Lisa E. Goldman

It’s when your life sucks. Whether you married an abusive or neglectful person, work for an evil boss or hang around with friends who hurt your feelings, the treatment for situational depression is to change things that can be changed. I like the Serenity Prayer from Alcoholics Anonymous which states, “Lord, Give me the Serenity to accept the things I cannot change, the Courage to change the things I can, and the Wisdom to know the difference”. Psychotherapy (counseling or talk therapy) May be able to help you sort out what type of situational stressors you face, changeable ones (bad job- look for a different job) or not changeable ones (caring for parents who have a terminal illness- your bad luck will change after they die and instead of caregiver burn-out, you will be dealing with grief until this resolved over time). Sometimes an antidepressant such as Prozac, Paxil or Zoloft May help with depressive symptoms such as low energy, poor self esteem, messed up sleep or changes in appetite. For these medications, seeing a primary care doctor or psychiatrist may help. There are no pills however that can fix a bad marriage or an evil job. For these things, refer to the Serenity Prayer, which applies equally well to alcoholics and not-alcoholics alike.

Not a good idea to switch from one to the other suddenly as they are similar but not the same medication. Don’t ever switch medications without speaking first with your healthcare provider. Your doctor or Nurse Practitioner has gone to school for many years to become specifically trained in their field. You would not get your car fixed at a dentist’s office, nor would you get teeth pulled at the mechanic’s shop. Please do not make changes in your medications without talking to your doctor first.

You should be seen by a physician. Searching for answers on a social media platform will get you all kinds of crazy advice. Go see your doctor. That’s what they are for. No home remedies are going to fix this problem, you need an actual doctor. It’s not an easy or simple problem. If it were, the grocery clerk could have told you what to do about it.

Doctors may prescribe benzodiazepines such as Xanax or Valium. If they do, run away and get a different doctor, one who reads the medical journals and knows that long term use of these medications leads to worsened anxiety symptoms AND a dependency (addiction) to these medicines. Or you may wish to go to a liquor store or a bar and purchase alcohol. Overall, benzodiazepines work on your brain in a similar fashion. Both are effective for reducing anxiety in the short run (minutes) and over a long term (months) cause addiction and a host of other psychological and medical problems.

To treat anxiety in a non-harmful way, studies show that getting regular exercise, quitting a toxic job, leaving an abusive spouse and thinking positive thoughts are truly helpful. Medications that are first line to treat anxiety and are not known for causing harm in 9 out of ten people are the SSRI’s such as Prozac or Paxil. These, combined with psychotherapy (talking to a counselor, social worker or psychologist on a regular basis about personal problems that are upsetting or too private to discuss with coworkers or family members) are proven to be first choice treatment for anxiety disorders. A primary care doctor can recommend a therapist for you and can prescribe medications for you. Be careful however if you have a personal or family history of bipolar disorder because the antidepressants in the SSRI family (Paxil, Prozac, Zoloft etc) can trigger an episode of mania for persons who have underlying bipolar disorder. If that happens, or if you don’t get relief from a combination of an SSRI plus counseling and or Yoga, then you need to see a psychiatrist. Just like I tell people to not get their teeth pulled by an auto mechanic, don’t try to pull your own teeth. See your doctor. If it’s too tough for your family doctor to treat, ask for a psychiatrist.

Whatever you do, RUN AWAY from doctors who try to prescribe Xanax, Clonazepam or Valium for anxiety. They are not keeping up with the medical literature and you would be better off drinking beer or wine because it’s nearly as effective, only slightly more habit forming, booze is cheaper than Xanax, and easier to get refills.