# Defining Anxiety Disorders and The Depression Connection



## Dreamer

*This is an excellent article, more up to date about anxiety disorders which it seems many of us suffer from. I fit the GAD category, and I really am very depressed a good bit of the time.

The trend in current research is to note that depression and anxiety (and I would then say DP/DR) come hand in hand in many circumstances.

I'm pinning this topic at the top of the board for now. I suppose it could be moved to the links section, but I feel it has some valuable information.

This tends to be my take on my own illness, and others may not agree with everything here, but I think this is a valuable resource in terms of definint various types of anxiety, and their link to depression. Very frustrating that nothing is directly mentioned about DP/DR. But this does discuss the presense of multiple symptoms that many of us seem to share.

*
Best,
D

*University of Michigan Depression Center
Understanding Depression
Anxiety Disorders
The Anxiety Disorders

Anxiety disorders only infrequently occur in isolated, pure form. They 
can vary in their presentation and are extensively co-morbid, with 
other anxiety disorders and with depression and substance abuse. All 
patients with depression and substance abuse should be screened for 
anxiety disorders. A significant portion of female alcoholism may be 
associated with panic and agoraphobia.*

Patients will not present complaining of panic attacks, obsessions or 
compulsions, or social phobia. When anxiety, obsessional traits, any 
type of behavioral rituals, significant shyness, depressive symptoms, 
or substance abuse are detected or suspected, then specific questions, 
probing for the key features described below, should be asked.

Anxiety disorders cannot be "cured." Full, functional recovery is an 
achievable goal, but complete resolution of symptoms and 
invulnerability to relapse are not expected outcomes. Lingering 
symptoms, vulnerability to "normal" anxiety, and stress-related 
intensification of symptoms and anxiety contribute to a continuous risk 
of relapse. These factors are directly addressed in CBT, which is 
probably why it improves long-term outcomes.

*Panic Disorder*

Rapid onset, discrete, episodes of anxiety/distress/discomfort, 
accompanied by physical symptoms that are often suggestive of cardiac, 
endocrine or neurologic disorder. Panic patients become frightened of 
fear itself and its symptoms. Associated with fear/avoidance of crowds, 
driving, being closed in, being far from home alone, etc. 
(agoraphobia). Temporal course of symptoms (sudden onset, rapid 
progression to a peak, and recovery over 5 to 30 minutes) is as 
important as enumeration of specific symptoms in diagnosing panic 
attacks. Agoraphobic fears and avoidance help confirm the diagnosis. 
Must always be evaluated for depression, substance abuse, and 
suicidality.

First line treatment: CBT and/or medication (SSRIs). New data and APA 
guidelines now support CBT as a first line treatment for Panic 
Disorder.

Screening questions: Have you ever had a spell or attack when all of a sudden you felt frightened, anxious or very uneasy in situations when 
most people would not be afraid or anxious? In the past 6 months, have 
you had a spell or attack when for no reason your heart suddenly began 
to race, you felt faint, or you couldn't catch your breath? Some people 
have such an unreasonably strong fear of being in a crowd, leaving home 
alone, traveling on buses, cars or trains, crossing a bridge that they 
always get very upset in such situation or avoid it altogether. Did you 
ever go through a period when being in any of these situations 
frightened you?

*Social Phobia*

Generalized: Excessive anxiety/distress in nearly all situations in 
which subject to attention, social scrutiny or evaluation

Specific: Anxiety and avoidance of a specific, social performance 
situation (public speaking, using public restrooms...)
Extremely common, can be severely debilitating, and is often minimized 
or ignored because social anxiety is "normal". Patients are also 
generally embarrassed and avoidant, so they often won't disclose their 
symptoms unless specifically asked. May have panic attacks but they are 
confined to situations in which the patient may be the center of 
attention.

First line treatment: CBT. Group CBT is our preferred treatment for 
those who are candidates for it. Medication is used for patients who 
are not likely to do well with CBT, such as those with extensively 
generalized or severe symptoms or co-morbid depression. Try standard SSRIs or Effexor first; MAOIs may be more effective. Beta-blockers havelittle direct impact on anxiety but can be helpful in performance situations where physical manifestations of anxiety (e.g., sweating, tremor) undermine the performance or become distractions. Some patients need social skills training.

Screening question: Some people have an unreasonably strong fear of doing things in front of other people - like speaking in public, using 
public rest rooms, eating in public, or even talking to people. Have 
you had any of these kinds of fears?

*Obsessive-Compulsive Disorder (OCD)*

Obsessions are recurrent, intrusive thoughts, disturbing to the 
patient, but experienced as uncontrollable, often involving fears of 
harm coming to self or others. Typical examples include obsessive 
thoughts about germ contamination leading to illness, obsessive 
thoughts about making mistakes that will lead to harm. Violent, sexual, 
or blasphemous content is common.

Compulsions are repetitive behaviors 
(e.g., washing, counting, repeating, checking...) that are performed 
according to certain rules or in a stereotyped fashion. Some patients 
may resist their compulsions, but usually cannot control them. OCD is 
the most hidden of the anxiety disorders. Patients must specifically be 
asked about counting, checking, washing rituals and intrusive, 
disturbing thoughts.

First line treatment: CBT and medication (SSRIs, often in high doses). 
Some patients do well without medication. Recovery is often incomplete, 
but substantial gains are usually possible.

Screening questions: Have you ever been bothered by thoughts that didn't make any sense, and kept coming back to you even when you tried not to have them? Was there ever anything you had to do over and over again and couldn't resist doing, like washing your hands again and 
again, counting up to a certain number, or checking something several 
times to make sure that you'd done it right?

*Specific Phobia*

Marked fear of specific, circumscribed objects or situations associated 
with severe distress upon exposure. Nearly all patients experience 
impairing avoidance. Impairment is often not evident to the patient, as 
they have incorporated accommodation to the phobia into their lives.

Height phobias and claustrophobia are among our most commonly treated 
phobias. Snake and spider phobias are among the most common in the 
community but few people with these seek treatment. Blood, illness, and 
injury phobias are common, impede medical care, and should be treated, 
though they sometimes keep patients from even visiting the doctor's 
office.

Treatment - CBT for phobias is simple, quick, and extremely effective. 
These patients need help overcoming their reluctance to seek treatment.

Screening question: Are there things that you have been especially 
afraid of, like flying, seeing blood, getting a shot, heights, closed 
places, or certain kinds of insects or animals?

*Generalized Anxiety Disorder*

The hallmark of this disorder is chronic, excessive worry. Patients 
often recognize that their worry is excessive and struggle with their 
inability to control it. Additional symptoms include restlessness, 
insomnia, poor concentration, fatigue and irritability. Though GAD can 
occur in isolation, it is far more common to see it in association with 
depressive symptoms, or other anxiety disorders. Many patients referred 
to us with suspected GAD turn out to have major depression with 
intense, ruminative anxiety.

First line treatment: antidepressant medication (SSRIs).

Screening questions: Are you a particularly nervous or anxious person? 
Do you or people who know you well think of you as a "worry wort"?

Last updated on:
Wednesday, 05-May-2004 10:36:56 EDT

-----------------------------------------
This site developed and maintained by: John Bennett

University of Michigan Health System 
1500 E. Medical Center Dr. 
Ann Arbor, MI 48109 
734-936-4000 
http://www.med.umich.edu/ 
(c) copyright 2001 University of Michigan Health System


----------



## Dreamer

*This is an excellent article, more up to date about anxiety disorders which it seems many of us suffer from. I fit the GAD category, and I really am very depressed a good bit of the time.

The trend in current research is to note that depression and anxiety (and I would then say DP/DR) come hand in hand in many circumstances.

I'm pinning this topic at the top of the board for now. I suppose it could be moved to the links section, but I feel it has some valuable information.

This tends to be my take on my own illness, and others may not agree with everything here, but I think this is a valuable resource in terms of definint various types of anxiety, and their link to depression. Very frustrating that nothing is directly mentioned about DP/DR. But this does discuss the presense of multiple symptoms that many of us seem to share.

*
Best,
D

*University of Michigan Depression Center
Understanding Depression
Anxiety Disorders
The Anxiety Disorders

Anxiety disorders only infrequently occur in isolated, pure form. They 
can vary in their presentation and are extensively co-morbid, with 
other anxiety disorders and with depression and substance abuse. All 
patients with depression and substance abuse should be screened for 
anxiety disorders. A significant portion of female alcoholism may be 
associated with panic and agoraphobia.*

Patients will not present complaining of panic attacks, obsessions or 
compulsions, or social phobia. When anxiety, obsessional traits, any 
type of behavioral rituals, significant shyness, depressive symptoms, 
or substance abuse are detected or suspected, then specific questions, 
probing for the key features described below, should be asked.

Anxiety disorders cannot be "cured." Full, functional recovery is an 
achievable goal, but complete resolution of symptoms and 
invulnerability to relapse are not expected outcomes. Lingering 
symptoms, vulnerability to "normal" anxiety, and stress-related 
intensification of symptoms and anxiety contribute to a continuous risk 
of relapse. These factors are directly addressed in CBT, which is 
probably why it improves long-term outcomes.

*Panic Disorder*

Rapid onset, discrete, episodes of anxiety/distress/discomfort, 
accompanied by physical symptoms that are often suggestive of cardiac, 
endocrine or neurologic disorder. Panic patients become frightened of 
fear itself and its symptoms. Associated with fear/avoidance of crowds, 
driving, being closed in, being far from home alone, etc. 
(agoraphobia). Temporal course of symptoms (sudden onset, rapid 
progression to a peak, and recovery over 5 to 30 minutes) is as 
important as enumeration of specific symptoms in diagnosing panic 
attacks. Agoraphobic fears and avoidance help confirm the diagnosis. 
Must always be evaluated for depression, substance abuse, and 
suicidality.

First line treatment: CBT and/or medication (SSRIs). New data and APA 
guidelines now support CBT as a first line treatment for Panic 
Disorder.

Screening questions: Have you ever had a spell or attack when all of a sudden you felt frightened, anxious or very uneasy in situations when 
most people would not be afraid or anxious? In the past 6 months, have 
you had a spell or attack when for no reason your heart suddenly began 
to race, you felt faint, or you couldn't catch your breath? Some people 
have such an unreasonably strong fear of being in a crowd, leaving home 
alone, traveling on buses, cars or trains, crossing a bridge that they 
always get very upset in such situation or avoid it altogether. Did you 
ever go through a period when being in any of these situations 
frightened you?

*Social Phobia*

Generalized: Excessive anxiety/distress in nearly all situations in 
which subject to attention, social scrutiny or evaluation

Specific: Anxiety and avoidance of a specific, social performance 
situation (public speaking, using public restrooms...)
Extremely common, can be severely debilitating, and is often minimized 
or ignored because social anxiety is "normal". Patients are also 
generally embarrassed and avoidant, so they often won't disclose their 
symptoms unless specifically asked. May have panic attacks but they are 
confined to situations in which the patient may be the center of 
attention.

First line treatment: CBT. Group CBT is our preferred treatment for 
those who are candidates for it. Medication is used for patients who 
are not likely to do well with CBT, such as those with extensively 
generalized or severe symptoms or co-morbid depression. Try standard SSRIs or Effexor first; MAOIs may be more effective. Beta-blockers havelittle direct impact on anxiety but can be helpful in performance situations where physical manifestations of anxiety (e.g., sweating, tremor) undermine the performance or become distractions. Some patients need social skills training.

Screening question: Some people have an unreasonably strong fear of doing things in front of other people - like speaking in public, using 
public rest rooms, eating in public, or even talking to people. Have 
you had any of these kinds of fears?

*Obsessive-Compulsive Disorder (OCD)*

Obsessions are recurrent, intrusive thoughts, disturbing to the 
patient, but experienced as uncontrollable, often involving fears of 
harm coming to self or others. Typical examples include obsessive 
thoughts about germ contamination leading to illness, obsessive 
thoughts about making mistakes that will lead to harm. Violent, sexual, 
or blasphemous content is common.

Compulsions are repetitive behaviors 
(e.g., washing, counting, repeating, checking...) that are performed 
according to certain rules or in a stereotyped fashion. Some patients 
may resist their compulsions, but usually cannot control them. OCD is 
the most hidden of the anxiety disorders. Patients must specifically be 
asked about counting, checking, washing rituals and intrusive, 
disturbing thoughts.

First line treatment: CBT and medication (SSRIs, often in high doses). 
Some patients do well without medication. Recovery is often incomplete, 
but substantial gains are usually possible.

Screening questions: Have you ever been bothered by thoughts that didn't make any sense, and kept coming back to you even when you tried not to have them? Was there ever anything you had to do over and over again and couldn't resist doing, like washing your hands again and 
again, counting up to a certain number, or checking something several 
times to make sure that you'd done it right?

*Specific Phobia*

Marked fear of specific, circumscribed objects or situations associated 
with severe distress upon exposure. Nearly all patients experience 
impairing avoidance. Impairment is often not evident to the patient, as 
they have incorporated accommodation to the phobia into their lives.

Height phobias and claustrophobia are among our most commonly treated 
phobias. Snake and spider phobias are among the most common in the 
community but few people with these seek treatment. Blood, illness, and 
injury phobias are common, impede medical care, and should be treated, 
though they sometimes keep patients from even visiting the doctor's 
office.

Treatment - CBT for phobias is simple, quick, and extremely effective. 
These patients need help overcoming their reluctance to seek treatment.

Screening question: Are there things that you have been especially 
afraid of, like flying, seeing blood, getting a shot, heights, closed 
places, or certain kinds of insects or animals?

*Generalized Anxiety Disorder*

The hallmark of this disorder is chronic, excessive worry. Patients 
often recognize that their worry is excessive and struggle with their 
inability to control it. Additional symptoms include restlessness, 
insomnia, poor concentration, fatigue and irritability. Though GAD can 
occur in isolation, it is far more common to see it in association with 
depressive symptoms, or other anxiety disorders. Many patients referred 
to us with suspected GAD turn out to have major depression with 
intense, ruminative anxiety.

First line treatment: antidepressant medication (SSRIs).

Screening questions: Are you a particularly nervous or anxious person? 
Do you or people who know you well think of you as a "worry wort"?

Last updated on:
Wednesday, 05-May-2004 10:36:56 EDT

-----------------------------------------
This site developed and maintained by: John Bennett

University of Michigan Health System 
1500 E. Medical Center Dr. 
Ann Arbor, MI 48109 
734-936-4000 
http://www.med.umich.edu/ 
(c) copyright 2001 University of Michigan Health System


----------



## Dreamer

The Link:

The University of Michigan, Ann Arbor, has a superb medical school and neuropsychiatric research and treatment facility.

http://www.med.umich.edu/depression/anxiety.htm

Best,
D


----------



## Dreamer

The Link:

The University of Michigan, Ann Arbor, has a superb medical school and neuropsychiatric research and treatment facility.

http://www.med.umich.edu/depression/anxiety.htm

Best,
D


----------



## DutchMark

why isn't CBT a first line treatment of GAD?


----------



## Dreamer

Dear Dutchmark,
Having GAD with chronic DP/DR and depression, I can sort of answer this. I have had had numerous forms of therapy and have tried various medications for my problems over the years.

I've had psychotherapy (most helpful), psychoanalysis, CBT (helpful to an extent).

The reason GAD is more difficult to treat, as I understand it, is that it is indeed "generalized", that is it is not specifically related to a particular anxiety as mentioned above, e.g. a Phobia is a very specific fear that can be dealt with by exposing one's self to the object of fear and desensitizing.

OCD can be very responsive to CBT as again, there are specific obsessions/compusions/rituals. Working (very hard) to force the brain through repetition can "recondition" the brain.

GAD again is anxiety that permeates one's whole life, many situations. Also, depression can be a big factor. Depression does not respond as well to CBT. And DP/DR, for me chronic for years, present ALL the time, even in my dreams, is very treatment resistant.

I'm not articulating this well, but GAD is not FOCUSED on a particular fear/obsession etc. GAD encompasses a broad range of symptoms. And if one has no relief, and it is chronic, there is difficulty getting a "reward" for one's efforts. I.E. I haven't felt reality in years. My work to change my thinking is slowly helping... trying to be more positive, making myself be more active... but the SYMPTOMS do not respond as well.

I'm rambling on. If you reread the whole article, you will see what I'm trying to say:

GAD = more .... general.. no other way to say it, not a specific "problem" to work on. Many problems that permeate the personality and come with depression and many other symptoms.

I have responded best to meds and psychotherapy. I also came from a very dysfunctional, traumatic background which makes me overreact to ALL situations that shouldn't cause so much anxiety or make my DP/DR get worse.

I'm rambling.
Hope this makes a whit of sense.
Best,
D


----------



## Guest

moving to top


----------



## qbsbrown

if you don't mind me asking Dreamer, what med/s are you taking?

I'm generalized too.


----------



## Guest

Yeah, I have OCD and social anxiety. These are my primary diagnoses I think. Especially OCD. I had social anxiety disorder as a child pretty bad. But I was undiagnosed. I was always the weird kid, lonely, outside, made fun of. Anyway, now it is OCD (and what I often think of as dp/ dr symptoms) that dominate me. My psychiatrist would not diagnose me with depersonalization disorder because he says if it occurs within the context of another disorder (with me OCD), he cannot do that. However, I don't know, dp and dr, if those are the correct labels for my problems feeling the way I do so much of the time, like I am unintegrated, not whole, broken, and not fully connected to reality, etc., dp and dr are a huge part of my life and what I identify with (in addition to OCD).

Depressions I have had and I still fear. Once in a while, I have a period of moderate depression now, and I have temporary moods and states of depression or transient depressive symptoms that come with certain situations. But actual depression is less of a direct problem now than it was 8- 10 years ago. Maybe this is due partly to medication and partly to coping skills.

Nikki


----------



## avaya

Problem with this kind of self-diagnostic approach is that you are bound to see all the symptoms in yourself! I strongly believe that most or all people have a little bit of everything in them! Also there is a big difference between a clinically diagnosed condition and what I might diagnose about myself.


----------



## agentcooper

ha  that's so funny, avaya! i just read the top and was like "oh my gosh, maybe i have ocd..." and then i got down to your post and realized that it was just some good ole' hypochondria.


----------



## Sojourner

What a night. I cannot do this again.

8:30 pm: Looked at the clock and said, "Wow, last night at this time, I was having a panic attack and had to take an Ativan. But because I'm up to 200 mg of Zoloft and feel good, I've made it. Maybe this will be my new dosage."

Ten minutes later, an attack walloped me over the head. It felt scarier than the others. The day hadn't been all terrific physically, though. I felt a kind of tightness in my scalp, but other than that, I was okay.

I decided not to immediately take the Ativan, and the monster lasted until just about half an hour ago. Of course, I cannot sleep yet.

I did talk to my sister long-distance for half an hour and told her something that had been eating at me regarding our relationship, but that must not be what's eating at me, because while it lifted briefly, it came back soon thereafter stronger than it had been earlier.

She's the one who's a doctor. She thinks that in my case it's primarily physical, so my task is to find a solution with my doctor. I suppose one day of a particular dose isn't the final word on the efficacy for me of 200 mg, but it certainly is discouraging.

I am never again going to not take an Ativan. Maybe I just have to be sedated at night or something. Everyone's so down on tranquilizers. I don't want to get addicted, but is one a day so very much?

Anyway, I really want to find a Catholic therapist, if I'm going to do therapy at all. I try to pray when I'm having an attack, but the irony is that when I'm in that state, I don't know if I even believe anymore.

Just now I felt it trying to come back, but I somehow got it to leave. I find that ignoring the physical manifestations doesn't work for me. All I do is suffer through a full-blown attack for, what, almost nine hours.

I'm starting to get sleepy, but I cannot get into bed until I am more ready than this. Thanks for listening.


----------



## rainboteers

Sojourner,
I hope you are feeling better!


----------



## Sojourner

Thanks, rain. I am feeling much better. I'm splitting up the 200 mg over the course of the day now. I slept from about 10:30 to 5:30 and feel pretty good. If the anxiety comes back tonight, I will take an Ativan, without guilt that I am not trying non-drug methods or worry that I will become an addict. My doctor said not to worry about that at all, because he feels I'm not an addictive personality and he can get me safely off it.

At least last night wasn't a total waste -- I know now for sure that I cannot control this with my will or my ingenuity in methods of distraction.


----------



## Sojourner

Oh, and whether 200 will be the right dose is something we'll know in about five days. It was silly of me to think that one day would do it.


----------



## rainboteers

Not silly at all. I am taking celexa and became extrememly frustrated when I didn't feel better in a week. We just want relief and I hope we all find it soon. 3 weeks later I am not much better, but I am still going to give it more time. Patience is very hard to have when you are suffering.

I am glad you got rid of your worry in regards to the ativan. You are not abusing the drug and the dr. is well aware that you do not want to become addicted. Let that worry go, I am sure you have others to bother you. Just glad you are feeling better.


----------



## Sojourner

Yes, it can take longer than a couple of weeks.

I'm going to ask my doctor if I can just take an Ativan prophylactically and not have to wait until it starts, because it takes too long to work. I had no relief tonight for about 2.5 hours. That's not good.

So, I guess I have a plan until Zoloft gets to the right level. Gotta check with him tomorrow. I'm sure he'll say yes, but I also want to tell him that I had to take 2 ativan to ge relief. Actually, he had said take another half tablet, but that didn't help, so I took the whole thing half an hour later.

So I've had 1.0 mg. of ativan. The Zoloft must be covering the panic during the day. The thing is, rain, there's a lag time when we start a new dosage. I'm still operating under 150 mg, not 200 mg, even though I've taken 200 mg for two days. It will take about a week for the concentration level to get up to 200 mg in my blood. If the anxiety isn't handled then, he said 200 mg. is NOT the maximum dosage, so I guess we'd increase it again.

I am not going to worry about it, frankly. As long as I am not having anxiety attacks and feel as relaxed and good as I do right now, I am just not going to worry about it. I think worrying about when the next one will come is a product of not having a plan that works to keep them from occurring. If people aren't getting medicine, I can understand how they feel.


----------



## rainboteers

You know if Zoloft doesn't work there are many other meds out there, and I am sure if the problem is only chemical you will find one to take care of it soon.

I always feel so bad at night. Alone and scared, noone to tell me that this will pass. Pity party for me, I know. 

Praying the zoloft is your answer and that you continue to feel good.


----------



## Sojourner

I know how you feel, rain. I get an attack at night, every night at 8:30. My doctor said today I can take Ativan prophylactically. Can you get something like that to help at night. It completely removes the anxiety for me and I wind up feeling just normal. After a while, I feel sleepy, but not tremendously so.

What medication are you taking now?


----------



## rainboteers

I am taking 40mg of celexa everyday, and I have xanax for the times I feel it is unbearable. My GP mentioned either adding neurontin(sp) to the celexa or switching to effexor.

She doesn't really have much faith an any of it and keeps telling me to find a GOOD therapist. She doesn't think medicine will help which is very discouraging. She thinks it is PTSD.

I know I probably have some "issues," but I am scared of facing them. I am also scared of therapy, the little bit I have gone through has always made me worse. I am just so sick of this, I am ready for anything, electric shock treatment, whatever would help.


----------



## Sojourner

You might feel worse at the beginning, because it hurts, but afterwards, you do feel better. Many people have benefitted from therapy.

Yes, it's scary, yes, it's hard, but it holds vastly more promise than medicine if the source of your problem is psychological.

I saw my therapist today and told her everything. She does have experience with panic disorder, so I'm going to stay with her, for now at least.

Would you trade your symptoms for the pain of therapy, whose pain does not last as long? That you are aware that you don't want to face things is a good sign. When you change your mind about it, I hope you'll pursue therapy.

It's like there's an irritant deep inside you that you need to get out of you. Therapy has completely relieved people of these kinds of things.

Think about it. To me, therapy is scary, but wholeness beckons and I am going to work harder than I did before.

The one thing I have trouble with is identifying some feelings that aren't very strong, but that are nonetheless there. I think I have a problem with expressing negative feelings to people when I have a beef with them.

The truth is, the unconscious is scary and unknown, and before I ever had a panic attack, I would feel fear when confronted with the idea of my unconscious. I would sit in therapy and tell her that I didn't know who I was and that things felt unreal. That would only happen during our conversations.

But, yes, it's scary, because we don't really know what our unconscious is trying to tell us. I am trying to think of my unconscious as my friend who is trying to help me. She helped me by repressing feelings (after all, she's a toddler), but she can learn to help me by revealing the secrets I hid within her.

I had to take an Ativan before my session today, though. First time I've had a panic attack during the day. But the one at 8:30 didn't come, although now I'm feeling very sad and a bit unreal, as if I don't know who I am or what I am doing. I cried quite a bit and felt a little better afterwards, but I felt like I was going to die. I feel the uncanniness of just being alive and I feel the wafer-thin distance between life and death and that perception scares me.

My doctor says Zoloft should control that when the right dose is achieved.

At any rate, I didn't have to take a second ativan, which I suppose is some measure of progress.

Think about therapy. I am more motivated than ever before; up until now, I'd see her every week and it seemed that not much got done. I was thinking of quitting, but now, I am determined to find out what, if anything, is unconscious that I need to know about.

The pain is less with therapy than with nothing.

It's a natural healing method, but can be used with drugs.

You do have to be willing to endure the pain for enormous rewards -- and as I understand it, they can truly be enormous.

S.


----------



## rainboteers

THANK YOU. You might have built my courage up enough to make the call tomorrow.

I just want them to help me and not try and tell me what is "wrong," with me. All the therapist I have seen, diagnose me with something right away (anxiety disorder, panic disorder, PTSD, anxoius depression). I am sick of that. I know I don't feel well otherwise I wouldn't be there.

I am going to tell the next one that I not there for a diagnosis, I am there to get well. I am not interested in being labeled with a disorder, it just makes things worse. How are you ever going to believe you can get better, when they are throwing disorders at you. It just makes me feel so trapped when they do that.

Sometimes I get the feeling they don't know what to do with me because I don't fit neatly in any of their boxes. They look at me baffled and I give up. I will try again. Thank you for your response and encouragment. So appreciated.


----------



## Sojourner

Rain,

These are psychotherapists you're talking about? That's totally unprofessional of them and is probably a violation of professional ethics.

Find a psychotherapist who also does psychoanalysis. Or call your psychiatrist and ask for a recommendation -- tell him or her what you posted here about their behavior (I don't mean that you should give their names unless your psychiatrist is as outraged as I am).

Such behavior is totally improper and could result in pulling of the license to practice in your state.


----------



## rainboteers

One of them was a psychoanalysis, he was the one that was only interested in my sex life. The other two were therapists.

They would say something like, "well sounds a little like panic disorder, maybe some PTSD, wait maybe you have anxious depression." Then I would hear, "you just don't seem to fit any of these, I'm not really sure what is going on."

From there they go on to say, "lets try some mediatation. Where do you see yourself right now?"

I just want to scream, "what do you think I see? I am seeing myself in a mental institution, with some exotic mental disease that has no name!"

I know there are some good ones out there, but just like guys, so far I am finding all the jerks/idiots. I am sure they mean well, but it only makes me worse. I leave feeling hopeless and misunderstood.

I have never actually seen a psychiatrist, my GP prescribes the medication I am on.


----------



## Brainsilence02

rainboteers said:


> I just want them to help me and not try and tell me what is "wrong," with me. All the therapist I have seen, diagnose me with something right away (anxiety disorder, panic disorder, PTSD, anxoius depression). I am sick of that. I know I don't feel well otherwise I wouldn't be there.


I will say my personal opinion based on my experience with doctors of all kinds.

The most difficult thing for the doctor is to understand what is wrong with you. I agree that the name isn't important. But keep in mind that the doctor is just a man who has been to school and learned some stuff. What a doctor wants is to classify you in a disorder so that he will know how to treat you. This is so professional eh? Like a lawyer.

The doctor must be really talented and gifted in order to try and search what is the case in you. The psychology prototypes of disorders are just to guide the doctor.

Disorders (refering to mind) is not a standard thing. A disorder appears when some common sympomps are been gothered. Each human is a completelly different case from the rest. It is possible that your DP/DR is different from everybody else's. Yes, it may have common elements, but it is not identical.

I believe that the only man that can really help me is me. I take what the doctors say, but I judge for myself.

I know that a lot of people can't just do that. They are in bad shape. I am, one of the luckiest people in here. My case is not severe. But I encourage you to ignore everything but the thin like that leads back to what happened and you ended up like this.

In me, this line is not always visible. I can see it when I jump from one issue to another randomly (I don't try to go somewhere, I just let myself think of everything he feels like). Through amazing connections between (logically) irrelevant issues, I have found answers of high importance uppon issues that bothered me for years.

Psycho-analysis should be a pasionate procedure for the doctor that doesn't only help you (the patient) but also helps him/herself find things about him/herself. Psych-doctoring should not be a profession, but a ministration.

I will try to create a topic with this, because I would like opinions on this, and not just stay buried in here. I have just posted it here first because I wanted you to see this Rainboteers.

Remember, that thing was just my opinion, and I am just someone like you.

Cheers


----------



## Brainsilence02

and something additional:

why don't you buy some books that explain psychology stuff?

but when you judge yourself, you must be extra-causius. you must see yourself as another person. like it's you and yourself: two different people.

complicated to explain in writen message and in a language i don't speak natively

ps: hmmm... he wanted to know about your sex-life. Am I beeing paradoid, or is there a "catch" here :|

ok, no worries, since you have left that doctor behind. I really hope that i helped, even a little


----------



## rainboteers

Reading about symptoms in psychology books is a very bad idea for me right now. I end up with additional symptoms and more fear. :shock:


----------



## Sojourner

Another thought: GPs are not always well-informed on mental health approaches. You need a specialist, someone who knows the field and who has a lot of experience treating people with panic.


----------



## reality27

i have panic disorder and anxiety, but the panic attacks are what make it even worse along with my derealization.


----------



## newuser20

So if I worry over everything and always expect the worse
& when I'm scared of something somewhere, I'm scared of it wherever,
as in a generalization, that's GAD?


----------

