I need to see a doctor for anxiety issues - how to convince myself
February 28, 2019 1:49 PM   Subscribe

I'm a really anxious person, both in general and with social anxiety in particular, and have been for as long as I can remember, but it's kind of reached a point where I can't keep going with it any longer. I've tried a bunch of different things but nothing really seems to stick. I'm reconsidering medication, but I'm really reluctant. Details inside.

I got into a mostly unhappy 4-year relationship when I was about 19, then when that ended I spent a few months alone then started another relationship that lasted about a year. That ended towards the end of 2017, and at that point, after maybe 5-6 years of feeling isolated and having no friends outside of a romantic relationship, I decided that even if it was emotionally taxing I really had to try and break out of the rut. I've spent the last year or so socialising (which is very difficult for me), making friends, focusing on hobbies outside of work, trying to gain fitness, activism, some self-help stuff, and I saw a counsellor privately for the last few months. I think the counselling gave me a bit of useful perspective, which was nice, but I decided to stop because it hasn't made much of a significant difference to my anxiety in general and it didn't feel like it was really going anywhere.

I think I really imagined that if I could just make some new friends and start to connect, I would feel a bit better, and as much as I care about the friends I've made, I don't feel any more confident or happy in myself. I'm anxious and on-edge all the time, I thoroughly dislike myself, and I alternate between a sort of constant low-level anxiety and random periods of feeling truly terrible for no apparent reason. I'm 26 now and I still feel like a teenager. I feel totally stuck.

I've hit a point where I feel like I need to reconsider medication because it's the main thing I haven't tried that might actually help, but I really don't want to go back to a GP.

I've been to a doctor for mental health issues twice, once when I was about 18, because I was having a really bad depressive episode and was suicidal (I haven't really had a serious depressive episode since my early 20's). I sort of got a sympathetic pat on the head and a citalopram prescription. The worst part of the depression lifted after a few weeks, but every other episode I'd had up until that time had lifted in the same way and the same time frame without medication. I sort of thought 'screw this', and withdrew (under doctor's guidance) over a few months. I saw a different doctor at the same surgery a few years later due to anxiety getting totally out of control, but she was pretty hopeless - she basically diagnosed me as being a Masters' student, immediately ruled out diazepam because I wouldn't be able to study, and offered me beta blockers (for symptoms I don't have). I kind of swore off the whole idea of doctors since then and decided to deal with it on my own, which I have pretty much failed to do.

There is a different doctor at this surgery who I've been considering making an appointment with, because I saw her for a couple of years ago for something unrelated and she was thorough, careful, empathic and didn't bulldoze over my feelings about treatment. But I've been burned before and I'm not optimistic about the general state of anti-anxiety medication at the moment. I know this is going to take a lot out of me and I'm scared of having to guinea-pig my way through a bunch of drugs that don't work. I know I could put this off for another month, 6 months, a year - how can I convince myself to take this risk? Or if you've got a completely different idea or perspective, I would love to hear it.
posted by AllShoesNoSocks to Health & Fitness (15 answers total)
 
Do you have a friend who would understand your concerns and would go with you? Even go into the room for you, be your notetaker and backup question-asker. It helps a lot, even with mediocre doctors, to bring someone who can serve as both a witness and assistant.

If not, I find that just having a notebook and pen in hand for the conversation - with bullet points pre-written about what I want and questions I might have - makes many doctors stand up a little straighter and think a little harder.
posted by Lyn Never at 1:57 PM on February 28, 2019 [1 favorite]


Two thoughts: first you might really benefit from a psychiatrist (a medical doctor specialized in psychiatric issues). You want someone who really knows the different options and can work with to you find what will help. Most generalists just a have a short list of solutions and don't really understand all the options.

Second, it sounds like you haven't tried counseling or talk therapy. It can be really helpful for anxiety, especially in combination with medication where the meds help you to function again and the counseling helps you learn how to make long term changes in how your brain works. Also, a therapist typically sees you every week so they can help you figure out the other things that are worth trying and give you emotional support for dealing with the meds.

Finally, this isn't really a big risk. If you do nothing, you will be in the same place in a month or six. If you try meds and they don't work you might have some mild, unnecessary side effects but otherwise you haven't lost much with the possibility of a big gain that you get your life back. With counseling the risk is even smaller - maybe money and time for the session with the upside of finally feeling better.
posted by metahawk at 1:59 PM on February 28, 2019 [5 favorites]


In my experience, even therapists don't always have a great understanding of anxiety compared to, say, depression. The field is developing rapidly. A therapist with specific expertise in anxiety might be able to help you a lot, either in combination with medication or alone.

I know I could put this off for another month, 6 months, a year - how can I convince myself to take this risk?

Oh boy do I know this feeling!

Do you have a friend you trust to talk to about this? Could you recruit them to help you? Even just to sit with you while you make the appointment? A while ago I had been putting off something super important, and I was hanging out with a friend and admitted it to him tearfully, and he said "well let's get it done!" and, you know what, we did! It was awesome, and such a load off my mind.
posted by showbiz_liz at 2:09 PM on February 28, 2019


I tend to think of all the ways something I want/have to do could be difficult or go wrong. It sounds like you might be doing that as well? I've been trying very hard to notice when I do that and then spend a moment or two imagining what it might be like if things go smoothly. Would that be helpful to you to do that about visiting the doctor? Maybe say out loud something like "maybe this won't be as difficult as I'm imagining"?

In any case, I'm an internet stranger who will be cheering you on as you take the steps to take care of yourself.
posted by mcduff at 2:38 PM on February 28, 2019 [1 favorite]


Hi, I was you a few years ago. I finally got myself into care (therapy and a GP who was willing to prescribe medications) when I realized I was stressed and miserable and mean more often than I liked.

I know I could put this off for another month, 6 months, a year - how can I convince myself to take this risk?

What's the risk of going now?
- You might have to suffer through an unpleasant appointment with a crappy doctor/provider.
- You might spend time and money on therapy and/or medication(s) that don't really work for you.

What's the potential reward of going now?
- You might stop feeling miserably anxious all the time. You might get to enjoy life for real.

Does the potential reward outweigh the potential risks for you? Keep in mind that the risks will be the same in a month, a year, or a decade -- but you'll have suffered that entire time when it could very likely have been avoided.

I'm not optimistic about the general state of anti-anxiety medication at the moment. I know this is going to take a lot out of me and I'm scared of having to guinea-pig my way through a bunch of drugs that don't work.

This is your anxiety talking. IT'S YOUR ANXIETY TALKING. Don't let your Lizard Brain deter you from seeking out help that could very likely improve your quality of life.
posted by schroedingersgirl at 2:39 PM on February 28, 2019 [5 favorites]


Please note the OP is not in the US and will not have access to a psychiatrist. A GP will provide meds.

OP, listen, you can put it off for a year but the only result of that is that you feel like shit for another year and you're one year further away from finding a way to hey, not feel like shit. I'm not trivialising; I have a GP practice with three doctors and one of them is a complete twatpot. But if you can get on a med that ramps down the anxiety and steadies out the depression, it's worth the trouble getting there.

Sertraline seems to be the current go-to for combined anxiety and depression; other than figuring out if I needed to take it in the morning or in the evening to not disrupt my sleep, it's been an easy, gentle ride (and I say this as someone who's been through the mill with this shit.)
posted by DarlingBri at 2:42 PM on February 28, 2019 [3 favorites]


Oh, man. I have felt this before, about the million different things I've tried for my anxiety:
I think I really imagined that if I could just make some new friends and start to connect, I would feel a bit better, and as much as I care about the friends I've made, I don't feel any more confident or happy in myself.

Like when I tried to run my way out of it. I got very fit and was still a nervous fucking wreck full of anxiety! Try to be proud that you've made those friends, even with this big dumb obstacle of anxiety in the way. It's so hard to get anything done when anxiety is around.

Just having medication available to you can help, honestly. I am on daily meds, but I also have rescue meds (benzos) for when the anxiety gets out of control. I only have to use them half the time -- the rest of the time, just knowing that they're there helps me.

Please don't think of medication as giving up. For me, it's the only thing that can really give me some relief.

I hope you can find some peace and something that works.
posted by fiercecupcake at 2:43 PM on February 28, 2019 [3 favorites]


I'm anxious and on-edge all the time, I thoroughly dislike myself, and I alternate between a sort of constant low-level anxiety and random periods of feeling truly terrible for no apparent reason.

In a different thread about anxiety that I don't have time to find now, I think it was jessamyn who noted something I found super helpful: Doctors don't acknowledge how scary it is for many anxious people to take medication. It is super scary. Some of us discover, after getting past that fear, that medication is truly helpful. Over many years, I suffered from debilitating healthy anxiety and panic attacks that made me so miserable that I thought it would be easier to just die already than to walk around in fear, dread, and misery anticipating imminent death.

That is not my only anxiety but it has been the main one. It never occurred to me that medicine might help until my psychiatrist offered me a tiny dose of citalopram after I mentioned, in passing, this horrible anxiety. It literally had never occurred to me that medicine might help. I was skeptical; he said, "My patients tell me fear gets up to the porch but not through the door," so I tried it. In my case, it was super helpful. Later on, I also took a 6-part workshop on managing anxiety via Kaiser. That was also helpful. I have been off citalopram for about a year, but will go back to it in a heartbeat if I feel like I need it again.

I'm 26 now and I still feel like a teenager. I feel totally stuck.
So by all means try medication, and by all means skip the GP. There is a reason mental health is a specialty. My former psychiatrist in the US did meds exclusively. Sometimes there is a lot of tinkering that needs to be done; other times, like in my case, a person gets lucky. Whatever your situation and experience to date, please, please, please do not give up. I suffered with anxiety until I was in my 50s. A friend of mine, in her 60s, is too terrified of medication to try anything for her anxiety, and she has suffered significantly for most of her adult life.

You can make different choices. There is no guaranteed perfect solution, but the odds are in your favour if you seek out experienced, professional help. Assuming, of course, that you can find such help. Assuming, of course, that you can afford it. Those are huge assumptions; I hope they are true.

Finally, try not to judge yourself. Self-care can be exhausting, especially for people who suffer from anxiety, depression, etc. Love on yourself as much as you can. This stuff is hard, hard, hard and that is not your fault. PM me if you ever need to vent. Good luck!
posted by Bella Donna at 2:52 PM on February 28, 2019 [3 favorites]


Heath anxiety. Forgive me. Damn typos!
posted by Bella Donna at 3:53 PM on February 28, 2019


I genuinely believe that seeing a Doctor about my anxiety totally changed the course of my life from one heading in the wrong direction, where this debilitating fear was slowly poisoning every part of my life, to a a new direction where I'm healthier, more accepting of myself (And others), and having better relationships and feelings.

I didn't even take medication, but it set me on the right path, and I have never regretted it for a second.
posted by smoke at 3:54 PM on February 28, 2019 [2 favorites]


So based on my friends' experiences, odds are good that you will indeed need to fuss around with various meds to find something that will work. Does it help to resign yourself to that possibility, accept it, and recognize that it's still a better choice than what you're going through now? And remembering that if you do find something that works for you, the sooner you start, the more time you'll have with a better life?
posted by metasarah at 4:29 PM on February 28, 2019 [3 favorites]


Are you in the UK? What local authority are you in? There are several routes to access a psychiatrist. My local authority has at least one route you can self refer through to get started. There’s usually a heck of a waiting list but you can totally get one. Feel free to post here or PM me and I’ll point you to some starting places. A GP may be involved but if you can get assessed by the mental health team it’s like, them writing letters to your GP. At least here, it’s the mental health experts guiding the process, not the GP.
posted by Mistress at 7:43 PM on February 28, 2019


I was anxious my whole life but didn't recognise it until I basically had a breakdown at 30 and couldn't function because of all the panic attacks. I kind of ended up having no choice but to get help, because it was so bad. I had been against meds but I accepted them at the time because I was so desperate. Long story short, I'm now healthy, though I will always be an 'anxious person'. Don't get me wrong, I'm still me. But I'm a much healthier and better regulated me, who can cope with things a lot better.
posted by thereader at 12:02 AM on March 1, 2019 [3 favorites]


I’ve been in therapy for months for anxiety, and although it was helping I didn’t make any real progress until I talked myself into getting on medication.Now I can make phone calls and send emails and leave the house without feeling so awful that I have to lay down afterwords. The process of navigating the healthcare system and advocating for myself was one of the hardest things I’ve done and it was still so, so worth it.
posted by velebita at 7:25 AM on March 1, 2019 [1 favorite]


Considering that you are struggling with anxiety, it's not surprising that you are anxious about embarking on this process.

Anxiety is largely about faulty expectations and assumptions you apply to situations - it's a spiral of what ifs and arbitrary rules your mind is assigning to your experiences. What if x happens and I can't do y or z? And I could never do q, because x and z...get what I mean? It's not just that you are scared of what ifs, you also often feel like you aren't "allowed" to respond in the way that feels right. Let me first say - you have permission. For whatever. You are allowed to feel and react however and people are allowed to feel however they feel about it, but what they feel belongs to them and what you feel belongs to you.

Now, what may help you start this process is to write down a list of what makes you nervous about it and then trying to find remedies to each fear you have that make you feel calm.

Some examples...

Problem: I'm afraid I won't like the first doctor I go to. Solution: Seek out a second opinion.
Problem: I'm afraid I'll be pressured to accept a medication I am not comfortable taking. Solution: If you don't want to argue, just take the prescription but don't fill it. Etc etc

These are my theoretical answers, but yours may be different. The point is to voice what is scaring you, and keep thinking through a different outcome that you can control until you find one that makes you feel calm and safe if the situation were to happen to you.

The key thing to remember is YOU ARE IN CONTROL. No matter how many doctors you speak to or how much good or bad advice you encounter, you are the final arbiter of what goes into your body. No matter what anyone says to you, you get to decide how this situation unfolds. Take your time and work with the facts.

For context: former anxiety disorder sufferer here. I became fully agoraphobic for about 6 months in my late teens, and spent most of my early 20s in a state of low grade panic with occasional spurts of panic attacks. I was resistant to meds and ultimately never took anything daily. I did succumb to a small scrip of benzos and it did help. Even knowing I had something to help me escape if I went over an edge took the fear out of certain situations. Ultimately thats what anxiety was often about for me - anticipating bad outcomes and fearing that I didn't know how to navigate my way out of them. Benzos were a solid way out if it came to it. As a second step a lot of talk therapy and learning strategies like I listed above to work through my anxious thought patterns were key to changing my brain. That said, were I to ever encounter the situation again, I would be more open to meds. Anxiety is a behavioral and chemical problem. Changing your behavior can ultimately change your chemicals, but it takes a lot longer. In retrospect, I suffered for a long time because I wasn't willing to embark on this process. Knowing what I know now, I would and I hope you give it a chance. There are good doctors and treatments out there and you deserve to feel better as soon as possible.
posted by amycup at 8:43 AM on March 1, 2019


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