The patients has been taking pari cr tablets 50 mg at night for anxiety related issues. He also has been taking clonazepam 0.5 once in the morning as advised by the doctor. Recently due to sleep disturbances, doctor added tab ativan 1 mg at bedtime as well. although ativan helps him sleep, day time anxiety, specially in morning hours has got increased. We are concerned about the short life of ativan, can ativan be the culprit for day time anxiety? If yes, what could be the reasons? Kindly advice. He takes clonazepam as well as mentioned above. Thanks.

No, ativan mostly is not related to your described symptoms. But the symptoms may be related to illness itself and some dose or time modifications in medicine would help.  

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Dear user you have a long history of depression and anxiety. You tried almost every kind of treatment but you didn’t try counseling sessions. With medicines you need proper counseling and then we will taper you medicines accordingly. I don't know what are the circumstances under which you are taking medicines, I want to know the whole details about your disorder. But due to certain reasons if you are on antidepressants you have to take some extra care of yourself. You need counseling session for a better control on this disorder and medicines. Medicines are not the only solution, do not make it a habit fir future, counseling is a best option for you so that you could better understand yourself and save yourself from the side effects of medicines. Please call and discuss your problem in detail and then will be able to help you better. My contact no is mobile.  

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Day time anxiety is not caused by ativan, more so when earlier it want there. Also, he is already ok clonazepam in morning, which should have ideally covered up his day time anxiety. I would suggest to get a re-evaluated for the reason for anxiety and take counselling sessions specially therapies oriented to decreased anxiety. The role of medication is not much in this type of anxiety as he already on high anti anxiety doses.  

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Looking at the problems objectively. A depression in any form starts with problems showing up in great abundance. These problems are not the real problem, but the fact that we maximize or minimize the problems to something far greater/smaller than they are. A break-up becomes the worst thing in existence and loosing your house doesn?t matter. Looking at the problems objectively creates a real chance to solve them accurately. Make sure you only focus on the facts, not the feelings, and talk it through with a friend, removing emotions from the problems entirely at first. Meditation. As guru-like as this may sound, meditation is receiving a much higher role in psychotherapy and is used in a lot of different approaches to many psychological disorders, but has shown to be especially helpful in combating depression. The reason for this is the fact that meditation helps calm the thoughts, which are extraordinarily negative during depressions. Limiting those thoughts limits the negativity and you can focus more on what is actually happening rather than what you believe is happening. (the specific therapy that uses this a lot is called act ? acceptance and commitment therapy) exercising. The most common symptom in people suffering from depression is apathy towards life. They are not motivated to do anything and simply sit around, trying to waste time. If you are experiencing this then force yourself to do something! anything is better than nothing, although exercise is one of the best things to do. Workout, do some physical activities, or be productive in some way. When you accomplish something you always feel better because you see that life can keep moving on! accepting your situation. Most people try to deny the fact that they are depressed, hide from the negative events in the world and, simply put, run away from the truth. This denial causes them to misinterpret other events and the depression is left room to grow. Accept that there is a problem, but also accept the fact that you can change. Nothing is forever and you can do something about it. But you must believe in this first otherwise all the help in the world is not going to do anything for you. Realize it is only a season. Most depressive episodes are just that: episodes. Meaning that they show up? and then they go away. Sometimes, we just have a bad day. Period. There is no dwiddle-daddling around it and nothing we can really do about it. Accept the fact that this will happen to you but think of it like the changing of a season. We all have to go through a winter too, but eventually spring and summer will appear! focus on what you can do. There are millions and millions of things that you cannot change. There are so many things that you wish you could do but can?t that focusing on it all the time is bound to make you depressed. Instead, focus on the actual things you can affect and change. You can do so much but you must focus on what you can do. The 3 most powerful words I have learned to do this are: ?okay? what now?? given the situation, given everything that is going on, what are you going to do about it now? Get help. I know I have said this 3 times already but it is just that important. You are strong? stronger than you think you are, but that does not mean you have to do this alone. We are all allowed to be weak at times. No one has to carry the entire world on just their own shoulders and no one should. Getting help, even from a therapist, is nothing to be ashamed of. Everyone suffers from depression at some point so everyone needs the help. Knowing where you are weak is a sign of strength and you should get all the help you can. I mean? are you really so proud you would bet your own life on it?  

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