help

my son is 29 years old, has been on lexapro, and now effexor for over 5 years, everything began with what i can only describe as a nervous breakdown, just over 5 years ago, we got him on the lexapro and he quit his job and went back to where he was safe-food service, he has been there until january when he needed a medical leave due to vision issues stemming from his diabetes.  he is to be cleared to return to work in june and now he is saying he doesnt know if he is comfortable going back to work and back to driving, he takes ativan more than i would like to see him taking it, i know he does not sleep well and i am just wondering if psyciatric help would be the next step, he says he really doesnt think he needs to talk to anyone, so i just keep thinking it is more chemical than anything

[Paxiled]

Though it might be chemical, there is as yet no scientific evidence of any chemical imbalance in anyone.  Everyone should try talk therapy before trying strong drugs, and the drugs are intended to help with therapy, not replace it.  That doesn't mean therapy will work, just that when it does it tends to be more permanent than the symptomatic relief of drugs.  You don't need a psychiatrist for talk therapy, in fact most don't even bother with it anymore -- much easier and more lucrative to just dole out drugs.  Psychologists do the talk therapy.  Do try and get him into therapy no matter what he does with medication.  And remember, blood sugar problems cause a lot of anxiety problems and it doesn't sound like he's sticking to his diet.