Is there light at the end of this tunnel?
April 21, 2015 4:16 AM   Subscribe

So, I am in the middle of a horrible depression/anxiety thing (some of you may remember my question from a few weeks ago when it had just started). I really need some encouragement that there is light at the end of my tunnel.

I have been suffering with anxiety for about a month and that has sort of deepened into depression for the last two weeks. At first it was "just" health anxiety, and although that was pretty bad it's nothing compared to how I feel now.

I am having horrible intrusive thoughts or even impulses about hurting myself or other people, that make me first panic and then when I stop panicking I feel depressed and kind of "flat" like I can't enjoy anything. I maybe feel like myself for about an hour per day, but it never lasts very long, because I start to worry about getting the thoughts again. And I think that's what partly leads up to my getting the thoughts again. But I don't know how to fight the worry. Whenever the thoughts come I try to distract myself by doing something else, but even after they go away, the worry about them remains.

It is a very, very hard time for me, but I have been working, exercising, meditating, seeing the doctor for regular check-ins, am having a full body check-up, am starting CBT in 2 weeks, and my mom is coming to stay with me. I know I'm doing all the right things, I just don't know why they aren't working.

I have also spoken with my doctor about medication but am very fearful of the side-effects of SSRIs so they have not put me on any. I have some Valium which I am to take at moments of severe panic, but it doesn't do a lot of good - it takes away the panic at the time, but the effects don't last, and it makes me really sleepy. The doctor said that what I have is "mild", which would be hilarious if I could find anything hilarious at the moment.

I've got a job interview for a job I really wanted (I say wanted because I just don't care about it now), and a holiday coming up that I'd been looking forward to for months. My life is objectively great. I just feel so bad that I can't feel it and that my illness is poisoning my enjoyment of life. I feel like I've lost the happy and optimistic person I know myself to be.

Please don't tell me any horror stories. My brain is constantly doing that already. Please give me some encouragement, I need all the hope that I can get.

Mods, sorry if this is not a good use of AskMeFi, but this has been such a great and supportive community in the past, I thought I would reach out.
posted by Ziggy500 to Health & Fitness (31 answers total) 15 users marked this as a favorite
I have also spoken with my doctor about medication but am very fearful of the side-effects of SSRIs so they have not put me on any.

Do you think part of this might be the depression and anxiety talking? I have never taken an SSRI, but I know they have helped many people. Can you talk to your doctor about a controlled trial with a plan for how you'd know to quit (and how to taper off it) if it's not working for you? Knowing I can quit something often helps me get started on something hard.

I understand the fear of side effects but the side effects of life seem pretty tough for you right now. Good for you for all you've done to try to counteract them.
posted by telepanda at 4:30 AM on April 21, 2015 [5 favorites]

What is a worse side effect, you hiring yourself or others, or the side effects from an SSRI?

Mess aren't necessarily the solution, they aren't the only solution, but they do routinely help people have an easier time finding the solution. They give you enough space to make progress forward.

It took a long while and a lot of misunderstanding their utility before I understood that about them.
posted by Nanukthedog at 5:02 AM on April 21, 2015 [1 favorite]

I know I'm doing all the right things, I just don't know why they aren't working.

They are working, but it's sort of like, I don't know, strep throat or something, to use a non-psychiatric analogy. The antibiotics are doing their bit, the medicine is working, but it takes a while to feel better nonetheless, because the feelings themselves, the irritation and cough and all, are so distant from the cause, that it takes time for the healing to spread.

Wow, that was not a very good analogy.

Depression and anxiety carry within them a distorted view of time and the future. Your doc says this is a mild case, and maybe objectively it is, but the distortion itself makes it seem like it's going to last forever. But that's just a feeling. It's just a thought, and as you go through CBT, you'll get some more practice changing your relationship to those thoughts. Maybe you'll begin to see "it's going to last forever" as just a script your mind tends to read when you feel a certain way. Maybe you'll begin to see it as something you have really believed for a long time--you've taken a thought, a distortion, a sort of wrong-self-diagnosis, as gospel truth--and you will begin to have the tools to disentangle yourself from that, to see it as just a thought, and not indicative of what's really going on. You're looking for a light at the end of the tunnel, but it's really only this script, this thought, telling you there's a tunnel at all.

You talk about fighting the worry, but that struggle just mires you in deeper. Which is okay! Everybody does that, everybody in the world! But for people who have panic, for people who worry worry worry, there is a lot of trying to escape from the discomfort and world-poisoning sickness of that worry. It's not something it's really possible to escape from, and frames the worry as this thing that is separate from you, this thing that encloses you. But it's not. It's just a habit, a way of thinking, a way of relating to thinking, and it can be unlearned. It's a language, a process, a lens, a mental trick; it is by its nature temporary and requires constant reinforcement to reach the kind of pain you're in. And that is wonderful news, because all you have to do is learn how not to reinforce it. "All you have to do," I say as if it's the simplest thing in the world. It's not. And it takes time. And it is uncomfortable. And involves looking very honestly and baldly at your pain. But the work, the learning, the practice, is sooooo much better than treating the Hopeless Gospel your brain is spinning as though it were the truth.

You are doing good things. You are doing good things early. And, if I may close by being totally corny, you are the light at the end of the tunnel. You are your own best hope, your best tool; being you, the experience of you, is your own goal, and you can reach that.
posted by mittens at 5:07 AM on April 21, 2015 [9 favorites]

So here is the thing. Hang on. Your issues sound like they are very likely to be effectively treated by CBT. Since you asked for encouragement I will give you my own story. In a nutshell at one juncture my anxiety/depression and anxiety attacks were so severe that I was not able to leave the house for more than a few minutes for over two months. I thought of suicide almost all the time and the mere thought of an anxiety attack would actually cause me to have one. It was just hell. Everday I was sliding down a glass wall. The reasons I did not kill myself were I did not want to stain my family and I was too cowardly.

I tried conventional therapy and it helped in some ways but much with the anxiety attacks. After two years my therapist referred me to a CBT practitoiner. Within a few weeks I was getting quite a lot better. Within a few months they were reduced by 90%. I have not had one in many years. I still have to deal with depression it has gotten better but I guess for me it is a chronic challenge. Drugs did not help. Exercise helps though and having friends does too.

I can say your life is likely to get a lot better, and soon. You will likely have struggles in the future but things will be much better than they are now. I wish you the best. kind regards, jcw
posted by jcworth at 5:08 AM on April 21, 2015 [4 favorites]

Man. For me, that was the worst part of depression - looking around and objectively adding everything up and feeling like I had so many good things in my life, that I was somehow obligated to be happy just because I had positive events around me. all those things that were supposed to make me happy, yet I wasn't - and it was almost worse that way, feeling guilty for not being able to be happy, instead of having something objective to be miserable or angry about. That's the plight of the depressed optimist. When you're accustomed to seeing the best in everything, it's really jarring to have your emotional response not line up with your rational evaluation of the situation.

I think it's great that you're taking so much control of the situation - you've got a doctor, you're eating well and trying to be physically healthy, you've got emotional support. Hang in there, you're going to be okay. (You're going to be great again eventually, but you're going to be okay very soon) Having a therapist made a huge difference for me, and I hope it does for you, too.
posted by aimedwander at 5:11 AM on April 21, 2015 [1 favorite]

I was resisting suggesting medication, but I take it back, I am going to at least suggest that you try it in the short term. Keep in mind that you can stop it if you want to.

It was absolutely infuriating to me that I would attempt to be nice to myself, I would buy good chocolate or my favorite comfort food or splurge on something I'd been wanting, something I knew I liked - and then get zero enjoyment out of it. The best grilled cheese sandwich from my favorite pub tasted like cardboard. It made no rational sense to me; I knew these things were objectively (as well as formerly subjectively) awesome, but my body was unable to let me enjoy them. This is what convinced me that my brain chemicals were just plain screwed up, and that it would be worthwhile attempting to fix that. I started therapy, then about a month in added a prescription with side effects I didn't like, then swapped to a better prescription in a couple of weeks. I was checking in with the doctor frequently to make sure we'd chosen the right medicine and the right dosage. And that "right" was a moving target, as I started working things out through therapy; we tapered the dosage down within a year, though I kept up at lower level until I finished school (left town, left therapist, etc).
posted by aimedwander at 5:23 AM on April 21, 2015 [3 favorites]

I'm sorry you're not feeling well.

Getting better from ANY illness, unfortunately, isn't immediate (oh how I wish it was). I read through your last question too and you're doing a lot of great things to help yourself get better (you're exercising, you're keeping in touch with friends, you're getting checkups from your doctor, and you have a CBT appointment scheduled). All these things really do take time to work though, keep going. You're on your way there.

About medication:
It really can help and you might want to consider using it in combination with the things you are already doing. I know how worrying potential side effects can be. If you're considering medication, maybe you could look into potential medications and choose the one that seems best for you? Do you have any friends/family/etc that have taken SSRIs before? If so, ask them what they took, what side effects they had, did they feel it worked well? If someone mentions a medication that they thought worked well for them, then maybe put that med on your candidate list, since you'll have first hand info about it.

And remember that medication doesn't have to be a permanent thing. Your doctor can taper you off it when you no longer need it or, if you don't like a side effect, you're doctor can take you off it or switch you to a different one.

Since you seem interested in CBT, here's a CBT book I really like that you might find helpful too:

When Panic Attacks

It's by Dr. David Burns, it's a CBT based book with lots of great exercises, stories, worksheets, and info. I know the title says it's a "medication free method", but the author isn't anti-medication at all, he just covers non-medication CBT techniques, that can be used in conjunction with medication or other techniques. The author is really entertaining and a great storyteller, so the book is surprisingly fun to read for a CBT book. Maybe read some of the reviews and see if it looks good to you?
posted by Chicoreus at 5:33 AM on April 21, 2015 [2 favorites]

I have also spoken with my doctor about medication but am very fearful of the side-effects of SSRIs so they have not put me on any. I have some Valium which I am to take at moments of severe panic, but it doesn't do a lot of good - it takes away the panic at the time, but the effects don't last, and it makes me really sleepy.

Most of my side effects from SSRIs have involved gut distress in the 2 days around changing dosage, FWIW.

There are other drugs in the same family as Valium (clonazepam in particular) that have a longer onset time (so not as good for cutting out immediate panic attack) but also stay in the bloodstream longer and have a less intense knock-you-out feeling.

posted by PMdixon at 5:36 AM on April 21, 2015

Hey guys, thank you for all your answers. Just to clarify my worry about SSRI side effects, I've just read that they can increase anxiety symptoms over the first few weeks of usage. This is my main worry and why I feel scared to use them, although I am thinking now they may be only chance for a return back to normality.
posted by Ziggy500 at 5:38 AM on April 21, 2015

Things will get better. CBT changed my life. I did a 12 week program at the Boston University Center for Anxiety and this is one of the tools I used. Go to this website, scroll down to Present-Focused Emotion Awareness Exercise and it's a very non-woo grounding exercise.

The thing about stupid panic attacks, as you know, is that fear of having another one can become paralyzing. You'll learn how to cope with that rising panicky feeling by learning to ground yourself.

And my favorite hack is I carry a deck of cards with me. When I start to get those uh-oh feelings, I take out the cards and either play Solitaire or I go through the deck and name the card.

The trick is to recognize that feeling but instead of running with it, I force my brain into the tangible by counting. It moves my focus and the panicky feeling passes.
posted by kinetic at 5:39 AM on April 21, 2015 [7 favorites]

You can also use something like a beta blocker (I take propranolol) to control physical anxiety symptoms if you want to try an SSRI and increased anxiety becomes an issue - they're not addictive, they don't knock you out, and they act on blood pressure/heart rate rather than sedating you.
posted by terretu at 5:53 AM on April 21, 2015 [3 favorites]

Just to clarify my worry about SSRI side effects, I've just read that they can increase anxiety symptoms over the first few weeks of usage. This is my main worry and why I feel scared to use them, although I am thinking now they may be only chance for a return back to normality.

This is true, but a good prescribing doctor can help by also giving you some type of benzo in case it does cause a short-term increase in anxiety.

One of the best analogies I've ever heard about taking SSRIs is, right now your brain is like a record that's stuck in one spot because there's a scratch in it and every time you play the record the groove gets deeper because the needle goes over and over and over the same spot. You can keep moving the needle to skip over the scratchy part, or you can learn how to fill in the scratch and repair the album.

The SSRI allows you to step back and learn how to repair the album with CBT. Without the SSRI, you'll just keep moving the needle.

*Of course, this analogy only works if you know what a record is. See, back when I rode my dinosaur to work...
posted by kinetic at 5:54 AM on April 21, 2015 [4 favorites]

Here is the opposite of a horror story.

In January, I was in a place a lot like you are now. A mix of life stuff had collapsed on me and sent me into a terrible, terrifying anxiety spiral I just could not get out of. I was in therapy three days a week and all I did was sob hysterically and insist that nothing would ever get better. It got so bad that eventually one night I ended up in the urgent care clinic at midnight to get a prescription for benzos, which took the edge off but didn't really help. And STILL, in the absolute depths of misery, in the worst place I've ever been in my life, I was too scared of the side effects to go on SSRIS.

The benzo prescription ran out and I had to go see a psychiatrist to refill it. The psychiatrist says, "You're clearly suffering from a lot of anxiety. Why not try some Zoloft?"

"Oh, no," I say, and I start enumerating all the reasons why I can't do that: what if I end up dependent on them? What if they kill my sex drive? What if they turn me into a zombie? etc. etc. etc.

He fixes me with a look and goes: "Yes, I can see that you're very anxious about the possibility of side effects, but I have a lot of experience with these drugs and I think you should try them. We'll start at a low dose and work our way up and if any of the side effects manifest we'll take you off them right away, but I don't think it'll be a problem."

So I did.

I did not experience any side effects except for a slight headache on the first day. I am so far out of the anxiety spiral that thinking about it feels like remembering a bad dream. I never refilled the prescription for the benzos. And get this: I don't just feel better than I did in January. I feel better than I ever have in my life.

Because it turns out that I've always had a (relatively minor! very controllable!) anxiety disorder and the medication helps it in a way that makes the quality of my life palpably better every single day. About a month into taking the medication, I woke up in a good mood and I wasn't worried about anything, and I realized that I felt free of something I'd been carrying around with me since I was eleven years old.

None of that would have happened if I hadn't gone into crisis in January. The crisis was the trigger that finally forced me to get the help I needed. So, in a way, even though it was one of the worst things that has ever happened to me, it was also the best thing, and my life is now better for it.

Whether or not you end up going on SSRI's, it's clear from your story that you're committed to getting the help you need. And what that means is that, as hard as it is to believe from the dark place you're in now, this may be the best thing that has ever happened to you, too.
posted by pretentious illiterate at 5:55 AM on April 21, 2015 [23 favorites]

Oh dear. I'm so sorry about your suffering.

IANAD, but I believe mittens has it right (and it's not a bad analogy at all). You have it right too that you are taking very good steps--please congratulate yourself for that. Seriously, please take a minute to treat yourself like you'd treat a friend who made some excellent choices and solid plans.

I understand that the two weeks before starting CBT seem like an eternity, and while SSRIs can be helpful for sure, they usually take several weeks to really kick in anyway. May I suggest asking your doctor about a medication similar to valium, but longer lasting? Klonopin, for example, has a much longer half-life and could be taken on a schedule over the next few weeks. I'll tell you what a doctor did for me that helped immensely:

I started on a large-ish dose with a schedule to taper down to zero over a few weeks. Yes, it's a sedative--and this is only anecdata--but in retrospect I was so relieved of my anxiety that I was more productive and energetic than usual. Gardening because I felt like it was so different than the flat feeling you mention and gave me a real boost into "oh I can enjoy things?" territory.

Is there any chance you'd be willing to try something like that, since it's in the same family as valium? It's okay to use medications, and it's okay to be wary of them. If you could start on something now-ish, though, and be wrapping that up as CBT gets underway, you might feel a lot better.

Regardless, hang in there, because yes, there is a light at the end of the tunnel, and you are heading toward it. It's frightening when you can't see that light, but to continue that analogy, when the tunnel curves (thus blocking the light) that doesn't mean it's time to turn around or stop. You'll get there!

On preview: Klonopin (clonazepam) has already been suggested, so consider that I'm just seconding that idea, and please don't let any doctor downplay your suffering. Insist that it is severe and the current treatment isn't changing that.

You will be okay! I'm impressed with your plans and wish you the very best.
posted by whoiam at 6:19 AM on April 21, 2015 [1 favorite]

(In your post above you mean beta blockers, not benzos, right? because Valium is a benzo)

When you say you're talking to your doctor, what type of doctor do you mean? If it's an internist/primary care, have you gotten a referral for a psychiatrist? Because that would seem to be a good idea, given the severity of your symptoms (severity = thoughts of harming yourself plus intense anxiety and depression).

Although many internists prescribe psychiatric medication, a good psychiatrist, who does that all day long, generally knows a lot more about specific drugs and their side effects and will work with you to find the right fit.

also I would like to second the idea that you can start with a tiny bit of an SSRI to minimize the side effects as you ramp up, and you may need less than you think to manage your symptoms.
posted by DMelanogaster at 6:22 AM on April 21, 2015

I recently started a new SSRI - I'd taken a different one many years in the past that worked great, but at this point in time anxiety is a bigger problem for me, and the doctor felt the old med had too high a chance of causing anxiety problems to be a good idea for me. She suggested Celexa or Lexapro instead, and also did the supplementary prescription (Ativan in my case) to take the edge off both my current anxiety and any increased anxiety the SSRI may cause before it reaches a therapeutic level for me. Which is to say, a good doctor will think about this stuff and not leave you just flailing around with worsening anxiety while you wait for medication to help. It would be worth at least discussing with a good psychiatrist.

You sound like you're doing all the right things, but unfortunately brain chemistry is just not a quick-fix problem for some people. If you stick at it, things can get better and you've already done so much good work that I'm hopeful that point for you will be soon. Please hang in there, and keep being gentle with yourself.
posted by Stacey at 6:24 AM on April 21, 2015 [1 favorite]

(In your post above you mean beta blockers, not benzos, right? because Valium is a benzo)

Yes, sorry, those are what I meant. I have asthma, so I can't take beta blockers.

I am just seeing the GP at my surgery (and not even the same GP for each visit). I will ask for a referral to a psychiatrist.

Thanks a lot for all your help.
posted by Ziggy500 at 6:25 AM on April 21, 2015

You've got a doctor looking over you. Your mom's coming to help. This is a really good thing, because you've got two people who can help observe and guide your progress. It's an excellent time to try medication if you think there's any possibility that the benefits will outweigh the potential side effects. Ask both your doctor (on preview: yes, see a psychiatrist) and your mom to keep an eye on you and check in regularly. With mental health, an outside observer or two can really help you figure out what's working and what's not, and they can often catch downturns before you're even aware of them.

I've been on antidepressants and they've helped me immensely, and I wish I'd gone on them years earlier instead of listening to my brain with its "you don't need them" and "what if they make you worse" bullhockey. SSRIs actually help anxiety a lot of the time. If you're doing everything else you can (and you are a champion for coming at this with everything you've got; even people without the ball and chain of depression have a really hard time sticking to healthy habits) and nothing seems to work, that's often a sign

Many psychiatrists will want to see you often when you're starting a new medication or changing doses, so they can be absolutely certain it's working for you. If your psych doesn't request checkups every week or two at the beginning, ask for them, or find another doctor. It's their job to make sure you're okay.

When I feel myself getting bad, I imagine myself physically clinging to the edge of a cliff, or climbing out of a hole. I acknowledge that I'm in a scary spot and I don't want to minimize that, but I also remind myself that I know where I am, and I'm hanging on and will continue to do so. As long as the fight's in me, I know I will get better. Periodically remind yourself that you want to get better and are willing to get better, and see if that keeps you going when things get scary.
posted by Metroid Baby at 6:38 AM on April 21, 2015 [1 favorite]

I have zero side effects from SSRIs. Not everyone gets side effects. Don't let that fear prevent you from trying them!
posted by joan_holloway at 6:49 AM on April 21, 2015 [2 favorites]

Your brain chemistry is out of whack. I finally found a psychiatrist who did a thyroid test and found Hashimoto's thyroiditis (autoimmune disorder) and goiter, a urine test to measure nuerotransmittors and found I had very low levels of GABA (the peaceful transmittor) and too high levels of Dopamine (the get shit done transmittor), which is a recipe for anxiety, and blood tests for food sensitivity (high IgG to food may exacerbate the autoimmune disease and brain chemistry). My previous pychiatrists never once looked at any blood, urine or otherwise but instead put me on anti-depressants and Klonopin. These drugs did not help me, in fact, Wellbutrin increases Dopamine, the last thing I needed. So, the new Dr. has me on Gabapentin to increase GABA, Armour thyroid medication and a diet absent of the foods I have IgG to. Guess what, I'm feeling super and am working toward a cure rather than a bandaid. I work out and can focus at my job like nobody's business. Just 6 months ago I wanted to die and have been suffering with "mental illness" for most of my adult life (am in my late 40s) and now I am like a new person. Apparently I have had thyroiditis for a very long time (according to the size of the goiter) and no Dr. has ever even looked at this, something so obviously linked to depression.
I would HIGHLY recommend a Dr. who does their research to determine the cause of your brain imbalance rather than one who just prescribes without any insight into YOUR body. If you MeMail me I can give you the name of my Dr. but if you are not in my area perhaps you can find a Dr. who will do these types of tests.
posted by waving at 7:07 AM on April 21, 2015 [3 favorites]

I know I'm doing all the right things, I just don't know why they aren't working.

Because all the right things take time. You don't gain the ability to lift enormous weights a few weeks after starting weight training, and the same applies to lifting enormous emotional weights. Keep practising the good things, because practising them makes you better at them, and you need to be better at them.

I've just read that they can increase anxiety symptoms over the first few weeks of usage. This is my main worry and why I feel scared to use them

If your doctor has suggested that an SSRI is worth trying, and the only reason you're fearful about doing that is the prospect of more anxiety, consider this: anxiety feels awful. It's like the emotional version of salmonella poisoning. It's limiting, it's crippling, it's a royal pain in the arse in every conceivable respect except one: anxiety in and of itself won't kill you, or even do you any irreversible damage. The only way your anxiety is going to do you any permanent harm is if you treat the bullshit it generates inside your mind as being in some way useful and physically harm yourself as a result. Don't do that. Take advice from well-informed people who care about you, like your doctor, instead.

Broken legs cause pain and immobility. Would you resist getting a broken leg set and plastered on the basis that having a plaster risks limiting your mobility? Of course you wouldn't. You might be anxious but you're not silly.

I don't know how to fight the worry. Whenever the thoughts come I try to distract myself by doing something else, but even after they go away, the worry about them remains.

Instead of distracting yourself and trying actively to dispel these intrusive thoughts, learn to treat them as unfortunate but acceptable brain farts. Next time you feel a bunch of them coming on, find yourself somewhere comfortable to sit, preferably out of doors and looking at something green and growing; resolve to do nothing but sit until the thoughts have run their course, and then just sit there and let them rip. As long as all you're doing is sitting and thinking you are perfectly safe and cannot possibly come to any harm.

Because here's the thing: at the moment you're shit-scared that something awful will happen to you as a result of letting yourself think certain things. But if you get in the habit of reacting to intrusive thoughts by just sitting down and just letting the miserable fuckers run riot until they blow themselves out, you will find that you no longer need to be afraid of thinking things; and getting rid of that chronic background of fear will do you good.

Don't fight the worry. Defuse it by training yourself to change the prospect of having intrusive thoughts from awful scary nope nope nope nope nope can't cope into that fucking nuisance that makes me sit down for ten minutes every time it happens. Learn to react to the prospect of intrusive thoughts not with fear, but with being pissed off. Fear is crippling; anger is energy. You might even get so pissed off that you make yourself laugh, and then you win.

Once you've become accustomed to intrusive thoughts as a thing-your-body-does rather than a thing-that-you-are, you'll be better positioned to make informed decisions about ways to change the way your brain works - via better living though chemistry, or meditation and exercise and dietary changes, or CBT, or combinations of all the above.

Most people will experience mental illness at some point in their lives. If it hasn't happened to you before, it's naturally going to feel like the Worst Thing Ever. But it isn't. It's a fucking pain in the arse that most people recover from, and taking your doctor's advice when you're ill is generally a good way to recover more quickly.
posted by flabdablet at 7:55 AM on April 21, 2015 [7 favorites]

By the way, one of my own favorite internal tricks for dealing with intrusive thoughts is to try to think them in the voice of Foghorn Leghorn or Elmer Fudd, at least by the second or third go-around. The way I see it, if my brain is going to insist on throwing bad scriptwriting at me, the least it can do is use it for comic effect.
posted by flabdablet at 8:05 AM on April 21, 2015 [4 favorites]

Man, I really feel for you. You're describing my exact symptoms during a very difficult period when I was a junior in college. You know what didn't help at ALL? Valium. Many years later, I was prescribed an SSRI for depression and it changed everything. It didn't make me complacent and it didn't take away the problems, but it did help me see that there was a way out. And there was. And I made it out and, although I can't guarantee that I'll never be depressed again, I have a strategy for dealing with it that has a proven track record. But damn, if I were you, I'd toss the valium. IANAD, and YMMV. But all valium did was make me not care that I was crying in public. Ugh. Plus it's so addictive.

Here's an old Buddhist story: A king once asked his advisor to give him something that would make him happy when he was sad and sad when he was happy. The advisor gave the king a ring that read "This too shall pass." It's part of human nature to think that whatever is going on right now will always be the case world without end amen. But everything changes. Everything. For everyone. Always. This too shall pass. Hang in there. And get you some SSRIs.
posted by janey47 at 9:34 AM on April 21, 2015 [1 favorite]

Oh man, do I ever sympathize. I also suffer from health anxiety, or at least I did (it could always come back, I suppose). In some ways, health anxiety is especially tough, because it comes with a built-in resistance to getting help in the form of anxiety about SSRI effects. Here's the thing though: a psychiatrist is going to monitor you while you start an SSRI. They will be able to react to any side effects, and those side effects will go away if you stop taking the medication. Prozac helped me immeasurably, and something similar may help you - I strongly suggest giving it a try.
posted by Ragged Richard at 10:26 AM on April 21, 2015

I was you recently. Like, very recently. A nasty depression compounded by some serious anxiety that was leading to physical symptoms (constant globus hystericus!). I'd taken a lot of the antidepressants that were common in the late 90s (Paxil, Prozac, Zoloft, Wellbutrin) and none of them were good - some were very bad.

But I decided that I would be willing to try Lexapro, since it seemed to be a miracle for a lot of people on MeFi. And I've been on it for two months and it HAS been a miracle. It hasn't worsened my anxiety, but I'm not sure if it's improved it either (my doctor also has me on a low dose of Klonopin, which is probably what's helped the anxiety).

So I'm glad I was brave enough to take that step and try an antidepressant. I've had no side effects and I felt better pretty quickly. Enough that I was able to see my own light at the end of the tunnel. The past two months of my life have been difficult otherwise (in a non-medical sense) and I don't think I could have managed it as well as I did without medication.
posted by elsietheeel at 10:47 AM on April 21, 2015 [1 favorite]

I had depression and anxiety for like two or three years. I couldn't really imagine my life without it and I felt like that's how I would always be. I thought it was going to be my life going forward. But I worked to make changes and do what I needed to do to get better. I did psychotherapy, medication for both the anxiety and the depression, and I started to try to diet and exercise (which are the hardest part and came later). (The exercise was literally just walking on the treadmill for an hour during a show I liked to watch. I wouldn't even run, but it helped to be a bit active.)

Anyway, it took a while before stuff worked. The therapy helped keep things in check, and I did it for a long time, but that fact was there was a chemical issue that needed to be dealt with. I finally did medication, but even that took a while to start working. Once it started working, it felt like it was "masking" the depression, but not actually making it go away. ("Masking" was the word I used at the time, I'm not quite sure what it means now looking back.) It masked it and kept it at bay enough for me to do functional things, like leave the house. It's not that I necessarily wanted to leave the house, but I could, which I could never do before, and doing things like that started to make me feel like a real person again. I also started to try to get physical activity at that point as well. I think the medication enabled me to resume some normal behaviors, even if I was still depressed, but it was resuming the normal behaviors that got me over the hump and got me out of my depressive funk.

For what it's worth, I took Celexa for depression and later added Neurontin for anxiety. Everyone reacts to these medicines differently, but I didn't have any side effects from Celexa or Neurontin, except maybe decreased libido, which did not bother me. Given that you have health-related anxiety, you should probably stop reading up about side effects of depression meds because you may just convince yourself you have the side effects. Worry about the life threatening ones you will need to call 911 over (like if your tongue swells up or something, whatever they are) but other side effects will most likely be very mild.
posted by AppleTurnover at 10:47 AM on April 21, 2015 [1 favorite]

Another thing that worked really well for me while in the pit of blackest depression was getting with horses. Just go somewhere that has horses in a paddock, and hang out with them for a while. I don't know what it is about horses, but it's definitely something.
posted by flabdablet at 12:07 PM on April 21, 2015

I've been on some dose of Lexapro for almost 8 years now and it has been life-changing. I still remember the moment I realized that everyone else didn't just feel crippling anxiety about every tiny daily event and hide it super well - that it was possible to actually NOT have that feeling hiding in a back corner of my brain at all times.

I personally never experienced any increase in anxiety when I started taking it, and the decrease was real and fairly quick. My main side effect was a slight increase in how much I sweated, which was easily dealt with by using new antiperspirant. Please give yourself the chance to know what less anxiety feels like, I really don't think you'll regret it and if you have any issues a good doctor will work with you immediately on adjusting dose or medication.
posted by augustimagination at 4:28 PM on April 21, 2015 [2 favorites]

I took Effexor and I have to tell you, the night sweats and vivid dreams were absolutely worth not having the kind of day you just described. Like night and day. I'm so sorry I waited. It cleared out anxiety I thought everyone had.

You don't need to stay on them, so please consider them. It's always a tough decision (anxiety offers a thousand no's to everything) but it could make the sun shine again.

It's 2015. There has never been a better year so far with more kinds of great meds available. Go get the best. I did it and you can do it and I look forward to hearing from the old you peeking through that fog soon. Go gently with yourself.
posted by heatherann at 6:18 PM on April 21, 2015 [1 favorite]

Hi, everyone. Just checking in to say I'm much better. Your support really helped, in general as well as specifically with relation to antidepressants and my worries re: the side effects. Therapy starts tomorrow but I've been doing a lot of reading about gratitude, mindfulness, and understanding intermittent bad feelings and thoughts to be nothing more than obnoxious brain farts. It has been very helpful telling myself not to sit in the worry but to acknowledge it and move on. I've had some rather stressful life events happen in the last few weeks (since posting this question) and I was SHOCKED at how well I was able to deal with them.

Really appreciate the MeFi mail and answers to this thread which helped me feel so much less alone. It has been a dark, dark time but it's gotten so much better, I truly feel like myself again, and I'm so grateful. I just wanted to say to anyone else who stumbles across this thread in future that it won't last, you're not alone and you'll be fine.

Thanks again, everyone. Hugs. Haha, I've just been rereading all these answers and I'm feeling a little teary. I love AskMetafilter. <3
posted by Ziggy500 at 4:08 AM on May 5, 2015 [2 favorites]

I was SHOCKED at how well I was able to deal with them

Well done you! Hugs back atcha.
posted by flabdablet at 11:08 AM on May 5, 2015

« Older ISO an indestructible diaper bag for a man   |   Examples of norms that prohibit costly behavior... Newer »
This thread is closed to new comments.