Please hope me take my anxiety meds.
May 20, 2011 11:25 AM   Subscribe

Please help me ease my anxiety about taking anti-anxiety medication. (This is not about fear of dependence, this is about fear of altering my mental state; a little long.)

So I’m taking a flight in a month, and I have a lot of anxiety about flying. Things I don’t like about it: enclosed space, no control, trapped for the duration. I’m seeing a great therapist and we’re working on making it a more tolerable experience: starting some CBT, I’ve recently started working out a lot more, we’re working on some visualizations. As a last resort, I’ve gotten a prescription for Lorazepem from my doctor. I’ve had it for months and never taken it because….

A lot of my anxiety was triggered by a bad (illegal, psychoactive) drug experience a few years ago in college. Since then, I’ve had a lot of random fear about food being dosed or accidentally taking drugs that will affect my perception of reality, to a point where I’ve never really felt able to take the meds I’ve been prescribed for depression and anxiety. However, I’m really not excited about this flight and I would like to have the option of falling asleep/stopping anxiety while in the air. Additionally, being able to take this medication feels like a milestone in recovery I’d really like to triumph over.

In consultation with my therapist, I’m planning on doing a dry run with this medication either this weekend or next, under the supportive supervision of my partner. The thing is, I have so much anxiety about taking the meds that it’s feeling a little impossible to do even that dry run. I’m afraid of freaking out once I take the pill (likely a half/quarter of a .5 mg tablet), or losing connection with reality, or not being able to snap back out of whatever state I experience. Primarily, I have a lot of anxiety about being stuck in an unnatural mental space and not being able to get myself out of it (being trapped in an unpleasant experience and not having control over when it ends is also part of why I’m afraid to fly, and the really unpleasant part of my drug experience was knowing it wouldn’t stop until the drugs wore off).

I know I’ve written a lot, and it’s all to say: is there anything I can do or practice or learn to help me cope with this anxiety about taking these meds? Sometimes I feel like I should just take the damn medications already, sometimes I feel physically sick at the prospect, and always I’m tired of this being such an issue. I know it’s irrational and lorazepam is not a big-deal drug, but anxiety doesn’t always make sense. Sometimes I feel like a matryoshka doll of crazy; any help you could offer with this particular layer would be most appreciated. Throwaway email:
posted by anonymous to Health & Fitness (16 answers total) 3 users marked this as a favorite
Hi -- you are me. I had exactly this problem up to and including a very bad nearly-died drug overdose that made me pretty well against ever taking any drug again for anything. I also was prescribed lorazepam, not for flying, but for pretty terrific post-breakup anxiety that was keeping me from sleeping and the lack of sleep was making me somewhat crazy. I had the bottle in hand for maybe weeks before I would even take a pill. I was so sure something completely terrible was going to happen etc etc [you know what these thoughts feel like, I do not have to tell you] and the upshot? I took a pill and I didn't even feel any different, to me. Like I didn't feel drugged or muzzy or stupid or spacey or dying. I just felt like me, only the nattering crazy thoughts that were keeping me aware weren't as ... sticky. That is I would see them in my head and I would say "huh, that's an anxious thought" and then I'd let it pass through and not get stuck worrying about it. The big deal for me is that I've been able to practice this "huh, that's a thought" thinking and use it even at times when I'm not flipped-out anxious, to help me respond more appropriately to baseline anxiety producing things. Have a friend with you, take it in a safe space, hell drive to the hospital and take it in the parking lot if that's the only way you can do it. But it will be fine. And then you can get on that plane and do the thing you want to do. I wish you the best of luck.
posted by jessamyn at 11:31 AM on May 20, 2011 [4 favorites]

That's Xanax, right? I take Xanax for flying, and it feels like the dulled-ness of being very slightly drunk, without the drunk part. Definitely not like pot or acid or anything consciousness-altering at all. But do you have a psychiatrist, too? Does your therapist know the extent of your fears about losing connection with reality?
posted by peep at 11:35 AM on May 20, 2011

I'm so sorry you're going through this. My answers are comnig not from a similar experience, but only a hunch and a system which I've found works for me.

I find that flooding myself with information helps me a lot when it comes to health matters. When something's going on with me healthwise, I tend to track down every last scrap of information possible; I think it helps me retain a feeling of control over what can be an odd and unusual situation. I may not be able to fend off the cold/flu/allergies/broken bone/whatever that way, but at least I will know how long the symptoms will last, I will be armed with the knowledge of whether it's getting worse or whether it's "a good sign," I will know the odds of complications, or what have you.

Perhaps that's the way to go -- look up every scrap of information you can find about the drug you took in college; the chemical makeup, the known responses, the side effects, the street names, everything. Then look all that information up about lorazepam. And I do mean everything -- how many people take it, whether there are any fatalities, what the percentages are of becoming one of them (I know that seems counter-intuitive, but odds are you'll see it's such a small number that will help right there), the chemical makeup, etc. Then compare all that. Then go find more.

This may also help by giving you a place to put all that nervous energy so you you aren't using it by flailing and fretting. (That may be what really is helping me, too, I'll admit.)

Good luck.
posted by EmpressCallipygos at 11:35 AM on May 20, 2011

I have the exact same phobias, down to the whys. (I also had a bad drug experience that rendered me terrified of taking any drugs at all, even antibiotics. I'm also afraid of flying for the same reasons.) I haven't conquered flying yet, but I've semi-conquered the medication thing. CBT helped a LOT.

For medication, I started with taking vitamins. (You may not be afraid of vitamins, but I was. You can substitute some low-risk medicine here - cold medicine, sleeping pills, whatever.) For my first vitamin, I made sure a loved one was around so I had that "safety net." Then I busied myself cleaning the house like mad. That way, my body was busy, which kept my mind busy. I experienced anxiety when I first swallowed the vitamin and also when I thought it was taking effect (completely psychological), but I used CBT to talk myself through it and keep the fear at bay.

When you get really good at CBT, you're able to see the fear as something separate from you, like a piece of clothing. You may not be able to get that clothing off right away, but you can convince yourself it's not part of you, it's not harming you and it'll come off soon.

Once I lived through that first vitamin, I started taking a vitamin every day, even when my husband wasn't home. Then I moved onto my anxiety medication. I started with the smallest dose of all time - a quarter pill of my Klonopin. I followed the same procedure - made sure my safety net was around, immediately gave myself a long, physical task. I experienced anxiety, it sucked, it passed. Then the next day, I took a half pill. Same procedure. Each time, it sucked less. Once I was able to teach myself, little by little, that a bad medication reaction is rare and that, in fact, my previous drug experience had been so awful because I panicked, I felt better about taking medication.

I could use SSRIs, and I'm still working up to taking those every day. With this medication thing, like with all my phobias and anxieties, what works best for me is taking the leap in the smallest increments possible - but still leaping. Taking that first harmless vitamin was HUGE for me. I started crying when I swallowed it, and immediately wanted to make myself throw up to get it out of me. But once that initial fear passed, it passed. I didn't stay anxious for hours. I didn't have a breakdown. My brain freaked, I calmed it down with CBT and I went on with my day, feeling victorious.

I wish you all the best. Feel free to MeMail me if you'd like.
posted by Laura Macbeth at 11:36 AM on May 20, 2011 [3 favorites]

Others may disagree but when I'm taking a medication for the first time that could potentially affect my mental state I'm a huge fan of 1/4 and 1/2 doses just to see what it feels like.

Do something relaxing that normally relieves anxiety, i.e. for me it would be reading or watching a movie, take a partial dose that you feel comfortable with and ask your partner to be close by just in case. That's really about all you can do.
posted by dgeiser13 at 11:46 AM on May 20, 2011

How about ways to prove that your mental state has not changed, or how it is changing? For example, you take the practice pill at 8 am on a day that you don't have any plans. Once an hour over the course of the day, you do something that you're normally pretty good at doing but that's not too mentally or physically taxing. Maybe knitting, sketching a picture, playing Angry Birds on your phone, singing a song you know by heart, etc. This will serve as a check on how well you do that thing when you are under the influence of the drug. If there IS an effect, then you will be able to tell when it is wearing off, because you will be able to do that thing better.

I'm 99.99999% certain that all it will do is make you a little sleepy and mellow. You'll still be able to knit (or whatever) but you'll probably feel like taking a nap instead.
posted by desjardins at 11:49 AM on May 20, 2011 [1 favorite]

Have you ever had an orgasm in the late afternoon, when it's warm and sunny but not too bright and immediately after you feel like you could fall asleep in a few minutes? At its strongest it will feel like a mild version of that moment, and you might give into the nap, but your pants will be zipped up the whole time.
posted by still lampin' at 12:23 PM on May 20, 2011 [3 favorites]

I wonder if the pill can be mixed with food. Crumbled in yogurt or cereal. Used in a pancake. A milkshake.

Once it's in your system, you'll start being less anxious about taking the pills.
posted by five fresh fish at 12:26 PM on May 20, 2011

Sorry, I addressed Laura's anxiety. You were asking about mental states.
posted by five fresh fish at 12:29 PM on May 20, 2011

I'll nth the practice run, maybe at a half dosage. Anectdotally, I take Xanax before flying, too, and I don't ever feel like I'm "on" anything. I take it about six hours before I have to fly, or right when I wake up, whichever is later. The Xanax doesn't feel like anything, but the anxiety - which is still there, but massively reduced - never gets a chance to build and take hold. I know, it's difficult to overcome the fear engendered by direct experience, but the only way to get past it is - to push yourself past it, in little steps at a time.
posted by OneMonkeysUncle at 1:21 PM on May 20, 2011

I've never taken Lorazepem specifically, but I've taken other benzos, and know someone who has had some experience with illegal psychoactives. I don't think you have anything to worry about. It's a completely different experience. still lampin's words sound about spot on. Having a "practice run" before your flight sounds like a good idea, if you are anxious about the effects of the medication. Good luck, and try not to worry too much. You'll be fine.

I also hate flying, for much the same reasons you cited, and have booked a 25 hour flight in a few months. I will DEFINITELY be asking my doctor for some benzos to help me get through it.
posted by Diag at 1:30 PM on May 20, 2011

I also have a super strong fear of taking psychoactive drugs. What I did when I, also, was prescribed meds for flying, was to take a TINY tiny sliver of the pill as a practice run. Not half the pill, I'm talking like a crumb. Then later I took a slightly bigger piece of the same one pill, and so on. I was prescribed Halcion, which I was told is like Xanax. I didn't really like like my mind/perception of reality had changed at all. I just felt drowsy and relaxed, that's all. Seemed like much more of a body thing.
posted by Ashley801 at 1:32 PM on May 20, 2011

(On non-preview, still lampin's comment is exactly what it felt like for me. And when I was actually on the plane my thought process was like, "okay, i'm in my chair... mmmmm, this is pretty relaxing... let me recline my chair a bit more... ahh that's good... whoa, was that just the announcement that we're landing?)
posted by Ashley801 at 1:34 PM on May 20, 2011

I was given a pretty large dose (4mg) of Lorazepam to take before some dental surgery in November. I made my husband sit with me, just in case, because, like you, I'd never taken it before and I was scared about taking a new-to-me drug that might alter my connection with reality.

Here's how it felt when the Lorazepam took effect: It didn't feel any different.

I didn't even notice when the drugs had taken effect. I took the sub-lingual tablets, waited half an hour, and on feeling nothing really change, decided that I would try to get upset about my impending dental extractions.

I couldn't get worked up at all. Not one bit. I felt totally normal otherwise.

You won't lose touch with reality. You'll lose touch with your anxiety. This is a good thing.
posted by burntflowers at 2:34 PM on May 20, 2011

First, lorazepam is NOT Xanax, it is the generic for Ativan. Important difference.

Ativan is one of the lighter and least addicting benzos. A quarter of a mg is a tiny tiny dose and should just chill you ever so slightly for a few hours. Half a mg probably won't even make you drowsy unless you are a freak like me who is insanely sensitive to benzos.

IANAD, but I've taken a lot of anxiety meds and done a lot of research. A good site for researching anecdotal experience is Crazymeds forum.
posted by monopas at 4:08 PM on May 20, 2011

".5mg on the night before air travel" is what it says on the prescription bottle in my travel bag. (I get super the anxious the night before, not during the travel).

Something you should know is that .5mg of lorazepam is an extremely low dose (see here). Low enough that my dentist -- who prescribes it for appointment anxiety -- claims it's pretty much a placebo. That's fine with me, I don't care as long as I manage to relax.

One thing I try to remember about drugs of all types is that back when they were coming up with the Controlled Substances Act there was serious consideration of adding caffeine to the list. Rumor is that it was saved from that fate only by the intervention of the coffee and soft drink manufacturers. It is now a legal and arguably addictive mood altering drug that more than 50% of Americans take every single day of their lives at 75mg per cup.

Now I may just have put you off coffee and soft drinks for the rest of your life, but for me at least it puts things in perspective. Yes I am taking a mood altering drug. No, I am not saturating my body in large quantities day after day after day.

Unfortunately these are all logical arguments, which I know probably won't speak to your anxiety. I hope they help a little bit though.
posted by Tell Me No Lies at 5:49 PM on May 20, 2011

« Older Remove fragrance from clothes washer?   |   ATV without a VIN Newer »
This thread is closed to new comments.