### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello doctor , ive been battling anxiety and depression since i was 18 that started because of a very bad reaction and experience with marijuana. I took medicine when i was 19 and went to therapy when it was at its height and It helped and really calmed down and i didnt have very many scary and confused thoughts but now im 22 and here recently for the past couple of months and very much so with the past few weeks, it has come back strong and im really frightened by how im feeling and how out of it I seem at times. I am now taking paxil and have been for two days and am meeting with a therapist on monday. Im wondering if you have any suggestions or advice?

### output:

Hi and welcome to Chat Doctor. Thanks for your question... Many substances of abuse, like alcohol, marijuana cocaine, etc. are associated with different psychiatric problems. You have not mentioned if you are still continuing to take marijuana or if you have started again recently after quitting. If so, then it is likely that your current psychiatric problems are related to it. If, on the other hand, you have developed the current depressive symptoms while you have been clean since the last episode, then you may be having a recurrent depressive disorder. It is also important to understand if your personal and social circumstances are causing you stress, since stress can be a precipitating or perpetuating factor for depression. It is a good thing that you are aware of your problems and are seeking appropriate help for the same. I hope that you have been started on Pail only on advise of a doctor. It is now important that you continue medication regularly and have periodic reviews to monitor your progress. Also, as anti-depressant medication usually take a few weeks to bring about their full effect, you have to be patient and continue them regularly without stopping them pre-maturely. Since you seem to be having recurrent symptoms, your doctor may advise continuing medication for a longer duration this time. Psychological therapy can definitely improve the outcome in depressive disorders and often, a combination of medication and therapy yields best results. So, do go for regular therapy sessions as advised and stay completely off marijuana or any other substance of abuse. All the best.- 