How to combat anxiety?

June 18, 2013 5:42 PM

My anti-depressant (Wellbutrin XL) is generally working, but one of the side-effects is a great deal of generalized anxiety. I'm stuck with the anti-depressant for now, so I'm looking for practices, foods, or medications you've been prescribed that helped you combat anxiety.

I really wish I was normal and didn't need to be on an anti-depressant, but my depression hits pretty hard and I don't really have a choice. After going through 5 or 6 anti-depressants, I've found one that mostly works, but it does cause (or amplify) a great deal of generalized anxiety. Just a creeping sense of dread that any given situation won't work out, something bad will happen, or that the tidal wave of life will take me under and I'll never surface. So as much as the anti-depressant helps me get out of bed in the morning, I now fear leaving the house.

Can you recommend any practices, foods, or herbal remedies that helped you with this? I'd prefer not to introduce another medication to the mix, but I'll try that too if I can find one that doesn't make me lethargic and put me back in bed.

Thanks for your help.

posted by anonymous to Health & Fitness (24 answers total)

I find that daily vigorous exercise (or more moderate exercise for a longer time) does a lot for my anxiety. My brother manages his anxiety with yoga, anywhere from 3x/week to 3x/day depending on circumstances. I have also found that reducing the starch and sugar in my diet helped both my depression and my anxiety tremendously.
posted by KathrynT at 5:48 PM on June 18, 2013

That doesn't actually sound like an antidepressant that's working. Have you talked to a psychiatrist about the side effects? It may be as simple as adjusting the dose.
posted by jaguar at 5:50 PM on June 18, 2013 [2 favorites]

That's a known side effect.

My doctor prescribed me buspirone to go with it. My therapist recommends inositol if you're also interested in non-prescription options.

The buspar+Wellbutrin was very good for me.
posted by Salamandrous at 5:58 PM on June 18, 2013 [4 favorites]

I'd like to chime in with an N'thing of what KathrynT says and than you for posting and her reminder. I gotta get back on the bike, just a few miles and the whole perspective is clearer and calmer.
posted by sammyo at 5:59 PM on June 18, 2013

Exercise. If you're like me, you won't get to the point where your enjoy it, but you'll feel the results & will keep at it
posted by .kobayashi. at 6:01 PM on June 18, 2013

I've successfully dealt with my mental illness through a combination of strength work (weightlifting/powerlifting, mostly) and clean eating. It responds really well to both of those things... I find that when I veer too far away from whole foods making up the majority of my diet, I pay a bit of a price in terms of a mood dip and anxiety spike. I ate junk for most of my life and didn't realize how much of an effect it had on my mental health until I cleaned my diet up. That said, I've found that I do need starch in my diet (eating very low carb triggers serious depression for me... miraculously cured by eating a potato.) Your mileage may vary, of course.

The standard AskMe answer of mindfulness meditation is a huge help, too, even if you only do it for ten or fifteen minutes a day... it really trains the mind to recognize and classify anxious thoughts appropriately. You still have to deal with the physical side effects but it can help to short-circuit the anxiety chain reaction.

And while you don't mention it, I'm assuming you're in therapy at the same time. If not, you should explore adding that to the mix if it's a possibility for you.
posted by Kosh at 6:02 PM on June 18, 2013

I had a big problem with general anxiety and Celexa has helped with that greatly. I used to take Wellbutrin too, so I did use both at the same time.
posted by disaster77 at 6:03 PM on June 18, 2013 [1 favorite]

Exercise. I think of it as my reset button when my brain is stuck in an anxiety loop.

Also, I've taken magnesium powder for anxiety and I believe it did help, although it was like draino for my digestive system in a bad way.
posted by RingerChopChop at 6:07 PM on June 18, 2013

Also, good herbs like milky oats or catnip steeped in hot water can't hurt.
posted by RingerChopChop at 6:08 PM on June 18, 2013

I'm on Celexa but am weaning off it under doctor's supervision. I'm glad I took it since it allowed me to get to a place where I could even consider exercising (I'm very active now). So what worked for me was exercise and also sleep, sunshine, and much less sugar.
posted by futureisunwritten at 6:09 PM on June 18, 2013

Yoga and turkey.
posted by bq at 6:09 PM on June 18, 2013

How long have you been on it?

If it's only been two or three weeks, exercise will help. Also back when I had to do meds I had this with other medications and my doc was always good about prescribing something for that particular side effect. I'd ask your doc if the exercise doesn't totally deal with the problem.
posted by St. Alia of the Bunnies at 6:30 PM on June 18, 2013

I am also an exercise-for-mild-anxiety advocate. The other things that helped me (not speaking to your specific case, but this worked for me) were

- cutting down coffee and other caffeine significantly
- being mindful of how much sugar I was eating and trying to avoid weird "I just ate a lot of candy and now I am crashing" thing
- staying fed generally, sometimes when I get nervous I don't eat enough and then I'd find myself in these weird dark moods and I was just hungry

Sunshine, being outside, interacting with people and animals are all also good ways to get out of anxiety spirals.
posted by jessamyn at 6:30 PM on June 18, 2013

I was anxious before I started Wellbutrin, so this might not be all that applicable, but Wellbutrin is the only AD I seem to be able to take that works. Since it doesn't dull me the way Prozac did, it became necessary to find something for anxiety as well. So I'm on Xanax. Because I can't take any other benzo for more than a day. And the other non-benzo meds either didn't work (propranalol and catapres) or were too sedating (Trazadone, Atarax and anything else that is an antihistamine in any way). Most docs with most patients would probably start with Ativan or Klonopin because they are less habituating than Xanax and easier to come off of.

Exercise is lovely and all, but you actually have to do it. I'm working on it. Though I haven't noticed any lessening of depression or anxiety. I think part of it is just the difference between chemical-created anxiety (natural or artificial) and thought-created anxiety. Thought anxiety is much more suceptable to distraction and change, in my experience.
posted by monopas at 7:23 PM on June 18, 2013

I took Wellbutrin for a while, and noticed this as well. The funny thing about it was that the anxiety felt less "real" to me. I'd walk into totally normal situations and then wonder why I'm sweating and amped up. Answer: I always had a little anxiety about everything, and the Wellbutrin amplified it. But at the same time, the increased anxiety was less bothersome. It was almost fun, sort of like an adrenalin rush. (Which sort of makes sense, since it is pharmacological similar to speed.) I ended up stopping it because of a different reason.

But I did notice the anxiety was returning to normal levels before I stopped. It was oddly helpful, in that by amplifying my anxiety, I was more able to recognize it and CBT my way out of it before it got too bad.

Another option might be to add an SSRI like Prozac to give you a little more "well being" feelings.
posted by gjc at 7:37 PM on June 18, 2013

Might make a difference if its brand or generic, how much you are taking, how often, and how long you've been on it.
posted by tilde at 7:38 PM on June 18, 2013

Agree with Tilde, some of the generics were worse for me than others. What dosage are you taking?

Nnthing the exercise. I remember that I really could only handle solo stuff like nature hikes, but it really helped for me to get out in areas sans other people.

I also found that mega doses of fish oil and regular doses of magnesium were very helpful.
posted by checkitnice at 7:56 PM on June 18, 2013

Generic bupropion is not necessarily identical across manufacturers. It might be worth calling around to other pharmacies to see if theirs comes from somewhere else, and to try it from another manufacturer to see if it's a better fit.
posted by gnomeloaf at 8:28 PM on June 18, 2013

I love bupropion but I also get anxious. I've been trying to cope by thinking through when and why I get anxious, then working from there to prevent it. For example, I get weirdly anxious at the end of the work day because I won't know what to do with myself. I'm trying to plan ahead so I know that after work, I have plans.

But also exercise - running and yoga for me. It almost acts like a vaccine with whatever thing might come up during my day. "I need to stay late at work to finish something? Thank goodness I got that run in this morning!"
posted by kat518 at 9:34 PM on June 18, 2013

Is the anxiety coming on at any particular point in the day?

For me the Wellbutrin enhanced anxiety usually comes on at night as the drug is wearing off, and is coupled with some greater then usual insomnia. I pretty much just deal with it by drinking too much. I don't recommend you try that.

Exercise helps, drinking lots of water might help, if you think animals are nice then petting them helps, some sort of meditation is probably good, getting away form screens if you spend to much time with them helps. Doing all of those things that you are supposed to do for anxiety and depression do all help some.

But it also sound like you might not be taking the right dosage, you don't say how long you have been taking it, but for me it took probably 3-4 months to find a dosage that I could live with, and maybe a year and a half before I figured out what worked best for me. It takes a good bit of patience both from you, and from your doctor, ( and if your doctor does not have the patience to work with you on this, it is new doctor time.)
posted by St. Sorryass at 10:32 PM on June 18, 2013

One coping mechanism I use when I feel anxiety creeping in is 4-7-8 breathing.

Breathe in through your nose for 4 counts, hold your breath for 7 counts, release the breath through your mouth for 8 counts. Repeat. It often helps me let go of tension and force myself to relax.

Oh and here is the totally cute GoZen kids video I learned this from :)
posted by quietta at 10:59 AM on June 19, 2013

1mg/night clonazepam did wonders for my anxiety.
posted by Jacqueline at 2:19 PM on June 19, 2013

I've been taking bupropion for a few years now to help me manage depression and ADHD, but it sure doesn't do my anxiety any favours.

In roughly descending order of effectiveness, I've found these lifestyle changes helpful on the macro scale:

• Mindfulness meditation
• Limiting my caffeine and sugar intake
• Drinking enough water every day ("enough" is more than you think)
• Fresh air and sunshine (weather permitting)
• Actual, strenuous, sweat-through-my-shirt exercise two or three times a week

On the micro scale, for those sudden ohshitohshitohshit moments:

• Bringing mindful attention to the physical manifestations of anxiety in my body ("okay, my shoulders are tense, I feel nauseated, cold sweat on my face, hands are shaking...")
• Journaling, sort of. I sit down at my laptop, fire up a text editor and just try to transcribe the ohshit stream of consciousness as it happens, until it starts to wind down on its own

(I've personally never found anything as effective as marijuana for short-term anxiety relief, but I'm going to stop short of an actual recommendation for what I assume are pretty obvious reasons.)

And hey, about this? I really wish I was normal and didn't need to be on an anti-depressant There's nothing wrong with being depressed, or having anxiety, or needing to be on an anti-depressant. You aren't weak, or defective, or lesser in any way because of that. You're facing a problem, and you're solving it. That's not "abnormal." That's fucking awesome.
posted by Zozo at 3:32 PM on June 19, 2013

Relaxation videos on Youtube, especially those that guide you through deep breathing. Buspirone helped a bit. To be honest, one of the most effective ways I've found of dealing with anxiety is e-cigarettes (not regular cigarettes) with a low dose of nicotine. No one in my health-conscious circle would ever have recommended that to me, and indeed I've gotten some negative reactions, but I'm throwing it out there because for me the risks are worth the very tangible relief it provides. My psychiatrist signed off on it, for what it's worth.
posted by asynchronous at 8:54 PM on June 19, 2013 [1 favorite]