I'm 19, and I have an extreme fear of drugs -- illegal ones like pot. It's gotten bad in the last few years. When I go outside, I think I might see them or hear people talking about them or smell them. I'm even afraid to touch door handles in fear I might somehow contract the effects of them. I wash my hands 40 times a day. A therapist had put me on Zoloft for a mild panic disorder, and I still take it. But it's getting so bad that I don't want to leave my house any more. Any ideas on what might help?

D.M.

I'd recommend your seeing a good psychotherapist who specializes in addressing fears, panic and anxiety through psychological and behavioral methods rather than the use of medication alone. Perhaps you could recontact your previous therapist for further work, or seek out another therapist for a different approach.

I can't comment specifically on your condition, of course, without evaluating you personally. But if one of my own clients reported experiencing similar fears and behaviors, I'd want to thoroughly assess the onset and course of their symptoms as well as getting a complete family, social and medical history. I'd want to know of your and your family's attitudes toward recreational drugs and any negative or traumatic experiences you or others you know might have had (whether about drugs or anything else).

We might then work on the problems and issues with a variety of methods, including relaxation and calming techniques, cognitive therapy (identifying and addressing unrealistic beliefs that might fuel anxiety or fears), and behavior therapy. Behavior therapy, for instance, has been found to be very effective for obsessive-compulsive behavior ... and its results last longer than medication alone for the same problem.

I hope this gives you some options to pursue in alleviating your distress. Good luck.