A 17 year old boy comes in to my office with his mother crying hysterically that his entire body feels bad. I can hardly understand him through his tears. He has recently lost his paternal grandfather to end stage Alzheimer's Disease. His paternal grandmother has recently been diagnosed with cancer. He is applying to college. He is a good student and he has lots of friends. His family situation is stable. The precipitating stress is not clear, although it could relate to his stress with his grandparents.. He complains of strange feelings in his body. His pediatrician stated that he is healthy. He states that he is worried he is losing his mind. I have known him since he was ten. He has always had anxiety. This episode appears to be an exacerbation. I suggest that he go back to taking medication for his anxiety, as he did when he was ten. He says "stop yelling at me". He then starts to scream saying that the side effects make him anxious. I understand that he is anxious and he needs help, but the tool to help him makes him even more anxious. I explain to him that anxiety is a complicated state of being and that the symptoms make it hard for him to take advantage of the therapeutic intervention which might help, but he needs to take medication and he needs to cope with the risks involved. He repeats "stop yelling at me". I wait a few moments. We start talking about sports. He is involved with gymnastics. He is talented. I show appreciation for his skills. At the end, I say "it was nice to see you" to which he responds "you too". He leaves with a prescription. I will see him again in three days.