A is for Anxiety

Miscellaneous and Personal Stuff I Must Share
21

A friend of mine got off of his SSRI’s by the expedient of forgetting to pack them when he flew into Tucson.

In Tucson, he bought a car, and proceeded to drive it first to North Dakota, to pick up some furniture, then on to Chicago.

He called me about every 100 miles to give progress reports on how he was coping. He said he reviewed his entire life as if thru a magnifying glass, while battling road rage (even when noone else was on the road) and fits of maudlin weeping. Then he also had to cope with the raging erection. Fortunately he mainly called his wife to complain about that aspect of his withdrawal.

But by the end of the drive, he was off, and hadn’t killed himself or anyone else. And his psychiatrist was amused by his method of getting off of the med.

Have you checked with your prescriber?

Good luck.

22

[QUOTE=Mouse_Maven]
A blood test revealed that I had hypothyroidism! Was this the cause of my mental health issues?
[/QUOTE]

What are the symptoms/signs of hypothyroidism? I’ve battled fatigue my whole life, and I know my mother takes thyroid medication, so I’ve always wondered about that one. BTW, I’m a male, so I don’t know if that matters or not.

And, like many on this thread, I’ve battled depression/anxiety my whole life. Currently, I’m on Effexor; while I don’t love it (although I did notice a difference when I first got on it), I feel like absolute shit the day after I stop taking it (it’s a weird feeling, but my head feels like its swimming, as if I have the flu). For now, then, I seem to be stuck on it.

23

[QUOTE=gigi]
I won’t argue with those who are encouraging CBT, but meds work for me. I don’t want to report to someone else or share with a group, whether that’s me “not wanting to do the work” or not. Maybe if I get to the point where meds don’t work, I would pursue an alternative, but in the meantime I am treating a disease and that seems fair to me.
[/QUOTE]

I don’t think that’s you “not wanting to do the work” at all. I think that mileage will vary, as** Jahdra **said. A combination of meds and therapy is working for me, because that’s what I have the time and resources for. There’s no way I could do 6 weeks in an intensive partial hospitalization program without it having serious repercussions for the rest of my life. And again, I don’t think that’s me not accepting my condition; it’s me doing what will work best in my life to treat it.

24

[QUOTE=featherlou]
Everybody with an anxiety disorder should also be engaging in Cognitive Behavioural Therapy (CBT) as well as taking meds [/snip]

Since discovering that you can recover from an anxiety disorder and participating in a self-help/support group, it really disappoints me how the word is not getting out about this. I think we have about a hundred people living with an anxiety disorder on the Dope, and about two people who know anything at all about CBT and the possibility of recovery. It frustrates the hell out of me. Of course, people who recover from anxiety and don’t take drugs any more aren’t making anyone any money.
[/QUOTE]

If by CBT, you mean seeing a therapist regularly, then add me to the list of Dopers who do. Weekly.

One thing that kinda sucks is that I’m paying out my butt to stay with Cobra for another year so that I can continue seeing this therapist, with whom I’ve made tons of progress. (I got laid off in Feb). I had an option of adding on to my BF’s plan next month as a domestic partner, but he’s with crappy Kaiser who allow only 20 visits/year (and I’d have to start over with someone new). I also contacted a Blue Cross guy to see what kind of option I might have with them. He very frankly told me that meds + therapist = denial in most cases. Which is bullshit.

If there’s more to CBT that I need to know, like resources to find groups, etc, outside of insurance-covered therapy, please do share.

By the way, I shared my “experiment” with my therapist this morning. She just smiled because I’ve done this before, but it’s funny how you don’t remember what real anxiety is like when you haven’t felt it for a while. She’s all for me giving this another week and seeing how I feel sans-meds. I’d really like to overcome this, drug-free, if I can.

Oh, and another thing, I tried the GABA last night, and maybe it was a coincidence, but I was up all night unable to sleep. Drats.

25

[QUOTE=Marconi & Schmeese]
PS - my hubby and I had wild sex tonight and I managed to have TWO, count them, TWO big O’s - even with all those meds I’m on. . . .
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I would like to subscribe to that newsletter!

26

[QUOTE=xanthous]

If there’s more to CBT that I need to know, like resources to find groups, etc, outside of insurance-covered therapy, please do share.

[/QUOTE]

There’s a new CBT book out called Overcoming Depression, by Addis and Martell (can’t remember their first names). I think it’s much better than the David Burns stuff. More user friendly and more helpful.

27

[QUOTE=Plan B]
There’s a new CBT book out called Overcoming Depression, by Addis and Martell (can’t remember their first names). I think it’s much better than the David Burns stuff. More user friendly and more helpful.
[/QUOTE]

Would this book also address anxiety? I mean, don’t get me wrong, I think I’ve got some mild depression thrown in there, too (sleeping a LOT, sometimes listless and uncaring about life/myself, etc) but it seems anxiety and depression get linked together a lot. Are they treatable in the same ways, with same methods?

28

[QUOTE=Atomicktom]
What are the symptoms/signs of hypothyroidism? I’ve battled fatigue my whole life, and I know my mother takes thyroid medication, so I’ve always wondered about that one. BTW, I’m a male, so I don’t know if that matters or not.
[/QUOTE]

Here is some information. Hypothyroidism is more common in women, but men can have it as well. Some symptoms are fatigue, depression, weight gain or trouble lossing weight, and constipation.

The blood test is straight forward and you don’t have to fast for it. It doesn’t hurt to have it checked out. (Other than the blood draw.)

29

featherlou - I think you and others are right to emphasize that CBT can, in some cases (maybe even lots of cases), provide good results without needing drugs. But each individual needs to find the right individual solution. It’s part of what makes treating mental health issues so tough, that there’s help to be had but no magic bullets.

gigi - what constitutes “the work” varies from person to person. Some people find talking helpful, some don’t. I’ve never done group and I doubt I ever will but I found (and it took some looking!) a private therapist who was just right for me. Not to push, since you’re happy with your current treatment, but there are CBT workbooks and things for working through on one’s own.

xanthous - Cognitive Behavior Therapy is a specific type of therapy. Not all therapists use CBT. Unlike traditional therapy where you talk about your feelings and your life and childhood and such, CBT focuses on two areas: your thoughts and your actions (that’s the cognitive and the behavior parts of the name.) CBT doesn’t worry about your feelings much at all, something that made a big difference for me. Before I did CBT therapy I was always agonizing about my feelings and if I feel this or that way and trying to feel or not feel something. With CBT, I’m focused on ‘what am I thinking?’ and ‘what am I doing?’.

CBT exercises focus on making people more aware of the thoughts that stream through our heads, especially illogical ‘distortions’ that warp our view of reality. Then it focuses on specific actions you can take to help retrain your mental dialog and keep you from acting on the distorted thoughts. It’s a very practical approach and personally I find it much more appealing than the traditional therapy I’ve experienced.

The book I was refering to earlier was David Burn’s “Feeling Good: the new mood therapy” (Yes it’s the world’s stupidest title.) I’m going to check out the book Plan B recomends too. That one I haven’t read yet.

xanthous, my only other advice about medicine would be to stick close to your doctor. Don’t go on and off the meds without talking to him. Every time you do that you go into withdrawl and it jerks your brain chemistry around. It’s like a diabetic deciding to take a few days holiday from the insulin injections. If you want to stop, then stop; but talk to your doc about it and he can help with the withdrawl process.

Good luck, and sorry if I sound too preachy.

30

[QUOTE=Merneith]
featherlou - I think you and others are right to emphasize that CBT can, in some cases (maybe even lots of cases), provide good results without needing drugs. But each individual needs to find the right individual solution. It’s part of what makes treating mental health issues so tough, that there’s help to be had but no magic bullets.
<snip>
[/QUOTE]

Good post altogether.

This part is absolutely right, but the point I want to make that gets overlooked almost completely when traditional doctors treat anxiety is that there is more to treatment than strong medications for the rest of your life. Most people agree that the combination of CBT plus meds is the most efficacious; the problem is that people are getting only the meds. There is still a lot of controversy over whether all people with an anxiety disorder can recover completely and not need any medication for it again. A therapist I saw for a short time made what is probably the best comment on this; try the CBT, see how far you get, and assess where you are at that point. Another thing to remember in recovering from anxiety is that you will feel anxiety when recovering; it is necessary, because you need to feel that anxiety and realize that it truly isn’t hurting you, and it won’t hurt you. It’s just an emotion - it can’t hurt you. Chronic anxiety feels terrible, and it’s not something that you want more of in your life, but it won’t hurt you.

gigi, I’m not willing to call anxiety disorders a disease. Anxiety is a normal human emotion like happiness or sadness; people with anxiety disorders think incorrectly about things, develop mal-adjusted coping skills (like avoidances) and scare themselves. I don’t think you can recover from a disease by changing the way you think and behave; I consider myself recovered from my long-term anxiety disorder and I did it by doing those things.

I know that doctors want to say that anxiety disorders are caused by a chemical imbalance in the brain; it’s interesting to note that thinking positive thoughts stimulates the same part of the brain that selective serotonin re-uptake inhibitors appear to stimulate. It’s a chicken-and-egg argument, too; if you are having anxiety every day, maybe you do reduce the level of serotonin in your brain. Which came first - the anxiety every day, or the reduced level of serotonin? Doctors hold fast to the belief that your serotonin levels dropped, and that’s why you’re having anxiety. People espousing methods of treatment like CBT would more likely say that you developed habits of thinking and acting negatively, and these chronic negative influences in your life eventually lowered your serotonin levels. If medication works for you to reduce your anxiety, that is good. Medications are not harmless, however, and not free, and not necessary for everyone with anxiety. If there is a way to produce the same results as medication without the dangers and the cost, I personally think that is also a good thing.

I’m not going to try to drag anyone kicking and screaming away from their Paxil and Xanax; I just want the message to get out that there is more to anxiety treatment than taking drugs. Maybe when the drugs stop working for you (if they’re actually working now; Dr. David Burns suggests that the effects of SSRIs can be attributed to the placebo effect), remember about CBT and look into it then. There has also been at least one drug for anxiety/depression taken off the market due to its being linked to liver failure (Serzone, the drug I was on for a long time). These drugs aren’t mother’s milk.

I should also mention that I realize that I am a stranger on a message board, telling you controversial and new, scary things. I can supply cites for everything I am telling you, however; I studied everything I could find on anxiety disorders for a couple of years. I certainly know what it’s like to live with one, and I also know what it’s like to recover from one. If anyone wants to email me, please feel free to do so. I work with a self-help/support group here in Calgary weekly, and I have no problem helping anyone else who wants it.

31

Good fuck xanthous, just take your goddamn meds and stop screwing around. Christ.

32

[QUOTE=xanthous]
Oh, and another thing, I tried the GABA last night, and maybe it was a coincidence, but I was up all night unable to sleep. Drats.
[/QUOTE]

The taurine? It’s the stimulant in Red Bull - a lot stronger than caffeine.

Don’t have any taurine and then try to sleep, it won’t work.

33

[QUOTE=featherlou]
gigi, I’m not willing to call anxiety disorders a disease. Anxiety is a normal human emotion like happiness or sadness; people with anxiety disorders think incorrectly about things, develop mal-adjusted coping skills (like avoidances) and scare themselves. …

I should also mention that I realize that I am a stranger on a message board, telling you controversial and new, scary things.
[/QUOTE]
I’ve been scared since I was tiny, before I knew anything about how to think about things, and finally after 30 years I have some relief from it and can think about things the way normal people do. It took me many years to work through the stigma of taking medication for something I should just “snap out of” or “get over”.

I don’t mean to argue with you because I do believe you that it works. I know that talk therapy plus meds is the ideal and that talk therapy has some of the same effects as meds. It’s just not a route that I can take.

34

My anxiety used to rule my life, even when I was all drugged up. Since going off the meds I´ve lost about 60 pounds and have become much more actively engaged with life. My experience recovering from anxiety had not been pleasant. It is not easy work. Terror is one of the most difficult emotions to learn to accept, but eventually I realized my fear is not going to go anywhere–I will always be afraid of things–so I might as well learn to use my rational mind to my advantage.

That´s where Cognitive Behavioral Therapy comes in. CBT is a specific kind of therapy focused on making behavioral and cognitive changes to help break those mental health cycles that send us spiraling downward. It is not the same as talk therapy, though I believe that talk therapy may have its benefits as well. CBT is very effective at helping people learn to cope with chronic anxiety.

I would also reccomend exposure therapy, which is a kind of CBT. Exposure therapy is not fun, but it is incredibly effective. I have a number of anxieties and phobias, and for a couple months I just focused on one specific phobia: fear of heights. Basically exposure therapy involves spending an hour a day deliberately scaring the crap out of yourself so that you get used to your fear and understand that it has no bearing on actual reality. I had to climb to the top floor of my local parking structure every day and lean over the railing and stand there for an hour–twice a week with my therapist, the other days on my own. It was awful.–but it worked.

Do you know how many times I´ve been convinced I am about to die? A gazillion. But every time I feel that way and don´t die, it reinforces the idea that anxious thoughts have nothing to do with actual danger. I have learned not to trust my anxious or depressed thoughts as holding the key to reality. I still feel fear, I´ve just learned to see fear as a physical reaction that, while unpleasant, is not necessarily dangerous.

Though I only did exposure for fear of heights, it had a lasting impact on the way I handle every single kind of anxiety I must face.

I´m not saying meds don´t help, but the truth is anxiety is one of the easiest disorders to treat effectively-- if you´re willing to do the work. I´m not going to lie, it´s not pleasant. It´s not pleasant at all. But it was totally worth it to get my life back.

35

I am curious if anyone here has tried exercise as therapy? I have read in a few articles that moderate exercise a few times a week can have exactly the same effects as medication without the side effects. (Sorry, no cites - I remember one article was from the RealAge website and another was a BBC science article.)

I have social anxiety, which I dealt with in short-term therapy using CBT. I still experience anxiety but I’ve learned to deal with it a lot better than at first, when I had no idea what was going on. I also get depressed, although I don’t know if it’s clinical. Exercising twice a week has been really good for my general mood, although I think three times a week would be optimal for me. (I do an hour or two of volleyball on Wednesdays and an hour and a half of yoga on another day of the week.) While I wouldn’t suggest anyone replacing meds with exercise, I’m curious if anyone has tried exercise as a mood treatment and how it worked for them.

36

What Olives said. The motto for our self-help group is “feel the fear, do it anyway.” We never, ever even suggest that recovering from anxiety is easy; it’s damned hard work, but the results are worth it. There are very few things in life that are worth having that come easily. It certainly isn’t a case of “snapping out of it” or “getting over it” (we never trivialize how bad people feel when they come in with anxiety, either - it feels truly miserable, and we all know that, because we’ve all been there).

gigi, I can’t speak to your particular condition, but I don’t believe that CBT (not talk therapy) can’t help you. I don’t say that to argue with you, either, but out of my faith that you can do something that you don’t think you can. Have you tried CBT and had it not work for you? It’s not some kind of magic or mind tricks; it’s simply learning to think more clearly and more accurately, and uncover the lies we all tell ourselves. If you’re not ready for it, that’s fine. I don’t think you have the special anxiety that can’t be treated, though. That’s one of the biggest fears of everyone who comes to our group, including me when I started - that they are the special case who can’t be helped with CBT. It hasn’t been proven true yet - the only people who aren’t helped by CBT are the people who aren’t willing to actually put in the work to do it. Olives would probably still have her fear of heights if she hadn’t been willing to stand up to it and spit in its eye over and over. Nobody did that for her - she did it for herself. And her anxiety knows there’s a new sheriff in town now. :smiley:

starry, we always recommend fresh air, exercise, sunlight, and cutting down on caffeine and sugar to people who come to our group with anxiety. I don’t think any of these things cures anxiety, but they sure help you feel better. Hell, they’ll make anyone feel better.

37

[QUOTE=featherlou]

starry, we always recommend fresh air, exercise, sunlight, and cutting down on caffeine and sugar to people who come to our group with anxiety. I don’t think any of these things cures anxiety, but they sure help you feel better. Hell, they’ll make anyone feel better.
[/QUOTE]

I’ve heard those recommendations as well. I guess I was just surprised that exercise would help anxiety and depression at the same level that medications do (whereas dropping caffeine and sugar might help, but wouldn’t help on the same level).

(In the same vein, I’d also be curious as to whether people with desk jobs as opposed to more physical jobs like farmers or construction workers are more prone to anxiety, simply because they’re sitting all day. That’s probably a topic for a different thread though…)

38

Exercise has complicated actions on the human body (and psyche). I’m not sure if exercise increases serotonin levels or just gives you endorphins that feel good and offer some relief from feeling rotten, but there are the psychological benefits of exercise as well. Getting out and exercising is a completely different thing than sitting in your house feeling sorry for yourself; after exercising, you feel like yeah, maybe things aren’t quite so bleak, you appreciate that you did something good for yourself, you might have talked with some other people and gotten out of your own head for a little while, you had a change of scenery, you got your blood pumping and carrying away toxins; there are any number of benefits from exercise.