Dr. Diane Bridgeman

It is important that you are inquiring regarding what is the best medicine for an anxiety disorder. There are several types of anxiety disorders for example, developmental/from childhood experiences, your current life situation, psychological and other issues such as panic disorder, and genetic. Your therapist will help you evaluate which area might represent your issue and then discuss if medication is appropriate, and if so which one. Typically, and depending on causation if a medication is appropriate it may well be an SSRI such as Lexapro, Prozac, Zoloft, Paxil or Celexa. It is important you follow your doctors instruction on how and when to take it. It takes awhile before you notice an effect. First, however depending on the type of anxiety disorder and possible causation, just talking about the triggering factors, and related concerns can help one better deal with the anxiety. Also, checking on your sleep patterns, exercise, social connections, work or family stress are all important areas to explore with your therapist and sometimes medications are not needed, or the combination of therapy and meds work very well for many people. Often practicing good self-care, use of meditation or journaling, and time with friends can all support good mental health. My best to you,

Diane Bridgeman, Ph.D.
Licensed Clinical Psychologist
Past president and current chair of MBPA's Social Justice/diversity committee
Past chair of APA’s ACCA committee
(831) 420-1109
dianebridgeman@mac.com

In general you do not have to be concerned about psychotherapy being harmful. The best ways to assure that it is appropriate is to work with a specific psychotherapist is to find someone who is a licensed therapist, such as a PhD psychologist, or LMFT, LCSW - with all being licensed and given your concern, one with some experience will be very helpful. Often your family doctor may be able to refer you to a licensed experienced therapist, or perhaps through a community counseling center referal. It is important to look at why you feel it might be harmful for you. Talking with your family doctor about this concern would be appropriate. Proud of you for checking into these feelings and wishing you much success with this effort.

Diane Bridgeman, Ph.D.
Licensed Clinical Psychologist
Past president and current chair of MBPA's Social Justice/diversity committee
Past chair of APA’s ACCA committee
(831) 420-1109
dianebridgeman@mac.com

Sorry to learn about your aunt. It can be part of the bereavement process to sleep as a way to cope with the loss. She would benefit from talking with a therapist or attending a bereavement group. She needs understanding, support, and ways to gently tell her she deserves to take care of herself and her son would want her to do so. Start out with a few minutes in another room, and then sitting outside and being in nature when she's ready. I wonder about the Covid piece, might she have long Covid, need for much rest, much fatigue, need to pace one's activity, can all be symptoms, have her talk with her doctor about the possibility of long Covid, often most tests come back normal, yet the inflammation can cause chronic fatigue like symptoms and checking with her doctor would be wise in any regard. Important you are checking on her and my best to you. Dr. Bridgeman

Yes, it is not unusual for one to experience anxious thoughts when in therapy given the nature of the process, yet when these feelings come up, talking with the therapist is very helpful and together you can assess why at specific times, or on specific issues you might feel more anxious. It may help for you to note when you feel your anxious feelings and see if there is a pattern as to time of day, level of sleep, around certain interactions, etc. The therapist will help you process the patterns you note and will probably recommend, healthy sleep habits, regular exercise, time in nature and with friends, meditation apps, etc. Overall therapy may elicit some anxiety while overall it will help you recognize, identify and deal with anxiety and generally feel better overall. Dr. Bridgeman

Thanks for your inquiry. It depends on the factor or factors that may be contributing to the anxious feelings. It would help if you could do a simple noting of when you feel most anxious, you might see a pattern that can help assess the timing, possible similar situations, how relates to quality and quantity of sleep, certain interactions, etc. Talking with a therapist can be very helpful and they can work with you to determine possible type and factors for the anxiety and they are in a position to asses whether an antidepressant/anxiety type medication may be helpful and perhaps they have a physician to refer you to for a prescription, or you can contact your family doctor. You might try, setting a time to think about your anxiety or other concerns and then try not to think about them at most other times, use medication apps, regular exercise, time in nature, walks, and time with friends as social connections are very important to our well being. Take care

It is very common for young people who start dating to feel anxiety around it. I am sorry you are experiencing these trying feelings. We are putting ourselves out there to be accepted, or not, and that naturally prompts anxious feelings. Often establishing a friendship first can help you assess whether this person might be appropriate to date or to just maintain as a friend which in itself can be very rewarding. First knowing your hurt feelings are understandable and "normal" may help you feel less anxious. Try also using regular relaxation apps such as Calm and Headspace on a regular basis and then if something anxiety provoking happens you will be more grounded, centered and better able to cope with it. How a relationship ends can also inform how people feel about it ending. If it is done with thoughtfulness and respect it can be much easier to accept. Also taking care of yourself with reasonable sleep, eating, exercise, time with others, in nature, etc can all contribute to feeling better to begin with, please take care.
Best, Diane Bridgeman, Ph.D.

Since reasonable sleep is at the heart of healthy psychological and physiological health it is important you access support around the issue of insomnia, which is unfortunately a common problem.
There are many reasons for insomnia, so depending on what might be contributing to it for your situation will inform how long it might take for CBT to help lessen the problem. It also depends on how long the insomnia has been in place and other important factors in your life. If one would be able to generalize we could say perhaps 6-8 sessions or less. Wise of you to seek support and the wishing you much success. Best, Diane Bridgeman, Ph.D.

Professionally it is stated that one generally should have 5 depression symptoms most days for at least 2 weeks including a depressed mood, or loss of interest or pleasure in most activities, of course this can vary. It is important to explore any possible variable that could elicit the changes in your mood. Yes, psychotherapy can help you with this process and discuss strategies for coping with the feelings you are experiencing. You can also write down or journal your thoughts to help you see any patterns and to try to let go of negative thoughts if you are experiencing them and this can also be shared in therapy as well. Sending you good wishes in this process. Diane Bridgeman, Ph.D,

The type of therapy for panic attacks varies and often depends on knowing more specifics about the panic feelings. You might make note of what seems to trigger your panicky feelings and use relaxing, grounding meditations (see the many apps to help with this) before or during those times. Often cognitive behavioral therapy is found helpful, as is anxiety focused psychodynamic psychotherapy, while primarily it is the level of therapeutic alliance that is developed between you and the therapist that bring about the most success. Good that you are wanting to reach out. It can take talking with, or seeing a few therapists to see which one would offer the best connection for you. Unfortunately, it is often currently difficult to find therapists that have openings, don't give up and check with your family doctor and/or your medical mental health insurance. Good luck to you. Diane Bridgeman, Ph.D.

Reply to a person with a question regarding vertigo when taking Sertraline - you have provided thoughtful information regarding the history of any precious vertigo. Given the only other vertigo was when on Sertraline previously it may well be the case that it is the contributing factor. The key question did previous vertigo go away after a few weeks? If so that may be the case this time. It is known that Sertraline and other SSRI antidepressants may cause dizziness, it should subside after being on it for a while, again did it last time? You should definitely check with your prescribing doctor. There is a possibility that starting with a lower dosage and gradually titrating the amount until the desired dosage might be helpful. This is something your doctor can review with you. Perhaps a different antidepressant would be appropriate yet again your doctor will need to go over this with you. You provide helpful facts and in talking with your doctor this should be able to be rectified. Take care!

Therapy is always absolutely confidential information. There are a few limits to the confidentiality agreement with respect to the exception for a clients' well-being, and if one is a danger to oneself or others. You should definitely talk with your therapist to review these official policies. The heart of therapy is built on trust, and a well developed therapeutic alliance so you want to be fully comfortable and assured so you can share whatever is helpful to you. Important that you clarify these feelings and much success to you in your therapy.

Perhaps you haven't fully dealt with the grief from your mother's passing.
Talking with a therapist around this issue may be helpful or even attending a Hospice grief group. In working with a therapist it would be helpful to that person (& to you), if you can identify what patterns emerge around specific types of anxieties and what may trigger them. Looking at changes before and then after your mother's passing in your behaviors, thoughts, routines, might provide some clues. It might be helpful to remember that many people have deep feelings around a major loss, so that you might look at this as a normal reaction that is deserving of fully processing.
Do you take time for regular self-care? Does the anxiety affect your sleep?
Do you try to find reasonable life/work balance? These are points you might want to discuss with a therapist. You might consider mindfulness based meditation, positive visual imagery, regular exercise, eating healthy, and finding regular moments of joy and purpose. You can also visit online the U.C. Berkeley Greater Good Science Center for many helpful articles, videos, classes on positive psychology and related concepts around reducing anxiety.
Good luck to you and your reaching out is an excellent start.