Question:
The 16 year panics at the thought of going out and can only do so if his
mother accompanies him.
In desperation she went to the GP last Friday. He said he would give him two
choices 1. antidepressants and 2 counciling. The mother said no to drugs and
asked what the quailification of the councilor were.
The doctor said he did not know. He said that was all he could do for the
mother and son and they left with no guidance or help.
Has anyone any where some suggestions I can pass onto the mother? The
mother is a highly intelligent working woman who holds down a responsible
job. However she has to take time off to take the son to the doctor.
Answer:
sadly this is all too common in the UK and I feel deeply sorry
for your friends' son. It sounds like they went to a fairly bog
standard NHS quack who slept through the 15 minute lecture on anxiety
disorders during their medical training! Whilst anti-depressants can
help, they are not a cure - sadly, there is no 'cure'. Most counsellors
have at best a passing knowledge of how to manage anxiety disorders, and
since there is no standard qualification here for becoming a counsellor
they might easily find themselves in the hands of another quack.
There are really only two useful pieces of advice that I can offer.
Firstly, both your friend and her son should learn as much as possible
about anxiety and its treatment. This newsgroup is a good place to
start. The weekly FAQ is normally posted here every Tuesday and there
are lots of links in there to websites with good information. Knowing
more about the subject than your doctor amounts to self defence in the
UK. That will at least mean that an NHS quack can't bullshit them
easily, which is all too common. You need to be aware that some of the
medications most commonly used to treat anxiety are difficult if not
impossible to get in the UK, specifically Xanax (alprazolam) and
Klonopin ( Clonazepam). Secondly, forget counsellors and see if there
is a Cognitive Behavioural Therapist in your area. Cognitive
behavioural therapy is the only psychotherapy with a good track record
with anxiety disorders. In some areas it is available on the NHS, but
it depends on where you live. At the minimum a CBT therapist should
have a degree in psychology, so DO check out their qualifications.
OK, that's it, I've finally had enough of ASAP, I'm leaving for good. The
few people who continually characterise all doctors as quacks because some
doctors don't fully understand anxiety really bug me.
In case you hadn't noticed, medicine is a vast subject area and you
seriously expect your neighbourhood GP to fully understand every last detail
of every possible physical and psychological symptom that they are going to
come across in their careers?!
Of cause as in any profession there are a few quacks, but the vast majority
genuinely want to do their best for every patient that comes through the
door, if they don't know the answer, they will generally refer you on to
someone whose field covers it better.
And before you ask, no, I'm not a doctor, my father was and it was the need
to continually reskill himself, people like you and others who consider
themselves better qualified than the doctor, who phone up in the middle of
the night wanting a home visit because of some trivial ailment that he could
do nothing about, that killed him with a stress induced heart attack at an
early age.
Anyway, in response to the original poster, Yes, CBT is often good for
anxiety, but doesn't work for everyone (it's had little effect for me). You
might also want to investigate psychoanalytic approaches (which are working
for me), I don't know where your friend lives, but have a look at
www.lcp-psychotherapy.org.uk or www.bcp.org.uk
I don't expect every UK doctor to be a panic specialist, but I don't
think it at all unreasonable to expect them to be aware of their own
shortcomings in that area, and not pretend that they know. Sadly, I've
come across far too many people both in here and elsewhere who think
their Doctor knows what they are talking about, when it is abundantly
clear that they don't. The UK seems to be especially bad in this
respect, although it clearly happens in other countries too. Moreover,
the UK stubbornly refuses to use benzodiazepines as a standard treatment
for panic. It took me 4 years and a spell in the local loony bin (where
I was treated with anti-psychotics) to even wheedle a small supply of
Valium out of my GP. Furthermore, it is NOT standard practice in the UK
to refer patients with anxiety symptoms to a psychiatrist or other
specialist to get an expert opinion. Even if you do manage to persuade
your GP to refer you it can take months to get an appointment on the NHS
and even then you have no way of knowing if that 'specialist' has
anything more than a passing knowledge of panic disorder or its
treatment. All too often the Doctor will write a prescription for anti-
depressants and tell the patient to come back in a month. It took me
around 4 months to get to see a psychiatrist. I was initially referred
to a 'counsellor' who worked for my GP's practice. She was a lovely
lady full of fascinating stories about ESP and UFO abductions, but knew
nothing whatsoever about panic!
If my own experience was just an isolated problem then I wouldn't have
such a dim view of British GP's but sadly, I've heard many similar
stories from other people in the UK, so now I tend to regard them as
quacks until proven otherwise!
