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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18211
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have a member of my family with what I think is general anxiety

Customer Question

I have a member of my family with what I think is general anxiety disorder. He is irrational in his thinking, constantly worrying that things are dirty and covered in germs and that he will catch some disease. He is constantly washing his hands.
He has had this to a lesser extent previously and was prescribed Citalapram, but he had other problems with this medication e.g. constant headaches. It did lift his mood somewhat but the side effects lead him to stop taking the tablets. This was some time ago now.
When out and about, he has sudden and urgent need for the lavatory.
All this is taking its toll on his work and his relationship (he has been married for 18 months now).
My problem is that I can not get him to go to the doctor now; he has little faith as he says they just prescribe the same old thing and it does not get to the route of the problem. He has had some counselling in the past, but as soon as he stops going, we are back to square one.
Can you offer any help/suggestions please?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
What has he said that he is willing to do?

Customer: replied 3 years ago.

He has been buying a method called The Linden Method, which is basically trying to keep the brain occupied with deep thinking so that the mind does not allow these negative issues to be constantly mulled over. The problem is that he seems to have some sort of mental inertia and talks about this programme but cannot get started, despite help from myself to encourage and make suggestions to him.

Expert:  Dr. D. Love replied 3 years ago.
Thank you for the additional information.

There is no easy answer when someone refuses to be seen for any mental health condition. It is impossible to force a person into any form of treatment unless that person is a danger to themselves or others. It certainly is appropriate to continue to encourage him, as you have been doing. However, it may work better to perform the encouragement as a group, rather than each person doing this separately. This will tend to work better if you include multiple family members and friends that have each witnessed worrisome behaviour and meet with him as a group, allowing each person to share their observations. When a person is interacting with a single person and the observations of that person alone, it is easier to deflect that single person's concerns, but when meeting with multiple people that all have similar concerns, it is not as easy to deflect the concerns of everyone. These group interactions are sometimes referred to as an "intervention."

I can tell you and you can relay to him that there are many other options for treatment. It is true that every medicine on the market has the potential for side effects, but for virtually everyone needing medicines, we can find a medicine that can be tolerated without side effects. And if he is still unwilling to consider the use of medicine, it would be appropriate to consider counselling.

It is also true that some people find success with a variety of self-help methods, such as the Linden method, but ultimately the proof is in the pudding. It may be a reasonable outcome of the first intervention to agree with an initial attempt at using the Linden method, but if there is no improvement that he would agree to consideration of another medicine or counselling.

If I can provide any further information, please let me know.

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18211
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
Dr. D. Love and other Medical Specialists are ready to help you
Customer: replied 3 years ago.

Thank you for your input. I will continue to encourage him and to involve others as you suggest. My worry is that his condition has progressed too far for him to improve without the help of medication, in order to lift him sufficiently to get him to accept other/additional help. I will also try to urge him to get his doctor to consider other medication, not to just offer the same tablets that he had in the past that give him such side effects. Of course, that is if we are successful in getting him to the doctor!

Expert:  Dr. D. Love replied 3 years ago.
I know that this can be very difficult for family members, but these interventions are usually the most effective at getting someone to take action. You are correct that people with more severe symptoms are more likely to require medicines, but it may require a period of him attempting to improve with the Linden method to get him to accept that he needs to go to the doctor for consideration of medicine. If you can get him to agree to be seen by reassuring him that we can typically find a medicine that is well tolerated without side effects, that is good, but he may insist that he wants to try the Linden method.

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