anxiety and medication

In My Humble Opinion
1

I started having anxiety attacks when I was 16. I remember that first episode vividly - it was a hot afternoon in the summer of 1984 and I was walking into a movie theatre with my mom and best friend. All of a sudden, a complete feeling of unreality came over me. My hands and feet felt as if lead weights had been attached to them. My heart raced, and my throat was suddenly bone-dry. I didn’t know what to do or say, and it felt like I was going crazy - just pure fear.

I didn’t say anything, and it went away after a few minutes. My next episode wouldn’t occur for another six years.

It’s now 1990, and I’m late for a dentist appointment. Weaving my way past the grandma (complete with floral hat and death grip on the steering wheel) driving in front of me, it hits me -BAM- a panic attack. I pull over. My vision is blurry, heart pounding, I’m suddenly sweating and shaking and completely terrified. In that time of no cell phones (shocking but true for you young ones reading this :wink: ) I drive back to our apartment and burst through the door, telling my startled husband to call 911, I’m having a heart attack. He jumps up and makes the call, and the ambulance arrives within minutes. In the emergency room after a series of tests, the ER doc informs me that I had a panic attack. I had no idea what that was, but ended up finding out the hard way, that’s for sure.

After that incident, it seemed to open the flood gates of panic. Waves of anxiety hit me many many times each day, and I was afraid to leave the house, even to get groceries. It was terrible, and debilitating. My husband didn’t understand. To him, I looked the same as I always had; couldn’t I get over it already? That was in a time before panic attacks were widely publicized, or even known about very much. I took Xanax when it got really bad, and attended AIM meetings every week (Agorophobics In Motion). Those meetings were a lifesaver to me. I met other peole who were experiencing the same issues, and guess what? They weren’t nuts! If anything, I found that people that experience panic attacks seem to be more intelligent, and as a whole just kind, thoughtful individuals. At least, the ones that I met. Maybe that thoughtfulness comes from going through hell on a regular basis, I don’t know.

I got along by using Xanax occasionally, and cognitive therapy. It helped a little, but panic was a daily thing, sometimes tapering down, then starting up again. I also developed generalized anxiety disorder, and was afraid of planes, the US entering into a war, and heights. Go figure - never dealt with any of that before. Meanwhile, we had two kids, and I prayed that they would never have to deal with that lovely legacy. My sister had been anorexic when she was a teen, and all three of my brothers have panic attacks. Lovely. Add the innumerable cousins, and we’re talking a really fun family legacy!

2

I started taking Paxil in 2000, and the panic attacks stopped cold turkey. I was on that med for four years, then switched to Lexapro. No panic at all, but I was also the most boring person on earth. I just didn’t care about much, and was very ‘flat’. All I seemed to do was sleep and watch TV, then take a nap. I decided to wean myself off, just to see how it went. Success! I’ve been off meds for a year now, and have no panic attacks. None. No generalized anxiety. None. I can take a flight, watch the news without getting freaked out about whatever problems are out there, and so on. Best of all, I can think straight again. I returned to school last fall, and am attending full time, as well as working full time. MY GPA is great… there must be a few brain cells wriggling around up there after all.

I do have a point. My daughter is 18, and guess what? Yup. Panic attacks and anxiety. Crap. I was afraid of this.

The first doctor recently put her on Wellbutrin, and it is not going well. She has had some hallucinations, and said that she blacks out sometimes. For example, she was driving home after class one day, and remembers leaving the campus, and then suddenly was in our driveway. She has no recollection of any of the journey. A couple of similar incidences have happened, so we need to make a change. She went to the doctor today, and they prescribed Effexor. After reading about the side effects, I DON’T THINK SO.

I know people have mentioned anxiety and meds on this site before. Would you please tell me your experiences, and suggestions. She is 18 years old and needs help. Please note that I am not asking for medical advice, and DD is under the care of a physician. Anything you can do to help us make a decision would be wonderful. My first thought is Lexapro, because it helped me and the side effects were manageable. Any thoughts?

3

I have very infrequent panic attacks (and mine may not be as severe as yours- I just feel like I’m so anxious that I might throw up). I’ve found that the beta blocker Inderal works well for me. The nice thing is, I don’t have to take it all the time. I take it when I know I will be going into a fear-inducing situation, or when I feel a panic attack coming on. It stops the physical symptoms of anxiety, which cuts that feedback loop where the physical and mental symptoms reinforce each other.

It does tend to make me feel winded easily- not surprising, since it blocks adrenalin. But I’m not often in situations where I’m fearful and have to do heavy physical activity, so that doesn’t matter so much. I try to make sure that, if I know I’m going to be going into a scary situation, I don’t have anything scheduled afterward that requires a lot of physical activity. Actually, I pretty much clear my calendar after something scary like a doctor’s or dentist’s appointment, since I know I will be totally exhausted for the rest of the day after the fear subsides.

4

I started having anxiety and depression attacks when I was 19.

I started seeing a psychiatrist soon afterwards. I didn’t start taking medication until I was 30. It was Xanax, which worked but also drugged me out too much. I got off it, but then struggled on with various problems until I finally ended in a psychiatric hospital at age 40.

That’s where I started taking Paxil. Hurrah! SSRIs work for me. I switched to Effexor, which I now take regularly with no ill effects and lots of improvement in my life.

If you have panic attacks, anxiety, depression, and so forth, you aren’t alone. In fact, it’s more likely that you know plenty of people who have the same condition but don’t admit it to you. Go get help.

Joe

5

I have generalized anxiety, but not panic attacks. I find that SSRIs, and I’ve tried at least four of them, don’t work for me; they make me more nervous, more anxious, more irritable. I was once taking Wellbutrin to quit smoking, which gave me panic attacks, yeesh. My doc has given me a couple of meds that off-label help anxiety, and they seem to work really well.

purple haze, I think Effexor has gotten a bad rap because it’s notoriously hard to wean off of for some people. I’ve taken it, with no ill effects, and got off of it easily (to my surprise, after reading some of the angry Effexor taker’s opinions). Other than that, it’s not much different than many other antidepressants, with the caution that missing a dose can be fairly harsh – unlike, say, Prozac, with is fairly persistent in the body, Effexor wears out more quickly, so you can experience SSRI withdrawal after missing just one dose. That’s a pretty harsh, but also fairly avoidable issue, and not really a side effect.

6

Since the OP is seeking opinions, this is better suited for IMHO.

Colibri
General Questions Moderator

7

I’m on Paxil and Effexor too and after the initial crap of my body getting used to the meds, I’ve been doing okay ever since. I have some really bad days where I have to take a couple Xanax during the day to keep from screaming myself sick, but overall, I’m okay.

Panic attacks suck. Suck, suck, suck. I feel for ya purple haze.

8

Interesting. I had the exact opposite experience. Paxil = bad. Lexapro = good.

I tried to ween myself off Lexapro at one point, but it didn’t work. Not only did the panic attacks come back, they were worse than before.

We are similar in that Wellbutrin didn’t work at all for me. Tried it. Never again. I couldn’t sleep, couldn’t sit still, couldn’t concentrate. I was like a bunny on crack!

At one point, I got a scrip for Xanax, but I never filled it. I was too afraid of getting addicted to the stuff. As it turns out, I don’t need it on top of the Lexapro.

9

I don’t get full scale “heart attack” panic attacks, but I do have an anxiety disorder.

I had depression as a teenager (which went untreated but was obvious in retrospect), but was otherwise fine until a few years ago (around age 27 or 28). I started to get extremely anxious at work for absolutely no reason at all - work was actually going unusually well at the time. After a few weeks of that, I went to my PCP and she prescribed 30mg of Cymbalta to start me off. While this apparently isn’t considered a therapeutic dose, we were both surprised to find that it stopped my anxiety completely and immediately. I experienced no side effects. I stayed on it at that low dose until a couple of months ago, despite a few suggestions by my doctor that I consider trying to go without it. I was unwilling to risk the anxiety coming back.

Around Thanksgiving, I started to notice that I was getting both depressed and anxious. (For the record, the anxiety is much more horrible than the depression.) This escalated until by mid-December I was completely unable to work - even forcing myself to look at my email was enough to send me into a panic. I called my supervisor to explain what was happening (her main response was, "That explains a lot. " I <3 her!). I was already planning to take off a good sized chunk of time around Christmas, so I took a week off, “worked” two days (which consisted of me browsing the web and calling around trying to find a psychiatrist), and then took my planned vacation until after New Year’s. I went back to my PCP as a stopgap, who increased my Cymbalta to 60 mg but urged me to keep trying to find a psychiatrist.

On the increased dose, I found myself swinging wildly between severe anxiety one day and deep depression the next. This lasted roughly a week or so, with the length of each “swing” decreasing steadily, until I was moving between the two modes a few times a day. Then I settled into mild depression. By this time the holidays were upon us, and I found myself feeling somewhat better after a few days making the family rounds. So when I headed back to work, I was nervous but thought that I would be moderately ok.

Big mistake. In between January 2nd and the 8th my anxiety and depression came zooming back, so that the 7th was the literally the worst I had ever felt in my life. I also failed to accomplish ANYTHING in that entire stretch of time. I got an emergency appointment with my PCP, who kicked me up to 90 mg (and also questioned me in great detail to make sure I wasn’t suicidal. I must have looked as awful as I felt.). Still, on the 8th my supervisor called and gently suggested that I consider taking a leave of absence until I could get sorted out. Later that day, my husband got me an appointment to be evaluated by our local hospital’s emergency psychiatric people, which got me placed in their Intensive Outpatient Program. (Group therapy and learning coping skills all morning three days a week, with a psychiatrist and a nurse practitioner prescribing and closely monitoring the medication, for 4 to 6 weeks.)

The psychiatrist diagnosed me as, if I remember the terminology correctly, “Axis I Bipolar NOS with Anxiety w/out Grandiosity”. She kept me on the Cymbalta at 90mg dose - I wasn’t in any condition to question her in detail, but I believe it was because I did well on it previously, and it’s also one of the ones that is fairly safe for me to stay on once I get pregnant. (We’ve been trying for some time.) I was also started on the mood stabilizer Lamictal for the bipolar, but it’s a several week process to get someone to a useful dose so the Cymbalta had to carry most of the burden for quite awhile. (They chose Lamictal despite the slowness because, again, it’s relatively safe during pregnancy.)

The increased Cymbalta dose again sent me into a week of alternating severe anxiety and depression modes that leveled off into moderate depression, but I started to come out of it after a few weeks. The only other side effect that I believe can be attributed to it is severe dry mouth that eased up after a few weeks until it’s hardly noticeable now. TMI alert: I also was somewhat less, err, lubricated for awhile, if you know what I mean.

Anyway, I didn’t really mean to go into my whole psychiatric history, so I apologize for that. What I meant to say that Cymbalta worked for me, with minimal long term side effects. Now that both meds are working in concert I feel like myself again and am back at work, and I don’t feel the least bit drugged up.

By the way, my father and mother are both bipolar with anxiety (and a side dose of schizophrenia in my mother’s case), my aunt and brother suffer from frequent panic attacks but refuse to admit to any psychiatric issues, and my grandmother recently told me that my (long deceased) grandfather had severe panic attacks, and her mother (who had eight children) had to be “hospitalized” for a month or two after each birth. That’s not counting innumerable cousins with a variety of issues and the large number of alcoholics and drug addicts among all of the above. So your daughter is far from the only one with the genetic deck stacked against her. :smiley:

10

I did this thread (“Ask the recovered from an anxiety disorder person”) about a year ago. You might find some interesting ideas in there.

11

Risha, I really enjoyed reading your post. When I first realized that anxiety/panic/depression and so on had strong genetic factors, it was awful. I felt as if there was no escape from that legacy, and that I couldn’t escape this “curse” that had been laid upon me. Maybe not, but what I could control was my reaction to what was happening. My oldest brother chose to medicate himself with alcohol and recreational drugs, which may have felt good at the time, but didn’t do anything to solve the underlying issues. My middle brother believes that good health, exercise, and nutrition are very helpful. I agree with him; a protien diet helped me when I was feeling especially bad. The brother closest in age to me seems to be doing OK.

I will always worry that panic is just around the corner. Don’t get me wrong - I am doing fine, and holding up well with the stressors of school and work. It’s more like a deep-seated fear that crouches in the corners of my mind. Will it come back? When? Why? How? My past anxiety makes me more fearful of change then the average bear, because change can bring stress, and won’t that bring about the return of my anxiety?

I wish my daughter had dodged this biological bullet. I pray that my son will. I know what she is going through right now, and it sucks. It’s hard enough being a teen without adding panic attacks into the mix.

Risha, you have been through a lot. I’m honestly glad that you feel better. An experience like that leaves scars, doesn’t it?

Thank you all for your opinions and experiences. It really does help.

12

purple haze, I know exactly what you mean. Severe anxiety is horrible in a way that most people can’t really understand. While I haven’t been worried in general since the switch in my head reset to normal, I was terrified to come back to work (only a little over a week ago!) for fear that it would all come rushing back again.

I have also thought about the near certainty that the child we’re trying for will have some sort of issue (especially since my husband has also experienced clinical depression). What I’ve realized, though, is that I don’t want to have a disease interfere with that decision, and that’s really all that this is. No more than I’m going to hold off having a child because my mother and one uncle has diabetes. Also, we have a lot of really good things in our genetic deck that shouldn’t be lost - my family produces (both sides, professional and amateur) musicians, artists, and athletes, and for some reason nurses and programmers. It’s unfortunate that my child will need to keep an eye on themselves, like a daughter of a breast cancer patient needs to get mamograms. But if they do inherit one of the family “curses”, then the treatment options available are worlds better than 50 years ago, or even 20. It’s not a death sentence, just a disease to be maintained.

/soapbox :smiley:

13

I take Effexor and have no side-effects other than being sick if I miss a pill. I’ve never had panic attacks, but I do have GAD. I take Xanax on the days when I need a little something extra to keep from killing someone. (One of my worst anxiety symptoms is being an irritable bitch for no reason. Like permanent PMS.)

14

I started having my first panic attacks at about 9. In the course of summer vacation, I went from being a sociable kid to telling all my friends to leave me alone and don’t come near me and hanging around the teachers at recess so they could tell the other kids to leave me be.

I don’t remember if I was 10 or 11 when I started on Paxil. It was a miracle for me - I managed to even make some friends again. I’m still on it at the age of 21. I’m thinking about going to see a psychiatrist because I’m overly tired and drowsy. It doesn’t matter how much or how little I sleep. Yeah, I’m fat, but it’s an endless cycle. And this isn’t just the tiredness of inactivity or depression, it’s ‘I cannot think through the haze in my mind’ kind of exhaustion.