Dr. Donald Allen Moses, M.D.

Back pain is frequently psychological, often caused by unexpressed anger, thus the expressions "pain in the neck", or "pain in the ass". I refer you to the books by Dr. John Sarno who was an orthopedist who recognized the connection between the psyche and back pain.

This is a common problem. Your older son is like the "squeaky wheel" that is getting more than is share of the grease. Your younger son's tantrums are an expression of his frustrated anger at the imbalance of attention. He needs special times with you and for you to recognize his anger and tell him to talk to you about it rather than tantruming.

There are certain learning disabilities the can cause grades to drop off during the year. It is not a reflection on intelligence, so a mental health professional who is capable of making a diagnosis of LD should be consulted. If there is a learning problem most schools are capable of creating a program to fit your son's learning methods.

This sounds less of a psychological problem, and more of a social one.  I don't know where you  live, but most places have support groups where people of similar age and interests and/or problems meet and are able to give a person a lot of what she needs.

Donald A Moses MD

Some doctors might recommend an anti-anxiety medication. I am not one of them. A person can frequently become overly dependent and find themselves unable to give them up.  They can even be physically addicting. My recommendation is to talk with a mental health professional, such as a psychologist or psychiatric social worker. You should be able to unravel the causes of the excessive anxiety in a relatively short time. In general, this excessive anxiety is due to a fear of the mother's own capability of keeping her child safe and healthy.

There are too any causes to be able to give a specific answer. However, panic attacks, in general, are an extreme fear of an unknown cause. It is important to find out that cause. Yes, medication, especially the anti-depressant Paxil, can often help.

Donald A. Moses, MD

The answer is "sometimes." It depends on your dedication (in my experience it requires at least two sessions/week, and it will not occur overnight) and the knowledge of the therapist. There is also a difference between O/C (we live in an obsessive/compulsive society, brush our teeth every morning, get to work on time, finish our projects on time, etc.) and OCD obsessive compulsive disorder where rituals interfere with functioning. I refer you to the movie "As Good As It Gets."  However, if millions perform a ritual, it is called a superstition like knocking on wood or throwing spilled salt over your left shoulder. These rituals are performed to ward off something bad or dangerous. Therefore, I have always considered OCD a symptom of a severe underlying anxiety of which the sufferer is not readily aware. For example, a woman I treated would ritually turn on and off a light 9 times, not less, not more. She did not know why until she became aware the she was afraid that if she did not perform the ritual, she would accidentally leave the light on and start a fire and burn down the house. This was only one of many "protective" rituals. When she left therapy, she was no longer afraid of being unintentionally destructive and the rituals disappeared. In the movie, my guess is that Jack Nicholson would lock and unlock the door may times to be sure no one would break in and hurt him. "Step on a crack, break you mother's back" is an old saying, so stepping on cracks is considered dangerous.

So, if you have the motivation for long-term therapy and find a therapist who understands the problem and knows how to get you to recognize your fears of destruction, then yes, psychotherapy can be very helpful. I hope this little bit of insight into your problem has been helpful.

Donald A. Moses, MD

That depends on your own goals. If you are merely looking for a palliative relief, then continuing in psychotherapy is unnecessary. Remember that many anti-anxiety medicines can become addicting. To get to the root of the problem and alleviate the cause, psychotherapy becomes necessary. The basic choice is yours depending on your own goals.

Donald A. Moses, MD

It is more likely a result of the medication, But I recommend a thorough neurological evaluation in case it is a result of something entirely different.

Donald A. Moses MD

It may be, it may not be. It would be advisable to see a mental health professional and go into more detail. If it is bad enough to ruin a relationship, it is bad enough to seek some personal help. 

Dr. Moses

In my experience being a shopaholic is a psychological/behavioral problem, and is usually an misdirected attempt to fill some more basic need. If she is willing, she may be helped by a mental health professional.

Donald A. Moses MD
Psychiatrist

This really calls for a discussion, without being critical, with your daughter.  Remember, she is a young adult and not a child, and should be approached as such.  You will want to find out what is causing her need for the medication, and if has been prescribed by a psychiatrist
and if not, suggest to her that she consults a psychiatrist or psychologist to make certain that it is necessary and if it is the drug of choice.  Her not telling you  could possibly mean that she is afraid of your response to her, and it is important to get her to trust you that you are on her side and respect her need to make her own decisions. 

Donald A. Moses MD
Psychiatrist