This is NOT a Happy New Year kind of day.
January 1, 2011 5:40 PM   Subscribe

I woke up today with strong feelings of fear, and I'm not sure exactly what's going on. I need help in getting a handle on them, figuring them out or otherwise learning how to deal because this is NOT how I wanted to start the new year. I'm also not sure if this is related to being sick, having surgery, and missing meds in the past 4 days. Please help!!

I'll give you the physical/medical info first. 4 days ago I had very minor outpatient surgery on an extremity that involved sedation anesthesia by IV, but no gas (this was my first experience with any kind of sedation or anesthesia). The night before I had nausea and vomited, so I wasn't able to take my night meds that included Citalopram. I have been sick and vomiting ever since surgery, which means I haven't been able to take and keep the Citalopram down except for 1/2 a pill I took 2 days ago. I've kept liquids down for the past 36 hours so I just took a full Citalopram pill in hopes of getting it back in my system. I'm not sure if what I have going on is related to that or not. I've only had one pain pill total the day of surgery, so this isn't related to pain meds.

Every since the surgery my sleep has been disturbed. 2 nights ago I had a dream about a guy I'm interested in that was basically him choosing someone else (in the dream). It was a pretty strong dream and it bothered me when I woke up. The next night I must have had another similar dream about him that I can't remember because I woke up this morning with the physical feeling of fear. I remember thinking "He's chosen someone else, he doesn't want me" and actually feeling the sinking feeling in my stomach, including having to actually calm my breathing down and tell myself that I was OK. I haven't been able to really shake that feeling all day.

My mom left today (she was here taking care of me) and I burst into tears after she left, and have had several crying spells today. The thoughts going through my head include "I'm all alone. I hate being lonely." (both related to her leaving and also about the guy no longer wanting me. To be clear, the guy and I haven't talked and to my knowledge nothing has changed between us in the past 2 days...I've been focused on healing and he's been preparing for military deployment and we're friends with a deeper interest in each other but not committed to anything. So I have no concrete evidence for my fears/feelings).

My other thoughts while having that strong fear reaction today was "I am an incomplete person" and "It's a new year and there is so much I should accomplish this year, but I'll screw it up." I'm literally AFRAID of failing this year and I feel it physically just like I'm afraid that someone has broken into my house. I feel frozen with fear.

WTF is going on? My thoughts are tied to some ongoing issues I have (not feeling loved, fear of failure, perfectionism, etc) but why am I just gripped with it today? I'm crying right now as I write this, and that is a very unusual reaction for me these days. Is this related to missing the citalopram doses? (I read about withdrawal syndrome, but I'm not recognizing any "brain zaps" that I know of). If this is all mental/emotional, how in the hell can I get a grip on the physical feelings and begin to process this rationally? I keep telling myself that if this dude doesn't want to date me when he gets back into the country a year from now, I am still OK and I will keep breathing and living and making money. I don't think this is just related to him...I've been having negative thoughts about a lot of things today. Anything uplifting I can read? Advice you have for me?

I do have a therapist that I will see in a couple of days and will definitely discuss with him.
posted by MultiFaceted to Health & Fitness (15 answers total) 5 users marked this as a favorite
Best answer: You had surgery, you're off your Celexa, and your Mom just left. Sounds like a recipe for anxiety, and your worry over your own anxiety seems to be making it even stronger.

I think if you acknowledge that you're in a stressful time and that you may be feeling like this until you can even out (medically, pharmaceutically, and situationally), that might help you to ride it through.
posted by xingcat at 6:02 PM on January 1, 2011 [6 favorites]

Best answer: Were you anxious far in advance of the procedure? Even if you weren't aware of it, you might've been holding your breath for weeks, and now you're experiencing the emotional crash of finally having this medical issue behind you. Plus, anesthesia is serious stuff. It's my understanding that it can cause temporary depression. That combined with the physical effects of the procedure can mean you need a few weeks to get back to normal, get the Citalopram back in your system, etc. It would be far stranger if you were happy-go-lucky right now.

I'm worried to hear you're been sick and vomiting since the procedure. I know this can be a side-effect of the anesthesia, but have you checked in with your doc? Don't be shy about calling the after hours answering service if you need to. Also, why not call your therapist and see if you can move your appointment up if you're feeling well enough to go?

What else can you do? You're off to a good start by reaching out for help. Any IRL friends you could call to hang out? Even if you're feeling crappy, it might be nice to have someone sit on your couch and watch TV. If you start to feel well enough to get out of the house, how about sitting in a Starbucks and watching the world go by? Lights, people, commerce, it'll make you feel a little more "normal." Also - goofy music? They Might Be Giants? Order some silly cartoon books on amazon and have 'em overnighted?
posted by MediaMer at 6:14 PM on January 1, 2011

Oh man if I miss an SSRI I'm a mess. I'd attribute it to that.
posted by radioamy at 6:16 PM on January 1, 2011 [1 favorite]

Best answer: I've had nightmares and increased anxiety after surgical anesthesia, and I think it's a relatively common response.

I also had an extreme emotional response after the first time I received IV anesthesia -- no matter how much trust and confidence you have in your surgeon even "minor" surgery can make you feel incredibly vulnerable and be triggering for anxiety and depression.

Which may not help much while you're in the midst of feeling this way, but I think there's light at the end of that tunnel. I'd give it at least a week, though (sorry; I know the doctors tell you the effects of the anesthesia will wear off in "a couple of days").

)The last couple of days have been a sucky time to be sick, too. I've been stuck in bed myself and ye gods has the internet been boring because of the holiday. My distraction of choice is mindless computer games, if that helps.)
posted by camyram at 6:21 PM on January 1, 2011 [1 favorite]

Best answer: Yeah, stuff like this is essentially the reason why people are cautioned not to discontinue taking SSRIs cold turkey. The withdrawal symptoms can sometimes be even worse than the symptoms that got you taking it in the first place! The stressors of the past week, plus the withdrawal, are probably exactly what's going on right now. And that's ok, it's a perfectly expectable consequence of this situation, and there are likely some clear solutions for how to get back to where you need to be, too.

As others have said, call a friend, watch some favorite movies, do some crosswords, whatever you need to get your mind on something else. Get back on your regular meds schedule and give yourself something else to spend your brain-energy on for a little while, and you'll feel like yourself again in no time, I'm sure. You're going to be ok! Get in touch with your therapist and also your prescribing person if you're overwhelmingly worried, though.
posted by so_gracefully at 6:39 PM on January 1, 2011 [1 favorite]

Best answer: Sorry you're feeling this way! I have not personally experienced this, but I've heard that there's a (apparently relatively common) phenomenon called "post-anaesthesia anxiety" or "post-anaesthesia depression". So (in addition to the withdrawal explanation, which seems reasonable as well) this might just be an acute physical reaction you're going through, not some deep psychological crisis. Can you talk to your anaesthesiologist as well? Hang in there!
posted by The Toad at 6:44 PM on January 1, 2011 [2 favorites]

Best answer: I'm currently coming off an SSRI (deliberately, slowly, in a controlled way) and each time I decrease my dosage, I get nightmares, weird attacks of anxiety, feelings of doom, and nausea/dizziness (feeling kind of drunk) for a few days afterwards. (I only got the brain zaps once for one day, so you can totally have other withdrawal symptoms without those).

I hate to think how much worse the symptoms might be if I had gone cold turkey, which is kind of what you did, or if I was taking random dosages (also kind of the case for you, since you just took a whole pill after several days without).

Your feelings could TOTALLY be withdrawal and you won't know for sure until you have been back on your pills for long enough (a week maybe?) for it all to even out. Just try to distract yourself until then, as much as you can, and/or sleep a lot, and remind yourself not to take the feelings too seriously.

Don't make any big decisions in the meanwhile!
posted by lollusc at 6:59 PM on January 1, 2011 [1 favorite]

Once I was trying out some medicine for ADHD, and I was switching from one to another, to see if I could find something that worked, I got just this awful reaction. I was crying on an off all day; feeling hopeless and depressed; really suicidal for no reason what so ever. I probably should have called my doctor, but what I did was to keep telling my self that this is just a chemical thing and not real. It will go away. Just have to get though this and things will be better. DON'T do any more self adjusting of your medicine. You should call your therapist or other doctor asap, esp if things don't get better by tomorrow. At least some what better.
posted by d4nj450n at 7:17 PM on January 1, 2011

Whatever you are feeling is probably normal for what you're going through. Once you get back on track with medication, etc, I'm sure you'll feel better. Stay home, relax, and watch old movies for the next couple of days or something.
posted by empath at 8:28 PM on January 1, 2011

Best answer: Nthing that this is a combination of citalopram-withdrawal and post-anesthesia anxiety/depression. It may help to remind yourself of this. I recently had to go without my anti-depressant for a few days, and that was HELL. It did help though to remember: This is NOT me; this is a chemical imbalance in my brain.

Give it a little bit for the SSRI to re-build-up in your system, and if it will help, call the Dr or a pharmacist to talk about the post-anesthesia stuff.

So sorry you're going through this. Find a good friend to keep you company and make yourself some hot calming tea. Chamomile helps me.
posted by MuChao at 8:35 PM on January 1, 2011

Oh IANAD but I'm sure it's just the anaesthesia and missed meds. Either of these would have been enough! It's physiological and will be over soon. Ask your doctor's advice and try to keep someone around to comfort you in the meantime.
posted by tel3path at 4:04 AM on January 2, 2011

Response by poster: Thank you all!!! You made me feel a lot more sane by pointing out this was most likely a physical reaction to everything. I wound up watching some football, then taking a Benedryl (which tends to knock me out) and getting a great night of sleep. Lolled around in bed this morning relaxing and going to continue relaxing today. I feel tons better this morning...clearer head and my stomach feels better. I'll definitely talk this over with my therapist and prescribing psychiatrist. The citalopram was meant to be a short term solution to get me over a "hump" (so to speak) but after this weeks events I'm not so sure I want to come off of it anytime soon.

Thanks again!
posted by MultiFaceted at 9:00 AM on January 2, 2011

Glad to hear you're feeling better. Sleep is a wonderful thing when you can get it. (While withdrawing from my meds, I had 3 nights of insomnia).

I understand your new(?) reluctance to stop the SSRI, but I suggest talking to the prescribing doctor about that. Tapering off a medication (especially SSRI's and other anti-depressants/anxiety meds) tends to be MUCH easier than going cold-turkey.
posted by MuChao at 10:55 AM on January 2, 2011

I need help in getting a handle on them, figuring them out or otherwise learning how to deal because this is NOT how I wanted to start the new year.

This is how you are starting the new year. Don't fight feelings. Acknowledge them without acting on them or crediting them as real. Acknowledge that part of your life is feeling shitty.
posted by Ironmouth at 11:24 AM on January 2, 2011

MultiFaceted: you mention that you had sedation but not full anesthesia. One common medication that can be used for this is ketamine. Ketamine is associated with nightmares and unusual emotional reactions after its use in some people.

Could be related to Celexa too, who knows, but I'm just throwing another possibility out there.
posted by treehorn+bunny at 5:18 PM on January 2, 2011

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