Dear Dr. Buckingham,

My fiancée has issues with anxiety and I am not sure if I can cope with her issue for a lifetime. She is always anxious and her moodiness is driving me crazy. Whenever she feels overwhelmed, she shuts down and becomes unproductive. I asked her if we could start planning our wedding and she stated, “I got too much going on right now.” I am not sure what she is referring to regarding “too much” because she always says the same thing.

I knew she was an anxious person when I met her because she often complained of feeling nervous and on edge. She has not attended therapy, but she has been on medication for a few years now. I am not sure if the medication is helping her. I thought medication was supposed to change and improve her mental illness. Maybe I do not understand the medication thing. I am starting to feel uncertain about our future. Please advise. My Fiancée is a Nervous Wreck: Can Therapy or Medication Fix Her Anxious Behavior?

Thanks in advance,

Fiancé is Distress

Dear Fiancé in Distress

I am glad that you contacted me. In order for you to help your fiancée cope effectively with her anxiety, you have to understand the problem. Unfortunately, learning about and understanding mental illness is not something that most people work at. Your fiancée’s anxiety could be caused by medical problems such as too much or too little calcium, low blood sugar or heart problems. From a psychological perspective, it could be caused by her way of thinking or cognitive processing. Generally speaking, anxious people have difficulty with turning their minds off. Also, they typically engage in “what if” thinking which cause them to spend a great deal of time thinking instead of acting.

In order to help individuals minimize symptoms of anxiety, professionals like myself often recommend participation in Cognitive Behavior Therapy (CBT) and medication treatment. CBT is designed to help address negative and distorted thoughts. Cognitive therapy explores how negative thoughts contribute to anxiety and behavior therapy explores how individuals behave and react in situations that trigger anxiety. The basic premise of cognitive behavior therapy is that our way of thinking affects how we feel, not external events. Given this, therapy cannot fix your fiancée’s anxious behavior, but it can help her develop effective cognitive and behavioral skills that can minimize the effect that anxiety has on her and your relationship.

In regards to medication, the answer to your question is also no. Medications such as Celexa, Prozac, Zoloft, Ativan and Effexor are commonly used to treat anxiety because they can help in preventing and reducing symptoms. However, no medication can fix your fiancée’s anxious behavior. Medication works as an internal agent that helps with physiological problems. Certain medications can help individuals relax enough so that they can process or think clearly.

As you continue to educate yourself, just know that there is no such thing as ‘Fixing” a human being. This kind of thinking is what causes thousands of individuals to enter their marriage believing that they can change their significant other. As a therapist, I often remind people that therapy and medication are tools to help individuals cope more effectively with their mental illness or physiological challenges.

Your fiancée’s anxious behavior will probably not change anytime soon. Therefore, if you desire to help her and yourself, please consult with a professional therapist who can help you make an informed decision about how to move forward.

Being with someone with a mental illness is definitely not a life sentence to unhappiness, but it can be challenging at times. Please remember that love will get you married, but unconditional love must be present in order to keep you married. Educating yourself about your fiancée’s mental illness is the best thing that you can do for you and her. Make sure that you are in it to win it before you say I do. Some people get it twisted, but through sickness and health means mental health as well.

Best regards,

Dr. Buckingham

If you have questions for Dr. Dwayne Buckingham regarding relationships (married, single, etc), parenting, or personal growth and development, please send an email to [email protected]

Disclaimer: The ideas, opinions and recommendations contained in this post are not intended as a substitute for seeking professional counseling or guidance. Any concerns or questions that you have about relationships or any other source of potential distress should be discussed with a professional, in person. The author is not liable or responsible for any personal or relational distress, loss or damage allegedly arising from any information or recommendations in this post.