Hello doctor,About every three years or so, I experience what I call an 'episode' where anxiety comes over me very quickly and I focus and worry about an issue that normally would not bother me. It takes over my mind so that it is all I can think about for weeks. This leads to instant insomnia and loss of appetite. I have been diagnosed with OCD. I describe this as an 'OCD of my thoughts', not physical actions like checking locks, straightening up, etc. I have been taking Zoloft (Sertraline) for the past 19 years. Most of these 19 years, I have been taking 100 mg. This drug has worked well for me with little side effects. Two years ago I reduced it to 50 mg. Then, recently I stopped taking it completely. This lasted for about seven weeks and then I had a change at work which caused anxiety to hit me like a ton of bricks. So, I started taking 100 mg for four days and then increased to 150 mg quickly. I have been taking this along with Xanax for the past five weeks. The difference between this episode and the past episodes is that I constantly feel an increased heart rate and shakiness for no real reason. I cannot relax and go about my day normally. And I feel the need to take Xanax every day. I have read that taking Zoloft can actually cause anxiety. My doctor says that anxiety from medication feels different from anxiety caused by an actual situation. He also is alright with me increasing my dosage to 200 mg, but I am fearful that it will cause more anxiety. I am wondering if I actually need to reduce my dosage to 100 mg. Please reply back with facts, and not information that may make me worry more. Thank you.
Hello, Welcome to ciliniq.com. I can understand you well. But, I ask you not to worry as many of my patients who went through anxiety disorder have recovered completely thanks to psychotherapy. Anxiety disorders are a category of mental disorders characterized by feelings of anxiety and fear, where anxiety is a worry about future events and fear is a reaction to current events. These feelings may cause physical symptoms, such as a racing of the heart and shakiness. There are a number of anxiety disorders including generalized anxiety disorder, a specific phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, and panic disorder among others. While each has its own characteristics and symptoms, they all include symptoms of anxiety. Anxiety medicines alone cannot cure anxiety disorders mainly because medicines do not alter behavior. Behavior change and continuous practice of the changed behavior cure anxiety. I suggest anxiety education, progressive counseling and progressive psychotherapy. I assure you complete cure. I need to know more about your anxiety so that I will be able to diagnose it properly and provide you tips to overcome and manage your anxiety. Obsessive-compulsive disorder (OCD) is a common mental health problem. Symptoms typically include recurring thoughts and repetitive actions in response to the recurring thoughts. A common example is recurring thoughts about germs and dirt, with a need to wash your hands repeatedly to clean off the germs. However, there are many other examples like sexual thoughts, counting, checking, orderliness, etc. The usual treatments are cognitive behavioral therapy (CBT), a selective serotonin reuptake inhibitor (SSRI) antidepressant medicine, or both. Treatment often works well to reduce the symptoms and distress of OCD greatly. Take care. For more information consult a psychiatrist online -->