This is an interesting discussion. Cardiactec, you are obviously an intelligent person who have done very well in terms of functioning with POTS. I am sorry that you went through a bad experience with doctors before getting a proper diagnosis. However, I do think that some of your statements and assumptions about SSRIs and physicians in general, which as you clearly stated are based on the mistreatment by the medical personnel prior to your diagnosis, are misleading to other people who may be struggling to find the right treatment. You stated that if one doesn't have a panic disorder and is prescribed an anti-anxiety medication by a doctor, that it can actually be more harmful than helpful. This is simply not true. As a doctor, I can assure you that SSRIs, as well as other classes of anti-anxiety drugs, are used in many conditions and situations that have nothing to do with anxiety or depression. For example, Cymbalta, an SNRI, has been recently approved by FDA for treatment of diabetic neuropathic pain, a very painful condition caused by diabetes. SSRIs have been used to treat sleep disorders, certain GI problems, headaches, pain conditions and autonomic dysfunction. Thus, panic disorder is just one of the few conditions where SSRIs are utilized. Can they be harmful? Like other medications, these have their own side effect profile, but if prescribed by a doctor who understands how these medications work, no danger should come from a trial of SSRIs. As for the stigma attached with the use of SSRIs or counseling from a psychologist, well, this is where everyone, doctors and patients, should do their part in NOT perpetuating it further than it already exists. Not all doctors are judgemental when they see an SSRI on your medication list. In fact, it has become so widely used for various conditions that many doctors do not automatically assume that you're anxious or depressed when they see it as part of your medical record. Speaking of the medical record, I think that you may be too concerned about what's written in your medical record. It sounds like you found good doctors to work with now, so why is it so important to hide the fact that you're seeing a counselor to help you deal with a chronic illness?! I think by suggesting that this information be hidden from your record, your PCP had actually perpetuated the problem of stigma associated with psychiatric disease, not to mention heightened your own fears of being stigmatized. Knowledgeable and caring doctors will not jump to a conclusion that you're anxious just because they read that you're taking an SSRI or seeing a counselor in your medical record. They will ask questions and try to understand your situation objectively. If this is not the case, then change doctors until you find a good one. Conversely, if you're seeing an arrogant doctor who doesn't care, they can still think that you're anxious despite your record mentioning no SSRI or counseling, so really it doesn't matter what your record states either way. Starting or abstaining from SSRIs is a personal choice that you can discuss with your doctor, but refusing to try a medication that has potential benefits on the premise of false assumptions, fears of societal views, or simply being misinformed can be detrimental. Modern medicine and patient education have come too far to afford negativity and dismiss a potentially effective, multi-purpose drug because it happens to be also used in psychiatry.