the Role of Medication in Managing Anxiety and Stress

The potency of medications?

I am someone who gets very anxious easily.
Before this exam, my family even asked me if I wanted to take medication (I had previously taken medications like Wu Yu Ning and Inderal, which my doctor said were for perfectionism and adjustment disorder, but later he said I was adjusting well and didn't need them anymore—actually, as long as I’m not facing any issues, I’m fine).
I told them that those medications take about two weeks to take effect, and I have my exam in a week—there's no time for that.
Plus, I was feeling fine until about three or four days before the exam when I found it very hard to get out of bed in the mornings, feeling hopeless and in pain.
I didn't want to see a doctor because I thought I should be strong enough (was I just putting on a brave face?).
Relying on medication made me feel inadequate and self-doubting.
Eventually, I couldn't take it anymore; I kept wanting to cry, so I went to see a doctor.
He immediately gave me an injection of Anxicam and prescribed Inderal and Sertraline (Serena).
Miraculously, my mood improved that same day, and I felt much calmer.
Two days later, I was able to smile again.
After my exam yesterday, I felt normal, but this morning I woke up feeling a bit down again—maybe it’s the anxiety about the results, as it concerns my lifelong career.

I want to ask the doctor if someone like me, who gets anxious easily and has low stress tolerance, should continue seeing a doctor? The doctor only prescribed me medication for three days and told me to maintain a calm mindset.
If taking medication makes me smile, should I keep taking it? Is this just a placebo effect? On one hand, I hope to feel empowered, but on the other hand, I wonder if not taking medication means I’m being foolish, as there might be simple solutions, yet I end up suffering for a long time.
I’m afraid that if my personality remains this way, will I have to take medication for life? I still sometimes feel inexplicably down.
I also heard about neuroprotective supplements (cognitive enhancers)—are they really effective? The doctor said these are out-of-pocket expenses, costing 20 NT dollars per pill.
If they truly help, of course, I would want to take them.
I want to ask the doctor if I should consider taking medication again (I’m feeling a bit down now), but it’s not like before when I was almost going crazy, clenching my fists and rubbing my skin.
Thank you, doctor.

neu, 30~39 year old female. Ask Date: 2011/07/10

Dr. Ding Shuyan reply Psychiatry

Hello, your question is very insightful, and I believe it holds value for many people.
We often face emotional issues that seem to stem from stress, and we might feel that our personality and resilience are lacking.
We also hear about conditions like depression and anxiety, leading us to wonder if we might have these disorders ourselves.
Current medical understanding suggests that emotional problems are multifactorial and cannot be attributed to a single cause.
The next concern is treatment.
Our symptoms can fluctuate; sometimes, they resolve on their own after the stressor has passed.
How should we approach treatment? If we recover, does taking medication again during future episodes indicate a lack of fundamental treatment? Could it become ineffective over time? Generally, physicians will help us assess whether our issues are primarily due to stress, inherent traits, or underlying medical conditions.
In terms of treatment, if stress is the main factor, psychological therapy is often recommended.
Medication is typically used as an adjunct or for short-term relief, rather than for long-term use.
If there are hereditary factors or if symptoms are severe enough to confirm a diagnosis of depression or anxiety, the physician may suggest a more comprehensive pharmacological treatment plan.
You raise a crucial point: if medication is a simple and effective solution, is it foolish to reject it? However, if the issue is personality-related, does that mean one must take medication for life? My advice is that if emotional problems are significantly impacting your studies, work, or exams, it is better to seek medication to improve your situation quickly, as learning and exams will not wait for us.
As for personality traits that lead to low resilience and heightened sensitivity to stress or setbacks, medication cannot change personality.
In such cases, non-pharmacological methods should be employed.
Psychological therapy, learning relaxation techniques, engaging with philosophical or spiritual wisdom, and surrounding oneself with positive-minded individuals can all be beneficial.
Regarding whether to consult a physician again, this question pertains to the continuation of treatment.
You can discuss this with your doctor, who seems quite knowledgeable and will provide suitable recommendations for your situation.
Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2011/07/10

More Info

Managing anxiety and stress through medication can be a complex and nuanced process, especially for individuals who are highly sensitive to pressure and stressors in their lives. Your experience highlights several important aspects of this journey, including the role of medication, the psychological impact of anxiety, and the importance of ongoing communication with healthcare providers.

Firstly, it’s essential to understand that medications like Inderal (propranolol) and other anxiolytics such as Anxicam can be effective in managing symptoms of anxiety. Inderal is often prescribed for performance anxiety, as it helps to reduce physical symptoms such as rapid heartbeat and tremors, allowing individuals to feel more composed in stressful situations. Anxicam, on the other hand, is an anxiolytic that can help alleviate feelings of anxiety and panic. However, it’s crucial to remember that these medications typically take time to build up in your system and may not provide immediate relief, which can be frustrating when facing imminent stressors like exams.

Your concern about relying on medication is valid. Many individuals grapple with feelings of inadequacy or self-doubt when they feel they need medication to cope. It’s important to recognize that needing medication does not equate to weakness; rather, it can be a necessary tool in managing mental health, much like how insulin is used for diabetes. The goal of medication is to help stabilize your mood and anxiety levels, allowing you to engage in therapy and develop coping strategies more effectively.

In your case, it seems that the medication has provided some immediate relief, which is a positive sign. However, the lingering feelings of sadness and anxiety after the exam indicate that there may be underlying issues that need to be addressed. It’s common for individuals with anxiety to experience fluctuations in mood, especially in response to stressors. This is where therapy can play a crucial role. Cognitive-behavioral therapy (CBT) is particularly effective for anxiety and can help you develop healthier thought patterns and coping mechanisms.

Regarding your question about whether you should continue medication, this is a decision best made in consultation with your healthcare provider. If you find that the medication helps you manage your symptoms and allows you to function better, it may be worth continuing. However, it’s also essential to explore non-pharmacological options, such as therapy, mindfulness practices, and lifestyle changes, which can provide long-term benefits.

As for the neuroprotective supplements you mentioned, while some may claim to enhance cognitive function, it’s essential to approach these with caution. The effectiveness of such supplements can vary widely, and they are not a substitute for evidence-based treatments. Always discuss any new supplements with your healthcare provider to ensure they are safe and appropriate for your situation.

In summary, managing anxiety and stress is a multifaceted process that often requires a combination of medication, therapy, and lifestyle adjustments. It’s crucial to maintain open communication with your healthcare provider, express your concerns, and work together to find the best approach for your individual needs. Remember, seeking help is a sign of strength, and taking steps to manage your mental health is a positive and proactive choice.

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