Dear Alice,

Recently I've begun experiencing attacks of phobia and anxiety much more than I ever have before. I am aware of most of the problems in my life causing these feelings and am working on fixing the problem from the inside out, but am worried that my life will suffer if I can't get these feelings squared away soon. I often wake up nauseous and am unfit to go to work for several hours, and my eating habits have also been suffering.

My question: would taking an anti-phobic or anti-anxiety (not anti-depressant) medication fabricate calm to such an extent that I wouldn't be able to feel and deal with the causes of my stress head on? I'm looking for something to keep me functioning while I work through this, not in finding a chemical solution that I end up dependent on for my happiness and well-being.

Thanks in advance.

Dear Reader,

Millions of people experience clinically diagnosable anxiety, which is often difficult to control and causes significant distress and impairment. Fortunately, the two main treatments for anxiety, medication and psychotherapy, are effective in helping people manage their symptoms. You’re not alone in wondering how medication, specifically, will affect your ability to deal with stress. The short of it? Both anti-anxiety and antidepressant medications help many people stabilize their emotions and reactions so that they’re better able to think through their worries and how they might cope in the moment. With the appropriate treatment (whether it’s medication, psychotherapy, or some combination of both), you can work toward a place of being able to deal with your stress without feeling like anyone but yourself.

The prescriptions available today have improved greatly on the negative side effects and extremely addictive nature of anti-anxiety medications prescriptions of the past. Fortunately — as both research and understanding of brain chemistry have expanded — there are a variety of drugs available to help people manage their feelings and the physical symptoms that often accompany them. Benzodiazepines are the most common anti-anxiety medications used to treat the short-term effects of a range of anxiety-related conditions. These work to reduce emotional and physiological symptoms, oftentimes within minutes to hours. Like benzodiazepines, beta blockers are another type of medication that treat the short-term symptoms of anxiety. However, they specifically target the physiological symptoms, such as trembling, rapid heartbeat, and sweating. Many find that taking benzodiazepines or beta blockers for a short period of time helps them keep their symptoms of anxiety under control and often use these medications as needed (rather than daily), as directed by a health care provider, to reduce anxiety. Whereas anti-anxiety medications treat short-term symptoms of anxiety, antidepressant medications — such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) — are meant to help with long-term management of a variety of psychiatric symptoms, including anxiety, and actually tend to be the first line of treatment for these symptoms.

In order to be prescribed any of these medications, a consultation with a health care provider about your symptoms is typically required. While a primary care provider can technically prescribe anti-anxiety and antidepressant medication, psychiatrists, a medical doctor trained in mental disorders, have the most thorough training in the pharmacological treatment of mental health disorders and are trained to help you consider what medication, if any, is right for you. When you first meet with a psychiatrist, they’ll likely ask about your symptoms and what you’ve already tried to do to address them so that they can determine what medications might help. At any point in this process, it’ll be good to express your concerns about longer-term medications such as antidepressants. Keep in mind that many people with anxiety have to try several medications before they find one (or a combination) that works for them. It’s also worth noting that medication works best when taken as directed by your health care provider. In addition to medication, your psychiatrist may also recommend that you engage in psychotherapy, as it’s common — and oftentimes more effective — to engage in therapy in addition to being on medication for anxiety.

If you and your psychiatrist decide that anti-anxiety medication is right for you, keep in mind that both benzodiazepines and beta blockers may lead to some common side effects such as drowsiness, dizziness, blurred vision, headaches, confusion, tiredness, and nightmares. For beta-blockers, common side effects include fatigue, cold hands, dizziness, light-headedness, and weakness. Anti-anxiety medications pose certain health risks as well. Some of these medications can have a psychologically addictive effect if taken for extended periods of time, and may lead to dependence or symptoms of withdrawal when stopped. For this reason, it’s worthwhile to share with your psychiatrist whether you've had any experiences with addiction or substance abuse in the past.

You mentioned not wanting to be dependent on medication for your happiness and well-being, and you may indeed reach a point at which you no longer want or need to take medication. In the meantime, seeking treatment, whether medication, psychotherapy, or both, could help lessen the disruptive effects of anxiety in your life.

Good luck as you begin to move forward,

Alice!

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