Category: Ask the Doctor

What Can Be Done For Sexual Dysfunction?

    What Can Be Done For Sexual Dysfunction?

    QUESTION:

    Dear Dr. Heller, My wife is taking Celexa for generalized anxiety disorder.  Our sex life was slow before, but we could deal with it.  Now — It’s nothing!  She would try, but no go.  Then it would just turn me off, because of her state. My question: Is their anything we can do to get her, or our sex life, back in order?

    ANSWER:

    Celexa usually worsens the GAD (generalized anxiety disorder), which can cause a lack of sexual interest.  BuSpar is usually needed also. SSRI drugs like Celexa can cause a lack of orgasms.  If she doesn’t need an SSRI, other antidepressants are an option.  If she does, high doses of ginkgo (120-240mg daily) or the addition of Wellbutrin could make a huge difference.

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Is the GAD curable?

QUESTION:

Dear Dr. Heller,

What do they mean that there is no cure for GAD, but it is treatable?  Aren’t you cured if you can treat GAD?  I know someone who had GAD for 3 months and treated herself, without medication or therapy, within 3 months.  She has been cured for 4 years now and states that she can’t cause any anxiety anymore no matter how hard she tries.  She even had her dad pass away in her arms, and the anxiety disorder never came back.  I want to know if GAD could also be a neurotic disorder not just a psychotic.  No one in my family ever had any emotional disorders.  My mom worries a lot (but that’s like most parents), but she has no disorder.

Please Reply ASAP.

Thanks

ANSWER:

The vast majority of people with the GAD, particularly those with the cognitive component, have a genetic disorder where the 5HT1A receptor is overactive.  These people made great “cave guarders” thousands of years ago.  Cognitive GAD means having persistent worry or the mind never shutting off.

There are many causes of anxiety, and I suspect the person you knew didn’t have the GAD, but was experiencing situational anxiety.

The GAD is considered a neurotic disorder, not a psychotic disorder.

What Can Be Done For My GAD?

QUESTION:

Dear Dr. Heller,

I am a 25-year-old male.  I have a 3-part diagnosis.  ADHD, Obsessive-Compulsive Disorder, and GAD.  I am now on 50mg. Zoloft a day, and just today started Ritalin for my ADHD (just 10mg. a day).  I also take a .25mg. Xanax before bed to sleep well and slow any racing thoughts.

Would the fact that the Xanax is the only thing that slows my thought process suggest that possibly my anxiety is seizure oriented after all?  I know that they can use Klonopin and Xanax to prevent seizures.  Or, would you think that the Zoloft is causing my mind to race out of control and my GAD is being completely undertreated?  It seems like this to me.  Finally, would something like Neurontin be a good suggestion to my doctor as a treatment for GAD?

Any response would be greatly appreciated.  Thank you.

ANSWER:

The cognitive GAD (persistent worry, mind always going) is a genetic trait that was of enormous help to our ancestors tens of thousands of years ago.  These individuals were sensational cave guarders.

The GAD appears to involve an overactive serotonin 1-A receptor.  This causes an imbalance with the OCD, which likely involves low serotonin.  This high/low imbalance is likely causing you problems.  SSRI medications like Zoloft increase all the serotonins, stimulating the already overactive 1-A receptor and worsening the anxiety.  Xanax and Klonopin, like all Valium like benzodiazepines, reduce anxiety.  It’s unlikely that it’s a seizure in your case.  Neurontin is highly unlikely to help.  Ritalin will likely make the GAD worse.

BuSpar is the best medication for the GAD, and lowers that receptor so SSRI and psychostimulant medications can be taken without worsening the GAD.

How Can I Be Treated If SSRI’S Make Me Sick?

QUESTION:

Dr. Heller, I am 37, and I think that I have suffered from anxiety and depression since childhood.  At about the age of 30, I was diagnosed by my doctor with GAD and depression.  According to my experience and your screening criteria, I think that “fractured happiness” and the inattentive type of ADD are also parts of my overall condition.  I have tried almost all of the SSRI’s, and generally they let me see what non-depressed, non-anxious thinking was like.  What a revelation! However, side effects have been a big problem.  Prozac made me hyper.  Paxil made me feel the best, but it also caused a rapid weight gain.  Zoloft made me feel wired.  Adding Trazodone caused a quick addition of 10 pounds despite a lot of exercise.  I tried Wellbutrin with Paxil and Celexa respectively but this did not lessen my side effects.  This includes memory glitches that were very disturbing.  Currently, I am on Serzone by itself, and it seems to have made my anxiety worse. Many family members, from both sides, have ADD, depression and anxiety.  Are these conditions related to one another?  Considering the fact that I have multiple issues, which medications would you suggest for me? (I have had my thyroid checked on several occasions.  It has always been normal.)

ANSWER:

The problem is the GAD and an overactive serotonin 1-A receptor.  This is the gene involved in the cognitive generalized anxiety disorder.  SSRI’s increase most serotonins, including this one.  BuSpar lowers that receptor so that SSRI’s and stimulants can be taken.

How Can my Friend Discover That Hope Exists?

QUESTION:

Dear Dr. Heller,

A friend who exhibits depression often – goes into hiding with himself for days. He has a problem with anger. He takes everything personally and explodes at people – rants and raves – loudly and expressively with his hands and arms. He is a large man, so he scares people – even though he is mostly verbal, no one knows when he might snap and become physical. I have tried to tell him that everyone is afraid to approach or talk to him or ask him anything, because they are afraid of his rage – even about very minor things. He has gotten worse over the past 5 years. I have tried to tell him this, but he does not see that he is verbally abusive and disrespectful to other human beings in how he speaks to them (yells at them). When he is quieter, calmed down, he will admit he has a problem but doesn’t know where to start to find the right help. He keeps procrastinating in going to get help – and always has an excuse – including that it is ‘everyone else’s fault’ that he reacts as he does. I keep telling him that he ‘over-reacts’ abnormally to things – in comparison to other humans. He ends up unhappy and depressed way too often and over too many things that are not that “big of a deal” . He has not been able to maintain a relationship, nor has he been in any long-term relationship, with any woman since he was in his early 20’s.

What can I send him to read? Where can I direct him? He is more likely to read and study before he will seek actual one-on-one counseling. Thanks.

 

ANSWER:

That’s what the covers of my book have been designed for. If the BPD is present – which seems likely – the cover of my first book “Life at the Border” can be printed from this website. The cover of “Biological Unhappiness” can also be printed up. The back cover shows many of these symptoms and can be found on the home page. The “Screening Test” will likely be of assistance as well. Most people with anger problems are suffering and would like for their suffering to end. That’s the purpose of my work.

Is Your information For Real?

QUESTION:

Dear Dr. Heller,

Life with my borderline husband has been pure hell. Medicines and therapy have made things worse. In the past year we have both been arrested due to his uncontrollable violence, neither of us has EVER been arrested before in our lives.

Just when things were seeming hopeless, I realized that you, this wonderful man I have read so much about, are very close to us. We live Outside of Orlando. My question to you is, is it really possible to actually get an appointment with you? Can it be as easy as it sounds on your web site?

When I saw your fees I nearly feel out of my chair. We have spent so much time, money, and effort getting nowhere. Is it really true that hope exists and I don’t have to relinquish my husband who I love more than anything in the world to the horror of BPD? If the answer to these questions is yes, then I hope to be seeing you as soon as possible. Either way I would like to thank you from the bottom of my heart for giving hope to the hopeless, you are a remarkable human being.

I hope you will continue to improve the lives of so many. God bless you.

 

ANSWER:

I appreciate the kind words. I have many, many patients from Orlando and would be happy to see you. I genuinely enjoy treating the BPD because of the enormous possibility of helping people have better lives and understand the goodness inside of themselves. The information is accurate.