Should a hypochondriac take SSRIs?
October 27, 2015 1:20 PM Subscribe
My depression and anxiety are getting out of control, and I think medication would help. However, I'm also a massive hypochondriac as part of my anxiety problem, and I'm really worried about the side effects. Is it worth giving meds a shot anyway?
My lifelong anxiety has spun massively out of control this year. I'm seeing a therapist but am still really overwhelmed. I feel like medication would help me, but I am a huge hypochondriac and really afraid of the side effects. I'm wondering if taking meds would actually make things worse because worrying about side effects would trigger my anxiety. One of my biggest phobias lately is hair loss (which I have worried about for 5+ years, despite retaining a full head of hair), which I know SSRIs can cause.
My therapist is not a psychiatrist so he can't prescribe me drugs. I am assuming I'd have to go to my GP to get them (or maybe get a referral to a psychiatrist? If anybody knows how this works in Canada, let me know) so I feel like I have to be in charge of my own decision to take meds.
My lifelong anxiety has spun massively out of control this year. I'm seeing a therapist but am still really overwhelmed. I feel like medication would help me, but I am a huge hypochondriac and really afraid of the side effects. I'm wondering if taking meds would actually make things worse because worrying about side effects would trigger my anxiety. One of my biggest phobias lately is hair loss (which I have worried about for 5+ years, despite retaining a full head of hair), which I know SSRIs can cause.
My therapist is not a psychiatrist so he can't prescribe me drugs. I am assuming I'd have to go to my GP to get them (or maybe get a referral to a psychiatrist? If anybody knows how this works in Canada, let me know) so I feel like I have to be in charge of my own decision to take meds.
Hypochondria and some of your concern about side effects could definitely be symptoms of your anxiety.
Why don't you see the GP or psychiatrist (however it works in Canada, I can't help with that) and then decide after talking to them? Just because you go to see the doc doesn't mean you have to take the drugs.
posted by Jahaza at 1:34 PM on October 27, 2015 [2 favorites]
Why don't you see the GP or psychiatrist (however it works in Canada, I can't help with that) and then decide after talking to them? Just because you go to see the doc doesn't mean you have to take the drugs.
posted by Jahaza at 1:34 PM on October 27, 2015 [2 favorites]
GP for the referral - but push for the referral, they might want to manage it themselves. The wait is kind of long, btw. I'm not sure whether it's possible to go through insurance for the psychiatrist (although I'd be surprised if it was, it's a medical/OHIP issue).
I am hugely reluctant to take prescriptions due to past bad experiences. I don't know if drugs would help in your specific case, but that's a question worth asking. A good psychiatrist would order a full blood panel [including thyroid and iron]; listen to your history of side effects with particular drugs, if any apply; carefully choose a drug with the most reasonable side effect profile for your concerns [and would address your concerns];, and be rigorous about follow-ups, where they would take your concerns seriously and make any amendments if required. If you went with a drug, you could also monitor side effects on your own, day to day (there are good apps for this, or you could use a spreadsheet or notebook).
Get a name from someone you know who has experienced this sort of thing with a good psychiatrist, if you can - you can ask for a referral to a specific person. Some psychiatrists do therapy, but most of them mostly handle medication management.
Also, you can see a psychiatrist, talk about options, and decide not to go for drugs in the end, if you don't want them.
posted by cotton dress sock at 1:37 PM on October 27, 2015
I am hugely reluctant to take prescriptions due to past bad experiences. I don't know if drugs would help in your specific case, but that's a question worth asking. A good psychiatrist would order a full blood panel [including thyroid and iron]; listen to your history of side effects with particular drugs, if any apply; carefully choose a drug with the most reasonable side effect profile for your concerns [and would address your concerns];, and be rigorous about follow-ups, where they would take your concerns seriously and make any amendments if required. If you went with a drug, you could also monitor side effects on your own, day to day (there are good apps for this, or you could use a spreadsheet or notebook).
Get a name from someone you know who has experienced this sort of thing with a good psychiatrist, if you can - you can ask for a referral to a specific person. Some psychiatrists do therapy, but most of them mostly handle medication management.
Also, you can see a psychiatrist, talk about options, and decide not to go for drugs in the end, if you don't want them.
posted by cotton dress sock at 1:37 PM on October 27, 2015
I think a good psychiatrist could help you with this - weighing the potential benefits of an SSRI for you against the possibility of it aggravating your hypochondria a bit. I'd talk to a doctor and take it from there.
You might also look into a drug called Buspirone (BuSpar), which is used to treat anxiety but is not an SSRI. It does have adverse effects of its own, of course, but it generally isn't hyped as Side Effect City in the same way that SSRIs are. (Anecdotally, I take it, and experience no side effects except for mild nausea if I haven't eaten enough before taking it.) Something like that might strike a good balance between Useful Medical Intervention and Minimizing Hypochondria Thoughts. A good doctor will be prepared to work with you to find the right solution for you.
posted by schroedingersgirl at 1:42 PM on October 27, 2015 [2 favorites]
You might also look into a drug called Buspirone (BuSpar), which is used to treat anxiety but is not an SSRI. It does have adverse effects of its own, of course, but it generally isn't hyped as Side Effect City in the same way that SSRIs are. (Anecdotally, I take it, and experience no side effects except for mild nausea if I haven't eaten enough before taking it.) Something like that might strike a good balance between Useful Medical Intervention and Minimizing Hypochondria Thoughts. A good doctor will be prepared to work with you to find the right solution for you.
posted by schroedingersgirl at 1:42 PM on October 27, 2015 [2 favorites]
In my personal experience the side effects of SSRIs were not even slightly comparable to the *side effects* of extreme anxiety. I have suffered debilitating bouts of (ironically) health- related anxiety and the palpitations, tension-related aches and pains, difficulty in eating, and sheer mental torment were much worse than the side effects of the remedial treatment. I have been on citalopram (which I think saved my mental health) and am currently on sertraline, which is not as good in my view.
I have been on them on and off for c.10 years and have not lost my hair or had any significant physical side effects at all, really, apart from nausea when starting a new type (very mild, and I just tell myself that it's the tablets and nothing more sinister - oh hypochondria, how I love you). Some fuzzy thinking, which is an issue for me at present, but overall my experience is that the relief outweighs the distress.
Obviously YMMV and if the thought of medication is a trigger for you, do explore alternatives with your GP.
posted by Martha My Dear Prudence at 1:49 PM on October 27, 2015 [5 favorites]
I have been on them on and off for c.10 years and have not lost my hair or had any significant physical side effects at all, really, apart from nausea when starting a new type (very mild, and I just tell myself that it's the tablets and nothing more sinister - oh hypochondria, how I love you). Some fuzzy thinking, which is an issue for me at present, but overall my experience is that the relief outweighs the distress.
Obviously YMMV and if the thought of medication is a trigger for you, do explore alternatives with your GP.
posted by Martha My Dear Prudence at 1:49 PM on October 27, 2015 [5 favorites]
I think you should absolutely give it a try. Remind yourself that not everyone experiences severe side effects from SSRIs and that you won't really know how your body will react until you try.
For me, the only side effects I've had from my SSRI are the following:
-constant thirst. This was initially annoying, but it does get me drinking a ton of water and I have great clear skin and no UTIs as a result, and after a while it just became habit for me to always carry water.
-weird hyper-vivid dreams. This one still bugs me from time to time but I'm always fine by the time I get myself out of bed and into the shower.
-temporary difficulty with orgasms. I didn't lose the ability entirely, I just had to work harder at it, and eventually they became a lot easier (like, easier than pre-meds).
Also, most likely your doctor will start you on a low dose and slowly increase dosage until you both find the right place to be. You won't be going from zero to full throttle overnight.
posted by joan_holloway at 1:55 PM on October 27, 2015 [1 favorite]
For me, the only side effects I've had from my SSRI are the following:
-constant thirst. This was initially annoying, but it does get me drinking a ton of water and I have great clear skin and no UTIs as a result, and after a while it just became habit for me to always carry water.
-weird hyper-vivid dreams. This one still bugs me from time to time but I'm always fine by the time I get myself out of bed and into the shower.
-temporary difficulty with orgasms. I didn't lose the ability entirely, I just had to work harder at it, and eventually they became a lot easier (like, easier than pre-meds).
Also, most likely your doctor will start you on a low dose and slowly increase dosage until you both find the right place to be. You won't be going from zero to full throttle overnight.
posted by joan_holloway at 1:55 PM on October 27, 2015 [1 favorite]
It's not unlikely you'll have some side effects, and you'll have to decide if they're worth it. If they're not, you would talk to your doctor about how to safely discontinue the medication, and then both the primary effects (reduced anxiety) and the side effects (difficulty urinating or whatever) will go away. This is basically the same process for all prescription medication, but I think psychiatric medicine particularly tends to have a lot of variation in how it affects people.
posted by aubilenon at 2:30 PM on October 27, 2015 [1 favorite]
posted by aubilenon at 2:30 PM on October 27, 2015 [1 favorite]
I'm on a low dose of citalopram after 40 plus years of health anxiety and it's made a world of difference to me. Hear's my new-meds trick: I get a good friend or my partner to check for drug interactions. Then I get them to read the consumer warning info, etc. this only works if your buddy is willing, of course. But it means I can take the medication, which I won't do if I read all the warnings. And if I start to feel weird for any reason, I check in with my buddy to see if what I'm feeling or experiencing matches any serious side effects. And thus far, it never has. And my life is a zillion times better because I have 90% less anxiety that I used to have. I got my life back, which is an incredible feeling. I still have anxiety from time to time and sometimes even mild panic attacks. But nothing like the nightmarish suffering I had for years before. Good luck!
posted by Bella Donna at 2:32 PM on October 27, 2015 [5 favorites]
posted by Bella Donna at 2:32 PM on October 27, 2015 [5 favorites]
it means I can take the medication, which I won't do if I read all the warnings. And if I start to feel weird for any reason, I check in with my buddy to see if what I'm feeling or experiencing matches any serious side effects. And thus far, it never has.
I do something really similar, and I was like this with anxiety meds for a long time. One of the things the doctors rarely tell you is that one of the issues with anxiety medication is that you will be afraid to take it. It's not data the doctors tend to have, but that most people who take anti-anxiety medication are very very familiar with. I was concerned about weight gain, about losing my drive, about losing my sex drive, and I finally had to decide even if those things were to happen (which was incredibly unlikely) it would be better than being a prisoner of my own runaway mind. Give it a shot. Say you're going to give it three months or something and if it's terrible you'll stop. Obviously check in with yourself if you're having really bad side effects but try to give it s hot but keep the "If I don't like this I'll stop" mindset in mind. It's incredibly likely that what's going to happen is you're going to forget that you ever made this deal with yourself and you will start feeling significantly better in a much shorter amount of time. I wish you luck.
posted by jessamyn at 2:54 PM on October 27, 2015 [4 favorites]
I do something really similar, and I was like this with anxiety meds for a long time. One of the things the doctors rarely tell you is that one of the issues with anxiety medication is that you will be afraid to take it. It's not data the doctors tend to have, but that most people who take anti-anxiety medication are very very familiar with. I was concerned about weight gain, about losing my drive, about losing my sex drive, and I finally had to decide even if those things were to happen (which was incredibly unlikely) it would be better than being a prisoner of my own runaway mind. Give it a shot. Say you're going to give it three months or something and if it's terrible you'll stop. Obviously check in with yourself if you're having really bad side effects but try to give it s hot but keep the "If I don't like this I'll stop" mindset in mind. It's incredibly likely that what's going to happen is you're going to forget that you ever made this deal with yourself and you will start feeling significantly better in a much shorter amount of time. I wish you luck.
posted by jessamyn at 2:54 PM on October 27, 2015 [4 favorites]
I live in Canada. My GP asked if I wanted him to give me a prescription, or if I wanted to go to a psychiatrist. I requested a psychiatrist, so he gave me a referral. This was about 10 years ago, but I assume it still works that way.
I take Effexor, and it has been very helpful for my anxiety disorder, with no noticeable side effects. (I have to go to a hairdresser to get my hair thinned; there is too much of it!)
posted by LauraJ at 3:22 PM on October 27, 2015
I take Effexor, and it has been very helpful for my anxiety disorder, with no noticeable side effects. (I have to go to a hairdresser to get my hair thinned; there is too much of it!)
posted by LauraJ at 3:22 PM on October 27, 2015
I don't take medicine, but agree with others that it's a good idea, despite your reservations. On the other hand, you can also work on your non-drug health (exercise, especially long aerobic exercise; good nutrition; lots of sleep; time outside, etc). If you haven't tried those things, you could give that a shot first.
posted by three_red_balloons at 3:28 PM on October 27, 2015
posted by three_red_balloons at 3:28 PM on October 27, 2015
In my experience (in the U.S.), doctors and psychiatrists are more likely to prescribe SSRIs for depression and/or anxiety than they are to prescribe shorter-acting anti-anxiety drugs such as Klonopin and Xanax (which may also have other names in Canada, sorry).
I don't know what worries you about taking these kinds of drugs. Personally, I took SSRIs for a long time, and I worried a lot about side effects. For me, that worry was compounded by the fact that people take SSRIs every day, for months or even years on end—what if I thought that something that was part of my personality was actually just because of the SSRI?!
That may not be one of your fears at all, but if it is, you might consider asking for something like Klonopin or Xanax. These drugs are designed to be taken during times of intense anxiety, but preferably not every day. They quickly make you feel calmer, and then their effects wear off 4-6 hours later. Some people worry that they can be habit-forming, but unless you already know that you are prone to addiction, I think that these fears are overblown.
It sort of depends on what your anxiety problem is like, how much depression is mixed in, and what kind of relief you're looking for, but it's something to consider. I've used Xanax a handful of times and always had a good experience. I think that for some problems, every-day SSRIs can be overkill.
posted by toomuchkatherine at 4:08 PM on October 27, 2015
I don't know what worries you about taking these kinds of drugs. Personally, I took SSRIs for a long time, and I worried a lot about side effects. For me, that worry was compounded by the fact that people take SSRIs every day, for months or even years on end—what if I thought that something that was part of my personality was actually just because of the SSRI?!
That may not be one of your fears at all, but if it is, you might consider asking for something like Klonopin or Xanax. These drugs are designed to be taken during times of intense anxiety, but preferably not every day. They quickly make you feel calmer, and then their effects wear off 4-6 hours later. Some people worry that they can be habit-forming, but unless you already know that you are prone to addiction, I think that these fears are overblown.
It sort of depends on what your anxiety problem is like, how much depression is mixed in, and what kind of relief you're looking for, but it's something to consider. I've used Xanax a handful of times and always had a good experience. I think that for some problems, every-day SSRIs can be overkill.
posted by toomuchkatherine at 4:08 PM on October 27, 2015
It certainly helped my hypochondria dramatically. Give it a shot — a short window of time on them is unlikely to have long-term side-effects if you discontinue, so you can test it out to see if it works for you. I had annoying side effects to start (fatigue etc.) but nothing scary.
posted by you're a kitty! at 4:14 PM on October 27, 2015
posted by you're a kitty! at 4:14 PM on October 27, 2015
If your doctor decides they're a good idea for your anxiety, you can always start off by taking a super low dose. Ask your doctor if you could start off by taking half of the smallest dose pill available. That way if there are side effects they'd be mild and less scary.
posted by ilovewinter at 5:02 PM on October 27, 2015
posted by ilovewinter at 5:02 PM on October 27, 2015
Depression and anxiety have serious negative effects on the body. So don't forget that part of it.
If you start, start on tiny doses and dose up. Get a pill cutter. I'm talking like 1mg of Prozac small.
posted by persona au gratin at 3:47 AM on October 28, 2015
If you start, start on tiny doses and dose up. Get a pill cutter. I'm talking like 1mg of Prozac small.
posted by persona au gratin at 3:47 AM on October 28, 2015
If you and your medical professionals choose this route, it's important to remember that it takes weeks for SSRI's to kick in. And that patients often experience temporary side effects that go away. Prepare yourself for 4-6 wks of weirdness before you evaluate whether a medication is working for you. Your prescriber should be able to give you clear instructions about what to look out for.
posted by JackBurden at 8:34 PM on October 28, 2015
posted by JackBurden at 8:34 PM on October 28, 2015
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posted by theraflu at 1:25 PM on October 27, 2015 [2 favorites]