How do I feel less apprehensive regarding anti-anxiety medication?
April 8, 2021 12:14 PM Subscribe
Following up on this question, I did see a doctor about my anxiety (and, I guess, depression, too). After getting blood work done, I have an appointment booked with him for Friday. However, I'm suddenly feeling apprehensive towards medication. I guess it's the anxiety talking, but ugh, how do I feel better about this? I'm honestly so embarrassed that my anxiety is so bad I have to get it treated.
I've read so many awful things about the effects of SSRIs and other medications that, ugh, I am so scared to take medication. People are sooo judgmental towards people who take medication for anxiety and depression, too.
I had a therapy appointment yesterday which, honestly, wasn't very productive and I'm feeling so pissed off at myself for just BEING LIKE THIS. I am so MAD that I am so anxious about EVERYTHING (I can't even bring myself to apply for jobs anymore). I've ALWAYS been anxious, since at least my mid-teens. Now I'm in my early 30s and, fuck, I'm just fucking miserable always being SO ANXIOUS.
I'm starting to HATE therapy because I just CANNOT think myself out of my anxiety. CBT, etc. is just NOT enough. And I feel stupid for being someone that has a hard time with CBT and all those mindfulness exercises and journaling (talk about cringe). It just does not work that well with me. I feel so ridiculous. Ugh, and then my therapist reminded me that medication ~isn't a cure all~ for anxiety, of course, which irrationally made me angry. Like, I just thought to myself "THEN WHY BOTHER GETTING MEDICATION?" if it doesn't fix shit!! Why am I even doing this?!
Is there anyway I can feel less apprehensive and anxious about speaking to my doctor tomorrow about anxiety medication? I am soooo afraid that it just won't work. That somehow I am too fucking "crazy" for medication OR therapy to work more than it already has. I'm just TIRED. I hate being like this!!
I've read so many awful things about the effects of SSRIs and other medications that, ugh, I am so scared to take medication. People are sooo judgmental towards people who take medication for anxiety and depression, too.
I had a therapy appointment yesterday which, honestly, wasn't very productive and I'm feeling so pissed off at myself for just BEING LIKE THIS. I am so MAD that I am so anxious about EVERYTHING (I can't even bring myself to apply for jobs anymore). I've ALWAYS been anxious, since at least my mid-teens. Now I'm in my early 30s and, fuck, I'm just fucking miserable always being SO ANXIOUS.
I'm starting to HATE therapy because I just CANNOT think myself out of my anxiety. CBT, etc. is just NOT enough. And I feel stupid for being someone that has a hard time with CBT and all those mindfulness exercises and journaling (talk about cringe). It just does not work that well with me. I feel so ridiculous. Ugh, and then my therapist reminded me that medication ~isn't a cure all~ for anxiety, of course, which irrationally made me angry. Like, I just thought to myself "THEN WHY BOTHER GETTING MEDICATION?" if it doesn't fix shit!! Why am I even doing this?!
Is there anyway I can feel less apprehensive and anxious about speaking to my doctor tomorrow about anxiety medication? I am soooo afraid that it just won't work. That somehow I am too fucking "crazy" for medication OR therapy to work more than it already has. I'm just TIRED. I hate being like this!!
Hello! These are super normal feelings for you to have. Do you or have you had good days where you are less anxious and more productive and generally in a better mood? What if just by taking a pill once a day you had more of those days per month? That's basically what these medications do. I have found that once that happened to me frequently find there's more space in your life to do the other things you know you "should" be doing like exercising journaling and meditating etc, if its not a herculean struggle just to exist throughout the day. Also what's the worst thing that happens if it doesn't work? You are where you are today. Also your doctor should be able to speak to all your questions and concerns about titrating and possible side effects. That's part of what you're paying them for.
posted by edbles at 12:28 PM on April 8, 2021 [8 favorites]
posted by edbles at 12:28 PM on April 8, 2021 [8 favorites]
There's a lot here, and I'm on mobile, so I'll address a few pieces only, from my pov, as someone both on and as someone who prescribes SSRIs.
People are sooo judgmental towards people who take medication for anxiety and depression, too.
I meet people who also think they are too tough or 'wellness' oriented to take their cholesterol meds or a daily aspirin after a stroke, but these are meds we have copious amounts of data for and can have their effects measured. Understandably, psych meds can't quantitatively have their effects measured and so there's more of an art than just science to them. Yeah, sometimes it takes a few tries to find the right one. Yeah, sometimes the side effects make a particular med less good for that person. And people are vocal about bad service or bad effects, far more than the millions of people you would never know take a daily ssri or snri or even some of the newer antipsychotics.
So ignore those people. Don't tell them. They don't need to know.
The other thing I tell folks when I am working with them on meds is that 1. It doesn't mean forever and 2. Think of them as a step stool to reach the things you want. (This works well for me because I'm short and it's a decent metaphor with notes of physical humor.) I'm Me, but I can now reach things, not me turning into someone else.
Hang in there. You are doing the work. It gets easier.
posted by cobaltnine at 12:37 PM on April 8, 2021 [7 favorites]
People are sooo judgmental towards people who take medication for anxiety and depression, too.
I meet people who also think they are too tough or 'wellness' oriented to take their cholesterol meds or a daily aspirin after a stroke, but these are meds we have copious amounts of data for and can have their effects measured. Understandably, psych meds can't quantitatively have their effects measured and so there's more of an art than just science to them. Yeah, sometimes it takes a few tries to find the right one. Yeah, sometimes the side effects make a particular med less good for that person. And people are vocal about bad service or bad effects, far more than the millions of people you would never know take a daily ssri or snri or even some of the newer antipsychotics.
So ignore those people. Don't tell them. They don't need to know.
The other thing I tell folks when I am working with them on meds is that 1. It doesn't mean forever and 2. Think of them as a step stool to reach the things you want. (This works well for me because I'm short and it's a decent metaphor with notes of physical humor.) I'm Me, but I can now reach things, not me turning into someone else.
Hang in there. You are doing the work. It gets easier.
posted by cobaltnine at 12:37 PM on April 8, 2021 [7 favorites]
Hello from a lifelong anxiety and panic attack sufferer! I didn't see a therapist or a psychiatrist until I was 27, and I refused any medication minus Ativan (for true panic emergencies) until I was 36. I had the same feelings as you -- I was afraid of side effects, didn't want to be on meds forever, didn't like the stigma around it, and wasn't even sure it would help.
But then I had what amounts to a nervous breakdown, which forced my hand and led me to try an SSRI as a last resort. ("Surely no side effect can be as horrific as what I'm experiencing right now.") IT WAS THE BEST DECISION I EVER MADE. You're right -- sometimes you CAN'T think your way out of anxiety. I'm a self-aware, intelligent person who dutifully went to therapy for years and years, and it was only my Lexapro that helped me get over the worst of the anxiety and panic. It also helped me get more out of therapy and various non-pharmaceutical anxiety approaches; my brain wasn't in a place to be receptive to those until it got some help from an SSRI.
Yes, some people judge folks who take psychiatrist medication. Fuck those people. They clearly don't know how debilitating and terrible mental illness can be, and it's none of their goddamn business how you choose to help yourself get better. Also, you'd be surprised at how many people take medication like this, either on a short-term or long-term basis. Anxiety is super common, SSRIs are super common, and there is nothing shameful or weird about your situation.
As for talking to your doctor about meds: just be honest with him. It's okay to be an anxious mess in front of your doctor; I guarantee you he's seen worse. (And if he doesn't react well, find a new doc.) You might want to eventually work with a psychiatrist, but your regular GP can absolutely be a first (or only) step.
Lastly: I totally understand being scared that the meds won't work. I was TERRIFIED when I went on Lexapro. But there are SO many medications and combinations of medication out there, and surely you'll find a regime that brings you enough relief that you can then get more out of therapy/CBT. I lucked out and responded beautifully to the first one I tried; other people have to try out a couple. You should know that it can take 6-8 weeks for an SSRI to take full effect, so it's important to manage your expectations and maybe have a fast-acting anxiety med on hand if you have any rough patches. After 2 or 3 weeks, I was like, "This isn't doing much, HMPH." After 5 weeks, I was like, "LEXAPRO, WHERE HAVE YOU BEEN ALL MY LIFE?!"
Good luck and feel free to memail me about any of this!
posted by leftover_scrabble_rack at 12:38 PM on April 8, 2021 [12 favorites]
But then I had what amounts to a nervous breakdown, which forced my hand and led me to try an SSRI as a last resort. ("Surely no side effect can be as horrific as what I'm experiencing right now.") IT WAS THE BEST DECISION I EVER MADE. You're right -- sometimes you CAN'T think your way out of anxiety. I'm a self-aware, intelligent person who dutifully went to therapy for years and years, and it was only my Lexapro that helped me get over the worst of the anxiety and panic. It also helped me get more out of therapy and various non-pharmaceutical anxiety approaches; my brain wasn't in a place to be receptive to those until it got some help from an SSRI.
Yes, some people judge folks who take psychiatrist medication. Fuck those people. They clearly don't know how debilitating and terrible mental illness can be, and it's none of their goddamn business how you choose to help yourself get better. Also, you'd be surprised at how many people take medication like this, either on a short-term or long-term basis. Anxiety is super common, SSRIs are super common, and there is nothing shameful or weird about your situation.
As for talking to your doctor about meds: just be honest with him. It's okay to be an anxious mess in front of your doctor; I guarantee you he's seen worse. (And if he doesn't react well, find a new doc.) You might want to eventually work with a psychiatrist, but your regular GP can absolutely be a first (or only) step.
Lastly: I totally understand being scared that the meds won't work. I was TERRIFIED when I went on Lexapro. But there are SO many medications and combinations of medication out there, and surely you'll find a regime that brings you enough relief that you can then get more out of therapy/CBT. I lucked out and responded beautifully to the first one I tried; other people have to try out a couple. You should know that it can take 6-8 weeks for an SSRI to take full effect, so it's important to manage your expectations and maybe have a fast-acting anxiety med on hand if you have any rough patches. After 2 or 3 weeks, I was like, "This isn't doing much, HMPH." After 5 weeks, I was like, "LEXAPRO, WHERE HAVE YOU BEEN ALL MY LIFE?!"
Good luck and feel free to memail me about any of this!
posted by leftover_scrabble_rack at 12:38 PM on April 8, 2021 [12 favorites]
Hey there my side effects from these medications were very minimal for over 15 years. These meds have been taken safely by huge numbers of people for a very long time. They are safe. And if the side effects are too much for you, you can stop taking them! This isn’t some huge and irrevocable step or statement about your quality as a person. It’s just the next thing you are trying out.
posted by bq at 12:51 PM on April 8, 2021 [4 favorites]
posted by bq at 12:51 PM on April 8, 2021 [4 favorites]
I totally identify with all of your feelings here!!
I am also not a big fan of psych meds, for lots of reasons. I mostly am cool managing my anxiety via other means, like exercise and breathing. But I found that my anxiety flared up so badly during this pandemic that I could no longer cope using my normal strategies, and was SO TIRED of feeling so incredibly anxious all the damn time. It was severely affecting my life and ability to cope. So despite my reservations I went to my fam doc who prescribed me a low dose of Prozac. And it has helped SO MUCH, my anxiety is back down to a very manageable level and my side effects have been extremely minimal.
So my suggestions to you are to just give it a try, even though you feel anxious about it. You can start on a low dose and increase if it's not working; this knowledge was something that helped me take the plunge as my body tends to react strongly to medications. If it is still not working or is giving you side effects, you can try another. And it's definitely not some sort of moral failing (and people who tell you that can fuck right off); you are just treating a condition and that is a good thing to do. =) Sometimes conditions can be managed well without medication and sometimes medication is a huge help (or a downright need).
Best of luck to you and I'd be happy to chat via memail if it's helpful!
posted by DTMFA at 1:03 PM on April 8, 2021
I am also not a big fan of psych meds, for lots of reasons. I mostly am cool managing my anxiety via other means, like exercise and breathing. But I found that my anxiety flared up so badly during this pandemic that I could no longer cope using my normal strategies, and was SO TIRED of feeling so incredibly anxious all the damn time. It was severely affecting my life and ability to cope. So despite my reservations I went to my fam doc who prescribed me a low dose of Prozac. And it has helped SO MUCH, my anxiety is back down to a very manageable level and my side effects have been extremely minimal.
So my suggestions to you are to just give it a try, even though you feel anxious about it. You can start on a low dose and increase if it's not working; this knowledge was something that helped me take the plunge as my body tends to react strongly to medications. If it is still not working or is giving you side effects, you can try another. And it's definitely not some sort of moral failing (and people who tell you that can fuck right off); you are just treating a condition and that is a good thing to do. =) Sometimes conditions can be managed well without medication and sometimes medication is a huge help (or a downright need).
Best of luck to you and I'd be happy to chat via memail if it's helpful!
posted by DTMFA at 1:03 PM on April 8, 2021
I've been taking escitalopram for 5 years now. It changed my life for the better and I haven't had side effects, aside from maybe the first few weeks when my body was adjusting (I just felt different, and it really bothered me at the time. My panic attacks manifested differently, for example. I guess something to do with the brain chemicals, who knows). I also had anxiety about going on them (my anxiety is all health related, so I thought they might somehow damage me), and once in the first week I even called up my psychiatrist and asked if I should keep going. He said yes I should, and he was right, because the symptoms I was worried about disappeared, along with the anxiety.
I wouldn't go on the internet reading about it. Lots of those people who are complaining have agendas. I don't really understand it but certain groups are just against SSRIs. They don't understand mental illness. I already exercised, did meditation (had to stop that because it made my symptoms worse), ate well etc. Changing my habits wasn't going to stop me from living life in a state of constant panic. These pills did, though, and I feel like they saved my life.
As for being judged....no one has to even know you are on them if you don't want them to know. Don't tell people who you think will judge you. I'm very open about it at work and with my family and friends, and they're all supportive. But that was something I chose to do, and you don't have to make the same choice.
posted by thereader at 1:07 PM on April 8, 2021 [2 favorites]
I wouldn't go on the internet reading about it. Lots of those people who are complaining have agendas. I don't really understand it but certain groups are just against SSRIs. They don't understand mental illness. I already exercised, did meditation (had to stop that because it made my symptoms worse), ate well etc. Changing my habits wasn't going to stop me from living life in a state of constant panic. These pills did, though, and I feel like they saved my life.
As for being judged....no one has to even know you are on them if you don't want them to know. Don't tell people who you think will judge you. I'm very open about it at work and with my family and friends, and they're all supportive. But that was something I chose to do, and you don't have to make the same choice.
posted by thereader at 1:07 PM on April 8, 2021 [2 favorites]
It helps me to think about my anxiety as misguidedly trying to keep me safe. It zeroes in on any possible risk and magnifies it by like 100. Of course it's going to focus on the potential side effects, others' perception, etc. of a psych med. And because I know my anxiety is misguided, I can take those points with a grain of salt once I've identified a person with expertise, a good information source, or another trustworthy counterpoint. I also try to remember: as much as I'm afraid of the potential negative outcome, there's a possible good outcome.
Have you been with your therapist long? Do you like them, generally? Have you communicated your sense that therapy is about trying to think your way out of anxiety? Have your shared your dissatisfaction with CBT? Because IAAT/IANYT, and I definitely don't think of my role as helping people think their way out of anxiety symptoms. I view my role as helping people learn how to calm their nervous system amidst difficult thoughts and feelings, re-teaching their body that it's safe despite whatever the anxiety is yelling about. So this isn't me saying your therapist is wrong for you, or they're a bad therapist, or CBT is a useless modality. Rather, I want to remind you that: your therapist doesn't necessarily know how you're thinking about and experiencing therapy if they haven't asked or you haven't shared, you're absolutely permitted to request alternative approaches if CBT or any other modality doesn't feel right, and you can find a new therapist if you don't feel this one is helpful to you.
posted by theotherdurassister at 1:14 PM on April 8, 2021
Have you been with your therapist long? Do you like them, generally? Have you communicated your sense that therapy is about trying to think your way out of anxiety? Have your shared your dissatisfaction with CBT? Because IAAT/IANYT, and I definitely don't think of my role as helping people think their way out of anxiety symptoms. I view my role as helping people learn how to calm their nervous system amidst difficult thoughts and feelings, re-teaching their body that it's safe despite whatever the anxiety is yelling about. So this isn't me saying your therapist is wrong for you, or they're a bad therapist, or CBT is a useless modality. Rather, I want to remind you that: your therapist doesn't necessarily know how you're thinking about and experiencing therapy if they haven't asked or you haven't shared, you're absolutely permitted to request alternative approaches if CBT or any other modality doesn't feel right, and you can find a new therapist if you don't feel this one is helpful to you.
posted by theotherdurassister at 1:14 PM on April 8, 2021
One more thought to share: a GP should be just fine to manage psych meds for anxiety and depression, they do this ALL the time. The main issue with GPs and psych meds is their overprescription, which is not a concern given your long-term symptoms. They should be very used to talking to their patients about all of this stuff, and should be able to do so in a supportive and knowledgeable way! If this is not true in your case I would recommend finding another doctor, as treating common mental health issues like anxiety and depression should be well within the wheelhouse of a GP in Canada.
posted by DTMFA at 1:16 PM on April 8, 2021 [1 favorite]
posted by DTMFA at 1:16 PM on April 8, 2021 [1 favorite]
I got back on sertraline (Zoloft) last month after a few years off and the difference has been night and day. Literally, in my case, because I had been so nocturnal I’d barely seen the sun all winter (except when I was still awake at dawn) and a couple days of tapering onto sertraline and I’m daytime Mizu again, waking up in the morning! Astounding! I have a lot of family history of mental illness and I think if these drugs had been around a couple generations back I would have had about twice the living relatives than I did and the ones who were around when I was growing up would have been soooo much happier, more able to love and be loved. It’s not the only thing I needed to do to help my anxiety and depression but holy shit does it make me better able to take those next steps and stick with the other things I was already trying to do.
Your feelings are all super normal but I think you know that. I try to be very vocal about my own experience with this stuff in large part because I hope it mitigates some of the stigma for people like you. These days a lot more people are experiencing mental health challenges, for obvious reasons. The amount of collective stress we are under is kind of unheard of. I bet your doctor has been prescribing anti anxiety meds left and right. Your doctor will likely be perfectly happy to discuss the different drug options, side effects, contraindications, etc with you. Ask him about how to know if a drug is not right or the wrong dosage, what to do in those cases, if there’s stuff about your medical history to keep an eye out for in this context. They will all probably be expected responses and might put you more at ease. These are very common drugs with a good history of usage by many people.
And the thing is, if you start them, you don’t have to keep taking them. I went off mine for a couple years for dumb reasons but at the time it made sense for me. You have to be careful and taper off of them so try to avoid being impulsive about the decision but for a lot of people an SSRI is like a temporary helping hand for a year or so, to take some of the burden off, so they can get other good coping techniques, habits, and opportunities into place that will help them for the rest of their lives, with or without medication. For plenty of other folks it’s like a permanent assistive device, like glasses (this is me), and that’s also okay.
SSRIs are just another tool to use to help us put ourselves in working order. Sometimes one isn’t the right fit for the job so we have to try another one, sometimes it’s the right fit the first time, sometimes we’re done using it until the next tune up, sometimes it’s a valuable experiment. The vast majority of the side effects are temporary and not nearly as scary as they sound. Sometimes when I am increasing my dose I experience “brain zaps” which sounds terrifying but is more on par with having very staticky clothes for a day. I can’t drink alcohol anymore but I previously only had like two drinks a year anyway so it’s no big deal for me, and the issue is that one glass of wine gets me plastered, nothing worse than normal drunk sensations. Other people who I know have side effects from their meds have things like a slightly harder time losing weight, or mild dry mouth. These are all equivalent to the kinds of side effects people put up with for stuff like diabetes medication, cholesterol medication, anti-seizure medication, and other vital life saving stuff. You can value your mental health as much as you value your heart or pancreas or whichever other organ needs the extra help.
posted by Mizu at 1:20 PM on April 8, 2021 [3 favorites]
Your feelings are all super normal but I think you know that. I try to be very vocal about my own experience with this stuff in large part because I hope it mitigates some of the stigma for people like you. These days a lot more people are experiencing mental health challenges, for obvious reasons. The amount of collective stress we are under is kind of unheard of. I bet your doctor has been prescribing anti anxiety meds left and right. Your doctor will likely be perfectly happy to discuss the different drug options, side effects, contraindications, etc with you. Ask him about how to know if a drug is not right or the wrong dosage, what to do in those cases, if there’s stuff about your medical history to keep an eye out for in this context. They will all probably be expected responses and might put you more at ease. These are very common drugs with a good history of usage by many people.
And the thing is, if you start them, you don’t have to keep taking them. I went off mine for a couple years for dumb reasons but at the time it made sense for me. You have to be careful and taper off of them so try to avoid being impulsive about the decision but for a lot of people an SSRI is like a temporary helping hand for a year or so, to take some of the burden off, so they can get other good coping techniques, habits, and opportunities into place that will help them for the rest of their lives, with or without medication. For plenty of other folks it’s like a permanent assistive device, like glasses (this is me), and that’s also okay.
SSRIs are just another tool to use to help us put ourselves in working order. Sometimes one isn’t the right fit for the job so we have to try another one, sometimes it’s the right fit the first time, sometimes we’re done using it until the next tune up, sometimes it’s a valuable experiment. The vast majority of the side effects are temporary and not nearly as scary as they sound. Sometimes when I am increasing my dose I experience “brain zaps” which sounds terrifying but is more on par with having very staticky clothes for a day. I can’t drink alcohol anymore but I previously only had like two drinks a year anyway so it’s no big deal for me, and the issue is that one glass of wine gets me plastered, nothing worse than normal drunk sensations. Other people who I know have side effects from their meds have things like a slightly harder time losing weight, or mild dry mouth. These are all equivalent to the kinds of side effects people put up with for stuff like diabetes medication, cholesterol medication, anti-seizure medication, and other vital life saving stuff. You can value your mental health as much as you value your heart or pancreas or whichever other organ needs the extra help.
posted by Mizu at 1:20 PM on April 8, 2021 [3 favorites]
Does logic help? If it really doesn't work, you'll notice that you're not feeling better enough and you'll stop taking it at that dose and maybe try something else. Similarly, if the side effects don't work for you, you'll try something else. But probably it will be helpful, in the same way that my asthma medication means that I can do more exercise without triggering an attack. So, it's worth doing even though it's causing a bit of anxiety right now. Because you deserve to have more good days, and there is no personal failing in being unwell, and lots to celebrate about seeking treatment.
posted by plonkee at 1:21 PM on April 8, 2021
posted by plonkee at 1:21 PM on April 8, 2021
Sometimes when you have a muscle so tight it hurts, you can stretch it out on your own. Sometimes that doesn't work and you have to go to a physical therapist for help working it out. Sometimes that doesn't work and you have to take a muscle relaxant so the muscle can re-learn how not to be agonizing.
That's all the SSRI is - a muscle relaxant for your anxiety brain, which has reached a point of constant twitch. Every time it starts to twitch back into being agonizing, the SSRI interrupts the "motion". It doesn't mean that a hard enough twitch can't break through the SSRI (especially before the dosage is calibrated right). It doesn't mean that you can't feel the twitches happening, or that you don't look at situations that used to cramp your brain and think "maybe I should be careful".
But oh my god, the RELIEF of not having that instant seize of panic, of not having endless "but what if"s running through your head. It's unreal. It's AMAZING. I mean - I can just get in my car and go places! Even places I've never been. Even if it might rain!
I was also one of the lucky ones who got prescribed the right med out of the gate. You may not - everyone reacts differently to different things. And you may need to keep upping the dosage for a while till you find the level that works for you.
But I swear to you, it is so, so worth trying. Your anxiety brain is just acting out against the idea of breaking out of its known ruts into scary, unknown territory - better the devil you know, right? But I promise, it's worth trying.
posted by current resident at 1:24 PM on April 8, 2021 [6 favorites]
That's all the SSRI is - a muscle relaxant for your anxiety brain, which has reached a point of constant twitch. Every time it starts to twitch back into being agonizing, the SSRI interrupts the "motion". It doesn't mean that a hard enough twitch can't break through the SSRI (especially before the dosage is calibrated right). It doesn't mean that you can't feel the twitches happening, or that you don't look at situations that used to cramp your brain and think "maybe I should be careful".
But oh my god, the RELIEF of not having that instant seize of panic, of not having endless "but what if"s running through your head. It's unreal. It's AMAZING. I mean - I can just get in my car and go places! Even places I've never been. Even if it might rain!
I was also one of the lucky ones who got prescribed the right med out of the gate. You may not - everyone reacts differently to different things. And you may need to keep upping the dosage for a while till you find the level that works for you.
But I swear to you, it is so, so worth trying. Your anxiety brain is just acting out against the idea of breaking out of its known ruts into scary, unknown territory - better the devil you know, right? But I promise, it's worth trying.
posted by current resident at 1:24 PM on April 8, 2021 [6 favorites]
I can't address most of your issues. I'm answering just to add that alprazolam (old brand name Xanax) is a very mild benzodiazapine-type anti-anxiety med that has changed the lives of millions for the better. Obviously not a scientific survey, but I've never heard anyone say they regretted using it. Far from it, the users I've spoken to swear by it.
I don't know what meds your psychiatrist would suggest you take, but I suggest you put your faith in them and take the leap.
and then my therapist reminded me that medication ~isn't a cure all~ for anxiety, of course, which irrationally made me angry. Like, I just thought to myself "THEN WHY BOTHER GETTING MEDICATION?" if it doesn't fix shit!! Why am I even doing this?!
I'd respectfully suggest there was a failure of communication on this point between you and your therapist. I hope you'll engage the issue more patiently tomorrow when you see the psychiatrist.
posted by JimN2TAW at 1:45 PM on April 8, 2021
I don't know what meds your psychiatrist would suggest you take, but I suggest you put your faith in them and take the leap.
and then my therapist reminded me that medication ~isn't a cure all~ for anxiety, of course, which irrationally made me angry. Like, I just thought to myself "THEN WHY BOTHER GETTING MEDICATION?" if it doesn't fix shit!! Why am I even doing this?!
I'd respectfully suggest there was a failure of communication on this point between you and your therapist. I hope you'll engage the issue more patiently tomorrow when you see the psychiatrist.
posted by JimN2TAW at 1:45 PM on April 8, 2021
I totally feel you. I have struggled with anxiety my whole life, he one, ONE time I had built up the confidence to even mention I was struggling with anxiety and needed help, my primary care doctor's response was basically that the medication is an addictive poison, and I "didn't sound stressed to him", which completely took the wind out of my sails and I never actually got the treatment I still need! Do not be like me.
Also, CBT is just ugh. As a culture we have a tendency to find one thing that works for one thing, and then just apply it to everything else whether or not it makes sense. CBT does work for some things, but it's become to default therapy treatment for everything even in cases where it makes no sense. I hated CBT and it made no sense to me at all how if my problem is that my brain ruminates to an uncomfortable degree, asking it to ruminate some more about what specific ways it's ruminating in is obviously just perpetuating the symptoms rather than easing them. The fact is is that many people become doctors and therapists who don't experience anxiety or anything at all and have no idea what you're talking about and they think that's what makes them qualified to help.
Sorry I don't have much help but you are not alone and what you're noticing isn't a you problem, it's a society problem.
posted by bleep at 2:05 PM on April 8, 2021 [3 favorites]
Also, CBT is just ugh. As a culture we have a tendency to find one thing that works for one thing, and then just apply it to everything else whether or not it makes sense. CBT does work for some things, but it's become to default therapy treatment for everything even in cases where it makes no sense. I hated CBT and it made no sense to me at all how if my problem is that my brain ruminates to an uncomfortable degree, asking it to ruminate some more about what specific ways it's ruminating in is obviously just perpetuating the symptoms rather than easing them. The fact is is that many people become doctors and therapists who don't experience anxiety or anything at all and have no idea what you're talking about and they think that's what makes them qualified to help.
Sorry I don't have much help but you are not alone and what you're noticing isn't a you problem, it's a society problem.
posted by bleep at 2:05 PM on April 8, 2021 [3 favorites]
Oh yeah the helpful thing I can say is that at least if no one will ever decide to help you, the one person who should always have your back is yourself. One thing that has massively helped my anxiety, that no therapist or doctor ever told me about, is that you can simply decline to beat yourself up. I am not going down that road of blaming myself, I am not spending any time litigating my behavior (unless I have really hurt someone or made them cry which only happened once and I did take that as a learning opportunity), I am not opening a shame spiral, I am closing the door on that. Us here in this brain are good. It's them outside who needs to either help me or get out of my way. I can still be anxious and fearful about known knowns and unknown unknowns but I'm not beating myself up anymore. This took down the temperature in my head and the amount of energy I was spending way, way, way down.
posted by bleep at 2:20 PM on April 8, 2021 [1 favorite]
posted by bleep at 2:20 PM on April 8, 2021 [1 favorite]
I don't know if this will help you but sometimes telling myself "You can be as anxious and apprehensive as you want but we're still going" can help. Your doctor will have seen all of this before! You just have to get yourself there. And, taking medication for a little while doesn't mean you're committing to taking it forever.
I also just wanted to say how much I admire you! It takes a lot of courage to address and seek help for mental health, especially when your anxiety is telling you it can never get better. It can!! I am rooting for you!
posted by stellaluna at 2:37 PM on April 8, 2021 [2 favorites]
I also just wanted to say how much I admire you! It takes a lot of courage to address and seek help for mental health, especially when your anxiety is telling you it can never get better. It can!! I am rooting for you!
posted by stellaluna at 2:37 PM on April 8, 2021 [2 favorites]
I personally don’t love SSRIs, but those aren’t the only options! I currently take Wellbutrin, which I think is commonly given to people with both depression and anxiety. Talk to your doctor about your options!
posted by showbiz_liz at 2:46 PM on April 8, 2021 [1 favorite]
posted by showbiz_liz at 2:46 PM on April 8, 2021 [1 favorite]
A significant segment of the population is likely to also believe that your diet, spiritual beliefs, favorite team, email font, haircut, sandwich-making skills, toilet paper installation, driving style, shopping habits, and shampoo routine are bad and wrong. It doesn't really matter what they think, and you're not obligated to divulge if you don't want to, though I think you should with the people closest to you and then bin 'em if they have a problem with it.
Nothing in life comes without side effects. Your anxiety clearly has significant ones. You may experience some from medication, but statistically it will most likely be insignificant to mildly tedious and most people find them extremely manageable compared to how much they improve the side effects of your anxiety.
It's really unlikely that you'll get no help at all. There are people with treatment-resistant depression or anxiety but they are generally not without significant evidence of treatment attempts, often at least some of them involuntary. You will probably find something that helps. You will probably find that a combination of that PLUS therapy (which I think is what your therapist was trying to point out, badly) work pretty well, and help you onboard the skills that will help you help yourself further.
Just do the thing, get through the appointment, and call your anxiety out as many times as you need to between now and then. Say it out loud when you catch yourself spinning out: that's the anxiety. That's the anxiety. That's not a useful thought, that argument doesn't even make sense, it's just the anxiety.
If you find later on that medication is not tolerable, you can stop taking it and find something else. Nobody's going to force you, it's an ongoing decision you will get to make.
posted by Lyn Never at 3:02 PM on April 8, 2021 [3 favorites]
Nothing in life comes without side effects. Your anxiety clearly has significant ones. You may experience some from medication, but statistically it will most likely be insignificant to mildly tedious and most people find them extremely manageable compared to how much they improve the side effects of your anxiety.
It's really unlikely that you'll get no help at all. There are people with treatment-resistant depression or anxiety but they are generally not without significant evidence of treatment attempts, often at least some of them involuntary. You will probably find something that helps. You will probably find that a combination of that PLUS therapy (which I think is what your therapist was trying to point out, badly) work pretty well, and help you onboard the skills that will help you help yourself further.
Just do the thing, get through the appointment, and call your anxiety out as many times as you need to between now and then. Say it out loud when you catch yourself spinning out: that's the anxiety. That's the anxiety. That's not a useful thought, that argument doesn't even make sense, it's just the anxiety.
If you find later on that medication is not tolerable, you can stop taking it and find something else. Nobody's going to force you, it's an ongoing decision you will get to make.
posted by Lyn Never at 3:02 PM on April 8, 2021 [3 favorites]
I hope this isn’t too off-base, but I wanted to speak directly to the “medication isn’t a cure all” issue, which was an idea I profoundly did not understand before I started taking meds.
It’s not the same thing, but I recently started taking Adderall to treat ADHD, which I was resistant to for a long time. One of the reasons was that if the medication wasn’t a “magic bullet” and I would still need to use a bunch of strategies and coping mechanisms and accommodations, then what was the point of medication, with all the extra cost and side effects?
What ended up happening, though, is that after I started taking meds, all of my previous, barely useful coping mechanisms (which I thought of as vaguely bogus strategies from my therapist, even while I blamed myself when they failed)—they started to work. Practices I had been struggling to implement for literal decades were all of a sudden just... possible. And other strategies that I had tried before and fully dismissed—they also suddenly started to work.
From speaking to friends with anxiety, it is my understanding that medication functions similarly for them. It’s the tool that makes the other tools actually work.
And for what it’s worth, I thought every single thing in your post before I started meds. Why can’t I just be disciplined? What if people think I’m “cheating” at life or my job? And the biggie: what if I try this and it doesn’t work and I prove that I really am just an unredeemable screw-up and have nothing left? I had to work each one through in painstaking sessions to finally come to believe that I needed to be kinder to myself, to speak to myself the same way I would speak to people I love, and to accept that my health and happiness were worth the trouble of trying to improve them, even if those attempts didn’t work out.
This is all so much easier said than done, but the same is true for you. You are worth trying to feel better, even if it’s hard, even if treatment fails, even if you only recover “imperfectly” and still struggle. And you’re not alone in any of your feelings. I hope you can take care of yourself, and let your loved ones take care of you. I am wishing you so much kindness.
posted by CtrlAltDelete at 3:53 PM on April 8, 2021 [11 favorites]
It’s not the same thing, but I recently started taking Adderall to treat ADHD, which I was resistant to for a long time. One of the reasons was that if the medication wasn’t a “magic bullet” and I would still need to use a bunch of strategies and coping mechanisms and accommodations, then what was the point of medication, with all the extra cost and side effects?
What ended up happening, though, is that after I started taking meds, all of my previous, barely useful coping mechanisms (which I thought of as vaguely bogus strategies from my therapist, even while I blamed myself when they failed)—they started to work. Practices I had been struggling to implement for literal decades were all of a sudden just... possible. And other strategies that I had tried before and fully dismissed—they also suddenly started to work.
From speaking to friends with anxiety, it is my understanding that medication functions similarly for them. It’s the tool that makes the other tools actually work.
And for what it’s worth, I thought every single thing in your post before I started meds. Why can’t I just be disciplined? What if people think I’m “cheating” at life or my job? And the biggie: what if I try this and it doesn’t work and I prove that I really am just an unredeemable screw-up and have nothing left? I had to work each one through in painstaking sessions to finally come to believe that I needed to be kinder to myself, to speak to myself the same way I would speak to people I love, and to accept that my health and happiness were worth the trouble of trying to improve them, even if those attempts didn’t work out.
This is all so much easier said than done, but the same is true for you. You are worth trying to feel better, even if it’s hard, even if treatment fails, even if you only recover “imperfectly” and still struggle. And you’re not alone in any of your feelings. I hope you can take care of yourself, and let your loved ones take care of you. I am wishing you so much kindness.
posted by CtrlAltDelete at 3:53 PM on April 8, 2021 [11 favorites]
Echoing CtrlAltDelete - the point of the medication is that it lets all the lessons learned in therapy work. I’ve taken anti-anxiety medicine for a long time. When I started it was out of desperation and the first couple of drugs I trie weren’t a good fit. And I then I found my match and it was like a lightbulb flipped on and all the “dumb” strategies started to work. The breathing techniques I thought were pointless actually made me feel calm. Etc etc...
Also, so what if you take a medication for your whole life? Lots of people take a daily medication for something. And if you find a drug that’s a good fit it won’t seem like a burden. It’ll just be a thing you do.
Also also... the run up to an SSRI working can be tough. If you are actively having a lot of panic attacks I would ask your doctor if there’s a short acting medication that you can take. Xanax and Ativan are two that I know about. It’s super helpful to have a way to short circuit a panic attack. And even if you only take it a few times having the ability to stop the panic can have a calming effect. I didn’t have a short acting medication given to me at the beginning when I began taking a long term medication and I wish it had been offered. Sometimes you need all the tools in the toolbox.
posted by MadMadam at 4:12 PM on April 8, 2021 [1 favorite]
Also, so what if you take a medication for your whole life? Lots of people take a daily medication for something. And if you find a drug that’s a good fit it won’t seem like a burden. It’ll just be a thing you do.
Also also... the run up to an SSRI working can be tough. If you are actively having a lot of panic attacks I would ask your doctor if there’s a short acting medication that you can take. Xanax and Ativan are two that I know about. It’s super helpful to have a way to short circuit a panic attack. And even if you only take it a few times having the ability to stop the panic can have a calming effect. I didn’t have a short acting medication given to me at the beginning when I began taking a long term medication and I wish it had been offered. Sometimes you need all the tools in the toolbox.
posted by MadMadam at 4:12 PM on April 8, 2021 [1 favorite]
Is there anyway I can feel less apprehensive and anxious about speaking to my doctor tomorrow about anxiety medication? I am soooo afraid that it just won't work. That somehow I am too fucking "crazy" for medication OR therapy to work more than it already has. I'm just TIRED. I hate being like this!!
Hey, I have been there and I know these feels. They are normal and I am sorry you are having them because I have been there and it sucks. I went from having a GP prescribe some as-needed meds (benzos and sleeping pills because a lot of my anxiety was around sleep stuff, I mostly didnt' take it but I liked having it as an option) and then over time pivoting towards therapy combined with a psychiatrist who could work with me on medication options. And I'm not really there yet, I tried one med (don't even remember which one) and it didn't work for me. So I stopped taking it and no one bugged me to do anything different.
A few things to just +1 on to
- the meds really can be the tools that help you just use therapy to fix the problem. Like... I liken it to decent painkillers, when you're distracted by pain you can't do the other things you need to do, or do them less well. Similar with anxiety/depression
- meds-judgmental people are everywhere and it's worth doing a review of the people closest to you to see if you have people near you who are like this and think a bit about how you may want to handle them. But it's absolutely possible to live in a world mostly without people who will meds-shame you, and you might care less if you were carrying less anxiety/depression with you. I am firmly in "fuck those people" territory now, but I wasn't always
- everyone's got their thing whether it's physical health, mental health, other weirdness, etc. I found the more I got to know people the more I realized that my thing, my anxiety thing, was sort of middle of the road as far as things go (I didn't have a truly awful family, as one example, or lived somewhere I hated but couldn't leave) and so I got better at accepting it
Your feelings feel bad, but they are normal and they will pass. I am sorry you are feeling bad and I really encourage you to take up some of the MeFites with their offers to chat.
posted by jessamyn at 5:24 PM on April 8, 2021 [2 favorites]
Hey, I have been there and I know these feels. They are normal and I am sorry you are having them because I have been there and it sucks. I went from having a GP prescribe some as-needed meds (benzos and sleeping pills because a lot of my anxiety was around sleep stuff, I mostly didnt' take it but I liked having it as an option) and then over time pivoting towards therapy combined with a psychiatrist who could work with me on medication options. And I'm not really there yet, I tried one med (don't even remember which one) and it didn't work for me. So I stopped taking it and no one bugged me to do anything different.
A few things to just +1 on to
- the meds really can be the tools that help you just use therapy to fix the problem. Like... I liken it to decent painkillers, when you're distracted by pain you can't do the other things you need to do, or do them less well. Similar with anxiety/depression
- meds-judgmental people are everywhere and it's worth doing a review of the people closest to you to see if you have people near you who are like this and think a bit about how you may want to handle them. But it's absolutely possible to live in a world mostly without people who will meds-shame you, and you might care less if you were carrying less anxiety/depression with you. I am firmly in "fuck those people" territory now, but I wasn't always
- everyone's got their thing whether it's physical health, mental health, other weirdness, etc. I found the more I got to know people the more I realized that my thing, my anxiety thing, was sort of middle of the road as far as things go (I didn't have a truly awful family, as one example, or lived somewhere I hated but couldn't leave) and so I got better at accepting it
Your feelings feel bad, but they are normal and they will pass. I am sorry you are feeling bad and I really encourage you to take up some of the MeFites with their offers to chat.
posted by jessamyn at 5:24 PM on April 8, 2021 [2 favorites]
Echoing CtrlAltDelete & MadMadam
SSRIs/NDRIs are useful tools in the toolbox. Truthfully, I see them as one of the most revolutionary invetions humans have made (antibiotics, NSAIDs, anaesthesia, antidepressants - these have saved lives!) (I'm a PhD in Neuroscience so I think about these things a lot). They have side effects and they don't work perfectly for everyone, BUT they do WORK!
With each tool you also have to learn how to use them, they give the necessary assistance to get you into the right place so that you can then learn and implement behavioral tools and good mental health hygiene: you learn habits that become normal, then those help you as well, and you and your doctor can determine if you want to remove that chemical tool (or not), but now with all the good mental health hygiene in place to make it easier.
Another way to put this: its like you're running a race/journey and exhausted, all these muscles are cramped and sore so you aren't running the right way anymore. Not only do you want to just finish the race, but you also want to be enjoying it again. Anti-anxiety meds can be that respite that you need, to let things heal, get on the right track; get the right habits in place to make it easier.
It doesn't have to be permanent. If you find it makes a wonderful difference in your life, it up to you how long you want to take them. Just give it a legitimate try (if that is what you and your doctor agree is right for you), which means months of trying: it takes at minimum 4 weeks for most SSRIs to have their real effect, and things stabilize more after that. It might be cliche, but I've seen it change so many people lives. As a matter of fact (being a Neuroscience PhD/knowing lots of scientists, I know a lot of people who are on them), I don't actually know anyone who regrets taking them, whether they were on them temporarily for anxiety & trauma; or people who expect to take them much longer.
As for side effects: many of those can be counterbalanced with the right drug or combination of drugs. This has changed radically in the past ~20 years. Modern SSRIs are not like the old trycyclics, not habit forming like the benzodiazepines, some of their side effects (like decreased libido) are well balanced by NDRIs (like wellbutrin).
Happy to chat; or connect try to connect you with Neuroscientists/Scientists who are currently on them. They cannot treat or diagnose you, but they can tell you their experience, and that they are happy to be taking them.
posted by rubatan at 5:40 PM on April 8, 2021 [2 favorites]
SSRIs/NDRIs are useful tools in the toolbox. Truthfully, I see them as one of the most revolutionary invetions humans have made (antibiotics, NSAIDs, anaesthesia, antidepressants - these have saved lives!) (I'm a PhD in Neuroscience so I think about these things a lot). They have side effects and they don't work perfectly for everyone, BUT they do WORK!
With each tool you also have to learn how to use them, they give the necessary assistance to get you into the right place so that you can then learn and implement behavioral tools and good mental health hygiene: you learn habits that become normal, then those help you as well, and you and your doctor can determine if you want to remove that chemical tool (or not), but now with all the good mental health hygiene in place to make it easier.
Another way to put this: its like you're running a race/journey and exhausted, all these muscles are cramped and sore so you aren't running the right way anymore. Not only do you want to just finish the race, but you also want to be enjoying it again. Anti-anxiety meds can be that respite that you need, to let things heal, get on the right track; get the right habits in place to make it easier.
It doesn't have to be permanent. If you find it makes a wonderful difference in your life, it up to you how long you want to take them. Just give it a legitimate try (if that is what you and your doctor agree is right for you), which means months of trying: it takes at minimum 4 weeks for most SSRIs to have their real effect, and things stabilize more after that. It might be cliche, but I've seen it change so many people lives. As a matter of fact (being a Neuroscience PhD/knowing lots of scientists, I know a lot of people who are on them), I don't actually know anyone who regrets taking them, whether they were on them temporarily for anxiety & trauma; or people who expect to take them much longer.
As for side effects: many of those can be counterbalanced with the right drug or combination of drugs. This has changed radically in the past ~20 years. Modern SSRIs are not like the old trycyclics, not habit forming like the benzodiazepines, some of their side effects (like decreased libido) are well balanced by NDRIs (like wellbutrin).
Happy to chat; or connect try to connect you with Neuroscientists/Scientists who are currently on them. They cannot treat or diagnose you, but they can tell you their experience, and that they are happy to be taking them.
posted by rubatan at 5:40 PM on April 8, 2021 [2 favorites]
I have been on SSRIs since the early 2000s and anxiety meds (buspar) since about 2015. I used to feel shame about this like I was somehow taking the easy road out. But, then, I realized that as my life stressors increased, my meds helped even things out and have helped me face my challenges with my best foot forward. I have Xanax too but only use it for truly serious emergencies when I need that re-set of my mind spiral. With the regular anxiety medication, however, that low level hum of anxiety has been pretty much kept at bay.
Until my life stressors subside (kids are not as needy and I can get more time to myself) meds are my safe and legal way of making it through.
posted by tafetta, darling! at 5:51 PM on April 8, 2021
Until my life stressors subside (kids are not as needy and I can get more time to myself) meds are my safe and legal way of making it through.
posted by tafetta, darling! at 5:51 PM on April 8, 2021
First of all, nobody needs to know. If you have internalized the negative judgments of medicating, and I think many of us have done that, it’s understandable. But if you let it stop you, you’re shooting yourself in the foot.
Either it’s going to be one of the better decisions you’ve ever made, or it won’t be quite right and you can try other meds/dosages, or you’ll decide meds aren’t for you so you’ll safely stop in a month, a year, 10 years. You’re in the driver’s seat here.
posted by kapers at 6:25 PM on April 8, 2021
Either it’s going to be one of the better decisions you’ve ever made, or it won’t be quite right and you can try other meds/dosages, or you’ll decide meds aren’t for you so you’ll safely stop in a month, a year, 10 years. You’re in the driver’s seat here.
posted by kapers at 6:25 PM on April 8, 2021
> People are sooo judgmental towards people who take medication for anxiety and depression, too.
This varies by environment. My office talks about mental health; most of us have (or have had) a therapist, and people talk about openly about taking SSRIs (in the context of how it's given them space to work on their goals, both work and personal).
I really like cats, and aside from having obviously accepting colleagues, it helped me to think that my dose of sertraline is the same as my friend's cat's.
posted by batter_my_heart at 12:04 AM on April 9, 2021
This varies by environment. My office talks about mental health; most of us have (or have had) a therapist, and people talk about openly about taking SSRIs (in the context of how it's given them space to work on their goals, both work and personal).
I really like cats, and aside from having obviously accepting colleagues, it helped me to think that my dose of sertraline is the same as my friend's cat's.
posted by batter_my_heart at 12:04 AM on April 9, 2021
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Once you've sorted your medication, you may want to consider whether your current therapeutic relationship is actually productive. I don't want to judge long-distance, but a therapist trying to downplay the value of meds while you are actively struggling to get through the process of getting them prescribed doesn't sound so great to me.
There are no magic fixes for this problem, but, believe me, you'll have so much more energy and patience if you're not, say, wanting to murder everyone walking on the street because they might get in your way and you can't take it. Not that I'd know anything about that. Meds may not get you all the way there, but they can definitely help. Good luck!
posted by praemunire at 12:27 PM on April 8, 2021 [7 favorites]