Dr. Hayley B. Sherwood, PhD, PHD

The best treatment for anxiety is often a combination of talk therapy and structure. It is important to find the therapist with whom you have a good fit, since so much of what happens in therapy occurs within the context of a psychologically safe therapeutic relationship. If you have tried talk therapy for some time and you are not feeling better, you may want to consult with your primary care provider or a psychiatrist (your therapist can often recommend someone) about trying a medication. Structure includes creating a schedule for yourself that includes nourishing your body properly, moving your body, maintaining a good sleep schedule, and interacting with other people. The combination of therapy, medication and structure can help you manage your anxiety symptoms well.

Extreme mood swings such as the ones you describe in your question may be indicative of a bipolar mood disorder. It is important to download a mood-tracking app in order to keep track of your mood for some period of time and to review it with your therapist. It is very important to let your therapist and/or any prescribing professional to know your family history. If you have a history of bipolar disorder in your family, you may be more likely to have it as well, particularly when the mood swings occur over time.

It depends. Talk therapy can be extremely helpful for people who struggle with depression. If, after some period of time (which varies from person to person), a person's mood is not improving, a consultation with a seasoned medical/psychiatric professional may be recommended. In general, research seems to indicate that a combination of therapy and medication is the most effective treatment for depression.

Alcohol addiction is treatable but the person with the addiction must be motivated to get sober. Depending on the individual's history with alcohol, inpatient detox may be necessary at first. There are also longer term rehabilitation facilities that are both inpatient and outpatient. Group therapy is extremely effective, but, again, the addict must take ownership of the problem and be motivated for treatment. For some people, AA is very helpful, particularly in early sobriety.

If you are considering a psychotropic medication for anxiety, I would meet with a medical professional (e.g., your PCP or a psychiatrist) in order to determine if you are a candidate for medication. I am a Psychologist and I evaluate and treat many patients with anxiety through talk therapy, which is highly effective for many people. If you are currently in therapy, I recommend talking with your therapist about pros and cons of medication and whether or not you are a candidate for medication.