Q. I have an appointment with my doctor to discuss medication for anxiety and depression. I get really nervous, and forget to ask questions. Can you tell me what I need to ask?
A. Everyone who is prescribed a new medication should have a list of questions to ask the doctor. According to the National Institute for Mental Health, the following questions should be asked any time a new psychotropic drug (those that treat psychological disorders) is prescribed:
• What is the name of the medication? Be certain that you understand the name. I know someone who was prescribed Restoril for sleep, and was given Risperdal (an anti-psychotic) by mistake at the pharmacy.
• What is the medication supposed to do? Is it for anxiety or depression or will it treat both?
• What are the possible side effects? Ask about the sexual side effects of anti-depressants. Not everyone has these issues, but some people do.
• When should I take it? This is important to ask since some psychotropic medications can be sedating.
• How long will it take to be effective? Since many antidepressant medications can take weeks to reach effectiveness, be certain that you understand that you will not experience immediate relief. Remember they are not “happy pills.”
• Will it interact with any other medications? Be certain that the doctor is fully aware of all prescription and non-prescription drugs you take. This includes vitamins and supplements.
• Do I take the medication with or without food? Some medications can cause nausea if taken on an empty stomach. Others need to be taken before a meal.
• Is it safe to drink alcohol with the medication? Be honest with your doctor about your drinking since there can be serious problems combining alcohol and some psychotropic drugs
Understanding what you are prescribed, why it was given to you, and how to take it are essential to your well-being. Never be afraid to ask.
Q. My sister says she has social anxiety, but I think it’s just an excuse to get out of things she doesn’t want to do. What are the symptoms of “social anxiety?”
A. Social anxiety is more than just becoming nervous when one has to give a speech or meet strangers.
According to Helpguide.org, “underlying social phobia is the fear of being scrutinized, judged, or embarrassed in public.” The fear can be so intense that one may avoid any situation in which judgment could be passed. Notice your sister probably has few problems talking with family or close friends, but cannot be persuaded to go somewhere where she must make small talk with strangers.
People with extreme social phobia have difficulty with activities that most people do with little thought. These can include making a phone call, eating or drinking in front of strangers or even using public bathrooms.
Most people with social phobia believe they are “mind readers.” They assume that everyone will have a negative reaction to them, so they are convinced of the worst before leaving home. When they get to an event, they have already decided that the evening will be a disaster, so it usually is.
There are many avenues that your sister can take to overcome her social anxiety. She can speak with her physician about giving her a beta blocker, an antidepressant (such as Paxil or Zoloft) or a benzodiazepine (such as Xanax, Klonopin or Ativan). If she does not want to take medication, she can schedule an appointment with a cognitive-behavior therapist (CBT) who will teach her relaxation techniques and ways to challenge her dysfunctional thinking.
If she does not want medication or psychotherapy, there are books about social phobia that will provide useful information. In larger towns or cities, there are also social anxiety groups that most people find helpful.
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Nancy Ryburn holds a doctorate degree in psychology from Yeshiva University in New York City. She currently teaches psychology at Southeast Arkansas College. If you have questions, e-mail them to firstname.lastname@example.org. They will not be answered personally, but could appear in a future column. There will be no identifying information and all e-mails remain confidential.