Dr. Jacqueline Gerhart: Anxiety Medication Useful, Although It May Have Side Effects
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Dr. Gerhart: I'm in college, and I was started on an SSRI for panic attacks and anxiety. When I went to the pharmacy to pick it up, the pharmacist said it's used for depression and can cause me to be suicidal. I don't want to take it. Is there something else I should try?
Dear Reader: SSRI medications may be termed "antidepressants," but they are often used for generalized anxiety, panic disorder, obsessive compulsive disorder and occasionally eating disorders. SSRI stands for selective serotonin reuptake inhibitor. It works by allowing one of your brain's natural chemicals, serotonin — to stay around in your brain longer, letting you to reap its mood-stabilization properties. SSRI medications are the most common medications used for depression. Since more than 20 million people in the U.S. are diagnosed with depression, this means they are used very frequently.
Depending on the severity of your anxiety and panic attacks, SSRI medications may be helpful. Recently, there seems to be more evidence for using SSRIs for anxiety than for depression. For many people, the best treatment for anxiety seems to be a multimodal treatment plan including a combination of medication, psychotherapy, physical activity and "mindfulness" training such as meditation or yoga. One effective type of therapy for anxiety is called cognitive behavioral therapy or CBT. This is usually done one-on-one with a counselor or therapist.
Unfortunately, most medications used for anxiety - including SSRI medications - have side effects. Some people actually notice increased anxiety, which usually goes away after the first week. Others notice sleep changes, either somnolence (drowsiness) or insomnia. Nausea, and sexual side effects also are common.
There are only certain medications recommended for teens with anxiety and depression, and diagnosis in these age groups is often more difficult. On some antidepressant medications, there is a warning against prescribing them to adolescents due to increased risk of suicidal thoughts. Although this is rare, you should contact your physician if such thoughts arise.
Also, remember that nearly all college students experience depression or anxiety at some point. Some common anxiety-prone situations include leaving home, concern about classes, dealing with peer pressure, managing money, forming relationships and coping with decreased contact with family. Your mental health can also be affected by hormonal changes, environmental changes and nutrition or health changes.
The key is to recognize the response you are having to each situation, and to evaluate whether it is a healthy or unhealthy response. Unfortunately, most people with depression and anxiety first notice it between the ages of 15 and 30, making college a prime time to stay aware of your mental health and to seek help if you, your family members, or your friends feel you may need it.
If you notice a change in your mood, or if you are feeling palpitations, chest pains or shortness of breath, consider seeing your primary care provider to discuss your symptoms. You may have an anxiety or panic disorder, or you may have a different medical problem, such as low blood sugar, a thyroid problem, or a heart or lung condition such as asthma or an abnormal hearth rhythm. Also, if you are concerned about the medications your provider has recommended, be sure to discuss this with him or her. It is important for your provider to know if you are taking your medications as prescribed and if you are experiencing side effects.
In addition, be sure to eat healthy and continue to exercise, two things that often are neglected when you leave home-cooked meals and high school sports practices behind. This will go a long way to balancing your mood and your well-being. Good luck with your classes and remember to take time for yourself!
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 02/21/2012