 Dear J,
Generalized Anxiety Disorder or GAD, OCD or Obsessive-Compulsive Disorder, ADD or Attention Deficit Disorder are generally believed to be a family of disorders with slightly different symptoms. They all can exist together and people suffering from OCD often exhibit phobias. A person who is Agoraphobic or has fear of being outside in public is just one of them. GAD can further develop into Anxiety Attacks and one of the symptoms of untreated ADD is panic. Tourette's Syndrome and Trichotillomania and some learning disabilities are believed to be part of the same family.
Anxiety disorders main symptom is anxiety or panic. Panic Attacks tend to be more discreet symptoms in a variable fashion, and GAD is more general in nature. OCD shows itself most often in having irrational beliefs that a person cannot stop thinking about or compulsive activities aimed at relieving the obsessive thoughts. This does not relieve the problem. ADD is a learning disorder that shows itself in distractibility, impulsiveness, and at times hyperactivity or anxiety. Phobias are particular irrational fears. Tourette's is the inability to not scream out obscenities and or facial grimaces. Trichotillomania is the compulsion of pulling ones hair or picking scabs.
I understand that anyone, especially in this country where there is a long history of taking care of ourselves and not asking for help, would rather take care of any problems without resorting to medication. I also do believe that very often doctors, especially general practitioners, forget how important the role of talk therapy, spirituality, and good hard work is in a client's ability to get better.
I believe that it is always necessary to include self-help and psychotherapy. However, some disorders lend themselves more to a chemical solution and all the will power and talk therapy will not resolve the issue. As an example, I have good coping skills and willpower, but I don't feel that this will allow me to have good vision without glasses if my eyesight is very poor. I also do not think it makes sense to suffer when a good solution is available.
All of the disorders that you are complaining about fit this category. Mild depression you could very possibly take care of yourself without medication. I also would expect that further symptoms would progress if you do not treat the condition in a timely manner. There is a lot of evidence for people having a difficult time resolving anxiety and phobias if left untreated too long.
Medication often gets a bad rap because many doctors do not manage it thoroughly and also because medication thirty years ago had such severe side effects. Most times in this day and age a competent doctor who is spending the time needed can keep side effects down to the 10% level. Now there are often more choices available in case there are serious side effects with one medication.
There are a number of anti-depressants to help with all the Anxiety Disorders, OCD, and all of the other disorders. Most often a mild stimulant of Ritalin or Adderall needs to be used with ADD. These medicines have been maligned mostly out of ignorance and they are very safe and do not "drug" the patient if administered correctly. I would also suggest diet changes, hypnotherapy, EMDR, NET™, exercise, vitamins and herbs, and some form of self-disciplinary hobby such as Yoga or Martial Arts in addition to psychotherapy. These are extremely important and beneficial. I wish you luck and hope you search out a good psychotherapist and psychiatrist.
Jef Gazley, M.S., LMFT© 2004
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