Anxiety relief medicine

SSRI/SNRI antidepressants, benzodiazepine sedatives, and non-benzodiazepine anti-anxiety drugs are all psychiatric prescription drugs and must be used according to the doctor's instructions after evaluating the condition. There is no "universal anti-anxiety drug" that is suitable for all patients, and drugs are only a link in the intervention system for anxiety disorders, not the only solution.

Last week, I accompanied a friend to a psychiatric follow-up visit. I met a college student who had just been diagnosed with panic disorder. He was squatting in the corridor and crying while holding a prescription for Lorazepam prescribed by the doctor. He asked, "Am I going to take the drug for the rest of my life? Will I become a fool?" You see, different people’s understanding of these medicines varies greatly.

Let’s first talk about the most commonly heard benzodiazepines, namely diazepam, alprazolam, and lorazepam, which are typical “emergency drugs.” When you have a panic attack, take one pill and it can suppress your racing heart and breathless suffocation in just ten minutes, like temporarily unplugging a blaring alarm. But the disadvantages are also clear: long-term consumption can easily lead to dependence and drug resistance. Generally speaking, doctors can only prescribe a dosage of 2-4 weeks at most. You must not increase the dosage or extend the taking time without permission. I once met a patient who secretly took alprazolam for half a year. Later, when he was tapering off the medication, he had insomnia all night long. His hands were shaking so much that he couldn't even hold a cup. He suffered a lot.

Nowadays, the first-line clinical drugs are actually SSRI/SNRI. Many people get confused when they see the word "antidepressant" printed on the instructions when they get the drug: "Why are you prescribing depressant drugs for me because I have anxiety?" ”In fact, anxiety and depression are often associated with each other, and their pathogenesis is related to the disorder of neurotransmitters such as 5-hydroxytryptamine and norepinephrine in the brain. These drugs do not temporarily silence the alarm, but slowly calibrate the parameters of the brain's safety system that reports random messages, thereby reducing the frequency of anxiety attacks from the source. But it has a very annoying disadvantage: it takes effect slowly. In the first week or two, you may experience dizziness, nausea, loss of appetite, and even a temporary increase in anxiety symptoms. Many people take it for three days and feel that it is "useless and miserable" and then stop privately. In fact, most of the time, after another week, the effect of the medicine will slowly increase. An Internet operation girl I met before took Sertraline and felt nauseous every morning when she woke up for the first two weeks. She endured it for 10 days. Suddenly, she found that her chest, which had been clenched at the thought of holding a quarterly meeting, suddenly relaxed.

Oh, by the way, the "taking medicine to make you stupid" and "getting fat" that everyone is afraid of are really stereotypes. The side effects of the current new SSRI drugs have been well controlled. Only less than 10% of people will experience weight gain. Most of them are due to the recovery of appetite after their mood improves. As long as they control their diet and take a few more steps, there will be no major problems, and it will not affect their IQ. On the contrary, when an anxiety attack occurs, the mind goes blank and cannot even recite the plan that I have memorized before. That is when I really cannot work and study normally.

There are also non-benzodiazepine anti-anxiety drugs such as buspirone and tandospirone, which are considered "mild". The advantage is that they are completely non-dependent and will not cause drowsiness. They will not make you dizzy after eating and affect meetings at work. They are suitable for long-term use by patients with mild to moderate chronic anxiety and generalized anxiety disorder. But the disadvantage is that it takes effect slowly, and it takes a week or two to be effective. If you really have a panic attack, you can't take it to withstand it, and it won't save you.

Practitioners in different fields do have different opinions on whether to take medication for anxiety, and there is no "absolutely right" answer. Many psychiatrists believe that as long as the anxiety is moderate or above and obvious physical symptoms have appeared (such as long-term insomnia, chest tightness, sudden weight loss, frequent panic attacks), medication should be taken as early as possible to quickly control the symptoms and avoid the condition becoming chronic and difficult to treat. ； However, many psychological counselors from the cognitive behavioral school believe that if you have mild anxiety, you can try CBT treatment and adjust your lifestyle first. You don’t need to take medicine as soon as you start it. After all, medicine cannot change your cognitive model. If you are still used to thinking about the worst when things happen, you will easily relapse after stopping the medicine.

I have seen real cases to support both of these statements: There is a patient who is a middle school teacher. He has mild anxiety and refuses to take medicine. He runs five kilometers a day and has CBT consultation twice a week. His symptoms have been almost cured in three months.； There are also high school students who have already had thoughts of self-harm, but despite half a year of counseling, the problem did not get better. After taking medication, they recovered in two months and were able to return to school normally. Which method to choose depends mainly on the severity of your condition. There is no unified standard answer.

Don’t believe the propaganda about “natural anti-anxiety gummies” and “aromatherapy anti-anxiety essential oils” on the Internet. Those things are at best placebos. If you are really diagnosed with anxiety disorder, you still have to go to a regular hospital for psychiatric evaluation. Don’t mess around and delay the condition.

After all, these anxiety-relieving drugs are never a scourge, nor are they a magic pill that can cure all diseases. It is more like a crutch that someone hands you when you are walking on a dirt road. When you fall and cannot stand up, it can support you for a while. When your legs are strong, you can naturally throw away the crutch and walk on your own.

As for whether you should use this crutch and which kind to use, you need to listen to a professional doctor's judgment. Don't hold it on yourself until your nose is bruised and swollen, and don't hold on to the crutch and refuse to let go, even if you can walk, you dare not move. Oh, by the way, while taking medicine, don’t forget to bask in the sun more and check less in the circle of friends of others who make millions a year. Anxiety is something that can never be completely solved by taking medicine alone, right?