Thinking of antidepressants, but not sure if I should try for anxiety?
August 8, 2023 2:08 PM Subscribe
Hi. I am F 32, and I have had anxiety since I was a child, but it has gotten worse in my early to mid-twenties and now it seems pretty hard again, unfortunately. I have a feeling it is genetic due to being born prematurely, as they tend to suffer from mental health issues.
I find it hard to control my health anxiety and stress periods, and I have a feeling medication might be the answer because it feels like a chemical imbalance. I am unsure if I should try a mild antidepressant with little side effects? I am worried because I do not handle side effects well; unfortunately, I am very sensitive to that kind of thing. I am also not sure if trying CDB oil or natural paths might help instead?
My anxiety can get pretty bad, so I am not sure what to do? Should I try antidepressants again or try CDB oil? I am going through an emotionally abusive relationship that is ending in eleven years, which has taken a toll on my overall well-being and I think it is causing more stress than normal. I am unsure of what to do. I do take magnesium and stress tablets but they only work for a few hours and it's not that strong either, sadly. I have a feeling medication or CDB oil is the way to go, but does anyone here have anxiety that is genetic and does natural things or exercise help? Or does only medication help you find?
I find it hard to control my health anxiety and stress periods, and I have a feeling medication might be the answer because it feels like a chemical imbalance. I am unsure if I should try a mild antidepressant with little side effects? I am worried because I do not handle side effects well; unfortunately, I am very sensitive to that kind of thing. I am also not sure if trying CDB oil or natural paths might help instead?
My anxiety can get pretty bad, so I am not sure what to do? Should I try antidepressants again or try CDB oil? I am going through an emotionally abusive relationship that is ending in eleven years, which has taken a toll on my overall well-being and I think it is causing more stress than normal. I am unsure of what to do. I do take magnesium and stress tablets but they only work for a few hours and it's not that strong either, sadly. I have a feeling medication or CDB oil is the way to go, but does anyone here have anxiety that is genetic and does natural things or exercise help? Or does only medication help you find?
Well, exercise tends to make many things feel better, so you can certainly try that while you wait for your appointment with a psychiatrist, who can help with diagnosis, management techniques, and if necessary medication treatments.
(Personally I manage my anxiety entirely with exercise, but there are definite downsides to that approach, including that it may not work as fabulously for you as it does for me).
posted by nat at 2:27 PM on August 8, 2023 [3 favorites]
(Personally I manage my anxiety entirely with exercise, but there are definite downsides to that approach, including that it may not work as fabulously for you as it does for me).
posted by nat at 2:27 PM on August 8, 2023 [3 favorites]
This is one hundred percent a question for your doctor and/or a psychiatrist; it's neither something the internet can tell you nor something you should attempt without medical guidance (I mean, if you even COULD get antidepressants without a doctor's supervision).
It also doesn't matter at all whether it is "genetic" (something caused by premature birth would not be "genetic," FYI, that's not what genetic means). Any number of interventions might work or not work to reduce or manage anxiety regardless of the cause.
posted by We put our faith in Blast Hardcheese at 2:43 PM on August 8, 2023 [41 favorites]
It also doesn't matter at all whether it is "genetic" (something caused by premature birth would not be "genetic," FYI, that's not what genetic means). Any number of interventions might work or not work to reduce or manage anxiety regardless of the cause.
posted by We put our faith in Blast Hardcheese at 2:43 PM on August 8, 2023 [41 favorites]
In my experience trying to work out what to do about mental health troubles without outside perspective and assistance doesn't work very well. To understate things.
That assistance can't come from people who don't know you, start with your doctor.
posted by deadwax at 2:46 PM on August 8, 2023 [3 favorites]
That assistance can't come from people who don't know you, start with your doctor.
posted by deadwax at 2:46 PM on August 8, 2023 [3 favorites]
It’s hard being in an abusive relationship. The abuse is a heavy weight, and you are the authority on how best to manage that weight.
I fear that exercise, medication, or other remedies will not be enough to mitigate the weight that is getting you down.
There are resources out there for people that are being abused, everything from private counseling to hotlines to shelters. Consider seeking those out. You don’t have to be ready to leave your abuser to get advice.
posted by shock muppet at 2:51 PM on August 8, 2023 [8 favorites]
I fear that exercise, medication, or other remedies will not be enough to mitigate the weight that is getting you down.
There are resources out there for people that are being abused, everything from private counseling to hotlines to shelters. Consider seeking those out. You don’t have to be ready to leave your abuser to get advice.
posted by shock muppet at 2:51 PM on August 8, 2023 [8 favorites]
Work with a doctor*. Do not try to treat with supplements - I mean take magnesium if it supports your sleep or whatever, but do not treat your anxiety and depression with supplements just to avoid medical treatment. Try treating it first while you onboard other supportive habits including a better toolbox for cognitive management of your issues, and then you can look at removing the medication layer when those other things are in place and you've had time to experience the positive aspects of medication treatment.
Like, maybe in a year after the dust settles from this incredibly stressful and burnout-inducing time in your life, revisit whether medication is something you can reduce or remove.
I know for people with health anxiety, the "side effect" issue looms so so so large, and at some point you just have to stick them on the "revisit if it's actually a problem" wall and trust yourself to know when the time comes if you need to do something differently.
I come by my anxiety and depression honestly - you can find it on basically every leaf on my family tree - and age/menopause/adverse life events/pandemic pushed me to the point where I needed to DO something decisive and proven by evidence to be highly effective instead of just hoping sunshine and supplements was going to suddenly start working so well I wasn't going to lose my job or collapse under the stress. And I got my lexapro and I was absolutely crawling the walls with terror of siiiide efffffects, which for me is a bit of drowsiness about an hour after taking it. But I was certain!!!! it was going to destroy my already-fragile sleep, so I took it in the morning for like a year before realizing I could probably take it at my 3:30am pee break and if it did ruin!!!! my sleep it would only be the last hour or two.
I did go off earlier this year, mostly because I finally also got my adhd treated and I wanted to see if the functionality bump I expected from those meds would negate the need for the lexapro. I tapered incredibly slowly off the lexapro, gave myself another 6 weeks to see where my mood was, and then promptly went back on because it turned out my mood was "short-tempered asshole with absolutely zero chill in the face of the slightest challenge or difficulty" and so yeah, confirmed I still need more serotonin than I can retain on my own organically. I'm back on, happy as a clam, cool in a crisis, oh and now I take it at bedtime and sleep great.
I am going to ask you to give yourself a better pep talk than "I do not handle side effects well" though, because life has side effects. Not being medicated when you need it has big freakin' side effects. Stress has side effects. Many medications have mild boring side effects that are not nearly as life-wrecking as those of untreated anxiety, and you are not going to be a zombie that can't tell the difference between actual catastrophic issues versus a bit of drowsiness or decreased lactose tolerance or even the dreaded lowered libido. Being unable to function wreaks havoc on all those things for me too, so it's a perspective issue as much as physical.
Obviously, there are some serious side effects that require a definite change in strategy rather than just side-effect management, but they are rare AND you're going to work with your treatment provider so that you can ring the alarm bell if those are an issue and they'll use their training and expertise to help figure it out.
*I would suggest if in any way feasible that you find a Mental Health Nurse Practitioner, or Psychiatric NP, to manage your care. EVEN using an online pill mill, my providers have all been super-smart engaged warm relatable medical professionals better than any MD I have ever dealt with in person. I think GYN NPs are harder to find but they are a thing and may generally be able to give you overall primary care that covers both ends, so to speak.
posted by Lyn Never at 2:54 PM on August 8, 2023 [28 favorites]
Like, maybe in a year after the dust settles from this incredibly stressful and burnout-inducing time in your life, revisit whether medication is something you can reduce or remove.
I know for people with health anxiety, the "side effect" issue looms so so so large, and at some point you just have to stick them on the "revisit if it's actually a problem" wall and trust yourself to know when the time comes if you need to do something differently.
I come by my anxiety and depression honestly - you can find it on basically every leaf on my family tree - and age/menopause/adverse life events/pandemic pushed me to the point where I needed to DO something decisive and proven by evidence to be highly effective instead of just hoping sunshine and supplements was going to suddenly start working so well I wasn't going to lose my job or collapse under the stress. And I got my lexapro and I was absolutely crawling the walls with terror of siiiide efffffects, which for me is a bit of drowsiness about an hour after taking it. But I was certain!!!! it was going to destroy my already-fragile sleep, so I took it in the morning for like a year before realizing I could probably take it at my 3:30am pee break and if it did ruin!!!! my sleep it would only be the last hour or two.
I did go off earlier this year, mostly because I finally also got my adhd treated and I wanted to see if the functionality bump I expected from those meds would negate the need for the lexapro. I tapered incredibly slowly off the lexapro, gave myself another 6 weeks to see where my mood was, and then promptly went back on because it turned out my mood was "short-tempered asshole with absolutely zero chill in the face of the slightest challenge or difficulty" and so yeah, confirmed I still need more serotonin than I can retain on my own organically. I'm back on, happy as a clam, cool in a crisis, oh and now I take it at bedtime and sleep great.
I am going to ask you to give yourself a better pep talk than "I do not handle side effects well" though, because life has side effects. Not being medicated when you need it has big freakin' side effects. Stress has side effects. Many medications have mild boring side effects that are not nearly as life-wrecking as those of untreated anxiety, and you are not going to be a zombie that can't tell the difference between actual catastrophic issues versus a bit of drowsiness or decreased lactose tolerance or even the dreaded lowered libido. Being unable to function wreaks havoc on all those things for me too, so it's a perspective issue as much as physical.
Obviously, there are some serious side effects that require a definite change in strategy rather than just side-effect management, but they are rare AND you're going to work with your treatment provider so that you can ring the alarm bell if those are an issue and they'll use their training and expertise to help figure it out.
*I would suggest if in any way feasible that you find a Mental Health Nurse Practitioner, or Psychiatric NP, to manage your care. EVEN using an online pill mill, my providers have all been super-smart engaged warm relatable medical professionals better than any MD I have ever dealt with in person. I think GYN NPs are harder to find but they are a thing and may generally be able to give you overall primary care that covers both ends, so to speak.
posted by Lyn Never at 2:54 PM on August 8, 2023 [28 favorites]
What you specifically should do for your mental health is a great question for a psychiatrist. (Maybe your primary care doctor if you have a really good one, but if you really want to sort be through all your options, get knowledgeable about different side effect profiles, etc., I think you need a specialist.) In the interim, there's no reason not to keep up with the supplements that are helping you a bit. But go talk to a doctor about your specific symptoms, medical history, and concerns to make a plan for what works best for you.
Personally, what works best for me is medication. Other healthy habits can help bolster my mental health, but I also need medication. I'm very grateful that it's an option, and the side effects were minimal and temporary. I encourage you to consider them *if* the medical professional you see thinks they're a good idea for you.
posted by Stacey at 4:02 PM on August 8, 2023 [2 favorites]
Personally, what works best for me is medication. Other healthy habits can help bolster my mental health, but I also need medication. I'm very grateful that it's an option, and the side effects were minimal and temporary. I encourage you to consider them *if* the medical professional you see thinks they're a good idea for you.
posted by Stacey at 4:02 PM on August 8, 2023 [2 favorites]
Yes to exercise
Are you out of the abusive relationship now? If not, your anxiety probably won't change until you are safe. So focus on getting out of the abusive situation. Seek out domestic violence organizations for help
Yes to seeing a professional-psychiatriat and therapist
I don't know if cbd oil helps.
posted by AnyUsernameWillDo at 4:18 PM on August 8, 2023
Are you out of the abusive relationship now? If not, your anxiety probably won't change until you are safe. So focus on getting out of the abusive situation. Seek out domestic violence organizations for help
Yes to seeing a professional-psychiatriat and therapist
I don't know if cbd oil helps.
posted by AnyUsernameWillDo at 4:18 PM on August 8, 2023
One thing that is well understood about antidepressants is that their effects and side effects will vary widely from person to person. You could spend a very long time wandering about trying different combinations on your own; it’s the kind of thing where keeping an expert (i.e psychiatrist) in the loop can save a lot of time and effort.
posted by Tell Me No Lies at 5:06 PM on August 8, 2023 [3 favorites]
posted by Tell Me No Lies at 5:06 PM on August 8, 2023 [3 favorites]
Regarding side effects: looking at lists of side effects for an anti-anxiety or anti-depression drug won't give you much information that actually applies to you. Every medication affects different people differently, even people in the same family. You might get a rare side effect and not get any of the common ones. I actually lost weight on a pill that makes most people gain weight.
I have both depression and anxiety that were limiting me terribly, and medication changed my life dramatically. I suggest that you talk with either a primary care doctor or a psychiatrist. General practitioners usually prescribe the most common anxiety meds; then if your side effect aren't manageable or the drugs aren't effective, you can go to a psychiatrist. But there's no harm in seeing a psychiatrist first if you want.
posted by wryly at 5:24 PM on August 8, 2023
I have both depression and anxiety that were limiting me terribly, and medication changed my life dramatically. I suggest that you talk with either a primary care doctor or a psychiatrist. General practitioners usually prescribe the most common anxiety meds; then if your side effect aren't manageable or the drugs aren't effective, you can go to a psychiatrist. But there's no harm in seeing a psychiatrist first if you want.
posted by wryly at 5:24 PM on August 8, 2023
Nthing the suggestion to work closely with a mental health professional to come up with a plan that fits what you need, whether that's antidepressants or some other form of treatment. It may take some time for you to find someone and then go through the intake process, so I would also strongly encourage you to reach out to an organization that deals specifically with intimate partner violence as they may be able to work with you in the more immediate term.
One thing from your post that is standing out to me is the idea that your anxiety might be genetic. I was married for 20yrs to someone who was abusive and by the time I got out, I felt broken to my core, like the person that I was had somehow been fundamentally and irrevocably shattered and that I had become a facsimile of a person, rather than a strong individual who had managed to survive for 2 decades under the thumb of a person who harmed myself and my children and sought to annihilate my identity and sense of self. It's possible that genetics plays a part in your anxiety, but be open to the possibility that the anxiety you are experiencing is your nervous system alerting you to the fact that you do not feel safe because you are not safe; not because you're broken. Anxiety may have been a part of your life for a long time, but you are so much more than how your body processes trauma and stress.
Leaving an abusive partner is hard and my heart goes out to you. Do what you need to do to take care of yourself and give yourself the life filled with love that you deserve.
posted by Ceridwen at 5:46 PM on August 8, 2023 [14 favorites]
One thing from your post that is standing out to me is the idea that your anxiety might be genetic. I was married for 20yrs to someone who was abusive and by the time I got out, I felt broken to my core, like the person that I was had somehow been fundamentally and irrevocably shattered and that I had become a facsimile of a person, rather than a strong individual who had managed to survive for 2 decades under the thumb of a person who harmed myself and my children and sought to annihilate my identity and sense of self. It's possible that genetics plays a part in your anxiety, but be open to the possibility that the anxiety you are experiencing is your nervous system alerting you to the fact that you do not feel safe because you are not safe; not because you're broken. Anxiety may have been a part of your life for a long time, but you are so much more than how your body processes trauma and stress.
Leaving an abusive partner is hard and my heart goes out to you. Do what you need to do to take care of yourself and give yourself the life filled with love that you deserve.
posted by Ceridwen at 5:46 PM on August 8, 2023 [14 favorites]
Just in case one more answer makes a difference: please listen to everyone up-thread suggesting you work with your medical providers, hopefully including a psychiatrist and a psychologist/therapist, to get professional and appropriate help. The pattern of things you’ve been asking about over the past year or so is well above the pay-grade of internet randoms here, including me.
posted by Alterscape at 9:10 PM on August 8, 2023 [13 favorites]
posted by Alterscape at 9:10 PM on August 8, 2023 [13 favorites]
If you do decide to try medication, see a psychiatrist rather than a GP.
A GP can prescribe the medication but is unlikely to have the neccesary knowledge about side effects etc to help you decide on the right medication for you.
My experience with anxiety was that finding a good therapist as well as medication was what helped. The two together.
posted by Zumbador at 10:06 PM on August 8, 2023 [4 favorites]
A GP can prescribe the medication but is unlikely to have the neccesary knowledge about side effects etc to help you decide on the right medication for you.
My experience with anxiety was that finding a good therapist as well as medication was what helped. The two together.
posted by Zumbador at 10:06 PM on August 8, 2023 [4 favorites]
Please remember that after you're safe from previous long term danger, like an abusive relationship, anxiety may get worse for a while because you're finally safe to feel all these feelings.
Antidepressants aren't magic, but they give you the breathing room to get at the root of anxiety and stop it from taking over your life. Speaking of genetics, every woman in my family has been on psychiatric-prescribed antidepressants for anxiety at some point in our lives and we've all had great results. I recently went back to mine for a few weeks where a combo of family and health stress was eating me alive, and while the escitalopram barely had time to work, ut gave me a distance that let me get through Yet Another Funeral without falling apart in a dissociative fugue.
The other things - magnesium, melatonin, eating and sleeping and exercising, CBD, yoga, prayer beads - all help, but antidepressants give them the room to be effective.
posted by I claim sanctuary at 4:35 AM on August 9, 2023 [3 favorites]
Antidepressants aren't magic, but they give you the breathing room to get at the root of anxiety and stop it from taking over your life. Speaking of genetics, every woman in my family has been on psychiatric-prescribed antidepressants for anxiety at some point in our lives and we've all had great results. I recently went back to mine for a few weeks where a combo of family and health stress was eating me alive, and while the escitalopram barely had time to work, ut gave me a distance that let me get through Yet Another Funeral without falling apart in a dissociative fugue.
The other things - magnesium, melatonin, eating and sleeping and exercising, CBD, yoga, prayer beads - all help, but antidepressants give them the room to be effective.
posted by I claim sanctuary at 4:35 AM on August 9, 2023 [3 favorites]
Just a personal experience note - I have been taking high-dose CBD (combined with the least possible THC as apparently it works better if there's a bit included) plus using it topically for several years for a series of knee injuries, and while I absolutely regard it as life-changing with regard to inflammation and pain management, it's pretty much a zilch for my anxiety or depression. I sleep better on it, and I'm sure that is an overall life improvement (especially when my knees are happier), but it's nothing like the effects of my SSRI.
posted by Lyn Never at 5:56 AM on August 9, 2023
posted by Lyn Never at 5:56 AM on August 9, 2023
Nth'ing seeing a psychiatrist. Mine works over videochat.
One thing I've gleaned is that my anxiety isnt' per-se anxiety, it's anxiety that arises as a coping mechanism for the problems my depression uses to fuck up my life. This made all of my self-diagnosis a waste of time.
Another thing is that the "why" stuff is for a therapist. You have symptoms of...something, and a psychiatrist will treat those. They're really just doctors, and like physical doctors, your thoughts about why you ride a bike like you do that caused you to fall and break your arm aren't really relevant. You just get a cast.
posted by rhizome at 7:58 PM on August 10, 2023 [2 favorites]
One thing I've gleaned is that my anxiety isnt' per-se anxiety, it's anxiety that arises as a coping mechanism for the problems my depression uses to fuck up my life. This made all of my self-diagnosis a waste of time.
Another thing is that the "why" stuff is for a therapist. You have symptoms of...something, and a psychiatrist will treat those. They're really just doctors, and like physical doctors, your thoughts about why you ride a bike like you do that caused you to fall and break your arm aren't really relevant. You just get a cast.
posted by rhizome at 7:58 PM on August 10, 2023 [2 favorites]
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