Loading practices
Loading practices
Areas › Worry and anxiety › Treatment and medication
In practice that means naming the target out loud before anything is started or changed: the surges that come from nowhere, the sleeplessness, the thinking that will not stop. Then there is something to check against in a month. Two people with the same diagnosis often need quite different things, and two people with different diagnoses often need the same thing.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
How can those who know be equal to those who do not know? (Quran 39:9). Knowing precisely what you are treating is not a small thing.
الزمر
أَمَّنۡ هُوَ قَٰنِتٌ ءَانَآءَ ٱلَّيۡلِ سَاجِدࣰ ا وَقَآئِمࣰ ا يَحۡذَرُ ٱلۡأٓخِرَةَ وَيَرۡجُواْ رَحۡمَةَ رَبِّهِۦۗ قُلۡ هَلۡ يَسۡتَوِي ٱلَّذِينَ يَعۡلَمُونَ وَٱلَّذِينَ لَا يَعۡلَمُونَۗ إِنَّمَا يَتَذَكَّرُ أُوْلُواْ ٱلۡأَلۡبَٰبِ
What about someone who worships devoutly during the night, bowing down, standing in prayer, ever mindful of the life to come, hoping for his Lord’s mercy? Say, ‘How can those who know be equal to those who do not know?’ Only those who have understanding will take heed
Qur’an 39:9read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
There is useful research on what the words response and remission actually mean in trials of panic, social anxiety and related conditions. They correspond to a large fall in symptom scores rather than to symptoms vanishing. So progress in the research itself is measured at the level of symptoms and by degree, which is a fairer standard to hold yourself to than asking whether the label has gone.
Bandelow B, Baldwin DS, Dolberg OT, Andersen HF, Stein DJ. (2006). What is the threshold for symptomatic response and remission for major depressive disorder, panic disorder, social anxiety disorder, and generalized anxiety disorder?. The Journal of clinical psychiatry doi
Strength of evidence: one line of research. A single study, or a theoretical account.
You can only tell whether something is working if you named what it was meant to touch.
The number worth watching is not the dose but the direction. A dose that keeps creeping upward says something that a steady one does not.
The dose that lifts low mood is often not enough for anxiety, and for obsessive symptoms it is usually well short. Needing more of it is a feature of the problem rather than anything wrong with the person taking it.
Making someone calmer is not the same as treating what is making them anxious. Obsessive worry is the clearest case: something sedating can take the edge off the distress and leave whatever drives it completely untouched.