Q: I was taking medication for awhile and then my doctor suggested I could taper my dose down until I was finally able to come off altogether. But now I am off the medication I feel worse than I was before. I have stopped going out and now only go out when I really have to but it is still a struggle. I find myself thinking about suicide. I have never thought like this before and that frightens me. My doctor suggested I see a psychologist who he thinks could help me, but I feel so bad I don't know I can do it. I don't want to go back on medication but I wonder if I should. What do you think?

A: If we haven't learnt any Cognitive Behavioral Skills we may have difficulty once we do stop taking medication. Many people who have not learnt any CBT Skills report that the Disorder can be worse the second time around.

In regards to medication, it is an individual choice and one that needs to be assessed with your doctor. If thoughts of suicide are constant you may need to review your situation and go back on medication again until you become more confident of your ability to work with the Disorder. People do sometimes need to go onto antidepressants to help manage any anxiety or any secondary major depression that may come as a result of these attacks and it is best to work closely with your doctor on this point.

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