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Just wondering if anyone can help me. I have had a problem with panic attacks for a year now, to the point I haven't really socialized for fear of them happening in public. My own doc put me on valium and betablockers short term but referred me to a Community Mental Health Team for more long term treatment.

I met with one them today - she took a history, diagnosed depression ( haven't felt in the slightest depressed ) and has referred me back to my own doc for antidepressants saying she'll see me again when they've worked a bit so I'm more motivated to work towards getting better.

I'll also have a relaxation course and some counselling to address the root of the anxiety.

This all sounds fine to me apart from the fact I don't feel depressed and don't understand why this is what I'm being told to do when I was referred in the first instance for anxiety.

I don't want to stay on valium and would have thought the obvious thing would have been to put me on some longer term med for the anxiety so I can function socially and at work? The valium and beta blockers are fine now while I'm not at work but they knock me out and I won't be able to function full time when I have to return to work.

I'm not criticizing the decision - just confused - very.

Any similar experiences anyone or any thoughts?

I'd really appreciate any responses.


Dear Foxy,

You've been put on antidepressants because the newer antidepressants don't only work on depression - they work on anxiety, too. The newest forms of antidepressants are called SSRIs; the first in this class was Prozac, though there are now many others, including Paxil, Zoloft, Celexa, ect. Drugs in similar classes include Effexor and Wellbutrin. Incidentally, Wellbutrin is also marketed under the name Zyban for smoking cessation - another example of how an "anti-depressant" is used for something other than depression.

The mechanism by which these drugs relieve depression is by maintaining a steady flow of serotonin - an important neurotransmitter (chemical messenger in the brain). People with depression are often suffering from a lack of serotonin; people with anxiety may suffer from sudden surges of it. Either way, the SSRIs help to modulate serotonin to prevent mood swings common to both anxiety and depression.

It is more common to have anxiety and depression in combination than to have any one of the two by itself. If you were diagnosed with depression, it was likely because you said yes to the criteria for depression when asked (even if you didn't know that's what you were being screened for). You need to meet five of the following criteria for two weeks or more - low mood, disturbed sleep (too much or not enough), lack of interest in normal activities, guilt, lack of energy, lack of concentration, change in appetite (more or less), agitation or restlessness, thoughts of suicide. So, if you said yes to five of those, you were likely diagnosed as depressed.

I would not put a patient of mine on Valium for panic attacks - Ativan and Xanaz are better drugs for panic since they works SHORT-TERM and quickly to relieve the sudden anxiety of panic attacks. Valium, on the other hand, has a very long half-life and that's why you've noted it keeps you feeling sedated. Valium works on Gabba receptors - the same receptors alcohol works on - which is why both of them leave you with a calm, relaxed but sedated feeling. Incidentally, both Valium and Beta Blockers can cause depression (as can alcohol). In addition, Valium is highly addictive. You are right to want to get off it.

In the future, never accept a diagnosis or a drug without being clear why the doctor has made that decision. You are the customer - the doctor is the supplier. Do not feel so intimidated that you need to ask important questions about your health online; your health is the most important thing you have and you owe it to yourself to get the information you need to make decisions about it. Hope that helps!


I was recently diagnosed with anxiety from several doctors. (I say several b/c I refused to believe that was the case.) I have always been in control and never had a problem before- but recently suffered a miscarriage. I didnt think it was bothering me- but I guess I guessed wrong.

The reason Im writing to you is b/c my biggest question was "why I am being given antidepressants (which seem to have a lot of side effects and are hard to get off) when Im not depressed at all." I wouldve written in the same question as you- "How do these meds work to cure anxiety if they are called antidepressants?" At least the respondant explained it to some degree and that definitely helps somewhat. I had recently been given Paxil and was very confused why and had horrible tremors, insomnia, diarrhea, feelings of losing my mind, etc. so I went off it. I am obviously hesitant to start a different SSRI- unless I can better understand why- I dont want to get in the vicious cycle of more and more meds. Right now its been 10 days since being off the Paxil (I was only on it for 9 days), and I have been given trazodone to sleep. Then we will talk about starting a different SSRI (Lexapro), but I am praying that the trazodone helps and I dont need any more meds.

Wel,, hopefully you are feeling better by now. Just thought Id write in and let you know youre not alone in being confused. Good luck- I keep everyone going through this nightmare in my prayers. maria


I feel for you because when I was 18 years old, I went through the same thing. I would have panic attacks, became socially isolated and during one summer, stayed in most of the time for fear of having an attack out in public. It felt like I was in a prison. I took librium, valium etc. but very little help and the attacks continued. One day I prayed for God to help me. I don't know if you believe in Jesus but He''s real and this is one of the reasons why I believe. I prayed that prayer and a couple of days later, a friend took me to talk to a minister. He and my friend prayed with me and agreed in prayer that I would not have a panic attack again. To be honest, I left there having some doubt thinking, "is this gonna work". Well, let me tell you, it has been 37 years and from the day that they prayed for me, I have not had a panic attack since. I just had to share that with you because what God will do for one person, he will do for another and I know how you feel.


I also feel for you as I have had anxiety and panic attacks for about 8 years now. I just recently went to my doctor and was diagnosed with generalized anxiety. She put me on Celexa, and I, too, felt like I was going crazy at times and could not sleep. I stuck with it, and those side effects disappeared, but I still had anxiety from time to time. She then doubled my dose, and I can honestly say that I am happier and more anxiety-free than I have ever been. I do think that anxiety can make you feel depressed whether you're aware of it or not. I am much happier than I was before I got on the medication, and my mood has improved, however, I did not realize that that was a problem until after I started taking the medication and started to feel better. You may not even realize that you could feel less depressed. Anyway, I hope you know that you're not alone, and you can find something that will work for you. Just don't stop trying. There are many antidepressants to try, and I hope that you find one that doesn't make you feel too uncomfortable to take it.