Q&A: Struggling with severe social anxiety and fatigue, should I be on medication?

Ask A Doctor Question: 

I am struggling with severe social anxiety.  It started about 2 years ago.  I am also extremely tired all the time. I want to start taking a medication but want one that won't cause me to be tired all the time. Please, can you tell me which one would be the best choice?

- Laura


Jeffrey Frank, LICSW -

I am not an MD, so not able to weigh in re: medication. But as a psychotherapist, I do know that medication will offer some relief from your symptoms (anxiety/fatigue) but will not address the cause of the symptoms. Experiencing anxiety without an actual environmental threat is often the result of unconscious emotions. These unacknowledged emotions can cause self doubt and undermine self confidence. When one is detached form their honest feelings it compromises one's natural intuitiveness making it difficult to navigate interpersonal situations. An active psychodynamic psychotherapist can help you shed light on internal conflicts that could be causing your suffering. The first question I would ask is 'What was happening in your life two years ago?'.

--Jeffrey Frank, LICSW
Washington, DC


Alan Meyers, PH.D. -

Hello ,
Sorry to hear that you are struggling.  There are a couple of ways to address and resolve your problem.  Medication may certainly help to reduce the anxiety, but medications do not get to the root cause of what is causing the anxiety in the first place.  I would recommend calling a therapist in your local area that specializes in social anxiety issues.  Youcan put those key words into Google and you should come up with a few therapists that you can call.  Taking this route will not only start the therapeutic process, but this professional will know of a good local Physician that can evaluate your situation and if indicated, prescribe the correct medication at the correct dosage that would control the anxiety episodes.  As I’m sure you are aware, there are many different medications that can be prescribed for this problem, but there are many different factors that may cause the medication to work as designed or may cause other problems of which you may not be aware.  Also, another option that you could consider is being admitted into a short term residential program that deals with social anxiety issues.  This option is more intensive, would probably involve prescribed medication by a Physician and assist you in breaking the pattern that is producing the anxiety, all in a healing and nurturing setting.  One of the benefits of this option is that it gets you out of your home environment where you can concentrate on a solid treatment plan to uncover and resolve the problem, without the daily stressors that may contribute to the anxiety.   If you can use this as an option,  you can call 800-897-8060.  This is the number for a nationally accredited wellness program that specializes is issues such as yours. So, you can call a local therapist who can refer you to a physician for medication, or you can look at a short term residential program that would uncover and resolve the cause of the problem and gets you away from the stressors of daily life.  Explore both options and see which would work best for you.
Hope this helps

--Alan Meyers, PH.D.
Clearwater, FL does not evaluate or guarantee the accuracy of any Ask A Doctor Q&A content. Read full conditions of use here.