Psychiatry & Psychology--General/fear anxiety.


QUESTION: Hello,  I'm not sure how to start,  I had hoped to be brief, but it doesn't look like that will be possible .  I've always had a phobia to medical things doctors etc.  I fractured my wrist 2 mos. ago, the orthopedist recommended surgery...for some reason I accepted it went through it, with little anxiety, which to me was strange because of the phobia I have. This is  due to 2 bad experiences with doctors, and now I can't seem to go back to them.  I had a slight stomach bug which was mild.  But it started it all up again.  I had no vomiting but loose movements not really diarrhea.  (not something I like to talk about).  I have anxiety now, and fear if this keeps up I'll have to have tests,  the word tests terrifies me.  part of me says it's OK other part of me says something serious ...I'd like to make something clear, I don't fear death it's how I die.  I've seen a lot of suffering of people I know, and they had little help from medical people, and I think this is what's going to happen to me.  these thoughts lead to depression.  

I think my anxiety causes a lot of the symptoms that I have so it's a vicious circle. Does anxiety cause things like what I described????? I have a husband who had a stroke that adds to the stress. Although I don't think he's the cause. those type of things I can handle.   It's mild symptoms that put me back into the anxiety.   Is there any hope for people like me.  some days I can barely go on. every day I think will today bring on something that will cause anxiety. I sometimes think if  I eat  will that cause a symptom.  I wish I had answers.  I know you're going to say get to a doctor or psychologist, but I had hoped you would help me be hopeful.  thank you.

ANSWER: You can continue to suffer or you can do something about breaking the circle. And people like you are hardly rare -- anxiety and depression are the most common mental problems.

To start with your simplest concern, you can discuss with a lawyer how to ensure that when the time comes you will not be subjected to any medical or other treatment that is likely to cause or increase suffering. Lots of people (including me) do that, and it has nothing to do with unreasonable fears or psychiatric conditions.

As for your mental state, the most effective treatment for what you describe is twofold: psychotherapy and medication.

Therapy can be provided by a psychiatrist or a clinical psychologist. I don't know if you consider a psychiatrist to be a "doctor" (although s/he is one) since you won't be examined but merely interviewed, likely in a single visit, and possibly prescribed an anti-anxiety medication.

A psychologist would be more accessible and cheaper for repeated visits, and might be the logical place to start. You could discuss with her how to deal with your doctor distaste, and in some jurisdictions (I don't know yours) psychologists can prescribe these pharmaceuticals.

Psychotherapy doesn't require opening up your brain, Jan. You just get guided in defining what the problem is, what parts of it are likely subject to improvement, and how best to go about making things somewhat better.

Please let me know if any questions arise from my comments. Meanwhile, thanks for asking us, and the best of luck in getting your concerns resolved.


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QUESTION: I'm writing back to thank you for your info. and I'm sure you are being kind.  as I said I was sure you were going to mention getting therapy...Yes I know a psychiatrist is a doctor and where I am psychologists can prescribe medication, but only if they are nurses.  whether male or female. I guess somehow I'll try to do this, but right now not sure I can.  I'm filled with anxiety and now I'm thinking  calm down what will be will be. But hard to keep those thoughts.  something will happen something very benign and it will start all over again.  Maybe I do have an illness.  And hopefully it will manifest itself and I can be done  with all this anxiety.  Thanks again appreciate your help

You're most welcome, and thanks for the ratings.

"Getting therapy" in the original sense is actually not practical. Modern psychotherapy should be termed "guided problem-solving" and is generally helpful for people with your problems. I doubt you are "ill" but you have learned how to respond maladaptively, and with the help of someone trained to do so, you can learn more constructive, healthy, and comfortable thoughts, interpretations, and responses.

Psychology and nursing are quite separate. In many places, specialized nurses (often called Nurse Practitioners) can prescribe certain drugs, and in a few states qualified psychologists can prescribe many psychoactive medications. But your best bet for the best drug would be a psychiatrist. That's what they do.

I'm not saying you should commit to extensive, prolonged, old-fashioned psychotherapy. I am saying that if you fail to look for a behavior-therapy-oriented clinical psychologist and just give it a try, then a year from now you will write essentially the same letter to another helper-at-a-distance.


Psychiatry & Psychology--General

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Alan Auerbach


Taught psychology for 30 years, authored four textbooks. Specialize in introductory and industrial/organizational psychology, but will tackle wider range of areas.

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