727 replies to this topic

[frog]

Thanks for the info on Buspar. That's probably not going to be good enough. I guess it's just confusing to me how medications that are called anti-depressants like Lexapro can be effective for anxiety (I do not have depression) so I feel skeptical about them. But I trust it if people who suffer from chronic anxiety say they help. 

 

I think this trip has absolutely sent me out of control. This may be impatient but I don't feel like I can take a year or two off my life to slowly build up. We have a much bigger and busier trip planned in October to attend a cousin's wedding and both mine and my husband's families live across the country including my grandparents in their 80s who I want to spend time with. I also feel guilty because I feel like I'm holding my husband and even myself back from enjoying everything California has to offer which was the biggest reason we left everything behind and moved out here a couple years ago. 

 

COVID definitely made everything way worse for sure. During the time where I would have needed small exposures the most, we were told to stay home so instead of expanding my confidence I just became EXTRA attached to being at home. 

 

It's the physical effects of the anxiety that really get to me. They are so intense it's unbearable and it can be impossible to rationalize with them in that state. CBT and all the therapy tricks are great but I'm only just learning how to use them so they don't work when I really need them. We're leaving for the airport in a few hours and I just took propranolol because I was starting to shake and it made a big difference. I'm still nervous and the thoughts are still there but because I'm not completely consumed by the shaking and jitteriness I feel more confident that I can actually make it out the door. 

 

In an ideal world I'd like to take medication for a year or two while I regain confidence in my body and my ability to do normal things, in the meantime I will continue to work with my therapist on addressing the actual anxiety and thoughts and when I'm ready I will SLOWLY taper off with the assistance of a competent psychiatrist. 

 

I am definitely curious though how I will feel when I come back from this trip, whether the anxiety will melt away now that the "danger" is gone. Will definitely report back

[fishinghat]

I know how important this trip is to you and I sympathize. When you are visiting try very hard to step away from all the noise, conversation and activity into a quiet room for about 5 or ten minutes. This will not cure everything but you will be surprised how much it helps.

[Mxpro32]

hey Frog.  I keep coming back to trying a different med too.  even on my "good" days, I'm a fraction of what I used to be during good times.  I keep feeling like my best days are behind me, like everything sucks.  like the world is full of future heartbreak and disappointment and I won't be able to handle it.  everything is objectively great in my life and I'm miserable.  I used to feel optimistic, I felt proud of myself and my accomplishments, and I felt fairly safe and secure.  I could enjoy my down time.  I was able to really enjoy my family and kids.  now I feel lazy, untalented and destined for failure.  I have a hard time enjoying my kids even.  nothing feels rewarding and I feel like everything I have is going to crumble.  I realize I'm in a deep depression right now that is coloring how I see things, but if I compare how I used to be to how I am most of the time now, it really makes me feel bad.  I'm anxious like the world is a terrifying place.  I don't know what to do, but I'm exhausted trying to keep functioning through this quagmire.  it sucks because this was never how I experienced depression before.  its the opposite almost.  before depression was a numb checked out feeling where I didn't care about anything and slept a lot.  now my system is the opposite of numb.  my nerves are super sensitive and on edge all the time.  the slightest thought jolts adrenaline through me.  It seems like the depression is in response to that.  my system can only take so much fear and stressful thoughts before it gives in and feels terrible.  I feel like a little optimism would work wonders.  if I could see a path that wasn't doom and gloom it would help the depression and the anxiety, but my system is on full threat detection and overreaction mode all the time.  I just wish it would mellow out.  being numbed by meds sounds pretty good a lot of the time.  I have 1 or 2 days a month where I feel alive and I'm glad I'm not on meds.  

[frog]

Hey all

Back from the trip. I survived! Which is the highlight I suppose. I had horrendous shaking, jittery anxiety every single morning but taking beta blockers allowed me to at least get out of the hotel room and do some things. Not everything I would have liked to do and with a lot less enthusiasm than I think was deserved (which kind of made it all feel like a chore rather than fun), but we spent a day at the zoo (had a wonderful time here once we actually got here), spent time at the beach and even went into the water for a few minutes which is something I haven't been able to do for a while (not a lot of beach weather in San Francisco) and we had a pleasant dinner at a restaurant. And of course most importantly I went to the airport and flew on a plane. TWICE. 

 

The anxiety has settled again since coming home except when I think about leaving the house for something. I tend to leave only for specific important things as it's hard to gather up the mental fortitude to do so and can be exhausting. Going through the anxiety on the trip and beyond has given me some additional clarity. My perspective is that the Cymbalta withdrawal induced a temporary panic disorder. I was having constant random panic attacks daily that were out of my control and could happen anywhere anytime. Those attacks are gone now and have been gone for a long long time. But one situation where they reliably happened and still do is when I would have a sudden diarrhea attack outside of my home. I don't even know if I actually have IBS or if it was just another temporary gift from Cymbalta withdrawal but I feel like at the moment it's fairly well managed by just taking 1/4 of an Imodium daily to be safe. Unfortunately I think the association between urgent diarrhea, panicking, and being outside of the safety of my home became really strong over the past year and has basically resulted in agoraphobia. I used to think that agoraphobia was something that applied to isolated anti-social hermit people so I found it to be embarrassing to consider but it looks like the definition has actually expanded in recent years and sounds perfectly in line with what I'm seeing in myself: 

Fear of places and situations that might cause panic, helplessness, or embarrassment.

Agoraphobia is an anxiety disorder that often develops after one or more panic attacks.

Symptoms include fear and avoidance of places and situations that might cause feelings of panic, entrapment, helplessness, or embarrassment.

--

 

It's the agoraphobia that makes me intensely anxious and fearful of leaving my home which I consider as "safe." In the same way I consider others as "unsafe." The unsafe situations where the bathroom availability is not clear are what give me that horrible anxiety: any kind of travel (car, public trans, whatever), outdoor spaces without bathrooms like hikes or even beaches or parks where the bathroom doesn't exist or is super busy, even indoor spaces where the bathroom situation is unclear like certain stores are tough. All places I've panicked about my gut before so my brain sends the message to avoid at all costs even if rationally I don't always feel afraid.

 

From what I've read agoraphobia almost never resolves on its own. You do have to do something about it. I think a mix of medication and CBT might be the ticket for me. I can see how CBT would be most valuable to untangle the mental web I've created but it's a long process and a hard one and I've been dealing with this for so long now that I could really use some relief in the meantime. I've started CBT for IBS already but so far have not been super pleased with the progress (or lack of) so may need to find someone else to work with. I'll be seeing a psychiatrist hopefully in the next week or two as well to get their perspective on CBT/medication for my issue. Agoraphobia feels embarrassing but it feels better to name the problem and understand what's happening as it makes it feel less like something I have no control over. 

 

MX I'm sorry to hear about what you're dealing with. It really sounds like a lot. And I think if things aren't getting better for you then medication might be the answer. Do you work with a therapist who you trust? Maybe they can offer some perspective of what they think is going on and what the best approach is to give you a quality of life back? Whether it's medication or some other kind of therapy (or both). As much as I'm scared of the possibility of going through another withdrawal down the line, I'm trying to not let the fear of the future keep me miserable in the present. A couple of things to keep in mind about going on another medication: Cymbalta is particularly nasty as it has such a short half life and affects multiple neurotransmitters, another medication will probably have some withdrawal but it won't be as bad as this plus you'll be more prepared. Also you and I both got off Cymbalta with horrible advice and lack of proper care and support. I know neither of us would repeat that same mistake again. 

 

Sorry this was a long one!

[Mxpro32]

thats good your trip went fairly well.  for agoraphobia, isn't the way out exposure therapy?  you have to endure the suffering in tolerable doses until the fear reaction subsides?  that doesn't sound fun at all, but its probably necessary.  

 

yeah, my fears on medicine are that it will numb me out too much like cymbalta did.  I didn't realize how numb I was till I got off.  I also worry it will set me back with another round of withdrawals.  I'm also worried it won't help and I'll feel hopeless with my misery.  its been my idea of a parachute, and realizing your parachute is not going to work might make me lose hope.  coming up on being off of cymbalta for 2 years is getting to me.  I can't believe its been that long, and I can't believe I'm still so miserable.  its nowhere near where it was during acute withdrawal, but its not good.  I really wish I could know if I'm still improving.  its like how being stuck in traffic is much harder when you don't know how long you are going to be stuck, only in this case you might be stuck forever.  

[fishinghat]

You did really well frog!! That's great. Rest up and then work onb somne occasional short trips. You will get there.

 

Mxpro - "for agoraphobia, isn't the way out exposure therapy?"  In general yes but I have been told that it depends on how much the in dividual is an introvert or an extrovert.  For me going on long trips, being at parties/family get togethers with large number of people is torture. I am very much an introvert and putting me into exposure therapy would only male things worse as I have a natural dislike of those situations. On the other hand  an extrovert has an inherent desire for social contact and views it in a positive light. Exposure therapy in those individuals would be more effective. At least that is the way my therapist explained it to me.  lol

[frog]

Exposure therapy is a part of CBT. You first learn the skills to start to reframe your thoughts around whatever your fear is, so first understanding what the fear/belief actually is, then patiently and diligently challenging those beliefs and thoughts as they come up and responding with alternative possibilities, other soothing thoughts, etc. Once you're able to more effectively challenge the thoughts you marry that with gradual exposure and use those skills in the moment. And then over time the exposures become less powerful and less scary, etc. 

 

In my case I pretty much have been doing exposure therapy on myself and I've been slapping together some form of mental reframing on my own, but honestly the physical anxiety is so intense and so overwhelming it can be really difficult to practice the therapy techniques alongside it. I'm hoping medication will at worst just "take the edge off" and allow me to continue working on what I'm learning in therapy without being under extreme duress all the time, or at best, by soothing my nervous system I'll be able to break out of the cycle of being anxious about being anxious and hitting that reset button will be enough to improve everything on its own. 

 

I'm testing out a few psychiatrists right now to find the right fit, but I just got off my first consultation and felt really reassured already. She was very adamant that she's not a medication pusher, she views it as one possible tool, but one of many others and she's always looking for other tools to utilize before jumping straight to medication. She was very comforting about my concern over having to try multiple medications before finding the right one and said she tries as much as possible to use the patient history to determine upfront which medication would be the best fit and feels she can often tell quite quickly if it's the wrong fit meaning you would still be on a low dose making the switch easier. Also, not that this is a big secret, but it made me feel better when she said SNRIs are notorious for being really hard to get off of due to their short half lives and extra neurotransmitter effects. Overall I felt really comforted by everything she said and to be honest feel a huge wave of relief now when I think about taking medication and feel more hopeful and positive about the future.

 

MX I absolutely understand your concern about your parachute. You want to maintain the hope that when things are truly unbearable, there is a safety net to catch you. Have you talked to your psychiatrist about it? Maybe they could offer you some thoughts that would be reassuring the way this Dr. did for me just now? Or if your psychiatrist isn't cutting it, there are others. The woman I just spoke to is based in Texas but also licensed in California so can do calls via video with you since you are also here. 

[invalidusername]

MX - The agoraphobia thing is exposure, but dealt with in specific ways. Not exposure in the way one might think - just as Hat said, going into a room full of people wouldn't be the right exposure for him. If I had a fear of jumping out of an airplane, I wouldn't go and do it to deal with the anxiety as it is simply not something I have a desire to do! Incidentally, I did do a few skydives back in the day!! I think I would be able to deal with larger crowds, but again, what would be the point when things like big parties, football matches, concerts... they don't interest me. I couldn't absorb myself in the environment as a means to overcome the anxiety as I simply would not want to be there! 

 

The best way to summarise is how the wonderful Dr Weekes put it; lose the fear of the feeling. All you fear is the feeling. Nothing else happens. Let the feeling come - encourage it. Tell it to do its worst. It will get to a point and can go no further because it is only a thought. This took me such a long time, but when I found Weekes' work, it helped immensely. 

 

The whole stuck in traffic I totally get. Fine when you are on a road where you are able to pull a u-turn and find another route, but on the freeway/motorway, you are trapped. The unknown as it always is. But you will never be stuck forever. Inevitably, there comes a point where you have pushed past the panic and your body settles. But don't forget that a vast majority of people have anxiety of being stuck in traffic. It is a symptom of a generation, not you.

 

Frog - That was a mammoth undertaking. An amazing feat of courage on your part there. You are right about the agoraphobia insomuch that people generally consider it to be a fear of leaving the home and being out in the open, but you are right, it is a lot more complex than this. Agoraphobia is rarely the same between individuals - not necessarily in its nature, but in its triggers and source. For you, it is the lack of facilities. It is a well-founded reason to be anxious though - that is the issue here. I would say that this all needs to start with some self-compassion. Don't think that due to this issue that it will never go away. It can't rain all the time my sweet. 

 

However, I feel you are right that the combination you speak of collectively compounded to creating the anxiety and agoraphobia. It started with one trigger and then those extraneous triggers that were not yet triggers... became triggers as they become more associated with the issue. If that makes sense...

 

Sounds like you have found a good fit with the p-doc. You certainly have done a lot of the exposure work yourself and done a cracking job. Hopefully with this extra input it will put you in a better situation to get past this current point. Anxiety of anxiety is often where people get. But for me, it is what I mentioned to MX. Claire Weekes really cuts through the crap and puts it as it is. It took me mornings of just reading the same chapter over and over so it stuck when I went outside into the scary world. 

 

It may have seemed futile to anyone else, but because my head had got trapped into a particularly way of thinking, I needed to hammer it with this information almost constantly for it to sink back in. It took time, patience and a lot of bravado, but it got the job done.

 

My thoughts and prayers are with you both.

[fishinghat]

Excellant post IUN!!

[invalidusername]

Thank you Hat - as we both know, anxiety is such a tricky thing to overcome as the cure seems counterintuative. But the last thing I want is to see people get stuck in this loop of thinking that the way forward is seen as the way back. It is such a difficult road to tread. 

 

Rather than saying "I have no idea how I got through it", it is far better to learn the skills such that when the anxiety starts coming back, you do not fear it, but rather apply the same skills and nip it in the bud (love that saying - anyone remember Three's Company from the 70's?)

[fishinghat]

"...and nip it in the bud (love that saying - anyone remember Three's Company from the 70's?)"

 

Ah yes but before that it was Don Knots in Andy Griffith show who said it all the time.

[invalidusername]

Was also Don Knotts in Three's company, but didn't know further back from there

[frog]

Thanks IUN. I am very aware that the best way to combat fear of anxiety is to accept that the anxiety will happen and make peace with it. My struggle with that statement is that while I can accept that I may have anxiety, I have a really hard time accepting having bad anxiety around other people (except my husband) or basically feeling like I'm completely falling apart around other people. My guess is that I have always had anxiety about being judged by others. Having visible anxiety/panic in public feels like another potential way to be criticized or judged so I want to avoid it at all costs. I'm not completely in tune with why I have always had SUCH a fear of this but I guess that's therapy fodder. 

 

I do wonder if I'm letting myself take the easy road out and not put in the work by leaning toward meds instead of pushing through and continuing the mental work? But the truth is that I feel like I have been pushing through my anxiety A LOT and yet it's still hanging around like this ominous cloud constantly sending the message that everything is scary, unsafe and dangerous and I'm just exhausted from fighting my brain 24/7. I need a rest. And when I feel rested and strong again, I'll be able to better tackle this. That's my opinion anyway. One nice piece of advice I just got from a GI NP I just spoke with, she said when you're choosing your mental health medications, don't settle. You shouldn't just "feel better for someone who has hypervigilance, etc" you should actually feel well. I found that encouraging even if it may be easier said than done

 

Hope you are all doing well

[invalidusername]

Hey Frog...

 

Is this fear of being judged by other you know? For example at a social gathering, or people just out and about? Or both? Is there any delineating between the two... worse if you don't know the people, or vice versa? 

 

This is for sure the result of a society driven by comparison to others. To be judged, there has to be a yardstick. If you fall beneath that, its a bad thing. But this yardstick is unknown, it is largely subjective, and this is the issue by the sounds of it.

 

My issues (and occasionally still are), is passing out in public. The attention it would cause, and then those same people seeing me and thinking "there's that guy that passed out that time". This was bought about as a result of a near-fatal car crash. It would have been fine is some sick b*stard hadn't taken pictures of the accident and sold them to the paper. Everyone I knew saw it and I couldn't escape the attention. I wanted to opportunity to tell people what happened in my own words and in my own time - this robbed me of this and caused no-end of panic. 

 

I completely understand your perspective on this - displaying visible anxiety or panic in public is what it is all about. The means by which this is reduced is partially subjective, but it also related to the "what is the worst that can happen?". How would you feel if someone was experiencing panic in your presence. There would be empathy and they would want to aid the situation for you as best they can. Hence the reason why it is sometimes better to be known. I joked with this concept in considering getting a t-shirt printed that had in big block letters "I HAVE PANIC ATTACKS" !! Because it can't be seen, it is a difficult one to get over. If you were in a wheel-chair, sure there would be the initial attention, but people don't care - it is part of everyday life. They are courteous. The same would be seen for mental health problems if they could be seen. But we are still scared of having them seen. Why? Is it a sign of weakness? What is the fear that is driving it...

 

I do understand that you need a break from it all. I would have given anything to have the same thing, but we can make bad decisions in our desperation. It is a tough road to walk. You have my every sympathy. And as always, you are never alone. If I am honest, my anxiety has flared up just writing this message thinking back to my past. I have got plans to go out with a couple of friends this afternoon to some woodlands. Is a good 20 minute drive away. Normally it would be fine, but now feeling I would be better off staying in!! Time to bring out the old skills...!

 

Bless you Frog...

 

IUN

[Mxpro32]

frog, did you decide which ssri you are going to try?  I had a really good couple of days this weekend.  I still had nervousness and anxiety, but my mindset was right.  I felt like my life was real and somewhat in my control.  I had motivation to work and achieve goals.  my "problems" seemed external and like things I could work to fix instead of purely in my head and out of my control.  I really felt like I got to this positive state by getting my thoughts straight, then I woke up in pure nightmarish terror the next morning and have slept like crap since, I have anxiety all the time, and I feel like crying.  I'll probably feel differently when I have a moment of feeling normal again, but this volatility in my mood, insomnia, and anxiety is exhausting and has me considering meds.  I'm probably just feeling sorry for myself due to the disappointment of tasting the good life and then having it yanked away again.  

[frog]

It's that volatility that I can't handle anymore. I was doing quite well up to about 2 months ago. I felt like most of it was behind me and there were some specific circumstances that caused anxiety but I could tackle them through therapy if I worked at it for a while. But I felt more in control so that felt achievable.

 

Then that Santa Barbara trip caused me a lot of stress and I've literally not been the same since. I feel like I'm back to the bad old days when I felt dread and stress every single morning without fail regardless of what I intended to do that day. I feel so unstable and hopeless about the future which then adds to the stress I'm already experiencing. I think my cortisol is all out of whack because of being under so much stress for so long. And messed up cortisol levels worsen anxiety, worsen sleep, worsen literally everything. Lowering stress sounds nice, but is kind of ridiculous. Life is stressful, my job is stressful, being away from my family during a pandemic is stressful, dealing with ongoing health ailments is stressful. 

 

I think the SSRI will reduce the cortisol and promote more serotonin and keep things on an even keel long enough that I can get my bearings again and let things settle down without having to constantly worry when something's going to knock me down again.  

 

I have my appt with the psychiatrist tomorrow so I'll let you know what she says and prescribes but I feel hopeful about what meds can do for me right now. It's not how I envisioned things turning out but it is what it is and I've gotta just roll with it. I'm nervous about it not working, nervous about the side effects being too much because I'm so fragile right now, nervous about feeling lethargic all the time like I did on Cymbalta, but I'm just going to try to put faith in my doctor that we're on the same team

 

Don't be hard on yourself for feeling disappointed that the good days didn't last. You have every right to feel sorry for yourself. It's a miserable state to be in survival mode all the time and not knowing when it'll randomly get better or get worse again. I empathize completely and feel sorry for myself all the time. 

[fishinghat]

I was afraid that trip would do that to you. I know it is very frustrating but it truly takes months to slowly (nothing abrupt) to get reaclimated back to a semi-normal life. Weeks to get use to going out and doing life things. Small trips first and then longer ones. Once I started to be more active it took me around 12 to 18 monthys to even get close to being normal in my exposure to social interaction. The good news is that this set back from the trip wil fade away over the next 4 to 8 weeks. Hang in there, you have come a long ways.

[frog]

Unfortunately I just don't feel like I have 12 to 18 months to wait Especially when I have already been waiting for so long. It's hard to lose joy in everything I used to find joy in. I literally feel like every day I'm just surviving and I just can't take survival mode anymore.

 

Anywho I just had a VERY affirming and positive first call with my new psychiatrist. She was wonderful and I felt so validated and heard and taken care of when speaking with her. She really listened to everything, asked tons of questions and ultimately agreed that if I'm up for it an SSRI is a good option for right now to squash the severe anxiety I'm experiencing as a result of the multiple layers of trauma that withdrawal (and then covid) caused and that I now find myself effectively "stuck" in. 

 

She said some incredibly reassuring things, like that she never prescribes Effexor because of how much of a struggle it is to get off, and even with Cymbalta she has in the past had to work with patients so slowly that they tapered all the way down to the very last bead. I know everyone here would find this validating as well. 

 

So with that said I will be starting Lexapro this week which she said tends to have the edge on combatting anxiety. She also suggested mirtrazapine as it has a bit of a sedating effect and could help with insomnia but I'm already so low energy I don't need additional sedation. I think my sleep will improve once my nervous system calms down. Anyway I asked her what I can expect to feel like if it works the way she expects it to and she said it would greatly reduce any physical anxiety, reduce or eliminate the thought loops I get stuck in now and greatly reduce the time I'm spending ruminating on things endlessly. I felt a wave of relief just from hearing her say that to be honest. And she promised that we would be able to get me off of this medication eventually when I felt I was ready. That it may not be a walk in the park given my reaction to Cymbalta, but that we would handle it as slowly and thoughtfully as possible to make it manageable. 

[fishinghat]

frog, o for it. Everyone deserves happiness. I truly hope it brings peace to you re your family. You have been so strong through all of this and have tried so hard. No shame here for sure.

[Mxpro32]

man I'm tempted to try ssris too.  my mood tracker app shows this month has been the worst in average mood for the whole year.  I've only marked 5 "good" days, and I define good as lack of misery.   my sleep has been atrocious and I'm exhausted and feel like crying.  my anxiety is terrible almost all the time.  it really feels like I'm not getting any better.  the sleep seems to be the key.  my sleep is so terrible I have a hard time imagining anyone feeling ok with the sleep I'm getting.  not only is the sleep terrible, I'm waking up with anxiety/fear every morning that has me begging for relief.  theres just no break from it.  I know I can tough it out if I had any certainty it would get better, but at this point I'm wondering how much longer I'm going to have to put up with feeling this terrible.  how much of my kids life will I essentially miss?  I would hope an ssri would be easier to come off of than an snri if I decide I don't want to stay on forever.  when I mention going back on a med to my wife she acts like she doesn't think its a good idea.  friends give me the same feedback.  

[frog]

Obviously I completely empathize and deeply understand everything you're feeling. I think bad sleep can certainly contribute to increased feeling of stress and anxiety, but I also think it's like chicken or the egg right? Are you sleeping badly because of the stress/anxiety or do you have stress/anxiety because you're not sleeping well? I think the answer is that it doesn't really matter because the focus should be the end result which is that you are experiencing severe anxiety, and that is what needs to be addressed. 

 

I've been toughing it out for as long as you have and similarly I just reached a point where there's no real end in sight because the anxiety will pop back up when I least expect it and throw everything out of balance again. I described it to my psychiatrist as feeling like I'm riding a razr scooter on the sidewalk. Everything's great when the surface is smooth, but the smallest pebble in my way will send me flying and it takes A LONG time to recover. And every setback compounds on itself because you start obsessing over the fact that you can never truly be at peace. There's always a possibility the anxiety will come back.

 

Everything else I've tried just hasn't been enough to beat back the anxiety for a prolonged time. It feels like the cartoons where a pipe bursts and they plug it with their finger then it bursts in another spot and they plug that up until they run out of fingers. That's how I feel these days. I've run out of fingers... The psychiatrist basically said that she sees this all the time. A traumatic event (the withdrawal definitely qualifies, for others it could be some other type of health event maybe a surgery or something like that) that is followed by periods of intense anxiety that then stacks on top of itself until you're swept away with it. She also agreed that the timing of COVID starting up as I was just coming out of the fog couldn't have been worse.

 

As for your friends and wife's opinion... I can understand where they're coming from. They have watched you suffer so they think they're protecting you. But they are not mental health professionals and they also can't really understand how you feel every single day, how miserable it can be and how bad it can really get if you leave it untreated. Me personally, I just decided that I can't live in the future scaring myself about some potential withdrawal that may or may not even happen. I'd rather feel good today and worry about that later. And knowing what I know now I will be sure to prepare really well in advance and go super slow. 

 

You could always just have a conversation with your psychiatrist and be really honest about your reservations and your concern that it may not work and see if they have anything valuable to offer. For what it's worth, I asked my doc the same thing. What if it just doesn't work? She said there's a chance the first thing we try won't reduce the anxiety as much as we want it to and so we may have to try something else, but she said she's never had it not help at all. That made me feel way better. 

[Mxpro32]

well said frog.  I think my psychiatrist is an idiot and I don't think there are any better in my area.  the fact he would prescribe klonopin for my sleep issues without warning me it can be habit forming shows how clueless he is. 

 

yesterday evening I was getting emotional and almost cried watching kung fu panda.  I've come to recognize that this means I have a good period coming.  any time I cry freely during touching movies or stories, its always followed up by good times.  I was laughing with my family last night and really felt grateful for my life.  I actually slept pretty well last night too.  I woke up at 2:30 and 5:00 pretty wide awake with some anxiety, but was able to go back to sleep and slept till 8:00.  my anxiety feels much lower today, and now I feel the depression crash coming.   it always happens after a prolonged intense bout with anxiety.  its like my system and psyche doesn't know what to do with itself in anxieties absence.  it doesn't feel very intense though, and its ok as its a necessary step toward equilibrium I think.  

 

on days like this I feel like I don't need meds, until the next time I wake up in terror and ride the bull again for a while.  thus the decision to make.  my life feels much richer and fuller during these good times than it ever did on meds, but the bad times are soo miserable the meds would definitely improve them.   

[frog]

The one positive thing about the pandemic is that I think it's made telemedicine way more normalized and more readily available. If you don't mind seeing a psychiatrist via Zoom vs in person then you'll have way more options! 

I've only talked to my new psychiatrist twice now but I really love her so far and feel like I'm in good hands. I'm seeing her via Zoom so since you're also in California I think you could see her as well. The only downside is that she's pricey and does not work with insurance (on the positive side, not working with insurance allows her to be way more flexible and set up care the way she thinks is most effective). Though she does provide a superbill that you can then submit to your insurance and get reimbursed. If you're interested I can message you her info. 

 

I found her through my therapist who has a listserv she messages out to whenever I ask her help to find someone in mental health. Do you have a therapist you talk to who perhaps could help you in finding some new options for psychiatry? I agree that going on a new medication with your current psychiatrist who you don't trust does not sound like a good idea and I'm sure contributes to your hesitation. 

 

When I was doing pretty well a few months ago I thought I could make it through without medication but the last 2 months have been terrible and also serve as a reminder that the severe anxiety is never really gone. It's just hiding below the surface. The whole Cymbalta ordeal + COVID made my mild agoraphobia so much worse and the last couple months I feel it's continuing to get worse. 

 

I've been on 5mg on Lexapro for 5 days now. I haven't noticed anything good or bad really. I feel pretty tired but I can't say for sure that has anything to do with meds as I'm not sleeping well either. Probably in a week or so I will bump up to 10mg. My hope is that I don't have to go to the full 20mg but if that's what it takes then that's ok

[Mxpro32]

I've been reading the lexapro reviews at rxlist.com and it sounds pretty good. people are describing waking up in fear all the time, insomnia, etc. and how lexapro took it all way and made them able to feel the sunshine and enjoy their lives again.  sounds worth a shot.  I would think a regular ssri would be easier to get off of than cymbalta too.  thats my biggest worry is going through that again if it didn't work.  

[frog]

Yes my psych said the SNRIs are the worst, she doesn't even prescribe Effexor because of that. And Cymbalta is really rough too because of the short half life. I think it's like 12 hours? Lexapro is more than 24 hours so I guess it just makes the reduction feel less like a rollercoaster. She said she can't promise it'll be a walk in the park given my reaction to Cymbalta but it's unlikely it would be that bad again. I also figure part of what made it really bad is that I cold turkey'd from 18mg with basically no safety net, so obviously I would never do that again either. 

 

I just want to be able to wake up every day and think 'what should I do today?' not 'i can't do anything today' or my favorite 'i havent left the house in days i really should go somewhere but everytime i think about it my anxiety goes nuts so nevermind' 

 

Keeping my fingers crossed that I get the same great results you and I have read about and I can take off this anxiety blanket and move forward and reclaim my normal life back and hopefully feeling normal for a year or two will put me back on track and I won't need the meds anymore

[invalidusername]

Catching up with you guys here - but mentioned a few comments on another topic somewhere earlier today. Can't remember where!

 

 

I just want to be able to wake up every day and think 'what should I do today?' not 'i can't do anything today' or my favorite 'i havent left the house in days i really should go somewhere but everytime i think about it my anxiety goes nuts so nevermind' 

 

I love how you just leave nothing out Frog. It is so good to read this stuff - there is no censoring with you - you say it like it is and its the best way as I really feel that you understand. Well I don't feel so much as I know! 

 

I really wish you well with your venture into Escitalopram and hope it helps. Cymbalta does indeed have a 12 hour half life - although, the same as any drug, can be +/- 25% or so. Always subjective, but I am sure you will not have the same issues this time around. This is why we suggest when members get to the <10mg point, that they divide the dose and take half twice a day rather than the full dose once a day. It can ease it, but the compound build up of the drug is what doesn't help like some of the SSRI's.

[frog]

Bumped up to 7.5mg on the lexapro today. Sleep issue was really my main problem. Along with feeling pretty physically tired and some mild jaw clenching/teeth grinding. Melatonin has taken care of the sleep problem for the past few days which is a relief. It makes me super groggy in the morning and I have weird dreams (like laughing and making weird faces in my sleep which I don't normally do) but that's not so bad compared to lying awake all night for days. Doc said that since the melatonin helped she feels pretty sure that the sleep issue will likely fade away with sometime but it's likely to stick around as long as I'm increasing the doseage.

 

In terms of positives, I haven't noticed any change in my anxiety which I wasn't necessarily expecting quite yet. But my mood is WAY better. The past couple months I've been on the verge of tears all day every day. Just an emotional time bomb. That is completely gone now. I feel happier and lighter like I have a force field around me and all the stuff that until recently would get in my head and make me spiral is now just bouncing off and away. It's a beautiful thing to not get caught up in every little stressful thing.

 

Overall my doc is happy with how I'm tolerating it so far and feels optimistic that it will get the anxiety under control at a higher dose. Assuming all stays on course over the next couple of weeks I will bump up to 10mg then and work my way up from there as needed until I feel like a functional person again. My primary goal is to feel the best I can by the end of October when I need to make the big trip home. 

 

Hope you all are doing well 

[Mxpro32]

Hey Frog.  I'm glad its improving your mood.  I think I'm going to call and make an appointment to try an ssri as well.  I've  woken up the last few nights again feeling like I'm losing everything and ever uncertainty in life feels like an existential threat.  I'm just tired of fighting.  I really hope it works, and isn't too tough to quit when I decide to do so.  

[mimi10]

Frog, 

I am glad things seem to be going well so far, I know that sleep is a real issue and I’m glad you’re finding relief with the melatonin.  Just wanted to let you know I’m thinking of you and hoping that things go well.  Thoughts and prayers are with you.

[frog]

Thank you Mimi Thinking of you too and hope you get your sleep and pain to a manageable level

 

MXPro I think it's the right move. Keep us updated. And you don't have to go from 0 to 100. Despite my impatience and wanting the anxiety to stop ASAP my doc and I are taking it slow. Increasing very gradually and only when things are feeling good. I have had a good experience with the Lexapro so far and even starting at 5mg (half the usual starting dose and a quarter of the usual anxiety dose) I felt like a new person. Stress isn't dragging me into a spiral of despair, panic and tears. Quite literally it feels like there is a mental barrier between my emotions and stress. I'm again able to view things rationally and not get triggered into thought loops I can't get out of. I just increased to 7.5mg a couple of days ago and hoping to start seeing more improvement in the anxiety/fears. 

 

If you don't feel like your doctor is super sensitive to your situation, just advocate for yourself. If you want to go slow, then go slow. They can't force you to do anything you don't want to do.