Marriage and Family Therapist
Cyndi Sarnoff-Ross is a licensed psychotherapist with almost twenty years of clinical experience in the fields of clinical psychology and organizational management. She has worked extensively with a wide variety of…
What type of doctor should I see about my severe stress and anxiety issues?
Posted in Stress Manageme... by Cyndi Sarnoff-Ross on Dec 22, 2009
"Dear Cyndi,

I am having some trouble with stress and anxiety and I feel I am at the point that I would like to get some medical advice or help controlling it or dealing with it so that i can get my life back. I feel that the stress and anxiety is controlling me and the way I think.

Should I start with my primary care doctor first? I really don't want to be dependent on medications to keep me stress free and calm, I'd rather find other ways to calm myself down. I mean, if I am having a bad anxiety attack and I need to calm it down and medication is the only way then fine. I just don't want to have take the medication everyday."

Your primary doctor is a good place to start by asking him or her for a referral to a therapist. Unfortunately many primary doctors respond to a patient’s complaints of depression and or anxiety by doling out medication. I have had many patients come into see me for the first time and tell me they are on some type of anti-anxiety or antidepressant medication but they have never been to see a psychiatrist. This is problematic for many reasons. First of all the issues that may be causing the emotional distress are not dealt with and are likely to increase in severity. If they are time limited circumstantial issues (ie. A divorce or bereavement) then medication can be helpful but learning coping skills to manage stress, along with meds, is a much better solution. Secondly, many primary doctors will write the prescription, allow for renewals and not monitor the patient’s progress or side effects. This is obviously concerning.

In terms of what kind of doctor you should see, you have a few choices. You can see a marriage and family therapist, a social worker, a psychologist or a psychiatrist. All of these individuals should be qualified to diagnose anxiety and depression and, other than the psychiatrist who is an MD, all of the other professionals will make an appropriate referral to a psychiatrist if it is determined that medication is a consideration.

Lastly, with regard to your concern about taking medication on a daily basis you will need to discuss the issue with your doctor. Most medications used to treat mental health issues need to be taken on a daily basis in order to be effective. There are some anti-anxiety medications that can be taken PRN (as needed) but a medical doctor would need to determine if those would be warranted in your case.

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ahoymatey83 - The titles of our articles are not always posted by the writers here and we are having trouble with the edit feature on this site so unfortunately things get published incorrectly and we are unable to edit it (as we were in the past). It looks like it has been edited since you made this comment. You may want to work on your style of feedback because, while you may have good advice or information, it may not get heard because of your delivery. Just a little feedback for you.
By CSR  Dec 25, 2009
"I have had many patients come into see me for the first time and tell me they are on some type of anti-anxiety or antidepressant medication but they have never been to see a psychiatrist. This is problematic for many reasons."

Indeed .. and I consider this malpractice by the prescribing doctor.
By WanderingVet  Dec 23, 2009
Hi! If you consider yourself a professional, you should proof read your article before it's posted. In the title, the word issues is not plural and does not need an apostrophe. Thank you.
By ahoymatey83  Dec 20, 2009
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