Medications for treating anxiety disorders
Introduction
Two major kinds of medication are used in the treatment of anxiety disorders. These can be characterised as the “slow but steady” kind, and the “fast and tricky” type.
Each type of medication has advantages and disadvantages. “Slow but steady” applies to the various antidepressants used to treat anxiety disorders. The term “antidepressant” is a poor one as these medications are certainly useful for depression (for which they are invariably first registered), but they are also very effective in treating most of the anxiety disorders.
Different antidepressants are, however, useful for treating different anxiety disorders. These medications are “slow” in that a positive response is seen only several weeks after the medication is first taken. They are “steady” in that they have relatively few side effects, and in that they can be discontinued whenever the person wants without undue problems. With most of these agents it is usually wise to taper the medication gradually rather than to suddenly discontinue it, but this is readily done.
“Fast and tricky” is a term that applies to several other agents, including alcohol, and benzodiazepines (also known as tranquillisers or sleeping tablets). The advantage of these medications is that they work immediately to decrease both the feelings of anxiety and the physical symptoms of anxiety.
They are therefore particularly helpful for use on an “as needed” basis, or for the short-term control of anxiety symptoms. Benzodiazepines are associated with side effects such as mild cognitive impairment and motor vehicle accidents, so care needs to be taken when operating vehicles or machinery.
Furthermore, sudden discontinuation of benzodiazepines leads to marked symptoms of anxiety (in other words, they cause dependence). Occasionally, various drugs other than antidepressants or benzodiazepines are prescribed for the treatment of anxiety disorders.
Are anti-anxiety medications dangerous?
No medication is made available to the South African public until it has been through strict testing. However, all medications have some type of side effects due to the way in which they work.
Also, there is a range of special situations in which taking medication can be dangerous. People who have pre-existing medical illness, who are on multiple medications or herbal products, or who are pregnant or breast-feeding, should take medication only under the supervision of an experienced psychopharmacologist.
Finally, you need to have a relationship with a professional (general practitioner or specialist psychiatrist) with whom you are able to discuss medications. One of the single biggest reasons that anti-anxiety medications don’t work is that people do not take them correctly. In particular, they discontinue their medications too early.
Antidepressants
It is important to note that the antidepressants are the best medication treatment for many of the anxiety disorders over the long haul. Even though it may take several weeks before symptoms feel better, these agents are generally easier to take and are effective. Many of these agents are now available in a more inexpensive, generic form.
Several different kinds of antidepressants are available
Tricyclics: Tricyclic antidepressants have been available for many years. These agents are effective in some anxiety disorders (such as panic disorder), but not others (such as social anxiety disorder).
The main problem with these agents is that many are associated with inconvenient side effects, in particular dry mouth, blurry vision, and other so-called “anticholinergic” effects. On the other hand, there are newer tricyclics where such side effects are relatively infrequent.
MAOIs: Another class of medication that has been available for many years is the monoamine oxidase inhibitors (MAOIs). These are very effective for a number of anxiety disorders (e.g. panic disorder, social anxiety disorder), but again not for all (e.g. obsessive-compulsive disorder). The main problem with this class of medication is that it requires a careful diet.
Certain foods (in particular, cheese) and certain other medications (such as other antidepressants) are dangerous in combination with MAOIs. A reversible inhibitor of monoamine oxidase A (RIMA), which does not require dietary restrictions, has been introduced more recently.
SSRIs: Several medications are available in this class. The selective serotonin reuptake inhibitor (SSRI) which has achieved the widest media coverage is Prozac (fluoxetine). Unfortunately, much of this media has been hype, with Prozac touted as either a miracle drug, or a dangerous medication that can cause people to commit suicide. Prozac is no more powerful or dangerous than any other SSRI.
These agents have the advantage that they work on only one very specific receptor in the brain and therefore have fewer side effects than the older tricyclics. Their advantage lies in their efficacy against depression and many anxiety disorders. Side effects include nausea and agitation (which tend to be short-lived) and delayed orgasm in some patients.
Other: A range of more recently introduced antidepressants are also available. These include the serotonin and noradrenaline reuptake inhibitor, venlafaxine, the noradrenergic and specific serotonergic antidepressant, mirtazapine, and the selective noradrenergic reuptake inhibitor, reboxetine.
These agents have somewhat different side effect profiles than do the SSRI’s, so they may be useful for people who have experienced SSRI side effects (such as delayed orgasm). There is growing evidence for the use of some of these newer agents in some anxiety disorders, but further research is still needed.
What about herbal medications?
Many people feel that while medications from a pharmacy are synthetic, herbs are in some way a more natural alternative. It is certainly true that a range of plant products can be useful for mood and anxiety symptoms.
However, the contrast of synthetic medications and natural herbs is too simplistic. For one thing, many medications were in fact originally developed from plants. And conversely, many herbs work in very similar ways to medications, and so have similar benefits and side effects.
How long will I need to take medication?
This is one of the main concerns of people taking medication. It is important to emphasise that the antidepressants are not associated with dependence and so can be stopped at any point in time.
On the other hand, it should also be emphasised that discontinuing medication too early is associated with a high risk of relapse. All too often, people feel better after taking 3 or 4 months of medication and so stop their medications at that point. Unfortunately, symptoms frequently return a few weeks later.
Three principles need to be considered when taking psychiatric medications.
Firstly, medication should be continued for at least 6 to 9 months after symptoms have responded to treatment. This will lower the chances of relapse once the medication is no longer present.
Secondly, medication should be tapered gradually rather than discontinued abruptly. This not only avoids certain physical symptoms that can be seen after abrupt discontinuation of some antidepressants, but it also provides the person a chance to gradually accommodate to life without medication.
Thirdly, the use of cognitive-behavioural therapy has been shown to decrease the chances of relapse after medication discontinuation. It is worthwhile learning the principles of this therapy before discontinuing medication, and making sure that these are applied during the discontinuation period.
Further references/ resources
Medicines Control Council, Pretoria:+27 12 312 0000
Medicines Information Centre, University of Cape Town: +27 21 406 6829
Poison Information Centre, University of Stellenbosch: +27 21 931 6129
Good Day,
Kindly advise which medication can i use to treat my social anxiety problem, it causes a lot of problems in my work life, home life and every personal relationship in general, people generally avoid me and even my friends lately stay away from me because i find it difficult to laugh and be social, i need help, have no serious personal problems but the fact that people shy away from me is a cause for concern. I need to get my mood back to normal and i suspect that something is wrong with me medically/physically/mentally.
Regards,
Ipelegeng
0826041808
Hi
I want to know what would be best for my situation, I get anxiety on a daily basis whether it be in social situations or in just speaking to friends , constantly feel like Iam being watched and judged , which forces me to leave , i don’t say much and people see it as negative and hence avoid me . I have much anger because of this but keep it in check . I prefer to be on my own than around people , as its too much effort , even at fun events etc .
was on anti depress a few years back but dont think it ever helped me really !
Hi Gary,
Please see the e-mail I’ve sent you.
Kind regards, Janine, MHIC
My name is Amanda and I have a 11 month little girl. I resently had to relocate for work and my daughter is staying with her granny. I find myself staring into oblivion and crying inconsolible, its a burder to socialise and I find it so hard to be intimate with my partner. I’m scared people around me don’t like me at all because I’m short tempered and randomly rude. Last thursday I was in a taxi and I suddenly couldn’t breath,the taxi had to stop but I recovered and still went to work. I’m starting to wonder if I’m okay, please help me!
Desparate
Hi Amanda, Let me know where you live so I can be able to assist. Kind regards, Janine Roos
Good article! Some of the anxiety medications are good to your health and some are not. Always consult your health professional.
Hi, i normally give an informal presentation every 3 months at work. This causes me a lot of stress, my legs shake involuntary, my voice breaks and i struggle to remember what I have prepared.
Is there any medication i can take to calm me down?
Dear Jody,
I’ve answered you via an e-mail.
Kind regards,
Janine Roos
Hi there
I am in my late twenties, and
I have recgently realised I have been suffering with anxiety since childhood. I was misdiagnosed with depression after going on the contraceptive when I was an early teen. I have been off the contraceptive and the anti depressant for about 2 and a half years. Since then I have been through quite a few life altering experiences that would cause anyone extreme amounts of anxiety. I have been prescribed fluanxol which didn’t work, valdoxane which also didn’t work although it did help for my overactive bladder, and am now on a beta blocker which is only making me dizzy and cold, but is not helping in any other way. I have tried herbal tabs, which only make me drowsy, but don’t help at all either. I have most anxiety symptoms but have never had a problem sleeping. I am at my wits end and among other anxiety symptoms, my bladder fills up every 20 min which is interfering with my daily routine. Help! What should I be taking?
Hi Cassandra,
Please have a look at the e-mail I’ve sent.
Kind regards,
Janine Roos
Hi Janine
Ek vermoed dat my man aan erge angs lei veral wanneer daar tye by die werk is wat hy onder geweldige druk is. Hy het in 2010 ‘n paniek aanval gekry maar nooit weer daarna nie en is ook nie rêrig bekommerd daaroor nie (wat ‘n goeie teken is). Wat ons wel bekommer is dat hy soms baie siek raak wanneer hy spanning ervaar en sy simptome sluit meestal die volgende in: koue koors, naarheid, maagkrampe, koors, bewerig, diaree en algemene moeg- en lamheid. Hy kla ook dat hy sukkel om asem te haal wanneer hy die bg ervaar en dis asof sy hart in sy keel klop. Wanneer hy so voel dan gee ek vir hom ‘n Ativan maar ek wonder nie tog of hy iemand moet gaan sien nie sodat hy die regte medikasie kan kry. Het jy dalk vir my raad in terme van watter rigting ek moet volg? BAie dankie
Goeiedag,
Sien asb hieronder simptome van ‘n panieksteuring. Ek sou sterk aanbeveel dat hy ‘n sielkundige gaan sien. Die beste behandeling sou ‘n kombinasie van medikasie en psigoterapie wees, maar ‘n volledige evaluasie en diagnose word eers vereis om seker te maak daar is nie ook ander toestande betrokke nie. Laat weet waar julle woon dan kan ek iemand aanbeveel. Jy kan ook ons webblad besoek https://www.mentalhealthsa.org.za en op die ‘service provider database’ gaan soek vir iemand naby jou?
Panic disorder
Within a 10 minute period have you felt 4 or more of the following:
sweaty
shaky
increased heart rate
short of breath
choked
nauseous or pain in the stomach
dizzy, lightheaded or faint
numb or tingly
derealisation (feelings of unreality) or depersonalization (feeling detached from yourself or your surroundings)
hot or cold flushes
scared of going crazy
scared of dying?
If you answered yes to all of these questions, have you also: felt scared, for 1 month or more, of experiencing these feelings again?
Groete,
MHIC
Hi
I have been on anti depressants for three years and have been fine. Recently there were two very sudden death in the family and since then I have been suffering from severe anxiety. My GP doubled my dose of antidepressants and put me on urbanol for anxiety.
I’ve been feeling very lethargic. I’m also very worried about becoming dependent on the urbanol.
Your thoughts would really be appreciated
Keep well
L
Hi!
Thank you for your enquiry. It is expected that two sudden deaths of family members could worsen your depression/anxiety. I would recommend psychotherapy in addition to the medication. As the talk /psychotherapy starts to help, you can stop/minimise the urbanol? And maybe get back to your initial dosage of antidepressants. This needs to be done under supervision of your doctor. Please keep him/her up to speed on how you are feeling on the medication. You can have a look for a mental health professional on our database on https://www.mentalhealthsa.org.za
Kind regards,
MHIC
For most of my life I have felt weak and not in control of my own feelings. I have always had a fear of public speaking and it has escalated to even fearing speaking to people in authority. When my son is ill i cant ask my manager for day off to take him to the doctor and have to let my husband take him. I tell myself they are human too but can’t control the way I speak and how nervous I seem. I sit in meetings and seem to be the only one not participating, I speak to clients over the telephone and it seems my voice is breaking and that I want to cry. I hate it when my phone rings at work even though I am in customer services and it is my job to speak to clients. I spent most of my time at university not being in class because I wanted to avoid presentations and random questions from the lecturer. I can’t speak up about my feelings and allow others to walk all over me. I over analyse situations and feel embarrassed for others when I raise my voice at them because I don’t want to hurt there feelings. I am constantly at the brink of tears and feel that if I am going to be pushed that I am going to cry and end up in hospital for a breakdown. I don’t know what to do anymore and just want to lock myself up and not face the world. if I could financially then I would choose this option.
Hi,
I think it would be worth your while to see someone. It is not necessary to live with such fears. Please let me know where you live so that I can make appropriate suggestions on where you can obtain help? Also, do you have a medical aid? I think a lot of people suffer with the same fears.
Kind regards,
Janine Roos
MHIC
Hi, thank you for the response. I live in cape town in the athlone area. I am on medical aid and am willing to speak to someone if it will help me as I don’t want to feel helpless anymore.
Hi,
Please see e-mail I’ve sent you.
Kind regards,
Janine
Please be careful guys, I am doing a lot of research on Anti Anxiety Meds. ITS DANGEROUS! My bro committed suicide 5 weeks ago and I only found out last week a GENERAL PRACTIITIONER prescribed Urbanol for him (Schedule V drug) for his anxiety, Problem is he was not a chronic anxiety sufferer – He wanted something to calm his nerves to participate in a major local pageant. Turns out GP gave him Urbanol – a 30 day supply. He must have abruptly stopped it considering only 15 tablets remained – He thought he only needed it for the week of his pageant/competition. No one is warning the public of the risks of taking meds you might not need. I don’t know if I have the ability to make any causal link between them BUT the point is my brother was not diagnosed with chronic anxiety. Guys if u can, don’t take this type of meds for the daily anxiety, be very careful before u let meds control ur thoughts and feelings
Hi,
Thank you for your note. Every suicide is a tragedy. Please see the following link from Health24.com http://www.health24.com/Experts/Question/urbanol-safe-20121206
We need to realise that medication has a place and in many cases prevents suicide as it relieves depression, etc. The best thing to do is to be evaluated carefully by a medical professional, preferably a psychiatrist, if you suspect that something is wrong and you are not well regarding your mental health. Then the medication has to be continued or discontinued under the doctor’s supervision. Be sure to keep the doctor posted on how you are doing on the medication and if you experience too many side-effects communicate that to the doctor.
Kind regards,
MHIC
I have been on Tranxene 15mg for 27 years. It has been taken off the market. My doctor prescribed Urbanol 3mg. I have been taking it for 4 weeks. Daily and at night I am having symptom’s of a thick tongue feeling (metal tongue), constant tingling in my feet, nausea, dry mouth, little co-ordination and focusing, still anxious with knot in my stomach. Being the 4th week, I have persevered giving Urbanol 3mg time to get into my system.
This evening, in desperation I phoned my doctor, she suggested I try Lexaton 1.5mg in the am if necessary 1.5mg pm for 10 days. I a good relationship with her and she fully understands me. I am in a quandary as to trying Lexaton or other medication for 10 days, and suffer the same symptoms.
My husband and I own the business, and I have to be focused. Please advise, if Lexaton will help me, or if you have a suggestion which is the closet medication to Tranxene 15mg, I would appreciate it.
This is the 2nd time they have taken Tranxene off the market which was 4 years ago. Thanking you, with kind regards.
Hi,
Thank you for your enquiry. The best would be to get the information from the doctor treating you. It is difficult to give advice/suggestions about medication if we do not have a history of your medical health. Please ask your doctor all the questions you have as she will be in the best position to give sound advice. Also keep her posted on the ‘side-effects’ and how you are doing on the medication.
Kind regards,
MHIC
Hi, I have to give presentations at work. This causes me a lot of stress, my legs shake involuntary, my voice shakes and I struggle to breath and to remember what I have prepared.I do not wnat to loose credibility.
Is there any medication I can take to calm my heart rate and clear my thoughts?
Letang
Good day Letang,
There are medication available for anxiety, but you need to remember that it can be habit-forming and that it needs to be taken under a doctor’s supervision. It might be a good idea to visit a psychologist for psycho-therapy or join the Toastmasters and not to rely on medication alone. Please visit our database of mental health professionals on https://www.mentalhealthsa.org.za to look for someone in your area.
Kind regards,
MHIC
hi
Am eugene am not sure if its AHDH or anxiety i can’t concentrate ,i think slow,i speak slow,often have nothing to say when i jst have to,lose focus and forget what i am actually doing,careless always lose things this is affecting everything in my life ,especially in varsity am not doing well academically as every year my grades are droping ,i can tell now that this has been happeng to me from a young age so this worries me a lot i do not know what to do..how can i get help with this
Hi Eugene,
I’ve sent you an e-mail.
Regards,
MHIC
Hi
I felt anxious for the past year or so. Some days are worse than others. A friend told me about pur bloka tablets as it can be used for several problems.
I got thr 10mg but noticed I had to take 40mg only to find it doesnt really do the thing.
Are there any over the counter meds that I can get to keep with me for days that I need it. Dont want to be on chronic meds.
I am staying in the East Rand.
Will appreciate it.
Xx
Hi Michelle,
I’ve sent you an e-mail.
Regards,
MHIC
Good day
Ever since I could remember I have been struggling with anxiety and stress. I would start something that means a lot to me, then I will go blank, frustrated and make a bugger up of everything. Sometimes I just need to talk about something and I will start vomiting from anxiety. For eg: I have to take my drivers test, I have failed twice already due to anxiety. I just switch down, start shaking and sometimes cry as if the whole world is crashing down around me. Please help me. I need to find something that will help me get rid of my problem forever.
Hi! Ek voel die afgelope ruk al ‘af’ en dit is asof my verlede my meer en meer begin pla. Ek het vrydag op die snelweg gery en moes aftrek en wag vir my man om te kom haal want alles het swart geword, my kop het te groot vir my nek gevoel en ek het koue sweet gekry. My bloeddruk was 144/102 en my hartklop was 126, ek het ‘paranoid’ gevoel en kon nie ophou huil nie! Sedert dan voel ek of ek sweef en buite myself is – die Dr het bir my 10mg Urbanol voorgeskryf maar ek voel steeds ‘lig’ en asof ek in ‘n droom leef. Soms haal ek baie vinnig asem en my kop raak duislig en dan voel ek dit alles weer van voor af. Enige raad?
Beste Lucinda,
Dit klink soos ‘n angs/paniek-aanval. Lees meer in die vlg. skakel: http://www.adaa.org/understanding-anxiety/panic-disorder-agoraphobia/symptoms
Die beste sou wees om die medikasie te drink, jou dokter op hoogte te hou hoe jy daarop reageer en miskien psigoterapie te kry om oor jou verlede te praat en kwessies uit te klaar wat jou pla. Jy kan op die ‘mental health professionals’ databasis op ons webblad gaan soek vir ‘n sielkundige/geregistreerde berader in jou area of kontak my by mhic@sun.ac.za
Groete,
MHIC
I have been suffering from social anxiety daily for 3 years now, It really affects me daily at work and whenever I am with friends and I try to avoid social events due to this. I have never been on any medication please assist, I stay in cape town. Response will be highly appreciated. Thnx
Dear Zana,
Thank you for your enquiry. Please have a look at the following link re social anxiety http://www.webmd.com/anxiety-panic/guide/mental-health-social-anxiety-disorder?page=2
You’ll see that the best way of treating social anxiety is with a combination of medication and psychotherapy (cognitive-behavioural therapy). Seeing that you are in Cape Town you are also welcome to contact us to join one of our research studies. Please let me know? You can send an email to mhic@sun.ac.za if you are interested or if you need more information.
Kind regards,
Janine Roos
Hi. I am required to do conference presentations every few months, but I suffer from debilitating anxiety during these presentations, up to the point of hyperventilating. Otherwise I am a very confident person. My Dr has prescribed Inderal and Urbanol (up to 10mg, 3x per day) for the next presentation. My question is: can I take the Urbanol only on the day of the presentation, or should I start using it a few days before?
Dear Ilse,
Thank you for the enquiry. Please contact your doctor with the question on medication. Just remember that presenting at a conference is a scary thought for most! Just a thought….have you ever thought of joining an organisation like Toastmasters to make it easier to present?
Kind regards,
The MHIC
Hi
I’ve been referred by my psychologist to a GP (of my choice) to obtain meds for generalised anxiety and depressive disorder. Could you recommend a GP in Johannesburg that I may see in this regard?
Good day,
Thank you for the enquiry. You can contact any GP – they should have knowledge about antidepressant/anti-anxiety medication. Please see the following link for more information on medication http://www.nhs.uk/Conditions/Anxiety/Pages/Treatment.aspx
Kind regards,
MHIC
Hi i was taken off venlafaxine and epitec in dec last year and pit on to brintillex. Apparently the best anxiety meds on the market. But i have anxiety all the time. So what do i do now. I have gained 15kgs and i cant seem to loose them again. I am at wits end. Pls can someone help
Good day Tamarin,
Thank you for your enquiry. We are not specialists in medication. Best would be to communicate your fears with the doctor who prescribed it. Brintillex is an anti-depressant which should work well for anxiety, but maybe is not the correct medication for you?
Kind regards,
MHIC
Hi: I have panic attacks especially when I drive on freeways. Kindly assist
Dear Mokgadi,
Thank you for your enquiry. Medication is used for prevention and/or immediate alleviation of symptoms and is usually the main line of treatment. In addition, psychotherapy such as cognitive-behavioral therapy, relaxation, and/or meditation are often used to help relax the body and relieve anxiety. If you’re in the middle of a panic attack, immediate relief of anxiety symptoms can come from taking a sedative type anti-anxiety medication such as Xanax, Klonopin, and Ativan. These drugs are provided at least in the beginning of medical therapy, but are not for long-term use. Certain antidepressants can help prevent anxiety and reduce the frequency and severity of panic attacks, but are not used for immediate relief during an attack. Frequently used antidepressants are the selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Paxil, Celexa, Lexapro, and Zoloft. This group of medications is often considered the first line of treatment for panic disorders. http://www.webmd.com
We hope this will be of help?
Kind regards,
MHIC
Hi,
I am required to do presentations and chair various meetings as part of my duties. I am able to control my anxiety during some interactions but mostly struggle to deal with the anxiety. My symptoms includes, cold sweets, shaky knees, sweaty palms, uncontrollable voice tone, etc. My doctor recently prescribed adco-alzam and it seems to assist a bit. What else can I do to control the anxiety to the extent that I am more comfortable with these tasks? I am based in JHB.
Thanking you in advance.
Regards
Good day,
Thank you for your enquiry. Adco-alzam is a brand name for alprazolam. Alprazolam is a benzodiazepine used for the treatment of anxiety disorder, panic disorder, with or without agoraphobia, and anxiety associated with depression. I’m glad that the medication appears to be helping. It would be good if you could combine it with some form of psychotherapy. Have a look on https://www.mentalhealthsa.org.za for a mental health professional in your area. Or have you ever thought about joining an organisation like Toatmasters? http://www.johannesburg-toastmasters.org.za/about-toastmasters/
Hope this will be of help?
Regards,
MHIC
I have a 20 year old son who was diagnosed with OCD when he was 16. He has been seeing a psychologist weekly since then. Initially our GP put him on paxil but he couldn’t sleep at night. He was on sertraline for a few months which seemed to help but its effectiveness wore off. After trying aropax for 6 months and battling with insomnia, he decided to try going without medication. We tried the homeopathic route but after a few months his condition had deteriorated considerably. He then saw a psychiatrist who put him onto faverin as well as Stilnox to help him sleep. Still he suffered from insomnia. After 6 months on this medication he decided to stop treatment. Since then I have been giving him Kanna together with vitamin B, omega 3+6, calcium and magnesium supplements. He is a student pilot and the aviation authorities have a ban on certain medications but there are some that are allowed. However, he is trying to stay off medication and is battling on with this debilitating condition. I feel that there must surely be something that he could take to control the anxiety. Is it worth trying Prozac and for how long should he take the medication before he is likely to see if it is effective?
Good day,
I’m not a medication expert – best would be to see a psychiatrist for a full evaluation and a rethink of his medication.
Kind regards,
MHIC
Hi,
Could you recommend to me someone I could see specifically for over coming chronic depersonalization in Cape Town CBD area? It is distressing and has risen its head again for me causing it hard to be myself in public and am so aware of myself and my behaviour constantly.
Thank you.
I would suggest that you visit our database of mental health professionals on our website and do a search (clinical psychologist…..psychotherapy). You’ll be able to see the profile as well as contact details of the professional.
Regards,
MHIC
Hi janine. Ek dink ek lei ook aan anxiety en nervousness. Erg. My hande begin bewe en my mond raak droog veral rondom baie mense. Hoe kan ek dit voorkom en verhoed.
Beste Andre,
Angs word die beste behandel deur ‘n sielkundige, maar jy kan ook by jou huisdokter luister vir opsies. Behandeling hang af van wat jou angs veroorsaak. Daar is angs-medikasie beskikbaar – dit is afhanklikheidsvormend op die lang duur. Kyk gerus na die vlg. skakel vir meer inligting. http://www.medicalnewstoday.com/info/anxiety/anxiety-treatments.php
Vriendelike groete,
GGIS
Hi I have had anxiety since i was in High School, i am 26 now, i have never spoken to anybody about it and have never been diagnosed but over the past few months i feel like it is getting progressively worse and i find myself getting very anxious especially when i am by myself, i try my best not to be left alone and will always find myself trying to be around friends so im not left alone with my thoughts. I am not sure who to speak to or to approach for medication to help with my anxiety. Its at a point where i feel like it is starting to affect my work because the environment is so quiet and i get very easily distracted. Please could you provide a starting point for me. I am based in Cape Town
Hi Jarred!
Thank you for making contact. Treatment may depend on what is causing the anxiety. Usually a combination of medication and psychotherapy will do the thing. Please have a look at the following http://www.medicalnewstoday.com/info/anxiety/anxiety-treatments.php
You can have a look for a mental health professional on our website. You can also contact your GP in this regard. If you need more assistance or information, please do not hesitate to contact me again? Email me at mhic@sun.ac.za
Kind regards,
Janine
Hi Thanks for getting back to me, since posting the comment i have seen a Psychiatrist and have been diagnosed with General Anxiety Disorder as well as Depression. I have been put onto an Anti-Depressant tablet as well as a calming tablet and sleeping tablet. I would recommend anybody to speak to a professional and not be afraid to as i suffered in silence for more than 10 years and only now getting the help that i need
Very glad that you had the courage to look for help! A lot of people suffer along in silence while these conditions are highly treatable. Thanks for letting us know. Stay on the treatment and keep the doctor posted on how you are doing. Remember that anti-depressants take in the order of 2 weeks before you will start feeling a difference and then you need to stay on the medication for quite a while. Everything of the best.
Kind regards,
Janine, MHIC
I’ve been taking antidepressants for the past 5 years, lexamil 20mg daily, serez25mg at night prn & sometimes urbanol10mg prn.Problem is I don’t think they are helping me anymore
Concerned.
Hi Promise,
Thank you for your question. Best would be to take this up with the prescribing doctor. Please have a look at the following link that explains why antidepressants may stop working after a while
http://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressants/faq-20057938
I would suggest that you go for a full medical examination to rule out other medical conditions. Hope this will be of help?
Regards,
MHIC
My anxiety is at its peak when I have to speak, being the focal point. It can be in a family meeting, at work and public speaking is the worse. It gets to a point when I feel I am going to collapse. I am intelligent person and I have missed so many opportunities because of the anxiety and fear that overwhelms me. I have seen a Psychiatrist and a Psychologist, my problem is I get tired of taking medication all the time. I feel like that this condition is limiting my happiness.
Hallo Lizette,
Thank you for your enquiry. You have already seen a psychiatrist and a psychologist. If the medication is working, I would advise you to continue with it and in the meantime try and join an organisation like Toastmasters http://www.toastmasters.org/ to assist you further? A lot of people find it very helpful. I’m not sure where you live and whether there is a branch near you?
Kind regards,
MHIC
Hi
I am permanently in a state of panic, heavy feelings of impending doom and constant nervous feeling in the pit of my stomach, it’s making my life unbearable. Any suggestions would be greatly appreciated. I don’t think my GP is taking me seriously, I was on zytomil but this did not relieve the hourly panic attacks, constant wanting to burst into tears and total de motivation to exsist. I wish I could hibernate for a few month, and yes, going through menapause.
Hi Veronica,
Thank you for the enquiry. Sorry to hear that you are not well. I do not know where you live and whether you make use of private or public health care? Have you ever considered making an appointment with a psychiatrist or a psychologist? I think this would be best seeing that the zytomil is not working? Please let me know where you live. Then I can try and make a suggestion about who you can see……
Kind regards,
Janine (MHIC)
hi
my muscles always tighten just before penetration making it impossible for sexual intercourse.I’ve been to a hospital where i was told theres no such condition.I googled vaginismus and anti-depressants and found positive feedback.would you recommend anti-depressants to relax my mind and vaginal muscles?
Good day,
Vaginismus is a well-known medical condition. And it is highly treatable as well. You just need to tap into the correct medical help. I would not advise using anti-depressants if you are not clinically depressed, but I am not a medical doctor. Best would be to see a doctor and you can also have a look at the following links: http://www.vaginismus.com/vaginismus-treatment/
http://www.webmd.com/women/guide/vaginismus-causes-symptoms-treatments
I hope this will be of help.
Kind regards,
MHIC
http://www.vaginismus.com/vaginismus-treatment/
Im not sure if theres such a thing as relationship anxiety but whenever im in a relationship I just feel down, heavy and really depressed. Everything is an effort….I’ve been with this girl for 5 years and break up with her often and when im alone and single I find that I want her back. Now im in this routine of not going out or doing anything…haven’t been with friends much because this feeling of depression and anxiety seems to be stuck with me because i’ve had it so long. Are there any meds to get my moods back up and my brain chemically balanced again. I don’t feel normal.
Dear Bruce,
Thank you for your enquiry. You can talk to your GP who’d be able to diagnose a clinical depression. Depression is highly treatable with medication and I would also suggest that you also talk to a registered counsellor/psychologist. Please have a look at the following link: http://www.psychalive.org/how-to-deal-with-relationship-anxiety/
I hope this will be of help.
Kind regards,
MHIC
Morning
My whole life i have lived with a fear of standing infront of people and doing any activity. even at school couldnt answer teachers questions.. couldnt talk during class activities. even today..will be turning 28 and still cant do a lot of activities… i write songs and whenever im given a chance to record my mouth goes try n no word comes of my mouth because i fear imbarrasing myself.. im in learnership n im unable to participate in most activities because i fear embarrasing myself.. last year i was offered an admin work n couldnt simply answer a telephone becouse i thought my english wasnt good enough and i was fired immediately.n now i have been thinking of starting a business and going to seda for help but i dont think i will be able to achieve this one as i wont be able to give my presentation… is there any way i could get rid of my fear or panic attacks.. are there any medication for this kind of situation.. i feel like a failure i realy wanna do a lot in my life but fear seems to be getting in my way.. please help.
Hallo Elizabeth,
Thank you for the enquiry. Please have a look at the following link:
http://www.nimh.nih.gov/health/topics/social-phobia-social-anxiety-disorder/index.shtml
Not sure whether you make use of public or private healthcare? If you let me know I’d be able to refer you appropriately. It would be advisable to see a psychologist for cognitive-behavioural psychotherapy. Anti-anxiety or anti-depressant medication are also used to treat anxiety. You can enquire at a GP or your local clinic or hospital.
Kind regards,
MHIC
Hi
I have recently resigned from a very stressful job and joined a new business . Prior to joining the new business I become very anxious. I went to a phycologist ,who put me onto Venlor and Urbanol. I became exhausted and unable to think clearly and felt zombie like. I went back to the same doctor, who changed the Venlor to Welbrutin but didn’t change the Urbanol. I am still exhausted and battling to stay awake at my new job. Sleep has also become difficult and I was prescribed Ivandal. I am really stressed about what the future holds for me if I can’t shake this exhaustion. I was previously on Cymgen and coped quite well then. Any advise would be greatly appreciated.
Dear Graham,
You need to inform your doctor about your symptoms. Please ask him/her whether you can go back to Cymgen (Cymgen is a brand name version of the antidepressant whose chemical name is Duloxetine. In another version it is sold as Cymbalta). If you’ve done well on it, why not try it again? It would also be advisable (because you are so anxious) to see a psychologist to assist you to deal with the anxiety.
Please let us know if you need more information?
Kind regards,
MHIC
Hallo, ek is opsoek na ‘n bietjie raad, ek vermoed my pa lei dalk aan angs, hy is gereeld gedisorienteerd, vergeet agtig en sukkel om te slaap. Ek glo dit is weens verskeie redes, waaroor hy ook nie gereeld praat nie. Hy is self ‘n sielkundige, wat hom dalk ‘n bietjie hardkoppig maak teenoor die moontlikheid van n angs diagnose, hy het ‘n angiogram gehad op sy dokter se voorstel, en moes hul vra om te stop omdat hy amper n aanval ervaar het weens die benoudheid en geraas. Sy dokter het hom nou na ‘n neuroloog verwys en hom vir tyd en wyl op medikasie gesit wat hul dink sal help vir die disorientering maar eintlik vir altzeimers is. Ek het geen mediese kwalifikasie hoegenaamd nie, en dit is nie my plek om te se die dokters is verkeerd nie, maar voel tog dat ek my pa op n daaglikse basis sien en kan observer, en voel baie sterk dat sy huidige simptome weens stress en angs is. wat kan ek doen of vir hom se om dit as ‘n moontlikheid te oorweeg?
Hallo Nerine,
Was jou pa reeds by die neuroloog? Sien asb. die skakels hieronder. Moontlik kan daar anti-angs medikasie bygevoeg word?
http://www.alz.org/care/alzheimers-dementia-agitation-anxiety.asp
http://www.alz.org/professionals_and_researchers_14310.asp
Hoop die inligting help?
Vriendelike groete,
MHIC
Hi daar. Ek is gediagnoseer met chronise asthma, vier spesialiste later het hulle vir my gesê ekt n onreëlmatige klier in my kop wat hulle oor 6 maande weer sal evalueer. Eks op medisyne en n nebulizer elke oggend en aand. Die neuroloog het vir my ook urbanol 10mg drie keer n dag voorgeskryf. My familie sê dit affekteer my spraak en ek het al myself agtergekom dat ek lelik van balans af is. As ek net bietjie skeef trap wil ek omval. Voel of n klein windjie my kan omstoot. Is dit normaal? Ek sukkel ook met klomp klein “lymph nodes” wat bietjie swel en pynlik is. Nog geen oplossing vir dit nie. Selfs voor my medisyne is ek dodelik moeg die hele dag deur al kry ek n volle nag se rus. Enige raad?
hi i am sufering from anaxity and depression and was first on a dangerous antideprsant aeropacs which caused lots of side efects ,i am curantly on leximal 10mg and urbanol 10mg and also got brazopam if i ge a big panick atack ,my bp rises about 160 over 100 and then i take a brazopam 6mg and a disprin to lower it ,sometimes i am afraid to go some where because i am a fraid ill get a panick atack ,side efects of leximal i exsperience omsomnia cant sleep and bladder disfunction and my head most of the time feel swollen and sensative to sharp light
Kan iemand dalk help: paar jaar gelede het n dokter vir my pille voorgeskryf vir ligte depressie (pil wat onder die tong gesit word sodra ek angstig raak) maar kan nie die naam onthou nie. Ek begin nou weer dieselfde simtome kry (angstig, buierig, huilerig, kortasem en kry hartkloppings). Ek wil nou net iets gebriuk wat tydlik van aard is net sodat ek meer verdraagsaam – veral met my huismense is. dankie
Hi Everyone ive been a chronic anxiety sufferer since 2015. I had previous symptoms over the years but completely ignored them has i grew into an adult to make matters worse i am a stutterer as well so my self esteem and ego was always low eventually i used to worry alot about a death in the family or is something bad going to happened.I realised that i cannot control the future and control ones mind, end of the day in the end i was the one suffering and stressing and my body ends up stressed and tired. Ive been on Xanor 0.25mg from 2015-2017. I had to up the dosage to Xanor 0.5mg till present and im also taking Purbloka 40mg since i gave a noticelable bounding pulse. I dont exceed over 2mg per a day on the Xanor and i take half Purbloka in the morning and afternoon. Before my diagnosis i weighed 90kg something now i weigh a whopping 130kg since the years as passed… Dont worry im not obese ive converted my fat into muscle i do strenous weight training. I hope i have reached out to some people thats going ton read this someday… we just need to chill and live for the day not for the week. BE GOOD DO GOOD FEEL GOOD…..
My child of 7 years is suffering from what i used to suffer from when i was her age up untill i gave birth to her and becamea wife. ever since i was a child i was a very shy person and couldnt even make conversation no matter how hard i tried, i couldnt even keep it going.this has made me to be very quiet as my language vocabulary was locked in, not to say i did not understand any language but the problem was responding i just got blanck even in class i didnt likje speaking as sometimes it would sound like i am stupid , well it did cos i would be laughed by every responds that i made…ok so i got older and was diognosed with depression and anxiety i took urbanols and nuzak after a while my confidence grew and sometimes i would say things i never thought i knew and meeting people and conversing became easier and easier to a point where people would ask me which scc=ool did i go to they would tell me how intelligent and wise i am and i could also notice that…so now because it had affected me before iam thinking of giving my child the anxiety pilss too for her to be able to speak and and shy free..
Kan ek xanor.5mg tesame met urbanol 10mg in die aand drink om aan die slaap te raak
Goeie dag
Ek is al jare lank op antidepresante. Eers op Nuzak maar het nie gehelp nie. Toe sit Dok my op VENLOR 150mg, Dit help redelik maar dit is vreeslik duur! Is daar ‘n ander produk wat ek kan gebruik wat nie so duur is nie maar wat wel SAL help? Soos Lexamil 20mg of wat?
Hi there, i am a 45yr old female and i have a bad case of claustrophobia which causes extreme anxiety. I cannot be in confined spaces, elevators, back seats of cars, small rooms, dark places and rooms with no windows. I immediately become scared, out of breath, sweaty, hot and can tear down anything to get out. It has recently become worse than ever in the last 3 months. Please help!
Good day Michelle,
I need to know where you live and whether you make use of public or private healthcare so that I can know where to refer you to.
Regards,
Janine
Hi kindly send me your email address. I need help
Good morning
I get anxiety on daily basis, struggle even to speak with my friends and it get worse when am in public, i panic alot. My voice become shakey which makes me very shy and my heart beat very fast. I’ve got social anxiety and panic disorders, I’ve tried using pur blocka pills but am worried if they could affect me badly because they were only recommended by a friend, I don’t have a professional health care.
am on adco alzam and zytomil. do i really need both ?
Good morning
I am on Adco Alzam half a tab x3 a day.. doesn’t really work, I’m very stressed and struggling with anxiety. I really need my stress lowered and need to be calmed down ? My doc suggested I now go onto it half a tab x4 a day .. will this help? it’s very sedating therefore I cannot take 1 full tab x3 a day
Hi ek was op antidepressante vir 25 jaar laaste 4 jaar was ek op venlor 75mg brazepam en ativan indien nodig in jan2020 het ek verskriklike angs aanvalle hoofpyne sweet en slaaploosheid gekry alles newe effekte van van venlor nadat ek by 5 dokters was het nie medies nie wat se ek moet aanhou met meds dit dal beter word het ek n laaste dr gaan sien wat cilift 20mg en urbanol 5mg voorgeskryf het wat presies dieselfde gedoen het ek het my werk verloor agv simptome ek het alle pille gelos in feb2020 ek is deur erge ontrekkigsimptome nou na 7 maande sonder pille kry ek geirriterfheid misikheid gevoel van ek gaan my kop verloor en ek het n knop op my krop van my maag en in my keel het 45 kg verloor kan nerens gaannie ook nie in n kar ry nie ek was nie so mens nie ek ken nie myself so nie wat kan ek doen ek is te bang om pille te drink omdat dit my so sleg laat voel help asb
My severe anxiety is not letting me sleep and i dont cope at work. Stressam is not working. What can i ask my doctor to give me
I have been suffering for a longtime, my father died when I was not around and was always thinking about him. I went to see a doctor who told me I had a disease and was scared every time thinking that I am going to die for more than a year then my BP started to go up 148/98, headache and my doctor prescribed an antiHTN and was feeling a left chest pain, overthinking, full bladder every time(had to urinate every 30min). I started these antiHTN drugs and my BP become normal but continued having the same symptoms: headache, scared about my life(dying??), dizzy sometime, neck pain and joints pain. I went to see more than 3 cardiologists who were telling me that my heart was normal. but recently I was told by my doctor that I have anxiety after doing all exams again. what other support could I need ? Any help please
Good day
I dont knoe ejat to do anymore
Please help me help my husband
He is 43 years old and has a bleeding ulcer, drinks 20mg lexamil The dr prescribed him Tegretol but he felt very weird for 3 days
Now, he started working at a sports bar/lounge – tavern
He gets anxiety attacks daily I dont know what to do Nothing is helping Hre cries, gets angry very Easily and hr doesn’t know ehat to do at work
If there’s too many people, he gets these attacks amd when he is in a stressful situation or if he doesn’t know how to handle a situation, he gets these attacks
He takes about 2p minutes to calm himself
My anxiety caused so many problems. I could not drive a car anymore, dizziness that drives me crazy and many more. My GP put me on Yelate60 and 5mg urbanol. This combination works excellently. I just want to know if I can go on with the usage of tbe urbanol. I mean for life.!!!!!! Thank you.
Dr / Me. Roos,
Ek ondervind 3-4 dae voor my maandelikse siklus ‘n tydperk van verhoogde angs en erge irritasie. Sodra my siklus begin gaan hierdie simptome weg. Ek het ablasie ondergaan weens Menorgieë, en omdat ek nie meer siklus fisies kry ondervind ek steeds hierdie simptome van erge angs en irritasie wat na 3-4 dae net skielik bedaar. Die ablasie in my opinie het ook my siklus-dae verwar, en dit voel dus of periodes van angs en irritasie alhoemeer gebeur. Dit is definitief nie gewone PMS simptome en ek vermoed ‘n sindroom van een- of ander aard. Ek is oor die algemeen ‘n angstige persoon, maar na my kinders se geboorte het dit beslis meer intiensief begin raak. Ek glo ook dat ek ‘n mate van PTS het as gevolg van verskeie gebeure die laaste paar jaar. Ek moet ook byvoeg dat ek 2-jarige het wat nie deurnag slaap wat ook al afgelope 2 jaar my slaappatroon versteur. So met dit kan my hormoonproduksie en angsvlakke beinvloed word en die angs en irritasie simptome verhoog, maar daar is drastiese styging in daardie 3-4 dae en ek is dan die slegste weergawe van myself en sal iemand te lyf gaan weens irritasie. Ek benodig medikasie om te help, ek kan nie meer so aangaan; mens kan net solank om verskoning vra vir uitlatings in daardie tyd gemaak en my geliefdes verdien beter. Ek wil nie graag net na huisdokter gaan en medisyne “uit probeer” totdat een gepas is. Ek wil graag ingeligte besluit/voorstel kan maak aan dokter van beste opsies van mediskasie is vir ‘n geval soos myne. Sal u my asb kan help hiermee? Byvoorbaat dankie en met groot waardering.
Can I take Urbanol and Xanor at the same time? Is it safe? I have GAD. Thank you.
Hi good day, I’m on antidepressant for anxiety. I just want to some help, I’m feeling very tired and it feels like energy level is very low. Should I get a vitamin injection or what.
Good morning,
My son is 12yrs old and has been battling with anxiety since about the age of 4. It’s definitely getting worse as he gets older. I’ve taken him to several psychologists who have tried to establish the cause of the anxiety but have come up empty. We’ve tried all the different techniques, flash cards, breathing exercises, yoga, meditation etc… But nothing helps. When he was 10yrs old we noticed his school work was really suffering as his mind was constantly filled with worry about random things and so he couldn’t concentrate on the lesson. He would also randomly burst into tears and was often inconsolable. He was prescribed Cilift which did help but the side effects were quite troubling. He would have episodes where he would become so down that he would hide out in his bedroom and tell me that he doesn’t want to be alive any more and wishes he was never born. These episodes weren’t caused by any specific events and he couldn’t explain how he felt or why he felt this way. He’s not bullied at school and does have many friends. My heart is broken for my child as he keeps asking me why God made him this way and why he can’t be “normal”. He says he wishes he could stop crying for no reason but he can’t control it. He has so many different fears and it’s honestly debilitating. Recently he has started experiencing severe panic attacks which cause him to feel as tho he can’t breathe, he becomes sweaty and his heart races. He tells me that he feels like he’s going to die. I do manage to talk him through it but it’s a struggle. I am open to any suggestions you may have to help my son as he’ll be starting high school next year and I’m worried that he may get bullied by the other boys if he can’t get control over his emotions /anxiety. Is there a medication that has been proven to work for situations like this? The Cilift isn’t working anymore and I’m genuinely concerned about the downside of the “suicidal thoughts”. Please help 🙁
Hi I have been diagnosed with anxiety and depression. My doctor first put me on Cymgen and still my mind would be filled worry and recently added 10mg of urbanol. Is it safe to take both drugs at the same time?
Another great resource for Vaginismus and Vaginismus treatment is:
https://www.womentc.com/conditions-and-treatments/penetration-pain-disorders/vaginismus/
Hi..I need help please…I have Extreme anxiety and depression n panic attacks…my symptoms are extreme…my doc put me on Cilift 20 mg antidepressants and alco alzam when needed…I find that I’m still struggling to cope…. recently I find that I’m getting pokey sensation in my body and head…somehow I feel it’s nerve related..please help because now Im more fearful of my health
Kindly advise, i am feeling anxious due to the fact that i am lonely , selling my house and business is rather slow as i am self employed , my Gp initially put me on Cilift antidepresents, took half for one day but made me feel sick , went to see a psychologist and stayed in hospital for four days , put me on serdep antidepresants , half a tablet and on sleeping tablets called zolpiclone , stopped the antidepreresents , felt suicidal , still have moments of feeling anxious , dont know what to do , still talking sleeping tablets , battle to sleep.
Hi
I have had a stutter since std 7. I got over it was with a company for 20 odd years left. I have been at present company 2 years… The stutter and anxiety has returned. I need to give prenetations at work it’s driving me mad as I stuff it up every time. Will urbonal help with this
Regards
I’m on Ativan, it’s been a month now. Can I safely continue?
This is the best Help I have seen able on the net.
I need help too. 73. Female. Husband passed away 2 years ago and it is hitting me harder now than ever. Cilift and urbanol prescribed. Does not stop the shakes and crying and lethargy. Losing weight and no appetite at all. Can you please advise. Thank you .
Hi, i dont know my problem but i use to feel dizzy almost every day.I am teacher but its diffivult to stand infront of the class to be in places where there are lots of people even to go shopping.I feel like falling down and sometimes difficult to breath,please help.
Hi I am suffering from depression and anxiety. I am on 10mg of Urbanol which keeps me calm and stops me from freaking out but every morning I will wake up worrying and a terrible feeling of foreboding. It is really starting to get me down. Thanks Kristy
This page is most helpfull. thank you.
Hallo
Ek borsvoed nog my amper 3 jarige. Dr het vir my urbanol 10mg x 2 n dag en venlor 125mg voorgeskryf, is dit veilig met borsvoeding?
Hi there
PLEASE HELP!!!?!?!?!
I have been on Rivotril 2mg daily for the last4years.
I now feel as if I need something different to help me cope with out feeling freaked out and anxious when people talk to me or I am required to be bigger crowds. My brain seems to run into a fuzz and I’m unable to prioritize and have a very low confidence when i do as I second guess my planning.
Unfortunately I don’t have the money to see a Dr and am not on a medical aid any more.
I have 2kids 12 and 3.
I am no longer breast feeding so that shouldn’t be an issue anymore…
Please advise..
Kind regards
Kerryn Bennett
Hi im on lexamil 10mg, olexar, 5mg and Zoxadon 1mg twice a day. Please advise on a way forward. As i sleep most of the day.
Wondering if judy came right and if so how as I have the exact same issue
Good Morning. I was recently precribed Duloxetine 30mg and Fluanxol 1mg for depression and anxiety. I’ve only been on it for 4 days and feel absolutely nothing apart drom sadness and sleepiness. Im acared to death that I will never be able to feel normal or motivated again. I used to be a very putgoing and happy person in general. My medication has been played around with quite alot since my suicide attempt in September and I haven’t really had a good day since then. Im starting to feel hopeless at the tought of ever feeling normal again and stating to wonder whether the medication can be causing me to feel so disotiated. Please any help is welcome.
hello
Kan die tyroid jou anxiety gee.
Ek het erg anxiety begin kry en my dr sit my nie op pille nie net vir 5 dae urbanol maar dit help net n rukkie is daar enige raad wat ek kan doen ek is moedeloos al
Does Xanax help for DpDR?
Good day,
My girlfriend is a very anxious person and struggles with anxiety. When looking at her you wouldn’t say that she struggles with it but recently it has become worse. She has been to the doctor as some concerns were raised. Her left arm was going numb and her heart was racing. She went to 3 different doctors over 2 months and they all tested her heart and said it was fine. The last doctor did a stress test and gave her Urbanol. She drank it for a while and all was good. If she doesn’t drink it the problem returns but it doesn’t happen on a daily basis. She says that she doesn’t feel stressed. My question is, is there a long-term solution other than staying on Urbanol?
Hi I’m really struggling with depersonalisation and derealization to a point that I can’t be with my family at all cause I feel so detached. Please help for Medication.