Psychiatrist | Psychiatry Questions Psychiatrist

Need a way to manage my anxiety but my history is making it hard on the doctors?

I've been diagnosed with GAD, panic disorder as well as others like major depressive disorder, borderline personality disorder, etc. I've been on every SSRI, antipsychotic, anti-anxiety medication you can imagine. I'm having trouble now because the psychiatrist I see knows my history of addiction. I had a problem with opiates, mainly H, but nothing else. I have a year clean under my belt and I'm on a methadone maintenance program. My dose is 160 but it's not even holding me completely. The doctor knows this but the only medication that helps with my anxiety is Klonopin. Since it's a benzo and I have history, it looks bad. My doctor wants me to lower my dose asap which I can't, and the anxiety of him dropping me as a client is not helping. I've seen other doctors and they would rather run me through the gauntlet again of every medication I've tried 10x only to tell me that they won't prescribe anything controlled and I've run out of medications to try. I know what helps, at least until an anti-depressant works to help my anxiety too (and that can take months). There's no worse feeling than not being able to breathe and feeling like your chest is being crushed. I guess the question is what can I do if all the doctors I see use my history against me? Its been 10+ years of this and it's only gotten worse.

Male | 25 years old
Complaint duration: At least the last 5 years
Medications: Klonopin, Methadone, Zoloft
Conditions: Depression, GAD, panic disorder, borderline personality disorder

6 Answers

Psychiatrist|PsychiatryPsychiatrist
Hi, You have a very complicated history and set of diagnoses. Are you seeing a psychologist? I would recommend that you do.. a psychologist may be able to give you some strategies to manage your symptoms that do not include increasing drugs youre taking. I hope this helps. Kind Regards Brooke E Hillary ph.D. Licensed Clinical Psychologist Www.drbrookehillary.com HTTPSdoxymedrbrookehillary
Hello So first, Benzodiazepines like Klonopin work by enhancing the effects of the neurotransmitter GABA, which helps calm the brain and reduce feelings of anxiety. Medication can certainly help reduce symptoms, but it does not fix the underlying issues and is a poor longer term solution for many people. While Klonopin is not an opoiod, it is a highly addictive class IV benzodiazepine. And addiction is only one risk. According to studies, over time people can develop other health issues with benzodiazepine use Autoimmune Hashimotos Disease, Lupus, Lyme Disease, Rheumatoid arthritis Cardiovascular Hypertension or Hypotension, Postural Orthostatic Tachycardia Syndrome POTS, Tachycardia Dental Dental Caries, Dry Mouth, Tooth Pain Endocrine Cushings Disease, Hypoglycemia, Hyperthyroidism, Hypothyroidism, Insulin Resistance Gastrointestinal Acid Reflux, Gastritis, Irritable Bowel Syndrome Genetic EhlersDanlos Immunologic Cancer, Hashimotos disease, Interstitial Cystitis, Mast Cell Activation Syndrome MCAS, Recurrent infections Neurologic Amyotrophic lateral sclerosis ALS, Confusion, Fibromyalgia, Migraines, Multiple Sclerosis, Muscle Weakness, Myalgic Encephalomyelitis Chronic Fatigue Syndrome, Neuralgia, Neuropathy, Numbness, StiffPerson Syndrome, Stroke, Tinnitus, Vertigo Optical Blurred Vision, Dry Eyes Psychiatric Bipolar Disorder, Borderline Personality Disorder, Conversion Disorder, Catatonia, Depression, Dementia, Dissociative Disorders, Generalized Anxiety Disorder, Insomnia, Mania, Obsessive Compulsive Disorder, Panic Disorder with or without Agoraphobia, Paranoia, Psychosis, PTSD, Self Harm, Somatoform Disorder Reproductive Erectile Dysfunction, Infertility, Irregular Menstruation, Polycystic Ovarian Syndrome Focusing on managing anxiety symptoms is a way to have relief without potential for negative medication side effects. I suggest you explore treatment modalities like CBT and hypnotherapy to learn and practice ways to manage the physical and cognitive symptoms of anxiety. In particular, relaxation techniques retrain you to reduce tension and quiet worries. It is not an instant fix, but it gives you tools to change your thoughts and feelings, and the benefits are both positive and enduring. It can be an incredibly powerful way to take control of your physical, emotional, and mental health.
Panic attacks are tricky. Though many individuals with panic attacks experience immediate relief from panic with Klonopin or related medications, even for individuals without a history of addiction, typically, it is not an enduring solution. The potential for tolerance is high regardless of addiction history, which can lead to diminishing effectiveness for panic attacks. The gold standard for panic attacks is a behavioral therapy involving both interoceptive and invivo exposure therapy. For panic attacks, it may be helpful to seek out a therapist who is experienced with that treatment approach.
Dear Sir,

Sorry to hear that you have a complicated history of multiple diagnoses. Have you learned progressive muscle relaxation? Or considered hypnotherapy to manage your anxieties, panic attacks, and depression? You may want to read "Feeling Good" by Dr. David Burns and "Anxiety and Phobia Workbook" by Edmund J. Bourne while you search for a licensed professional in your area. There are many free guided relaxation and meditation available online. 
Take care and be safe.

Dr. Lata Sonpal
You might want to consider a systems approach to your anxiety issues and work an integrated team of psychologist//psychiatrist/nutritionist. There is an excellent self-help workbook you should get called Anxiety and Phobia Workbook by Bourne 7th edition. Just using medication is not the answer.
From what you have shared, it sounds like your difficulties have only been addressed with medication. In my experience, that is at best a partial answer to the kinds of problems that have had the greatest influence on your life. If I were you, I would try to find an experienced therapist who could help you gain greater influence over the issues confronting your life. Again, in my experience, such issues are not "brain diseases" they are challenges in living that include relationships, meaningful work, safety.