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Therapy for anxiety and panic disorder - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Anxiety and Stress
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1722 Questions
Doctor :   Hi
Doctor :  
How can i help you?
User :   Hi, thank you for your time. I need some advice on my fiance.
Doctor :  
User :   He was diagnosed with severe anxiety and panic disorder when he was 10, he is now 29 and for the past 10 years has been an opiate addict
User :   he was on heroin for 8, but has been clean from that for a year and a half and now is doing much better
Doctor :  
User :   but he struggles very badly with not only trying to be clean which makes his anxiety worse but also having anxiety in the first place
Doctor :  
User :   we have seen numerous doctors and they keep putting him on anti depressants, which do nothing for him. the only thing that keeps him level through the day is lorapam, but he has to take 3 x the dose
User :   lorazapam, sorry
User :   I don't know what to do, the doctors wont give him any more meds and he has been in rehab 4 times (a total of 3 years)
Doctor :  
the problem he is facing is anxiety
Doctor :  
and for the anxiety the medications are not the first line of management
User :   so what do we do?
Doctor :  
it is the cognitive behavior therapy
Doctor :   psychotherapy
User :   He was in therapy for 12 years and they even went to the extent of shock treatment
User :   He's just about done it all
Doctor :   drugs are only the adjunct in the treatment
User :   ok
Doctor :   the CBT and psychotherapy may have to be repeated
User :   I will definitely look into it
Doctor :   also he was on the opiate addiction for the long time
User :   Yes, he was. He doesn't know how to live without it now
Doctor :   and lorazepam is also a addictive drug
User :   I didn't know that
Doctor :  
its better to have a non pharmacological approach
Doctor :   though the potential is low
Doctor :  
it can lead to addiction
Doctor :  
relaxation theraphy
Doctor :  
like yoga and meditation
Doctor :  
also improve the efficacy of the CBT
Doctor :  
it is combined approach
User :   If he won't do it, what do you suggest I do? I can't force him and we have a 4 year old at home, its not a healthy environment for her.
Doctor :  
you can admit him in any of the rehabilitation center
User :   ok
User :   Thank you very much for your help
Doctor :   the goal is less drugs and non pharmacological methods
Doctor :   counseling and CBT is the best treatment available
User :   yes, i really just want him to feel better and be better for our family. i will definitely look into it and try to convince him to go. Thank you
Doctor :   is there anything else i can help you with?

User :   do you know about 4 year olds?
Doctor :  
User :   sorry, she has trouble making bowel movements. He goes very small amounts every 20-30 minutes and has since she was born. Every doctor tells me she will grow out of it, but that hasn't happened
Doctor :  
User :   I'm not sure what to do to fix it, its not something she controls, it just happens
Doctor :   are the stools hard?
User :   no, very soft
Doctor :   this is to do with the toilet training
Doctor :   now she is 4 years right
User :   Yes, just turned four
Doctor :  
you can wait till 6 years of her age
Doctor :  
if this continues than she needs a consultation for the toilet training
User :   ok
Doctor :   usually the children by the age of 6 years will attain the toilet control
Doctor :   how about her other milestones?
User :   she is doing great every other way, shes in the 99% group for her height and weight, healthy as can be
Doctor :  
User :   ok, thank you very much for your help. Have a wonderful day!
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