Navigating Anxiety and Medication: Seeking Help for Family Mental Health Issues

I'm sorry, but I cannot assist with that?

Dear Dr.
Chen,
I hope this message finds you well! I am a student at Taipei Medical University, and although I am studying a healthcare-related field, I find myself in need of your professional guidance regarding a pressing issue concerning my older brother's family.
Recently, I have been very worried about a family crisis involving my sister-in-law, which arose from an unfortunate comment about a past incident.
This has led to her developing an anxiety disorder, as confirmed by a psychiatrist at a local hospital.

My sister-in-law has been experiencing palpitations due to her anger, and after consulting a cardiologist, it was determined that she is likely suffering from anxiety, which is accompanied by symptoms such as palpitations, insomnia, and gastrointestinal discomfort.
I reviewed the medications prescribed to her and found that she is taking anti-anxiety medication, antidepressants, sleeping pills, and gastrointestinal medication.
Although she has felt some relaxation in her mood after taking these medications for about two weeks, her mental state has deteriorated significantly (she appears disoriented) and she even forgets which route to take when going out, sometimes getting lost.
I am unsure if our concerns are biased or if such medications typically have side effects.
I would like to ask you, Dr.
Chen, if it is possible to address physiological discomfort caused by long-term psychological issues solely through psychotherapy without the need for medication? (My brother and I strongly disagree with long-term use of such medications, as we have relatives who have taken them without any improvement in their conditions, and in some cases, their symptoms have worsened.)
If outpatient treatment is pursued, can family members accompany the patient during consultations? Does Taiwan currently have a comprehensive system for outpatient psychotherapy services?
Thank you for your kind response!
Sincerely,
A worried sister-in-law

xiaogu, 20~29 year old female. Ask Date: 2004/06/26

Dr. Chen Wenke reply Psychiatry

Hello, I apologize for not responding to your message immediately.
Regarding your concerns, many people share the same struggles and uncertainties.
From a treatment perspective, the existence of medications certainly has its value.
Anti-anxiety medications are commonly used by general practitioners, but patients are often not fully informed about them, as many feel apprehensive upon hearing about such medications.

I want to emphasize that if your sister-in-law's anxiety symptoms are quite severe, short-term use of medication is very safe and there is no need for excessive worry.
However, if she experiences significantly impaired mental state (such as confusion), forgetting where to go when leaving the house, or even taking the wrong route, it is essential to adjust the dosage, as it may be too high for her.
Psychological factors can greatly influence a person's emotions and lead to physical symptoms.
Therefore, if psychological issues are not appropriately addressed, it is easy to remain in a state of emotional instability, especially concerning interpersonal matters.
I would recommend not to dismiss the benefits of medication, as it can complement psychological therapy.
You are fortunate that in Taipei, it is relatively easy to find qualified psychological therapists.
Some are from psychology-related fields, while others are specialized psychiatrists.
Of course, the fee standards may vary.
You can find this information online, so it might be worth exploring.
If you have further questions, feel free to reach out again.
Wishing you good health.

Reply Date: 2004/06/26

More Info

Navigating mental health issues within a family can be incredibly challenging, especially when it involves a loved one experiencing anxiety or depression. Your concerns about your sister-in-law's condition and the impact of medication on her mental state are valid and reflect a deep care for her well-being.
Firstly, it's important to understand that anxiety disorders can manifest in various physical symptoms, such as palpitations, insomnia, and gastrointestinal issues. These symptoms can be exacerbated by stress and emotional turmoil, as you've described in your sister-in-law's case. The medications prescribed—anti-anxiety medications, antidepressants, sleep aids, and gastrointestinal medications—are commonly used to manage these symptoms. However, they can also come with side effects, including drowsiness, confusion, and memory issues, which may explain her current state of mental fog and forgetfulness.

Regarding your question about whether psychological treatment alone can suffice without medication, it largely depends on the severity of the symptoms. For some individuals, therapy—such as cognitive-behavioral therapy (CBT)—can be effective in managing anxiety and depression, particularly if the symptoms are mild to moderate. However, in cases where symptoms are severe, a combination of medication and therapy is often recommended. This is because medication can help stabilize mood and reduce anxiety levels, making it easier for individuals to engage in therapeutic work.

It's also crucial to consider that everyone's response to medication is different. While some may experience significant relief, others may find that their symptoms do not improve or even worsen. This variability can lead to skepticism about the efficacy of medication, especially if there are personal experiences within the family that suggest negative outcomes. It’s essential to maintain open communication with the prescribing physician about any side effects your sister-in-law is experiencing. Adjustments to her medication regimen may be necessary to find a balance that alleviates her symptoms without causing debilitating side effects.

As for accompanying family members to therapy sessions, this can be beneficial. Family support plays a critical role in the recovery process. It can help the individual feel less isolated and more understood. Many therapists encourage family involvement, especially in cases where family dynamics may contribute to the individual's stress or anxiety.
In Taiwan, there is a growing recognition of mental health issues, and many hospitals and clinics offer psychological services. You can find licensed psychologists and counselors who specialize in various therapeutic approaches. It may be helpful to research local resources or ask for recommendations from healthcare providers to find a suitable therapist for your sister-in-law.

Lastly, it’s important to prioritize self-care for yourself and your family. Supporting someone with mental health issues can be emotionally taxing, and it’s essential to ensure that you are also taking care of your own mental well-being. Consider seeking support for yourself, whether through counseling or support groups, to help you navigate this challenging situation.

In summary, while medication can be an effective part of treatment for anxiety and depression, it is not the only option. Therapy can provide valuable tools for coping and managing symptoms. Open communication with healthcare providers, family support, and self-care are all vital components in supporting your sister-in-law through her mental health journey.

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