I Am at a Loss

By Dr. Marie Hartwell-Walker

I grew up bouncing from house to house. Sometimes with my mom, but most of the time with grandparents or having my sister look after me. My father left when I was 2 and popped his head in here and there. He and my mother are both addicts. My mother got clean when I was 15, but is still an alcoholic. Because of their addictions, I never really had a real home, let alone parents. I was never able to count on them and they were constantly letting me down. When was 17 and graduated high school I left for college and never looked back. I knew I needed to make something of myself so that I would not turn into them.

In college I was diagnosed as clinically depressed with some anxiety about 4 years ago and put on Zoloft. I tried therapy once and felt so anxious that it seemed terribly counterproductive, so I never went back. I took the Zoloft for a year and then weaned myself off of it because I didn’t like how it made me feel emotions that I felt were not “me.” I did well for about a year without it, but turned to drinking and marijuana use to ease my anxiety. I got married and pregnant and obviously the partying stopped. When I was pregnant I began having severe anxiety. I hated going in public and would have a severe panic attack when I did. There were several times that I would have to leave the grocery store in the middle of shopping because I got so hot and dizzy and needed to sit down. I just had this overwhelming feeling that everyone was staring at me. I was pregnant, of course people were looking at me. But I felt very judged for some reason. When I had my daughter my anxiety continued to be high like any new mother. I worried about my child, I checked on her several times a night. Since then, I seem to have less anxiety about her and more about other people, just like I did when I was pregnant.

My daughter is now 18 months old and I rarely leave the house. I go several days in a stretch without leaving and then only do when I absolutely have to. I just do not like interacting with other people. I am just not comfortable, I don’t trust other people. The second someone talks to me I start to panic, and I withdraw into myself again. My husband is very outgoing, so does not understand my feelings at all. I sought help from my PCP about this and he said this is classic case of Agoraphobia and probably OCD. He gave me a referral to a therapist and a prescription for Klonopin on a p.r.n. basis. I have not gone to the therapist, as I can not push myself to leave the house and go talk to a stranger about personal things when that is my ultimate fear in the first place.

Since my PCP mentioned OCD I have noticed many other things that I obsess about and compulsions I have. I am an avid skin picker. I hate it. I hate that I do it, but I can sit for hours and pick my face, my arms, etc. to shreds. I have picked and bit my nails since I was a small child, incessantly. Getting sunburnt and peeling is a field day for me and I can sit and peel my skin for hours and hours and feel such anxiety and angst if I don’t. I have to brush my teeth a very certain way, if I don’t or if I don’t do it well enough I have to go back and do it again.

All of these things make me agree with the idea of OCD. But for years before I thought it was just depression and anxiety, or maybe even Bipolar because I will cycle. I will have a really depressed few months and then switch to really anxious, then back again. ADD has been thrown around in my head too because of my inability to stay focused at all and my constant finger/face picking.

I guess I am just looking for an outside view of it all. My constant anxiety is very trying, not only for me but my whole family. I stay at home with my daughter and she is suffering from my constant fears as well. I just need an insight about what this could be, and where to go from here.

Thank you.

A: You already have a pretty good idea about what the problems are. I would agree that the symptoms you report probably add up to Agoraphobia and/or Social Anxiety Disorder and OCD. I’m glad you are searching for answers. I’m especially glad that you are concerned about the effect your issues may have on your little daughter. Both of you deserve to be able to go to the playground and to do the normal errands of everyday life without you falling apart.

I understand completely why going to see a therapist puts you right in the teeth of the problem. If it were easy for you to get to the therapist, half the work would already have been accomplished. Often people with your issues find it easier to get out of the house if someone they trust is with them. If that is the case with you, please consider asking your husband to go to therapy with you — not because he is in any way at fault but because you need the crutch, at least at first. Your therapist will help you get comfortable and will help your husband learn some practical ways to be more supportive of you. Eventually, you’ll be able to continue your treatment on your own.

Although medicine may take the edge off your anxiety, it alone is not going to be enough to help you get better. Cognitive-behavior therapy plus medication has been shown to be the best treatment for anxiety disorders. You do need both. I also suggest that you see a psychiatrist for your medications. As helpful as your PCP may be, he or she does not specialize in mental health disorders. A psychiatrist does. Klonopin prn is a good place to start but I suspect a psychiatrist will have an alternative idea of which medication you should be taking.

I’m very glad you wrote. That was an important first step. Now please follow through. With treatment you can continue your project to make a better life for yourself and your little family than your folks were able to make for you.

I wish you well.
Dr. Marie

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Last reviewed: By John M. Grohol, Psy.D. on 10 Feb 2011

APA Reference
Hartwell-Walker, D. (2011). I Am at a Loss. Psych Central. Retrieved on October 24, 2014, from http://psychcentral.com/ask-the-therapist/2011/02/10/i-am-at-a-loss/