Coping With Anxiety in Sobriety

Hello Ginuwineswf:

First and foremost, a hearty congratulations to you on 16 months of sobriety.  That is outstanding!!

For starters, I am honestly unsure as to what a "tel-a-med" doc is, but it does not exactly sound like the ideal "one stop shop" for the support in recovery from addiction and anxiety that we mental health professionals would consider ideal for you, given your situation.  If that is your source for meds, fine.  But it's probably not enough to handle everything.  Otherwise, you wouldn't be writing to me!

It is quite common, and very understandible, that a newly sober individual will experience a broad rush of somewhat foreign, and perhaps distressing, feelings and experiences to emerge after "self-medication" has ceased.  The removal of meth from the equation simply gives you the opportunity to directly address the difficult feelings that were being masked in the first place.  So, it is not believed that sobriety would be a direct road to freedom from these underlying challenges, contrary to what you may have expected (sorry!).  In fact, as anxiety is a natural part of being human, and is hardwired for evoulutionary purposes; it's emergence is, again, rather normal. 

I do not know how qualified your "tel-a-med" provider is in treating anxiety with tools other than medicine, but psychological treatment (meaning that which is delivered in addition to, or instead of meds) has been shown to be extremely effective and is, in many cases of anxiety, more effective over the longterm than medicine is, on it's own.  And yes, concern about abuse potential with minor tranquilizers would also be a risk and I commend you for being mindful of this.

So, you clearly need some additional tools and techniques for managing your anxiety in addition to the medications you are taking (although you are not taking anything to directly address anxiety, and I am unsure as to what condition the chlorpromazine is addressing).  My best recommendation for you would be to have you to begin working with a psychologist well-trained in the treatment of anxiety.  Ideally, you would want a provider who has advanced training in cognitive-behavioral therapy, aka CBT.  I do not know what your resources are for obtaining such treatment, but this would be the best next step. 

If you cannot obtain face to face consultation/treatment with such a provider, you can certainly make use of written materials, which do, in most cases, prove helpful in recovery.

If anxiety is your primary "monster" (worry, nervousness, worst case scenario thinking), then I would suggest you start reading David Burns' excellent book, "When Panic Attacks."  This is the most up to date of his writings about anxiety.  "The Feeling Good Handbook" is also still quite relevant, and also includes sections on depression, anger, and relationship skills.  Both books will, however, begin to help you learn the theories and applied concepts of CBT, and will most certainly start you off in the right direction.  If your primary struggle is with panic attacks or social anxiety, useful resources for these conditions can be found in the "resources" section of my website, drschultz.org.

I do hope this information is useful, and I am sorry for the distress you are experiencing.  These difficulties ARE, however, quite treatable with or without medication, so I want to encourage you to use the resources I have suggested, in addition to other traditional recovery tools (twelve step meetings, etc.). 

Again, Bravo to you for conquering such a difficult challenge (freedom from meth)!  Surely, each additional step you take toward continued recovery will be easier than that one.  Please keep me posted on your progress and feel free to write back if I can be of any further assistance.

Sincerely,

Richard E. Schultz, Ph.D.