Dr. Laura Cestnick

This is something you should talk to your prescribing physician about. What is often a better idea to taking medications all of the time IF the panic attacks are limited, is to determine the "triggers" and take fast acting medications just prior to events or situations that tend to trigger panic. You could discuss the pros/cons of short acting 'sometimes" meds as opposed to "all of the time" meds with your physician. To give you an example, I have many patients who get anxious with social situations specifically so might take something prescribed by their physician or other, in conjunction with CBT, visualization, etc., just prior to events such as gatherings (weddings, work parties, etc.).

CBT, visualization, behavioral techniques, sometimes exposure therapies, and short term medications at times when triggers are likely to happen can help.

Hmmm ...well, I would say "life long" in the sense that it is getting accustomed to a new way of "being" that is healthier to stand the tests of time. Relapse is normal, don't beat yourself up over it (or the person shouldn't) so long as the curve is going upward after relapses you are making progress that should be celebrated. 30 day inpatient programs are not known to work well, 4 month ones work better and statistics show the longer one goes without drinking the better off their long term outcomes are, e.g. no drinking for 5 years seldomly leads to relapsing. Many people with alcoholism have AVOIDANT tendencies which is why they are trying to "drink their problems away." As soon as one realizes that avoidance is harder and hurts more than facing problems, one is on the road to recovery.

The definition of Bipolar Disorder has changed over the years and I'm not sure how helpful the change has been ..let's dial this back a bit. Initially, the definition referred to extreme mania (feeling like "I'm a god ..I can do anything ..I'm invisible") and extreme depression (not being able to get out of bed or function). An example might be someone like Robert Downey Jr (the actor), maybe Robin Williams could fall into that category a bit too? These swings are a problem when they make it very hard to function normally such as doing risky things that can ruin one's life when manic (selling something off, leaving someone abruptly, etc.) or depressed (unable to do one's life). Medications can be used to help reduce the severity of the swings so that a person can function more normally in the world without the negative life consequences that come with such swings. I find that in recent years we have forgotten about this "difference severity" and we have forgotten that the original definition of mania included risky destructive impulsive behaviors. Now, it seems when one has ups and downs people can be quick to think "bipolar". Also, physicians/psychologists use the term for children now as well which I'm not sure I agree with; children present much differently than adults in many instances. At any rate, I guess the bottom line is, if someone has large mood swings of very high and very low that are destructive to life and make it difficult to function, the diagnosis might apply and medications with psych services could be considered.

YES! It depends on the cause of the social anxiety and how it is addressed but the short answer is yes. Many people on the autistic spectrum struggle with social anxiety and it could be related to poor communication skills (verbal or nonverbal), difficulty empathizing or understanding the intentions of others, some may have had traume that leads to social anxiety, some are overstimulated by lights/sounds and they are afraid of reacting in front of others, some are afraid of having physical pain or illness while in a group and having to explain why to leave politiely so they avoid social situation, etc. The cause should be identified first to know how to address it. There is always help with correct diagosis :) Typical treatments might include: improving communication skills, exposure therapies, systematic desensitization, medications, etc.

I made a few short videos on this topic:

https://www.youtube.com/watch?v=BPbpehXhczk
https://www.youtube.com/watch?v=_yKNTE1NHzM

Also, I have free videos at www.drlauriecestnick.com under "Videos for Adults"
search "OCD" in the search bar under the first video that shows up "large' -- there is a program (series of videos) there referred to as RO-DBT to help reduce rigid thinking.

Yes of course. This is a bit of a loaded question, however, not understanding the nature of the anxiety, e.g. trauma related, neurodevelopmental concerns such as sensory issues, Autism, speech problems, social concerns, etc. or other. You will want her to see a neuropsychologist/ psychologist to discuss how long the anxiety has been present and to help determine the nature of the anxiety. There is a lot of help available once the nature of the anxiety is better understood. Rule the above listed things out (there are many potential contributors even PANDAS and other things that a neuropsychologist can rule in/out).