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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I am a 23 y.o. female who has always had some form lf

Customer Question

I am a 23 y.o. female who has always had some form lf anxiety her entire life. As a kid my mom would often say that I worried about things most people my age did not. I have the tendency to run a situation over and over in my head to rationalize it or pick it apart as to what might be happened/could happened. Recently I graduated college and started my first grown up job in sales. Which was very stressful, the last three months have been total hell. I have had extremeeee health anxiety, my medical bills are piling high, I quit my job bc of the pressure and increase to my anxiety. Every day I am convinced I am terminally ill in some way. My doc prescribed generic lexapro (cotalpram?) But I am refusing to take it even though it's a 5mg dose. Ks there any hope for me? Can i come out lf this without medication? Lol
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

*This website DOES NOT constitute treatment and only provides information and advice in a Q&A format. For treatment (therapy and/or medications) you must go to a licensed professional in your area.

Hello and thank you for your question. I am very sorry that you are suffering from this level of health anxiety. Typically health anxiety is a combination of Obsessive Compulsive Disorder (OCD) and Somatic symptom (physical symptoms caused by a mental illness) and this is why this disorder is so complex. The Escitalopram (Lexapro) definitely would help to lessen your OCD and Somatic symptoms as part of the overall Health Anxiety, but it will not address the core causes and cure this Health Anxiety. In order to do that you should undergo a dual type of therapy called Cognitive Behavioral Therapy (CBT) and Exposure Response Prevention (ERP) with a psychologist to help address the core causes of your Health Anxiety and help you resolve this issue. You can definitely just do the therapy without medication, but the treatment may be longer and more difficult because you are still going to have active symptoms during the therapy process since it usually takes a few months of therapy to truly be effective. The medication Lexapro will provide you with relief of symptoms allowing you to focus more on the therapy and the core of your treatment. Think of it like this...lets say you broke your leg and you needed to undergo physical therapy to truly heal, but every time you tried to do physical therapy the pain was a bit too much so your progress was not as fast as you would like. Thus a pain killer would be prescribed to help you go through physical therapy more and increase your progress in treatment by relieving your pain. So the pain killer is not a cure, but it would help you in your overall treatment. This is the same for how antidepressants work and how they benefit patients who undergo therapy, which is the core of your treatment.

So overall you can definitely go through only the CBT and ERP therapy to treat your Health Anxiety, but it may prolong your treatment without the Lexapro. Either way there is no reason for this Health Anxiety to be a permanent fixture in your life as it is definitely treatable.

I hope this answers your question and gives you some guidance on this issue. Please let me know if you have any questions or concerns as I am happy to assist and support you regarding this issue.

*****YOU ARE ALMOST FINISHED…EXPERTS ONLY GET COMPENSATED FOR EACH POSITIVE RATING, SO I WOULD APPRECIATE IF YOU COULD GENTLY MASH ONE OF THE 3, 4, 5 SMILEY FACES/STARS THAT YOU SEE BEFORE YOU GO. THANK YOU SO MUCH AND IT WAS MY PLEASURE HELPING YOU WITH YOUR ISSUE*****

Customer: replied 1 year ago.
Thanks for that response! Due to the fact that I worry about being ill often, I am afraid that the medicine will bring about dangerous side effects that will add on top of my already steady somatic symptoms. How safe is this drug? I read it was a Class C! Futhermore, I am worried that all of this stress could turn my body against me and make me sick as well. I feel anxiety symptoms even when I don't necessarily feel anxious.
Expert:  Dr. Z replied 1 year ago.

Its a Class C in terms of pregnancy, that has nothing to do with side effect profile at all. And also most antidepressants are Class C for pregnancy concern. Lexapro is actually considered very safe and has one of the lowest side effect profiles, second to Zoloft. Lexapro is more effective than Zoloft so that is probably why it was suggested as a first line treatment for you. I understand your concern about the side effects, but in most cases they only last a few weeks as your body adjusts to the medications. Try taking only 5mg/day of the Lexapro for 2 weeks and then gradually increase to 10mg so that you can ease your body into the medication. Also you want to combine any medication with the CBT and ERP therapy to get the most out of your treatment.

*Please do not forget to leave a positive rating before you sign off. Thank you, ***** ***** appreciate it.

Expert:  Dr. Z replied 1 year ago.

Hello, I noticed that you viewed my answer and I was checking in to see if you have any further questions or concerns that you would like me to address on this issue?

*****YOU ARE ALMOST FINISHED…EXPERTS ONLY GET COMPENSATED FOR EACH POSITIVE RATING, SO I WOULD APPRECIATE IF YOU COULD GENTLY MASH ONE OF THE 3, 4, 5 SMILEY FACES/STARS THAT YOU SEE BEFORE YOU GO. THANK YOU SO MUCH AND IT WAS MY PLEASURE HELPING YOU WITH YOUR ISSUE*****

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