. Z :

I understand, well discuss what you told me about your friend and co-worker who suggested Valium, that is a good approach and then describe your symptoms and what your job is. There should be no difficulty getting the benzodiazepine with those explanations. And the SSRI antidepressant are not addictive at all, so there is no worries there

Dr. Z :

Your doctor is there for you, so explain your symptoms and that you believe that you have symptoms of PTSD and you would like some medications to augment the therapy techniques that I recommended.

Customer:

Ok thank you. Now I know where to start and that is a big help

Dr. Z :

Anytime, is there anything else I can help you with?

Customer:

No I think that is all for now. Thanks again

Dr. Z :

I am happy that I was able to help you tonight. I wish you the best with your treatment and I hope that your symptoms resolve soon. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime. Before you sign off though, I would very much appreciate if you could rate my performance in helping you so that I can get credit for this question. Thank you very much

Customer:

Absolutely, will do!

Dr. Z :

Thank you it is much appreciated :)

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 6029
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Dr. Z and other Mental Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education
 
 
 
Chat Now With A Mental Health Professional
Dr. Z
Dr. Z
Psychologist
5417 Satisfied Customers
Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.