Brief Answer:
deep breathing exercise will help, go for CBT if anxiety is frequent

Detailed Answer:
Hello,

Thanks for writing to us. I can understand your concern. Your GAD have been successfully treated before 4 years. So you can again be treated. If your anxiety is not frequent it is not GAD. Any person who faces tense situation gets anxiety and that is normal. When this anxiety exceeds optimal limit and affects persons' social/occupational life it is problematic and we need to treat it.

- Let me know what is status of current anxiety in your case?

Specific treatment of anxiety disorder includes both medicines and cognitive behavior therapy (CBT).

In mild cases only CBT is sufficient. In moderate to severe cases initially medicines and then CBT is added. And later on medicines stopped gradually.
If medicines alone are used chances of relapse are more after stopping the medicines.

In medicines SSRI group of drugs(fluoxetine,paroxetine,sertraline, escitalopram) are main stay of the treatment. I prefer paroxetine. Benzodiazepines group of drugs(clonazeapm, lorazepam or etizolam) are used initially for short duration for fast symptomatic relief.

- Which medicines were given before 4 years in your case?

Regular Meditation can help you. Use of Deep breathing technique (slowly inhale for 3 seconds deep in lungs with open mouth, keep breath in lungs for 3 seconds and then exhale slowly for 3 seconds) while anxiety/panic attack can reduce or stop severity of symptoms. You can do the same exercise for 10-15 minutes whenever you feel anxious.

Apart from this you need to maintain healthy lifestyle to prevent worsening of health. This includes regular daily exercise (walking or running), hygienic food habits ( no junk food, no fatty food, preferably only home-made food with law salt and fat with more fruits and vegetables) and timely scheduled sleep.

Restyl or anxit contains Alprazolam which is a benzodiazepine group of drug. It must be used under strict medical supervision otherwise it can cause tolerance, severe dependence and chances of abuse become higher. Instead I recommend mouth dissolving clonazepam as and when required.

- Please give me some example in which situation you get disturbed and how do you cope up?

I will be happy to help further after your response.
Regards,
Dr.Chintan Solanki.

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Brief Answer:
You have agoraphobia and CBT will help

Detailed Answer:
Hi,

Thanks for follow up.

"Normally get tensed while have to travel a long distance alone
Work related matters, While Driving alone. It is severe when I am alone.' - This suggests agoraphobia and likely it is with panic disorder - a type of anxiety disorder. CBT will surely help in this case. You need to ask for CBT to your psychiatrist. Your psychiatrist can provide sessions of CBT or will refer you somewhere for the same.

Clonazepam is a prescription drug and you need to consult psychiatrist/doctor for the same. In your case 0.25 mg should be started at present.

Feel free to discuss further.

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