Treatment For Women With Adhd
Women face an additional challenge when treating their ADHD. Hormones! The natural fluctuations of hormones, both monthly and through the different phases of life, can increase ADHD symptoms. However, when you understand what is happening and why, you feel empowered and in a stronger position to seek the best treatment for your ADHD.
Treatment Considerations For Comorbid Anxiety And Depression
Resolving anxiety quickly should be the first goal of treatment in patients with anxiety and depression.61 Once this objective is accomplished, patients are much more likely to remain compliant with their antidepressant regimen and to continue their therapy for the full duration necessary to achieve complete remission of their depression.
One choice for pharmacotherapy in patients with comorbid anxiety and depression is the combination of a BZD or buspirone with an antidepressant. Alternatively, some patients may respond to antidepressant therapy alone, provided a drug that is effective in treating both disorders is used. Because the traditional anxiolytics will have little if any effect on depression, an adequate course of therapy with an antidepressant is imperative.62 On the other hand, in patients treated with an antidepressant plus an anxiolytic, the clinician may consider tapering the anxiolytic slowly, then discontinuing it when the symptoms of acute anxiety have resolved.61 Because of their well-documented withdrawal effects, the BZDs should be tapered gradually over the course of at least several weeks, depending on the dosage and duration of BZD therapy.
Who Needs Medication For Anxiety
Feeling anxious now and then is part of life. It is a component of the bodyâs natural self-defense system and linked closely with the fight or flight response. But there is a difference between feeling anxious prior to performing in front of a crowd, and being afraid to leave your house because you might encounter people outside. Just as there is a difference between jiggling the doorknob once as you leave your home to make sure it is locked, and checking the doorknob two dozen times.
Essentially, anyone who suffers from an anxiety disorder is a potential candidate for anxiety medication. But, just because someone might benefit from anxiety medication, it does not mean they necessarily should take one. They may be served just as effectively by a combination of psychotherapy and exercise. The most important thing is that the decision to use an anxiety medication is arrived at only after careful consultation with your doctor.
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The Emotion Dysregulation Model
The emotion dysregulation model is based on the premise that individuals with GAD experience their emotions more intensely and/or more easily and quickly and have poor understanding of their emotions, negative attitudes about emotions and maladaptive emotional regulation and management strategies. The treatment methods that were developed based on the emotion dysregulation model seeks to improve emotional regulation as a means to improve GAD symptoms. The components include: relaxation exercises reframing of beliefs education about emotions emotion skills training and experiential exposure exercises. An open label study results have demonstrated 66.7% of participants achieved high end state functioning while 81%-95% experienced significant reduction in mood, worry and other GAD symptoms.
Drug Interactions And Overdose
While benzodiazepines are relatively safe when taken only occasionally and in small doses, they can be dangerous and even deadly when combined with other central nervous system depressants. Always talk to your doctor or pharmacist before combining medications.
Dont drink on benzodiazepines. When mixed with alcohol, benzodiazepines can lead to fatal overdose.
Dont mix with painkillers or sleeping pills. Taking benzodiazepines with prescription pain or sleeping pills can also lead to fatal overdose.
Antihistamines amplify their effects. Antihistaminesfound in many over-the-counter sleep, cold, and allergy medicinesare sedating on their own. Be cautious when mixing with benzodiazepines to avoid over-sedation.
Be cautious when combining with antidepressants. SSRIs such as Prozac and Zoloft can heighten benzodiazepine toxicity. You may need to adjust your dose accordingly.
Paradoxical effects of benzodiazepines
The benzodiazepines work because they slow down the nervous system. But sometimes, for reasons that arent well understood, they have the opposite effect. Paradoxical reactions are most common in children, the elderly, and people with developmental disabilities. They include:
- Increased anxiety, irritability, agitation, aggression, and rage
- Mania, impulsive behavior, and hallucinations
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Differential Diagnosis And Comorbidity
When evaluating a patient for a suspected anxiety disorder, it is important to exclude medical conditions with similar presentations . Other psychiatric disorders use of substances such as caffeine, albuterol, levothyroxine, or decongestants or substance withdrawal may also present with similar symptoms and should be ruled out.5
Complicating the diagnosis of GAD and PD is that many conditions in the differential diagnosis are also common comorbidities. Additionally, many patients with GAD or PD meet criteria for other psychiatric disorders, including major depressive disorder and social phobia. Evidence suggests that GAD and PD usually occur with at least one other psychiatric disorder, such as mood, anxiety, or substance use disorders.10 When anxiety disorders occur with other conditions, historic, physical, and laboratory findings may be helpful in distinguishing each diagnosis and developing appropriate treatment plans.
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Medication Isnt Your Only Option For Anxiety Relief
Anxiety medication wont solve your problems if youre anxious because of mounting bills, a tendency to jump to worst-case scenarios, or an unhealthy relationship. Thats where self-help, therapy, and other lifestyle changes come in. These non-drug treatments can produce lasting changes and long-term relief.
Exercise Exercise is a powerful anxiety treatment. Studies show that regular workouts can ease symptoms just as effectively as medication.
Worry busting strategies You can train your brain to stop worrying and look at life from a more calm and balanced perspective.
Therapy Cognitive behavioral therapy can teach you how to control your anxiety levels, stop worrisome thoughts, and conquer your fears.
Yoga and tai chi Yoga and tai chi are mind-body interventions that engage you emotionally, psychologically, and spiritually. Data has shown their efficacy for many different medical conditions, including anxiety.
Mindfulness and meditation Mindfulness is a state of mind where you learn to observe your thoughts, feelings, and behaviors in a present, compassionate, and non-judgmental way. It often brings a sense of calm and relaxation.
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The Acceptance Based Model
The Acceptance based model is based on Hayes model of experiential avoidance and Borkovecs avoidance model, both of which deal with a problematic relationship with internal experiences and experiential avoidance and behavioral restriction. In this model, worry is defined as behavioral and cognitive avoidance of internal experiences. Whereas avoidance reduces short-term distress, it reinforces long-term behavioral restriction. The treatment methods that were developed based on the acceptance model comprises psycho-education about worry, avoidance, the reduction in valued action, how emotions function and how to promote valued actions mindfulness and acceptance exercises along with present moment awareness with the ultimate goal of behavioral change and valued actions. The results of a study demonstrate that 75% show response to treatment, whereas 62.5% of individuals meet end-state high functioning post-treatment.
Questions To Ask Yourself And A Mental Health Professional
- Is medication the best option for my anxiety problem?
- Am I willing to put up with unpleasant side effects in return for anxiety relief?
- What non-drug treatments for anxiety might help?
- Do I have the time and am I willing to pursue non-drug treatments such as cognitive-behavioral therapy?
- What self-help strategies might help me get my anxiety under control?
- If I decide to take anxiety medication, should I pursue other therapy as well?
- Is anxiety really my problem? Or is something else going on, such as an underlying health condition or pain, for example?
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Anxiety And Depression Medication List
The difficulties of modern life often are reflected in the high prevalence of mental health disorders, particularly anxiety disorders and major depressive disorders. The Anxiety and Depression Association of America states that an estimated 40 million adults suffer from one of the eight disorders within the anxiety spectrum. In addition, depression impacts approximately 16 million, about 6.7% of the U.S. adult population.
These statistics translate to a vast number of the American population reliant on psychotropic medications. In fact, one in ten adults now take an antidepressant regularly, with women aged 40-60 taking them at a rate of one in four. While these medications do help manage symptoms for anxiety and depression in about half of the patients prescribed them, the drugs are not effective in reducing symptoms in the remaining 50%. The following is a list of the most popular anxiety and depression medications.
Anxiety and Depression Medications List and their Side Effects
Anxiety. Medications that treat anxiety fall into four categories:
Depression. Medications that treat depression fall into nine categories:
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Taking Adderall For Adhd When You Have Anxiety
Adderall is a popular medication doctors prescribe to treat people with ADHD and narcolepsy. The stimulant, a combination of amphetamine and dextroamphetamine, is taken to elevate or enhance ones mood. The drugs chemical makeup is akin to methamphetamine and MDMA, more commonly known as ecstasy.
When people with ADHD take Adderall in prescribed therapeutic doses, they do so to improve their attention span and ability to concentrate for prolonged periods. People with narcolepsy take it to help them stay awake. Adderall doses can range between 5 mg and 30 mg and be taken once or twice a day.
Because of these effects, Adderall has attracted recreational users, particularly those in high school or college. They abuse the drug to give them more staying power to boost their sports or academic performances.
These reasons are why some refer to the addictive, habit-forming medication as a smart drug or study drug. Adderall also has appealed to people with eating disorders, who use it to curb their appetites.
Side effects of Adderall include elevated blood pressure, headache, appetite loss, weight loss, stomach pain, nervousness, agitation, dry mouth, diarrhea, nausea, and insomnia, among others.
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Do I Have An Anxiety Disorder
Common signs and symptoms of anxiety include nervousness, restlessness or tenseness, a sense of impending danger or doom, increased heart rate, breathing rapidly, sweating, trembling, feeling weak or tired, trouble concentrating or sleeping, stomach aches and headaches and the urge to avoid things that trigger anxiety.
Anxiety disorders often develop from a complex set of risk factors. The risk factors may include exposure to trauma, certain medical problems like thyroid disease or heart disease, stress due to a severe illness and other mental health disorders like depression. The use or misuse of drugs and alcohol can worsen symptoms of anxiety.
Anxiety disorders are best treated with a combination of therapy and medication, Alonzo said. It takes time to find the perfect combination for your symptoms. Your primary care provider is the best place to start that journey.
The Severity Of Side Effects
During a consultation with your doctor, you will be asked whether you experienced any side effects while using antidepressants in the past.
A doctor also strives to select one with the fewest side effects if you take any other medicine with side effects that you cant stand. You may have to try a few before finding the right one.
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Foods That Help Or Hurt Anxiety
There are several types of medications used to treat anxiety disorders.
- Hydroxyzine
- Beta-blockers
Within each of these categories, there are subgroups of drugs that work differently and have their own benefits, risks, and possible side effects.
Theyre supereffective in treating anxiety disorders, says Beth Salcedo, MD, the medical director of the Ross Center for Anxiety & Related Disorders and a past board president of the Anxiety and Depression Association of America. Its not known exactly how SSRIs work on serotonin to alleviate anxiety, says Dr. Salcedo, but what is known is that theyre not addictive like benzodiazepines are .
Its important to follow your doctors instructions when taking any prescription drug. Talk to your doctor if youre concerned about the side effects of a medication, or if the drug youre taking doesn’t seem to be alleviating your symptoms.
Other antidepressants that may be prescribed for anxiety include:
- Wellbutrin, Zyban, Aplenzin, Budeprion, or Buproban
- Tricyclic antidepressants, such as Amitid, Amitril, Elavil, or Endep Aventyl, Pamelor or Tofranil
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Psychotherapy And Relaxation Therapies
Psychotherapy includes many different approaches, such as cognitive behavior therapy and applied relaxation .33,34 CBT may use applied relaxation, exposure therapy, breathing, cognitive restructuring, or education. Psychotherapy is as effective as medication for GAD and PD.11 Although existing evidence is insufficient to draw conclusions about many psychotherapeutic interventions, structured CBT interventions have consistently proven effective for the treatment of anxiety in the primary care setting.3436 Psychotherapy may be used alone or combined with medication as first-line treatment for PD37 and GAD,11 based on patient preference. Psychotherapy should be performed weekly for at least eight weeks to assess its effect.
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Ways To Relieve Anxiety Without Medication
Anxiety is a common struggle, and medication isn’t the only route to finding some relief.
Reviewed by:
Vivian Sun
Dr. Vivian Sun is a child, adolescent, and adult psychiatrist based in the San Francisco Bay Area. She received her medical degree from University of Maryland and psychiatry training at University of Pennsylvania and Stanford. She is board certified in general and child/adolescent psychiatry and specializes in the treatment of conditions such as ADHD, autism, anxiety, depression, bipolar disorder, and PTSD.
Joshua Cox-Steib
Joshua Cox-Steib is a sociologist and freelance writer. He lives in Tulsa, Oklahoma, with his wife and their menagerie of pets. Joshua holds a degree in sociology from the University of Tulsa and worked as a behavioral analyst before becoming a professional writer.
Anxiety is a natural human emotion, but when it gets severe enough to interfere with daily life, it can be debilitating. According to the American Psychiatric Association, roughly 30% of people experience anxiety disorders. This more recent estimate is significantly higher than the 19% reported in the early 2000s by the US National Institute for Mental Health. Thankfully, anxiety is treatable, and there is a wide array of treatment options.
Medications and therapy are two of the most common treatments for anxiety, and they’re highly effective. But there are also natural anxiety remedies like exercise, meditation and breathing exercises that may be able to address your symptoms.
Pharmacotherapy Of The Bipolar Patient With Mixed Anxiety/depression
Frequently a patient with bipolar disorder presenting with mixed anxiety and depression is on an antidepressant. Bipolar disorder can be comorbid with any of the anxiety disorders and is frequently comorbid with substance abuse . Approximately 70% of bipolar disorders are misdiagnosed and if it is not appreciated that a patient has bipolar disorder, the patient will, in all likelihood, remain treatment-resistant. Although controversial, we generally recommend not discontinuing the antidepressant, but rather recommend augmentation of the antidepressant with a medication with mood-stabilizing properties. Bipolar patients are less likely to respond to psychotherapy including CBT, yet psychotherapy is an integral part of stabilization.
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Treating Anxiety And Depression
Treating anxiety comorbid with mood disorders requires an adjustment of pharmacological approaches when compared to treating only anxiety or only depression. We discuss how anxiety disorders may manifest with variations of depression and how we should adapt pharmacotherapy for a range of situations that may be encountered. Conversely, when patients are being treated for bipolar disorder or major depression, anxiety disorders commonly go unnoticed. For instance, data obtained from the first 500 participants in the systematic treatment enhancement program for bipolar disorder indicated that lifetime comorbid anxiety disorders were extremely common, occurring in over one-half of the sample. Bipolar disorder comorbid with anxiety disorders was associated with younger age at onset, decreased likelihood of recovery, poorer quality of life, less time euthymic, and greater likelihood of suicide attempts. In one study, panic disorder occurred at higher rates in patients with bipolar compared to unipolar mood depression. Similarly, in cross-national epidemiological surveys, patients with major were shown to be at increased risk for comorbidity with substance abuse and anxiety disorders at all sites.
What About Prescription Medication And Treatments For Anxiety And Depression
More info on this topic
According to Henry Emmons in his book TheChemistry of Joy, you should consider taking medications if you have any of the following symptoms:
- Severe depression that makes it hard to function in daily life or is accompanied by suicidal or self-destructive thoughts
- Moderate depression that has not improved within three to four weeks of trying natural therapies
- Mild depression that has not improved within six to eight weeks of trying natural therapies
- A severe sleep disturbance that does not improve with natural therapies
- Repeated episodes of depressions, especially if they occur without any particular trigger
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If You Feel Better Can You Stop Taking Antidepressants
Once you and your provider have determined it is safe for you to stop taking your medicine altogether, you should continue to be monitored during periodic follow-up appointments to detect any signs of depression returning.
Long-term treatment with antidepressant medicine may be recommended to prevent further episodes of depression in people who have already had two or more episodes of major depression. A history of depression in ones family is another factor that supports long-term treatment.
Last reviewed by a Cleveland Clinic medical professional on 05/24/2019.
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