Brief Answer:
you need treatment for anxiety disorder, provide some information

Detailed Answer:
Hello,

Thanks for writing to us. I can understand your concern.

You have been depress for eighteen years. I guess you have taken treatment for the same. I would like to know following information.

- If you have taken treatment , please provide details about medications.

- Do you have any physical problem/illness? If yes describe details with treatment you are taking for the same.

- is there any stress - social, occupational, emotional - in your life?

The symptoms you have describes suggest some kind of anxiety problem.

Best treatment of any anxiety disorder/depression include both medicines and psychotherapy. .

In psychotherapy I recommend cognitive behavior therapy (CBT). In mild cases only CBT is sufficient. In moderate to severe cases initially medicines and then CBT is added. And later on medicines stopped gradually.
If medicines alone are used chances of relapse are more after stopping the medicines.

In medicines SSRI group of drugs (fluoxetine, paroxetine, sertraline, escitalopram) are main stay of the treatment. I prefer paroxetine when anxiety is more. Benzodiazepines group of drugs (clonazepam, lorazepam, alprazolam or etizolam) are used initially for short duration for fast symptomatic relief. I never recommend alprazolam.

I will be happy to help further after your response.

Regards,
Dr.Chintan Solanki.

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