instruction: hello doctor this is a bit embarrassing I am afraid of going to the doctor because I am embarrassed and ashamed I have bad anxiety and social anxiety and depression I pick at my skin constantly and I do it unknowingly and also when I am aware I feel like I cannot help but I do it and I do it mostly when I am having an anxiety attack I also do it because I feel as if I need to pop everything on my body and I am creating scars on my body and try to avoid looking in the mirror as much as I can because I do not want to do it to my face what is wrong with me and how can I help myself is there anything I can get myself over the counter that I can take or put on my skin to help so maybe I would not have anything to constantly pick at
output: hi I am so sorry to hear about your problem I can understand it must be really difficult for you anxiety has to be managed in two ways medical management you will require some medications if the problem is severe I cannot prescribe them online because it needs complete evaluation and some blood test might also be required so for that you will have to see a local psychiatrist therapy psychotherapy is one of the most effective ways of controlling anxiety and depression you need to understand the negative thought pattern which is causing the anxiety in the first place so that you can either stop them or at least not get affected by them cognitive behavioral therapy is one such tool as you have mentioned that you are not comfortable with going to a doctor which is completely understandable I would suggest to opt for online counseling sessions which are equally effective and works well for people who either have social anxiety or have difficulty traveling the counseling sessions are done online once a week via video consultation therapy and medication combined are the gold standards for the treatment of anxiety and depression apart from that take out some time every day and engage in some relaxing activities like deep breathing meditation progressive muscle relaxation etc I can understand it is overwhelming when you have kids around and so much to do but it is important that you also take care of yourself and make yourself a priority too only if you are healthy you will be able to provide a healthy environment for the family if you want to start with therapy sessions you can let me know