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Battling Anorexia and Anxiety

By January 22, 2013

I have been battling anorexia for over four years. Recently, I have had to take a medical leave from my employer because my social anxiety has gotten so bad. I cannot just stay home and do nothing, I need something to keep my mind busy. Do you have any advice on what I can do? I am afraid I am not going to be able to return to my employer of nine years. I have had three medical leaves since I started to struggle with this. I really wish I could work, but it has been so hard to face people. Thank you for your time. – Christine

Christine,

The first thing I would like to say is that anxiety is very common in patients with anorexia.  We approach it is a bio-psycho-social-spiritual model. I will address the biological dimension of this condition.

As a psychiatrist, I always recommend a combination of Cognitive Behavioral/ Exposure Therapy and Medication. The medications for Social Anxiety are antidepressants such as SSRI’s (e.g. Prozac, Paxil, Zoloft, Celexa. Lexapro) or SNRI such as Effexor.  These medications are very helpful for both depression and anxiety.  It takes time, two to three months for these medications to be fully effective and even longer if you do not respond to the first one.  I have treated patients that have begun to respond almost immediately. 

These options must be discussed with your treating provider, taking into consideration the risks and benefits.  In addition, working with a therapist who knows Cognitive Behavioral and Exposure Therapy will generally make the recovery process go faster.  The good news is that there is help. 

Blessings,

Kevin Wandler, MD