Author of The Kitchen Shrink
Dear Dr. Dora,
Last weekend, I was home alone for the first time in twenty years. My oldest son started college, and has moved away from home. My husband was on a business trip. My two other kids had plans with friends! I’m so used to a house full of people—I didn’t know what to do with myself.
I felt so sad and empty. Is this what I’m looking forward to in the future, when all my kids leave the home?
A Dedicated Mom
Dear Dedicated,
Dear Dr. Dora,
What are some of the pitfalls of a non-specialist prescribing anxiety medications?
Anxious about Anxiety
Dear Anxious,
The main pitfall is that only medications are offered, and not therapy. For many people, cognitive-behavior therapy will work faster than medications, and will be just as effective—perhaps even more effective than medications.
I tell my patients—medications will work for as long as you take them. When you stop taking them, they’ll stop working. On the other hand, the skills you’ll learn by doing cognitive behavioral therapy, will last a lifetime. It’s like learning to read, write or ride a bike—you won’t forget these skills. It’s worth the investment to learn these skills, just like you invest in your education.
Dear Dr. Dora
In general, what specific training or education does a general practitioner/family practice doctor/internist receive regarding pharmaceuticals and therapy for anxiety disorders? Does their normal continuing education include these topics?
Man with Questions
Dear Man with Questions,
About 20 percent of us has an anxiety disorder at any given time—like social phobia, panic disorder, obsessive-compulsive disorder, or post-traumatic stress disorder. However, half of us will suffer from an anxiety condition during our lives.
Dear Dr. Dora,
What are psychopharmacologists and what special training do they get?
Thinking of Drugs
Dear Thinking,
In New Yorker cartoons, psychiatrists are usually next to a couch, talking to a patient. All psychiatrists used to do talk therapy. But a recent study out of Columbia University showed that nowadays, only 11 percent of psychiatrists offer psychotherapy at all.
Today’s reality is that most psychiatrists are psychopharmacologists, only. In addition, nurse practitioners increasingly prescribe psych medications. In some states, psychologists can prescribe medications after several weeks of classes.
Dear Dr. Dora,
Since I moved a couple of months ago, my heart feels heavy and even hurts. My stomach gets upset, and my hands shake. My doctor says that there’s nothing physically wrong with me. It’s just anxiety.
We moved because of my husband’s new job,. I have left my friends, and a job I loved. I haven’t found a new job yet, so I’m home a lot. I miss the look of the mountains, the trees, and the sky, of where I used to live. Actually, whenever I visit my old neighborhood, I feel just fine. The symptoms all go away.
Dear Dr. Dora,
I retired last year, and had trouble adjusting. I had a lot of stress, and couldn’t sleep. My doctor gave me Xanax. It helped, thank goodness. But now I’m stressed even though I take Xanax four times a day. I’m also not sleeping, even though I take the Xanax. I wake up after a couple of hours, and can’t get back to sleep. Should I try melatonin?
Sleepless
Dear Sleepless,
Xanax is a very short-acting medicine. It works quickly, which is why it can quite addictive. But it also leaves your body quickly.
Dear Dr. Dora,
I am the single mother of a 16 year old girl who seems well adjusted. She does well in school and has a lot of friends.
Her father died when she was eight. Everything was a struggle. I was an attorney in a large law firm at the time. I started my own firm close to home, to be more available to her. I never remarried, or dated—she’s been my priority.
She seems fine. But I wonder if her father’s death might be affecting her. Should she be in therapy, just in case?
Last weekend, I was home alone for the first time in twenty years. My oldest son started college, and has moved away from home. My husband was on a business trip. My two other kids had plans with friends!
First of all, congratulations on your success, that your son is in college. You’ve launched a young man into the world.