Medications and medical conditions

Often a patient may choose to take a psychological medication to increase the benefits of psychotherapy.  Often, “medication is like snow tires for a slippery mountain road; you do the driving; but when you accelerate, brake, or turn, the snow tires keep you on the road.” (Martin, 2006).  Often, anti-depressants are the first line medications for anxiety disorders.  Other classes of medication may be helpful as well.

When indicated, Dr. Martin discusses the possible benefits of medication with each patient.  If the patient is interested in exploring medications further, Dr. Martin refers to, collaborates with, or consults with the patient’s Psychiatrist or Primary Care Physician who will evaluate the patient, discuss options and prescribe when indicated. If a new patient does not already have a psychiatrist or primary care physician, Dr. Martin will assist the patient in locating one.  If medication is chosen, it is combined with psychotherapy in an effort to provide the most effective treatment .  As time goes by, Dr. Martin, his patient, and the prescribing physician will study the benefits of both medication and psychotherapy.  Psychotherapy may also serve as an intervention to help a patient reduce the dose or discontinue a medication as the patient learns alternative tools for coping.

Numerous medical conditions may have an impact on anxiety or depression. For instance, vestibular (inner ear) disorders may cause dizziness, vertigo, or light headedness, and in turn trigger anxiety or panic. These bothersome inner ear conditions may be caused, for instance, by allergies, infection, old scar tissue from childhood ear infections, or Meniere’s Disease. Metabolic problems such as thyroid disease often contribute to anxiety or depression.  Medication side effects can also cause or contribute to anxiety or depression. 

Finally, medical fears and phobias often contribute to anxiety or depression.  These might include fear of simply visiting a doctor; blood or needle phobia; fear of general anesthesia; fear of pain; fear of fear itself if “trapped” in a diagnostic or treatment procedure such as an MRI or simple CT Scan, EKG, or dental exam. Avoidance of medical evaluations and treatment can be dangerous as disease can worsen or be life threatening. When helpful, Dr. Martin may consult with the patient’s medical specialist.  Exposure CBT is often effective in treating the anxiety, avoidance, or procrastination associated with medical fears and phobias.