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Question
Posted by: | 2018/06/27

I battle to concentrate at work, also have difficulty controlling my emotions.

My husband passed away a few years ago. Since the trauma of his sudden death, it seems that my difficulty to concentrate under certain circumstances has increased significantly. I work in an open plan environment and battle to block out noise and other sensory stimulae. After reading up on this quite a lot, I think that I might have a form of ADD, but I am definitely not ADHD. My concentration problems also seems to be exaggerated whenever I am facing emotional issues relating to my own life or that of my family's (e.g. sickness in the family, divorce of family members, financial difficulty, etc.). It seems to occupy my mind in such a way that I battle to concentrate on my work. I saw a psychologist a few months ago, for a while, to help me deal with some of my grief issues. Her therapy was very helpful, but at that stage the concentration problem was not the main issue in my life, so we never got around to discussing it. Her professional opinion was that I am not depressed but we never discussed the possibility of anxiety or whatever is causing/aggravating my concentration issues. I haven't seen her for a while, mainly due to financial constraints. I would like to know from you, where do you suggest I start addressing this problem? Should I bite the financial bullet and go back to therapy? Should I ask my GP about medication that could assist? Should I look for a psychiatrist? (if I get meds prescribed, I am not looking for chronic meds, but rather something I could use if and when I feel the need to calm myself down - I seem to have difficulty holding back tears in some circumstances. I am a 45 year old female, so would accept that some of this might relate to hormonal changes). Your opinion would be greatly valued. Thank you.

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Our expert says:
Expert ImageCyberShrink
- 2018/06/28

Hi, and thanks for an interesting question. As I stated reading I began wondering about the possibility of Depression, but you've seen a moment psychologist who has ruled this out. It's a pity that you two didn't discuss whether there were other diagnostic possibilities, but as you say these current concentration issues weren't troubling you then. 
Where possible, I don't like suggesting particular medications before there's been a proper effort to work out the diagnosis.  It's best to select a drug for a specific condition, to achieve a specific aim.
From your description, and especially where you eventually talk about wanting "something I could use if and when I feel the need to calm myself down", it sounds as though your main problem currently might be anxiety.
Personally, I would usually see this as best handled by CBT type counselling ( because I see better quality and quantity of research showing this to be cost-effective than other available methods, though I remain open to changing this recommendation here I can find more and better data favouring an alternative ) rather than drugs alone.  
As for drugs, I see the evidence as favouring using drugs also used to treat depression, as these also help anxiety.  Too often doctors prescribe sedative tranquillizers of the Valium family, which, like a stiff gin, provide a rather quick feeling of often enjoyable relaxation, and with some of the  disadvantages of gin, too.  They impair your concentration, sometimes significantly, and also reduce reaction times, so they can, for instance, demonstrably impair driving skills.  And when used for more than a couple of months, they can cause dependency.
So, overall ?  I don't know what sort of psychologist you were seeing, but they could probably offer a session focused on assessing you and identifying the diagnosis and nature of your primary problem(s) and suggesting what therapy would be most likely to help.  In my experience, psychologists are more likely to recognize when medication could also help and refer someone for a psychiatrist or GP to assess that; than for a psychiatrist to recognize that  psychotherapy would be needed, and refer someone to a psychologist.


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Our users say:
Posted by: Anonymous | 2018/06/28

Thank you very much for taking the time to answer my post in so much detail, I really appreciate it. I quite like your last statement regarding psychologists and psychiatrists, and I think it is spot on. I am also quite in favour of at least exploring more psychotherapy to learn to deal with some of these challenges, rather than only medicating and possibly just "numbing" a deeper problem. I am also not completely averse to discussing the possibility of depression (albeit "mild") as there is more than one occurence of depression in my family. Thank you. I think writing this out in words and seeing it formulated in front of me also helps me to recognise that this is a real problem in my life and I need to prioritise it (e.g. spend money on therapy and not gin) :) Will keep you posted.

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