Managing Anxiety and Medication: A Guide for Mental Health Patients

Overthinking!!!

Hello Doctor: Thank you for your previous response! I have been seeing a psychiatrist for three weeks now, but I feel like there hasn't been much change.
My lower back continues to hurt, my neck is still uncomfortable, my sleep is not very stable, and I sometimes experience palpitations.
Currently, the medications prescribed by my doctor are: Trazodone 50mg, Sulpride 200mg, Midazolam 7.5mg (to be taken at bedtime), Fluoxetine 20mg, acetaminophen 500mg, and Fludiazepam 0.25mg (to be taken in the morning and evening).
I am concerned about the potential for medication dependence and whether these medications could be harmful to my body.
The dosage keeps increasing, and I fear I might have to take them for life.
I feel unable to control my thoughts, constantly worrying and fearing that I might harm my family or friends.
This anxiety has troubled me for a long time.
Could you provide some psychological therapy options or direct me to resources available online? Thank you...

A-Rong, 20~29 year old female. Ask Date: 2003/11/19

Dr. Tang Xinbei reply Psychiatry

Dear A-Rong,
It seems that your distress is due to taking many medications without noticeable improvement.
With your current medications, it generally takes more than ten days to see significant effects.
Are you concerned that continuing this way might lead to dependence or addiction to the medications? In fact, mental illness is a chronic condition that requires long-term medication treatment and psychological support (psychotherapy).
Once your condition stabilizes for a period and you have developed some self-regulation skills, your physician will gradually reduce the medication dosage based on your situation.
If you are worried about medication overdose or dependence and end up taking your medications irregularly, reducing the dosage on your own, or suddenly stopping the medication, it could lead to a rebound of the illness or ineffective treatment, requiring a longer time to manage.
I recommend discussing your entire treatment plan with your primary physician and asking for a referral to a psychologist for psychotherapy if needed.
It is also crucial to adhere to the prescribed medication regimen consistently.
Wishing you peace and joy!

Reply Date: 2003/11/19

More Info

Managing anxiety can be a challenging journey, especially when it involves medication and the fear of dependency. It’s important to understand that anxiety disorders are complex and often require a multifaceted approach to treatment, which can include both medication and psychotherapy.

Understanding Your Medication
From your description, it seems you are currently prescribed a combination of medications, including Trazodone, Sulpride, Midazolam, Fluoxetine, Acetaminophen, and Fludiazepam. Each of these medications serves a specific purpose:
1. Trazodone: Primarily used as an antidepressant, it is also effective for sleep disturbances.

2. Sulpride: An antipsychotic that can help with anxiety and depressive symptoms.

3. Midazolam: A short-acting benzodiazepine used for its sedative properties, often prescribed for anxiety relief.

4. Fluoxetine: A selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression and anxiety.

5. Acetaminophen: Typically used for pain relief.

6. Fludiazepam: Another benzodiazepine, which can help with anxiety but carries a risk of dependence.

Concerns About Dependency and Side Effects
Your concerns about potential dependency on medications, especially benzodiazepines like Midazolam and Fludiazepam, are valid. These medications can lead to tolerance and dependence if used long-term. It’s crucial to have open discussions with your prescribing physician about these concerns. They can help you understand the risks and benefits of your current regimen and may suggest alternatives or adjustments to your treatment plan.

Managing Anxiety Without Medication
While medication can be beneficial, it’s also important to incorporate non-pharmacological strategies into your treatment plan. Here are some effective methods for managing anxiety:
1. Cognitive Behavioral Therapy (CBT): This is a highly effective form of psychotherapy that helps individuals identify and change negative thought patterns and behaviors associated with anxiety.

2. Mindfulness and Meditation: Practicing mindfulness can help you stay grounded in the present moment, reducing anxiety about the future. Apps like Headspace or Calm can guide you through meditation practices.

3. Breathing Exercises: Techniques such as diaphragmatic breathing or the 4-7-8 method can help calm your nervous system and reduce feelings of panic.

4. Physical Activity: Regular exercise is known to reduce anxiety levels. Activities like walking, yoga, or swimming can be particularly beneficial.

5. Journaling: Writing down your thoughts and feelings can help you process your emotions and reduce anxiety.

6. Support Groups: Connecting with others who are experiencing similar challenges can provide comfort and understanding.

Seeking Professional Help
If you feel that your current treatment isn’t effective, it’s essential to communicate this to your healthcare provider. They may consider adjusting your medication, exploring alternative therapies, or referring you to a psychologist or counselor for additional support.

Resources for Further Learning
There are numerous resources available online and in print that can help you understand anxiety and its management better. Some recommended books include:
- "The Anxiety and Phobia Workbook" by Edmund J. Bourne: This workbook provides practical strategies for managing anxiety.

- "Feeling Good: The New Mood Therapy" by David D. Burns: This book offers insights into cognitive behavioral therapy techniques.

- "The Mindful Way Through Anxiety" by Susan M. Orsillo and Lizabeth Roemer: This book combines mindfulness practices with cognitive behavioral techniques.

Conclusion
Managing anxiety is a process that often requires patience and persistence. It’s essential to work closely with your healthcare provider to find the right balance of medication and therapy that works for you. Remember, you are not alone in this journey, and there are many resources and strategies available to help you regain control over your anxiety and improve your overall well-being.

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