Social Anxiety? General Anxiety? Medication?

January 22, 2016 11:47 PM

I've been struggling with general anxiety my entire life, however it's been getting out of control lately. I also have random social anxiety and obsessive thinking mixed in. Looking for people's experiences and whether or not medication has helped.

I've been going to see a therapist for quite a while and I've been working with CBT to try and reign in my symptoms. When I first went to her I was struggling with coming out as gay, however that moved on into a pretty severe anxiety when attempting to flirt / date / etc. I believe it was just beyond normal realms of anxiety that people get; but we are talking about wasting hours and hours brooding about sending a text to someone I like. And then if they don't respond quickly I would have a meltdown. Rejection would destroy me. I've gotten a BIT better at this, however I still tend towards brooding and obsessive thoughts about whomever I may be interested in at the time. Do they like me? What did this mean? Should I text them? Should I ask them out? I search google endlessly for "does she like me" clues on lists from dating advice blogs. Repeat ad nauseum. And I waste so much time. It's often hard for me to get things done when I have to sit down to do work. I can't concentrate because my mind loves to spin endlessly about these people of interest. I also believe that anxiety in this area is hindering my success as I've had a terrible time being rejected by people for unknown reasons. I can't flirt or show interest very well because I am PETRIFIED of rejection, thus I shoot myself in the foot.

I have had many different phobias growing up and a LOT of anxiety and a touch of OCD, however those acute anxieties seem to have abated, but perhaps they are now reappearing in a lesser form in the fact that I obsess and worry and ruminate over these romantic interests.

Recently my anxiety has spiked to very uncomfortable levels in the form of panic attacks over minor health symptoms as well as a definite increase in depressive symptoms. I had to go to urgent care to get Xanax because I had a mole biopsied and I became completely immobilized with a violent acute anxiety episode, convinced I had cancer and would be handed a death sentence.

Anyway the increase in acute anxiety lately has led me to seriously seek out drugs to alleviate my overall anxiety and curb these spinning thoughts I tend to have. I was also quite impressed by the effectiveness of Xanax, but I know that Xanax is not a permanent solution (I also hate the drowsiness it brings with it).

The thing is, I'm relatively functional as a human day to day - I'm actually very good in regular social situations and have a lot of good friends. I'm not a recluse and don't have debilitating anxiety over doing normal day to day things. This is why I've put off medication for so long. However I'm seriously leaning towards trying it out, especially given the extreme angst and depression I've been having over my complete failure of a romantic life. I can't just will myself to be happy anymore. Things seem dull and I'm not myself.

My therapist has been encouraging me to try antidepressants for quite a while and I was resistant, but I'm optimistic about trying them now. I've noticed other comments here and there on this forum about people taking antidepressants for similar issues and I'm curious to know how those experiences were for you. I mean, do you need to be completely non-functional to try them out? I guess I believed for so long that you did, and that my situation wasn't "bad enough" to try them.

posted by anonymous to Health & Fitness (16 answers total)

I take antidepressants for anxiety. I was prescribed Zoloft for depression but it's value for my anxiety has surpassed my wildest dreams - looking back I can see that my anxiety was at about 80% most of the time and now it's more like 5%, maybe 10%. This makes EVERYTHING easier to cope with.

But I was high functioning before, I work in a busy, people facing job. I just knew from conversations with friends and colleagues that I worried way more about everything than 'regular' people did. I mostly played it as a weird 'quirk' in public but it was freaking exhausting living life with that level of stress, I used to think I'd just explode one day.

I went to the doctor on that occasion because I'd done a quiz about depression symptoms and the answer was, yeah, you really need to see a doctor (I've had depression my who,e life but hadn't seen doctors for it in well over a decade, not realising how much had changed) This time, I had a trusted GP so I did. But I had asked another doc in the past if there were medications, since I'd experimented with sugar, caffeine etc as triggers with no luck and she said there wasn't. I'm still a little annoyed about that.

I'm not a doctor or your doctor but I think you should speak to yours. Mine said that research indicated the best results with therapy and medication and that was true for me. I moved on from the therapy as my depressive episode resolved but the benefit of the Zoloft on my anxiety continues to be life changing. I can't believe how long I'd suffered.

re obsessive symptoms, apparently Zoloft is prescribed for OCD. I have some traits - obsessive thoughts and constant checking of things - but never enough to get a diagnosis (I never wanted one as it was annoying but not life-hindering). That Zoloft has eased those too has been a bonus (and maybe they were more anxiety related than OCD, I don't know).

Trying them isn't a life sentence. They are a tool you can explore. And no, you don't need to be totally non functional. A surprising number of people you know will be on them and you'd never have known.
posted by kitten magic at 1:02 AM on January 23, 2016 [4 favorites]

You definitely do not have to be non functional! My husband is on Lexapro. He says it takes the edge off his anxiety so that all the other things his therapist was suggesting (CBT, meditate, exercise) actually could work.
posted by jrobin276 at 1:07 AM on January 23, 2016 [2 favorites]

I have similar experiences with zoloft. It tones the anxiety way down. I finally tried it after resisting for years and am very glad I did.
posted by Cocodrillo at 1:59 AM on January 23, 2016 [2 favorites]

When I was first started on antidepressants I was working 60 hour weeks and had an active social life. I was also struggling with social anxiety in some but not all situations. I was reluctant to start medication but once I did the difference was enormous. I remember thinking, wow, can you really just live like this, without worrying about something every day?
It was definitely a good choice for me, and I was highly functional. It freed up my mental energy for other things.
I wish you the best of luck.
posted by M. at 5:24 AM on January 23, 2016 [3 favorites]

I take Celexa and it's made a HUGE improvement in my life.
posted by Ruthless Bunny at 7:21 AM on January 23, 2016

I've had panic attacks that left me curled up in my closet struggling to breathe, but honestly most people would never know because I am pretty functional even with my severe anxiety and depression. I swore I would just deal with it without meds.

Now a year later and I'm wondering why I didn't take meds sooner. I have the lowest dose xanax in case I have a severe problem, but I'm also on Celexa as a management prescription. It helps sooo much with my anxiety, although I'm currently waiting on another dose increase because sometimes your body acclimates to one dosage and it stops working. Which does suck a little, but it's better than the stomach tearing pain and shortness of breath I'd otherwise get almost daily.
posted by Stupidratcreature at 8:06 AM on January 23, 2016 [2 favorites]

You must know from reading AskMe that you don't need to be completely nonfunctional for anti-depressants to be useful - I've written a fair amount about my experiences taking Zoloft for my anxiety, and you can go back and read them if you want.

One small thing I'll add is that I was astonished by how much of the difference was physical: no longer feeling like you got punched in the stomach when someone said something slightly unpleasant to you! No longer feeling like you couldn't breathe as you raised your hand to say something in class! No longer being drenched with sweat when you approached someone you liked! No longer feeling physically exhausted and wrung out after a perfectly lovely social gathering!

As a high-functioning socially adept human being, I'd spent thirty years learning to live with those symptoms and devoting a large part of my willpower to forcing myself to overcome them. Now, they're just gone, and in their absence, I can tell you that they served no useful purpose - they were just a stupid weight that dragged me down and I was carrying around for no reason. I didn't even know how light and free it was possible to feel until they were gone.
posted by pretentious illiterate at 8:18 AM on January 23, 2016 [6 favorites]

I was also quite impressed by the effectiveness of Xanax, but I know that Xanax is not a permanent solution

I have anxiety that gets spikey and is mostly okay. I find that benzos allow me to hit the RESET button and calm down and get some sleep and then I wake up with my brain doing better. Combining this with exercise, decent food and enough rest did the trick for me, but yes I was like you down to the IHAVECANCER and weird time-wasting loops. At this point you have some concrete things you'd like to change (which helps) and maybe a path. A doctor can help you explore some options. My guy takes Wellbutrin for some similar symptoms and it's really helped him deal with panic and dread. You do not need to be non-functional, you just need to want to make a change, want something better. Keep in mind that you may need to try a few medications to see which ones are right for you and this is normal, not a sign that something is wrong. I wish you the best.
posted by jessamyn at 8:42 AM on January 23, 2016 [1 favorite]

Do it. Do it yesterday. Not-living-like-that is lovely! SSRIs knock the stuffing out of the monster, and you can take a breather and learn how to live without always being embattled and exhausted (which of course makes you more vulnerable to catastrophizing.) It's not a magic pill that excises bad thinking, it makes room for you to do the cleaning-up yourself (that'd be the therapy part.) This means that even if you wean off the meds later on, you still have the skills to recognize the beginning of unreasonable anxiety or depression inclination, and address the issues before they get overwhelming. Anxiety doesn't really care what it latches on to; it will find something and work away at it. When you're tired or stressed, it can get all out of proportion and when you've been anxious for a long time, you can forget what normal looks and feels like. Meds + therapy are a reset button. You're stuck in a morass right now. But your baseline quality of life can be so much better.
posted by Lou Stuells at 9:37 AM on January 23, 2016 [2 favorites]

I've never had serious, life-altering anxiety or panic attacks, but you know what? I was scared all the time, and being scared all the time sucks. A lot. Even if you can manage it. A low dose of Paxil made my life way, way, way better, and waaaaay happier. I'm not scared all the time anymore. I didn't have to be non-functional to want to stop being miserable.

You deserve that too.
posted by you're a kitty! at 11:39 AM on January 23, 2016 [2 favorites]

I echo everything here. When I got back on antidepressants, I was taking 1-2 xanax a day to cope. Once we got the meds calibrated over a few months, no xanax needed at all. I'm one of those people who would use it to "take the edge off." Now I don't use it ever. The antidepressants made my anxiety GO AWAY.

Please, please take them. I know the reluctance. I wish I could get the six months back where I kept telling myself I could tough it out.
posted by Sweet Dee Kat at 12:28 PM on January 23, 2016 [1 favorite]

Yes please try them. I had the kind of OCD as a child/preeteen with rituals that "went away" to be replaced with OCD thought-loops and anxiety I didnt know all of this stuff was related until Effexor got rid of the whole shebang. Like pretntious illiterate, it was a fucking RELIEF to not have to employ my own coping mechanisms all the time. Finally I felt as non-anxious inside as I appeared to the rest of the world. A It feels really, really good OP - like being released from torture. You deserve it so much. (Not saying Effexor is the drug for you, of course. There are many options, from a daily med like Effexor, to tranquilizers you can take only when you feel symptoms.). And keep up your therapy and CBT as well.
posted by Kloryne at 3:43 PM on January 23, 2016 [1 favorite]

"I mean, do you need to be completely non-functional to try them out?"

Nope. It sounds like it's worth trying them.

But just to provide another perspective: they were never that helpful for my anxiety, and I tried a whole bunch of different SSRIs/SNRIs.
posted by needs more cowbell at 9:16 PM on January 23, 2016

I didn't believe medication would help my problems. I thought it would feel like a band-aid or like I had become a different person or that it would have really bad side effects. My specific problems were chronic low-level depression that intermittently spiked, officially diagnosed as major depression, and social anxiety/severe shyness. I was also pretty scattered, distracted, and disorganized while in social situations. For about 3 years I went to regular therapy to work on these things, and cognitive behavioral techniques definitely did make some substantial impact, but not enough to make me functional, in retrospect.

After starting the medication that worked for me, lifelong social anxiety that had made it nearly impossible to communicate under certain circumstances, completely dissipated after three days. This was about two years ago.

Medication requires management/monitoring for your health and its effectiveness, and I've found that CBT is still a helpful tool to work on the psychological components--cleaning up ineffective patterns of thinking, but not only do I have no noticeable side effects, I actually feel *more* like myself now for the most part, because I don't have as much doubt and other mental static gumming up the works.

Rather than tell you the meds that work for me, I'd recommend getting your doctor to do a psych genetic test. Mine used Genomind and Genesight. Genomind tests genes that will tell the doc how well you metabolize certain meds, which will tell you those that are more likely to have bad side effects for you or just be inefficient. Genesight tests genes that are indicators for causes of mental illness, which can help identify what brain chemistry might be deficient. They identified that I have a gene that malforms serotonin transporters, which means I need a med that will produce extra serotonin, not just increase the time available for the transmitter to reuptake (no traditional SSRIs). They also identified genes associated with deficient production of dopamine. I think both of these kinds of tests are very useful, and seem to speed up the process of finding the right medication.

I have a good friend diagnosed with severe OCD who takes antidepressants and anti-anxiety meds that he says definitely help, in concert with exposure response prevention therapy.
posted by grokfest at 9:18 PM on January 23, 2016 [6 favorites]

Ok, look. I literally have cancer. After my diagnosis I was having panic attacks almost constantly. Fortunately, I'd been on anti-depressants in the past, so I knew that my mental health was as severely out of whack as my physical health was. My oncologist prescribed Zoloft, but it gave me suicidal thoughts, so I immediately told him and he got me in to see a psychiatrist who switched me to Remeron. It works beautifully. I feel totally like myself, I have no side effects, and I can now deal with the steps I need to take to work on my cancer treatment. It is like night and day. Go get a prescription. If it makes you feel WORSE it's the wrong one. Tell your doctor right away and they'll switch you to something else. We don't expect any other medical condition to go away without treatment, so why expect it of our mental health?
posted by MsMolly at 8:42 AM on January 24, 2016

I have taken mirtazipine, which I think is mostly known as brand names Avanza or Memeron. Whether it helped me with anxiety is .... debatable. But it DOES help with getting to sleep (which in turn would surely help with anxiety). There was no drowziness the next day, and, if your script runs out, there are no withdrawal symptoms (at least, not in my case).

CrazyMeds has been quite a helpful, if somewhat quirky and completely not medically approved touch-point for all of the medicines listed above.
posted by Diag at 2:46 AM on January 26, 2016