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Question
Posted by: Anon | 2012/06/01

Anxiety and OCD

Dear CS

My husband has a family history of anxiety and OCD. We had a long chat tonight and he told me that he has great anxiety and stress over our personal finances and that stress over money has always been something he has struggled with.The anxiety ebbs and flows, being intensive for a few days and then it settles for a few days, only to return. We are in a very secure place financially. We dont have much debt other(a small bond) and our income is more than adequate. So his anxiety is not alieviated by the facts of the situtation - i.e we have nothing to worry about. The anxiety over money consumes him to the point that he becomes obsessive in his thinking and feels powerless to stop his thoughts, checking and rechecking every detail on the budget, unable to sleep, finding it hard to concentrate on work or anything else. We have only one account that we use together. He is an extremely honourable and trustworthy man. There is nothing more practically that we can do to alleviate the tension for him. I was wondering if our next step would be medication to control the anxiety. Does he go and see a gp? Do you recommend cbt with medication or just medication to start with. Am I correct in saying that this is an anxiety problem rather than depression? We have a strong marriage and a good fulfilled life both professionally and personally. My husband is also a pastor, and we have spoken at length - the issue is not a lack of faith or money, the issue is his inability to control his irrational anxiety and obessive thinking. We both feel that we have done everything practically and spiritually. I am wondering if this may be something that he needs medical help now. Thank you.

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Our expert says:
Expert ImageCyberShrink

An early important point you make is that he feels this anxiety over financial matters despite being financially secure. So it is inapprpriate / excessive anxiety. It's typical of an anxiety disorder that one experiences the reaction without an appropriate or proportionate external cause. And you are also describing an obsessive-compulsive component to these reactions.
Auch symptoms are distressing for anyone, but maybe more so for a religious professional, who may feel that their faith should somehow be strong enough not to allow such problems to arise. Yet this is not about weakness of faith, but a biological / chemical process intervening and obscuring his usual methods of coping.
The next step would indeed be to seek ways of alleviating the anxiety, but not necessarily by mediation, or not by medication alone.
Though medication especially of the sorts also used to treat depression, can help relieve anxiety symptoms, I personally prefer, alone or in combination with the meds, Cognitive-behaviour Therapy ( CBT ) is a well-tested method of talking therapy what focuses on helping the person learn methods for testing their automatic and unhelp[ful assumptions underlying the anxiety, to deliberately relax when needed, and so on - to modify HOW they become anxious and how they try to deal with that.

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Our users say:
Posted by: cybershrink | 2012/06/02

An early important point you make is that he feels this anxiety over financial matters despite being financially secure. So it is inapprpriate / excessive anxiety. It's typical of an anxiety disorder that one experiences the reaction without an appropriate or proportionate external cause. And you are also describing an obsessive-compulsive component to these reactions.
Auch symptoms are distressing for anyone, but maybe more so for a religious professional, who may feel that their faith should somehow be strong enough not to allow such problems to arise. Yet this is not about weakness of faith, but a biological / chemical process intervening and obscuring his usual methods of coping.
The next step would indeed be to seek ways of alleviating the anxiety, but not necessarily by mediation, or not by medication alone.
Though medication especially of the sorts also used to treat depression, can help relieve anxiety symptoms, I personally prefer, alone or in combination with the meds, Cognitive-behaviour Therapy ( CBT ) is a well-tested method of talking therapy what focuses on helping the person learn methods for testing their automatic and unhelp[ful assumptions underlying the anxiety, to deliberately relax when needed, and so on - to modify HOW they become anxious and how they try to deal with that.

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