As a medical biochemist and a lifelong anxiety patient...
1. Remove as much negativity in your life as possible...people, job stress, finances, relationships...surround yourself with people and activities that are positive experiences for you. Buy some meditation CD's and use them at night when you lay down to sleep, in the car, on your lunch time at work, any time you have a few minutes. Learn to relax. Exercise and eat correctly. Cut out all caffeine, smoking, and alcohol. Cover all of the obvious things before thinking that a miracle is going to cure you.
2. Get a referral to a psychiatrist known to do a lot of work with anxiety. Not every psychiatrist is good at working through the treatments with you. And they also have tons of pharmaceutical sales reps that call on them too. So try to find one that is several years out of college (med students are always looking for free food and drug companies spend lots of money to feed med students) and been around the block a few times. Sad to say, but some of the most knowledgeable docs I've found are the ones that treat the worst cases in the mental health facilities and prisons. Neither place is likely to pay for expensive meds and the docs get to see the results of less expensive drugs first hand.
3. Try counseling to see if it helps. some of us have acquired anxiety as a result of life experiences. And some of us have inherited anxiety just like heart disease or any other thing our DNA has passed along. If you can document cases of anxiety in generations past (look for alcoholism and other substance abuses as they were often suggested by docs before the 1950's when benzos were developed), you probably have the inherited form. Counseling may not work for the inherited type, but will help you cope better.
4. If you are agoraphobic (have difficulty leaving the house) get help sooner rather than later. Read about the kindling effect below. I have experienced agoraphobia and all I can say is take the first step outside the door. Ask your spouse to put a lawn chair on the back porch (where no one can see you) and just go out for 2 minutes to enjoy the sunshine. Increase as your tolerance allows. Try walking to the mailbox or just to the end of your driveway. And try to get professional help.
4. Don't be afraid to take medication. It is a known biological fact that some anxiety is caused by a problem with a chemical known as GABA. It is the very receptor that benzos act upon. Serotonin is a neurotransmitter that docs may talk about in treatment plans. Well, 95% of your serotonin receptors are in your gut, not your brain. May have something to do with those of us who have the urgency, frequency, constipation, diarrhea problems. For those cases and also sleep problems there is a little known anti-depressant, mirtazapine (brand name is Remeron in the US, but is available as a cheap generic for a few years now), that works wonders for me and many others. It sucks as an anti-depressant but it is wonderful for the gut and getting you to sleep. But because it has not worked well for depression and has undesirable side effects for depressed patients (sleepiness, lethargy, weight gain) there is very little taught to docs about it. Also, it is not in the same biochemical category as Paxil and Prozac. So if those drugs have not worked or made you worse, give it a try. You need to give it a fair chance if you try it, have your dr work with you adjusting doses and be willing to give it time to work out the side effects. Most people can barely move and want to sleep for the first 24 hours. And most people will crave carbs and many gain weight on the med. But when you find the right dose...priceless. Also helpful for the diarrhea / nausea types is an over the counter med known as loperamide. You can buy it at
Walmart dirt cheap. You take one tab as soon as you have an episode or feel your bladder, bowels start to gyrate. And you can take a second tab if the symptoms persist. It does not tend to constipate but you do have to eat a good diet anyway. It is fairly harmless and I know many people with IBS / Ibd who use it as part of their daily meds, for years.
Remember...if you were diabetic would you resist taking insulin daily? If someone gives you grief about meds, try that on them. You have a chemical insufficiency and there are medications that can treat it.
Smoky...0.25 mg is barely even on the scale to be considered a therapeutic dose.
And for everyone out there who thinks benzodiazepines are addictive...addiction is defined medically as using more and more drug to get an effect...rarely does this happen to people taking those drugs (xanax, klono, valium) for anxiety. In fact, most people are able to reduce their dose once they gain control of the situation. Xanax is one of the most abused drugs...but not by patients with anxiety. And there are many well documented, well reviewed studies of patients who have used benzos for over 40-50 years now with no adverse effects, and have lived very long healthier lives because they took the meds and went on to lead productive lives. Beats sitting on the sofa with the drapes closed for the rest of your life, IMO.
Secondly, anti-depressants (Paxil, Prozac, Effexor) work in about 30% of the cases in anxiety and the drug companies have to do almost 100 studies each to prove efficacy of those drugs to the FDA for approval to sell them for anxiety. How do I know? I used to work for the companies that make these drugs. They only test for 6-12 weeks and use very vague scales to gauge improvements. So if those drugs aren't working for you consider a benzodiazepine. It is a known fact that benzos stop the symptoms of anxiety and panic 100% of the time. It is what an ER doc would use if you showed up in a panic attack. So why wouldn't you use it as long as you are given the correct dose and proper instructions.
On the other hand...general practitioners (GP's, family practice, ob/gyns, internists) usually have little experience with these drugs and diagnoses, so find a good psychiatrist to do a proper diagnosis and treatment plan. Don't let every shmoo mess with your brain. Most patients also find that there are groups of docs in their areas that do not believe in benzos and will only prescribe anti-depressants, even local psychs. The benzos have been on the market since the 1950's, are no longer patented (= cheap generics available), and don't make any money for the major drug companies...so the drug companies pay sales reps tons of money to market the more expensive anti-depressants. If the AD's work for you, great. If they don't, ask for benzos. You are not a drug seeker, just need plain old relief from something that is known to work 100% of the time.
StawberryHouseMouse...get a good diagnosis and then get a Rx for benzodiazepines. They are dirt cheap.
Walmart charges less than $10 per month.
There is also a theory out there called kindling. The longer you experience symptoms, the more likely your body will feed off the results and you may get worse if not treated.
So, first take control of what you can to make your life better. Get a referral to a good psychiatrist. Do some counseling to see if it helps. Add meds if needed. Try to move outside your comfort zone every day, even if it is just one more foot outside the door. Continue to explore new ideas as they develop in the treatment of anxiety.
Why? Because the pursuit of happiness is a constitutional right.
