Anne was finally about to get laser eye surgery, which had been something she had wanted since middle school. She hated wearing glasses or contact lenses first thing in the morning and was very excited to kiss that morning routine goodbye. The only problem was that she was incredibly anxious about the surgery. She knew that it was the right thing for her and wanted it, but as the big date got closer, she found her anxiety worsening. Ultimately, she needed to get medication for her nerves to calm her down so that she could get through the surgery. The surgery, of course, was a success, and Anne was so happy to get rid of her glasses and contact lenses finally.
John wasn’t happy with his current job as a Social Media Specialist for a big corporate and was looking for a career change. He applied for a Master’s degree at his dream University and was selected for an interview! While he was over the moon, he was also very anxious about the interview. He found himself sweating and shaking even thinking about it–so much so that his doctor thought it was a good idea to prescribe him anti-anxiety medication to get some relief from his physical symptoms. John went into the interview as confident as ever and was cleared on to the next round!
It’s very common for us to experience anxiety when something big comes up in our lives. The anxiety that we may be feeling tends to deteriorate our experience of the event and may even hamper our performance. It can even take a toll on their physical health and well-being for some people. So, it’s natural for us to want to control those symptoms and ask for a prescription for anxiety medication. But, some people find it challenging to get access to a mental health professional and wonder if a regular physician can write them a prescription instead.
Technically, any licensed physician (MD, DO, NP or PA) can prescribe medication for anxiety. However, many doctors are reluctant to prescribe medications for mental health without a patient having visited a psychiatrist.
Anxiety is not just an emotional, mental health problem as it manifests into physical health issues. For this reason, many primary care physicians and physician assistants will take the issue seriously and prescribe any number of treatments, one of which may sometimes be medication.
How to Tell if you are Experiencing Anxiety
Every person experiences anxiety differently, and it can manifest in several ways. Before we talk about anxiety symptoms, we must know why we experience it.
Anxiety is your body’s natural response to something it flags as a dangerous situation so that it can protect itself. When you experience anxiety, your sympathetic nervous system gets activated, and you experience various physical symptoms, such as pupils dilating, increased heartbeat and blood pressure, etc.
All this means is that your body rings the alarm bells and gets into fight or flight mode. This is your body’s emergency mode and something that’s meant to keep you alive when faced with emergencies–that’s how your ancestors survived animal attacks, wars, and more.
Now that you have a better understanding of what anxiety is, let’s take a look at some symptoms of anxiety according to the American Psychiatric Association’s DSM-V:
- Excessive anxiety or worry
- Inability to control the worry
- Feeling restless, keyed up, or on edge
- Unable to concentrate on the task at hand
- Having your mind go blank
- Felling easily fatigued
- Experiencing sleep disturbances
- Being easily irritated
- Experiencing muscle tension
The symptoms may affect your day-to-day functioning and cause you significant distress. You may even see them impacting other areas of your life, such as your relationships, work-life, etc.
Is it Anxiety or Just The Nerves?
There is a difference between feeling ‘nervous‘ or ‘anxious‘ before an exam and feeling ongoing anxiety that permeates various aspects of your life. Nervousness might be a symptom of anxiety but feeling nervous before important events do not necessarily mean you suffer from an anxiety disorder.
How Anxiety is Typically Treated within Primary Care
Your primary care physician is the regular doctor you visit for annual checkups and any general health problems that arise throughout the year. Doctors and physician assistants handle cases of anxiety and depression every day. However, each doctor and doctor’s office manage anxiety on a case-by-case basis, as there are multiple ways in which anxiety is typically treated within the primary care sector.
- Offer Referral for Licensed Therapist or Psychiatrist – the most common treatment for anxiety in the primary care sector is for your doctor or PA to write you a referral to a mental health professional.
- Offer Limited Prescription – if your doctor feels it is justified and they feel comfortable prescribing you an anxiety medication, they are likely only going to write you a 2-3 week MAX prescription to encourage you to seek help from a mental health professional at the end of the prescription.
- Recommend Diet Change – before prescribing anti-anxiety meds, your doctor might recommend you make some dietary changes, like reducing your intake of caffeine (to give your adrenal a break, so you don’t feel like you’re burning the candle at both ends) and to avoid drinking alcohol (as it’s a depressant and can exacerbate depression and anxiety as opposed to relieving it.)
- Lifestyle Changes – In addition to drinking less coffee, your doctor might also recommend some lifestyle adjustments. You’ll likely be asked whether your exercise regularly or not. If the answer is ‘no,’ your physician or PA will likely recommend introducing regular exercise into your schedule. They may even suggest you take on relaxing practices like yoga or meditation – all of which many studies have proven help with mental health issues across the board.
What if You Had a Prescription in the Past for an Anxiety Medication?
A non-psychiatric doctor is more likely to prescribe an anxiety medication if you already have on file that you were previously prescribed the drug. A doctor will feel more comfortable prescribing the meds if they have proof that you have previously met with a psychologist or psychiatrist (to show that you are actively seeking help for your anxiety beyond just medication.
Types of Anxiety Medications
Some of the most common medications used to help with anxiety are Xanax, Ativan, Valium, and Klonopin. These drugs are classified as benzodiazepines (psychoactive drugs that act like minor tranquilizers.) Many doctors are reluctant to prescribe these at will because of patients’ risk of becoming tolerant or dependent on them.
Suddenly stopping a benzodiazepine medication after even a few months of therapy will cause mental withdrawal symptoms (agitation, insomnia, depression, low self-esteem, loss of self-worth.) A sudden medication stop can also induce physical symptoms like sweating, vomiting, tremors, muscle cramping, and even seizures.
Anxiety medications are risky and cannot be prescribed to patients with previous drug abuse problems (due to the benzos’ addictive nature.) Additionally, anxiety medications do not permanently fix anxiety. At best, they are a band-aid for a much deeper issue. Medications are external fixes when anxiety is an internal, mental issue.
Suppose you want to deal with anxiety on the most effective level. In that case, you must also attend regular cognitive or behavioral therapy to tackle the fear, depression, or deep-rooted trauma behind the anxiety.
Benzodiazepines are typically taken in conjunction with therapy, so many doctors do not wish to prescribe these drugs unless there is proof of psychiatric help and or previous approval of the said drug. No one wants to be responsible for someone’s psychoactive drug dependency, as addiction can seriously derail someone’s life.
What to do if your Doctor Won’t Prescribe Anxiety Medication
If you do not currently have access to a psychiatrist and your regular GP won’t write the prescription, you have a couple of different options:
- Ask for a referral to a psychiatrist – they are likely going to offer this anyways; however, if they do not, ask for a referral to a psychiatrist. Do not ask for a psychologist. While a normal marriage and family counseling therapist can help you dig through your trauma and help with cognitive and behavioral changes, they cannot prescribe medicine. A psychiatrist, however, is both a doctor and therapist and can prescribe meds.
- Administer Self-Care – if you cannot get the anxiety meds you need from your GP, it’s important to help yourself in the meantime. Practice meditation, do a yoga class and surround yourself with loved ones who make you feel safe and loved. Stay away from coffee, alcohol, and tobacco. Try to eat healthy (more produce) to ensure your body gets all the vitamins and minerals it needs to function properly. The only thing that makes crippling anxiety worse is if you harm your body by ingesting food, drink, and drugs that make it even more challenging to function.
- Seek Herbal Remedies – if you don’t like the idea of being on benzos of any kind but would like to dive into herbal remedies, there are quite a few effective options. Try things like kava, passionflower, valerian, chamomile, lavender, and lemon balm (to name a few.)
The Key Take Away
Some general practitioners and physician assistants will give you a prescription for anxiety medications; however, many are still hesitant to prescribe such potent sedatives without approval from a mental health professional. It is a positive thing that doctors are so wary of providing patients with a band-aid type cure that can be incredibly addicting.
If your doctor doesn’t prescribe you anxiety meds, don’t panic. Remember, you have options (and anxiety meds are a temporary fix, they do not tackle the mental/emotional side of anxiety…i.e.…the root cause.) Ask your doctor for a referral to a good therapist or psychiatrist. Make healthy lifestyle changes like eating healthier, cutting caffeine and alcohol, and getting regular exercise.
Meditation and other such relaxing practices also help calm the mind and are proven to help with such disorders as anxiety and depression.
The Importance of Therapy in Overcoming Anxiety
While medication is excellent at providing relief from the unpleasant physical symptoms of anxiety, it rarely is a long-term solution unless you address the underlying causes and work on them safely with a professional therapist.
Studies show that medication and therapy in conjunction can help you with long-term relief as you gain more awareness about your behavior and develop better coping strategies to deal with the stress. This can take a lot of time and patience but will help improve the quality of your life.
Therapy for Anxiety
Following are some evidence-backed therapeutic techniques that help provide relief for anxiety:
- Mindfulness-based Therapy: This form of therapy integrates principles of mindfulness such as meditation, body scanning, and yoga into traditional cognitive therapy and is highly effective in treating anxiety.
- Cognitive Behavioral Therapy: The basic premise of this therapy is that your thoughts, behaviors, and actions are interconnected. You’re shown how your negative thoughts may be creating a cycle that’s influencing your emotions and behaviors and are taught how to control that. It’s highly effective in treating symptoms of anxiety.
- Exposure Therapy: With this therapy, you face your fears head-on through systematic desensitization, which involves listing the things that bring you anxiety in a hierarchal order and learning new relaxation techniques to use. At the same time, you’re exposed to these situations (through imagination or virtually).
- Acceptance and Commitment Therapy: This form of therapy teaches you to embrace your thoughts while changing how you react to these thoughts and face them while being present as you commit yourself to actions that help you meet your long-term goals.
Anxiety is something you can overcome with the right tools and support. A therapist can help you understand your anxiety and teach you healthy coping mechanisms to live your life in peace.
