Real Life Questions and Answers

Questions from our Readers
Answered by - Director, Dr. Fredric Neuman

"My son is 23-years-old and is afraid of being alone. He has had anxiety for about six years, and has a girlfriend and a new baby. Although they have their own apartment, he is now staying with me. I have taken him to doctors, who have suggested medication and talk therapy. He still won ’t stay by himself and doesn't have a job. I would give anything to help him, but I don't know what to do. This has taken a toll on me too."

This is a straightforward and familiar problem. Most patients proceed through the following stages:
1) Remaining at home alone while his girlfriend stays within reach at a neighbors house, first for an hour or two, then longer. Phone calls back and forth are allowed.

2) Staying home alone without knowing where his girlfriend is, but she reliably comes home at a set time. Then 1/2 hour late, an hour late, and so on.

3) Longer and longer times alone, but on the phone with family members.

4) At home alone while his girlfriend stays overnight at a nearby location within telephone reach. He can use a sleeping pill to get some sleep.

As you can see, gradual and manageable steps are what are necessary to overcome this fear. Books, such as my “Fighting Fear,“ have suggestions to help the time (and anxiety) pass away.

"I am on two milligrams of Klonopin for panic attacks. I don't get the racing heart anymore but a do have a tightness in my chest. I had all tests which turned out okay. When I get emotional I feel this tightness—and think it may be a heart attack. For example, our son told us he didn't know what to do after college in 10 weeks, after being there for four years. I'm 55, and the Klonopin has helped my hot flashes, but not the panic."

Classic panic attacks have two aspects:
1) physical: heart racing, shortness of breath, various muscular pains, including chest pains, stomach cramps, trouble swallowing, weak legs, and others.

2) psychological: the sense that the individual is trapped somewhere and will shortly lose control if escape is not immediate, and the fear of fainting, screaming, throwing up, or having to go to the bathroom.

Treatment involves having panic attacks in somewhat controlled circumstances so that the individual learns that he or she will not lose control and do something dangerous or embarrassing.

I don't like tranquilizers in this situation because it perpetuates the myth that the drug is necessary to calm down.

"I have had anxiety attacks for 10 years. I have been under a lot of stress for awhile now, and I even had to go for tests because I fainted in a restaurant. With managing my aunt's Alzheimer's disease, worrying about my college-age son, and worrying about my own health (even though I have had a clean bill of health), I am feeling very anxious. I take Klonopin, but feel guilty taking them as if I am a weak person. What can I do?"

Any parent can sympathize with your concerns, but they don't seem any worse, frankly, than anyone else's—or more stressful. How much we worry depends on how dangerous we consider these ordinary problems of life to be. Someone who sees the possibility of accidents, illness, failure and other catastrophes everywhere is anxious all the time—and is sometimes described as having a generalized anxiety disorder.
Tranquilizers have a place—but not a central place—in therapy.

We have to test out the world in ways that allow us to determine the real risks accurately and put aside unrealistic fears. These are the methods of cognitive therapy.