Social Anxiety Medication
There are many ways in which drugs have helped people with mental health issues. I personally know many people who have had a sudden and positive response to a psychoactive or psychotropic medication (a medication that affects the brain).
However, I have known many others who take medications to no avail. If you have done a serious inquiry into the actual peer-reviewed scientific literature on the topic of psychotropic medication, you will find that there is an ongoing dispute about whether psychotropic medications really help enough to justify their frequent use.
It appears that some individuals have unique biochemistry that causes them to respond favorably to certain medications but not others (often within the same class of drugs). I say this because it is the only serious conclusion I’ve been able to come to in my attempt to reconcile the stories of positive outcomes with the meta-analysis studies that indicate that antidepressant medications (like Prozac, Celexa, Welbutrin, Zoloft, Effexor, etc.) have no more effect than placebo. Meta-analysis is a statistical research method in which researchers pool a lot of data from all the studies that fit their research criteria to see if some sort of treatment is having a positive effect when you look at all the data combined. It is possible that these meta-analysis studies are hiding the small, powerful effects of drugs on unique individuals by massing together tons and tons of data (which sort of “averages-out” the effects).
All we can say for sure is that, based on statistical predictions, people are unlikely to have powerful improvements in anxiety or depression by taking the most common class of drugs prescribed for those conditions (the SSRI’s and SNRI’s which are called antidepressants because their effect on anxiety wasn’t noticed until after the effect on depression was noticed).
The honest truth about psychiatric treatments that affect the brain in a physical way (like anti-anxiety medications or anti-depressant medications) is that we don’t know enough about the physical functioning of the brain to be specific in the way we administer drugs. It’s a trial and error process at best, and a harmful process at its worst. That’s why my personal opinion is that people should first use non-drug methods of addressing psychological issues (unless the issues are so severe that the need justifies the risks associated with trial and error medication prescriptions with your physician).
An expert in medication for mental health disorders (a psychiatrist or psychologist with advanced psychopharmacology training) might criticize my statements in this article by pointing to some of the detailed information we have about how the minor tranquilizers work. The minor tranquilizers are medications like Xanax and Ativan, which are different in their mechanism of action when compared to the antidepressants. This class of drugs has a clear impact on the brain that can be seen within about 45 minutes after taking the drugs.
The problem for anxiety sufferers is that these minor tranquilizer medications cause mild, gradual dependence (meaning your brain becomes dependent on them) and some research seems to suggest that people who use cognitive therapy (mind based instead of drug based therapy) have improvements in anxiety that last better when no anti-anxiety drugs are used compared to using both drug treatments and cognitive therapy treatments combined. The hypothesized reason is that people attribute their success to the medication instead of realizing that it is how they manage their thoughts and actions that makes the difference. So when the anxiety begins to resurface at some point in the future, they feel helpless without the medication and they relapse.
Whether or not you use a drug along with mind-based methods of battling anxiety is a personal decision that you should make after consulting with your physicians and psychologist. The important point is that you have options, and you should consider all of your options before you form a plan of attack. The other important point (the one you’ll hear me make over and over again if you read much of my material) is that you never give up on fighting the anxiety. Make a plan. Form your strategy, and attack.
Be Courageous!
Dr. Todd Snyder
