Folks with anxiety - when is it time to start medication?

[sequins]

6 month update!

PDQ

I have GAD and I see a therapist. I've managed it ok over the last two years with talk therapy/breathing etc. She did use some CBT techniques when I was having panic attacks and I haven't had them in a while.

My anxiety was tied to residency so I thought things would be better once I'm done. But I'm done and now my anxiety is no longer tied to it so it pops up all the time instead. It's still quite mild to moderate. But I'm so tired of being on guard and constantly putting the work in and breathing and reducing my stress etc. Taking meds seems so much easier like I just take a pill and I'm my normal self??!! 

Somethings that are stopping me -

I don't want to gain anymore weight. I'm already pre-diabetic.

I don't want any mental side effects - depression etc

It freaks me out that I could build tolerance to meds and end up with no options

My life is still pretty high stress - phd/applying for jobs/licensing exams/boards/pandemic etc

I just finished my program a couple of months ago. Should I give it more time to heal from that? Another girl above me in the program also developed GAD during the program. She is a year out and she says she has very little anxiety now compared to before.

Anyway, my question is at what point did you start medication? Talk to me about your experience. Thanks!

Update in replies!

[sproctopus]

The weight gain thing also stopped me for much longer than it should have. I worked hard to lose a lot of weight (also pre-diabetic and have PCOS).

I got to a point where I needed xanax to survive. Everyday my brain told me I was dying and I could not get out if bed without xanax. I was living to sleep-- it was the only break I got from it. I was not suicidal, but for the very first time in my life I fully understood why people would take their own lives because I did not want to live if that's what every day would be like. That scared the SHIT out of me.

I should have started meds much, much sooner (I had been on them before, Lexapro).

I did gain some weight. I also am alive, so I guess given the choice, I prefer to be slightly heavier.

I'm sorry you're struggling and I hope you find some relief soon.

[sequins]

sproctopus , ahhhh I understand your point about people taking their own lives I didn't want to put it in my OP because it seemed too much for a friday morning but yes, I do understand and have thought about what anyone can do when they run out of options. And yes, it scares the shit out of me.

[msmerymac]

I went on lexapro in May and it's been AMAZING.

I haven't gained weight, but that's because the medicine let me actually start leaving the house and getting back to working out. I haven't lost too much either, so I guess I've achieved equilibrium.

I started having physical symptoms from anxiety around October 2020. I had always had mild GAD, but didn't realize for several months that the anxiety was tied to me having tingling and numbing sensations throughout my body at different times, or my heart palpitations. I constantly thought of the worst-case scenario, like if I left the house, something would happen to my husband or cats and I'd never see them again. On New Year's Eve 2020/2021 my H had to go pick up a sparkling wine and cheese pairing we were participating in over zoom, since it was the height of the pandemic and we couldn't really go out. Being December and dark, I had so many horrible thoughts of separation anxiety that I just rode in the car with him for like 1:30 round trip just to be able to be with him. I constantly thought my medical issues would end up being heart failure or cancer and that I was dying and I desperately didn't want to die. I could barely do anything around the house except get up, work, watch TV, and go to bed. I could barely even finish reading a book, and I love to read - it just required too much attention. I was a mess. CBD didn't help much. Weirdly, dextromethorphan did (regular doses, I'm not abusing mucinex) and I've heard that there are some studies that say it can help anxiety, but overdose is also a real possibility, so... Breathing and stuff helps too, and fidget spinners, and laying down for 5 minutes if I need to (I work at home).

Anyway, I started on 10 mg of lexapro, as you do, and in August I went up to 15 mg. I'm still tired and have some brain fog at times, but I'm so, so much better than I was. It feels like I have some semblance of a life back.

[sproctopus]

Also, I do weekly therapy. While there is some definite benefit to it, talking can't change a chemical issue. I know you know that too ❤ The hardest part of the decision to medicate is deciding you will! So it feels hard because it is.

I think my advice would be to not let the anxiety steal anymore time from you. You deserve to feel better.

[wildrice]

For me, it was when I couldn't really get through the day. It is hard to describe and still seems kind of unreal to me because it was so outside of my norm, but I just felt crippled and like I wanted to lay in bed and not do anything or go anywhere. All of the things that should have worked - deep breathing, exercise, journaling, meditating - would work while I was doing them and then it would go right back to being miserable. I didn't honestly really feel like I had a choice but to go on meds because I could not live like that.

I started them a little over a year ago and that's all gone. I won't say that I have no anxiety ever, but now it's actually triggered by something vs just feeling awful sitting around my house. And if I take some deep breaths it usually eases or at least goes away soon. I do feel like have less emotions in general (when was the last time I cried? I have no idea) but I don't think that's a poor trade off.

I have gained about 20lbs in the last year. I don't think it's directly because of the meds (I'm on Effexor and weight gain is not a reported side effect) but I do think I have a harder time caring about restricting myself. I have always had a pretty chill personality and if anything I'm even more chill now. Mentally I feel like it's actually really nice not to give a shit, but I recognize that for my health I need to get motivated.

From what you describe, I think you could go either way. It doesn't sound dire, but if you feel like it's interfering with your daily life to have to manage your anxiety through behavior, it might be worth looking into.

[quesyrah]

For me, it was when my anxiety impacted my ability to function and quality of life.

Once I could no longer control it any other way and it was negatively impacting my life at work and home, it was time for meds.

[sproctopus]

wildrice My exact same experience (same med, same gain). I also gained with Lexapro and I call BS on the lack of weight gain ties to a lot of these meds-- like our brain literally regulates everything we do-- how can we assertively say something that is helping reshape brain chemistry isn't impacting feeding cues, satiety, hunger, etc. *dismounts from soapbox*

I try not t think of it as "not giving a shit". When I'm anxious, I cannot eat and feel like dying. If the meds make me realize a cookie a day is making me happy and keeping me from spiraling to a point where I realize idgaf tomorrow is coming, I'd love to kiss the scientists who came up with it.

[sonrisa]

Not all meds are linked with weight gain. Wellbutrin helped my anxiety and I didn't need to be on it long term for it to make a longterm difference (I took it for under a year and it gave me the space to heal and build the skills I needed). (I actually lost weight which can be normal for Wellbutrin and slept better which is not normal for Wellbutrin - but anxiety was causing my insomnia. The alertness Wellbutrin brought on was much easier to sleep through than the crushing fear, loathing and stress my anxiety had

[sequins]

Feb 18, 2022 13:18:41 GMT -5 sonrisa said:

Not all meds are linked with weight gain. Wellbutrin helped my anxiety and I didn't need to be on it long term for it to make a longterm difference (I took it for under a year and it gave me the space to heal and build the skills I needed).

This sounds interesting. How did you know when to stop?

[sproctopus]

Hi, it's me again, lol.

I told my therapist and prescriber that I was hoping to not be on the meds forever. My doctor told me we definitely had ways to wean off the drug (Effexor is very fast acting so missing a dose by even a couple hours can have really bad withdrawal effects).

They both told me I got to say when I was done and felt better about my ability to manage things without the help. Just having a professional tell me that made me feel more "in control" but also less alone-- like I had a team to help. And just like I don't want to take it forever, I also want to be open to taking it again in the future if need be.

I don't think there is am exact length of time-- when it feels right and you have more confidence in self-management, you get to make the call.

[InBetweenDays]

I have what I'd describe as mild to moderate anxiety - mostly health related. It got much worse during the pandemic. I had no problem getting up and going about my day, but often I wasn't able to relax and enjoy the moment because my mind was elsewhere. Or I'd spend way more time on my phone than I wanted because I was trying to distract myself. And it was manifesting itself physically with heart palpitations, stomach issues, not being able to eat so I'd eat crappy foods or whatever was in front of me, etc.

I went on Buspirone about a year ago and it's made a world of difference. I slowly ramped up to the maximum dose my doctor recommended, and then backed way off once I was feeling better. I still feel anxious and over-worry about things at times, but it isn't a constant presence in the back of my mind. And the physical symptoms are all but gone.

And I'll say I gained weight before going on the medication because I stopped exercising and was eating like crap. Once I had the anxiety under control I could get back to the things I loved and have actually lost most of the weight I gained during the pandemic.

Hugs to you - I know it isn't an easy decision.

[sonrisa]

Feb 18, 2022 13:20:34 GMT -5 sequins said:

Feb 18, 2022 13:18:41 GMT -5 sonrisa said:

Not all meds are linked with weight gain. Wellbutrin helped my anxiety and I didn't need to be on it long term for it to make a longterm difference (I took it for under a year and it gave me the space to heal and build the skills I needed).

This sounds interesting. How did you know when to stop?

When I started, my doctor had talked about it as a step to get back on track rather than an indefinite solution. The goal was to try it for 6 months to see if it helped. I extended that another 3 months. Then I felt ready and weaned down sloooowly over the next month (alternating half and full doses, then half doses, then every other day). 

I knew it was working when a week in I laughed. And I couldn't remember the last time I'd really laughed. Like you, I had wondered if I really needed something, but that moment was such a wake up call. I hadn't noticed how far I'd strayed from my normal. 

[katieb4tom]

Citalopram (generic) has had zero side effects for me and when I moved up from 10 to 20 mg, it helped w my desire to drink. Highly recommend.

Editing to say this is a generic for celexa. No weight gain, but able to hear bad things and rationalize, not obsess for days/weeks after.

[wildrice]

sproctopus, that's interesting that you had the same experience. And it makes sense - I don't think the medication likely slowed down my metabolism, more like it made it easier for me to say yes to doing and eating whatever I want. I'm kind of a hedonist at heart, so I guess I don't even mean not giving a shit in a negative way - I don't feel depressed or down - but more like "if I want to consume that, I'm going to do it because life's too short to restrict yourself and fat is just a social construct!" An attitude I fully believe in theory but is probably going to cut my life short eventually if I don't get a handle on it and at least cut back on the sugar and other less healthy stuff

Anyway, I'd rather gain an additional 40lbs than to feel like I did before meds, so there does come a point where it's worth it no matter what the trade off is. I realize if you have other weight related health problems that might be harder to ignore, though (luckily for me, despite being a good 80lbs overweight at this point, my overall health is still fine).

[livinitup]

Now. Now would be a good time, I think - I am not a doctor, nor do I have medical training. So, listen to your care providers.

I am a person who was so affected by anxiety that I could not sleep for more than 2-3 hours/day, so I suffered from exhaustion with all of THOSE crippling side effects.

So, my doctor prescribed xanax and it helped SO MUCH. When I was fine, I did not take it. Which was fine, too. I got relief when I needed if. So, everything else fell into place and I needed it less and less. Then, I was just comforted to know I COULD take it and mostly didn’t- because my other healthy coping mechanisms kicked in. Just knowing I had an option meant, over time, I didn’t take it much.

Talk about your medication options, trust your medical providers. See what works and when.

[sproctopus]

wildrice I hear you entirely! ❤

[Deleted]

For me, I decided to start on meds when the anxiety was interfering with my life more than it was at bay. I've been on anti-anxiety meds twice and was able to be weaned off over time. I had 2 particular instances where the anxiety seemed to be getting worse and worse. I couldn't focus at work and I was making mistakes I wouldn't normally make. At home I was super restless and my emotions consisted of bouts of being angry or crying. There was no happy medium.

Both times I went on meds (Zoloft the first time and Wellbutrin the second time), after about 3 weeks or so I felt more "even" and things that were bothering me before (and they were little things) rolled off my back or I was able to deal with more productively instead of just shutting down emotionally.

I understand the concern about weight gain, that was a concern of mine too. I was so miserable and desperate to feel better that the meds won out because I knew I couldn't keep going on like I was.

I'm really sorry you're struggling and I hope you can find a way to get some relief.

[pumpkincat]

I would agree that now would be the time to start.

I started on Wellbutrin last summer. While it's not technically an anti-anxiety (usually used for depression), it has helped me tremendously. Additionally, have lost 15lbs since then due to decreased appetite related to the drug.

It's been great for me. Takes the "edge" off. Weight loss. I couldn't be happier with the decision.

[sent]

I have more depression and mild anxiety but the names of the meds in this thread are very familiar. I started with Lexapro from my regular doctor and then found a psychiatrist a few months later. I started medication because my brother helped me realize that I needed something more to help my mental breakdowns. I really should have started them like 3 years earlier but I seriously thought everything was a "me" problem and not a medical problem. I switched to Zoloft right away with the new doctor and was on it for years, like 5 years. I tried some other ones now and then but kept coming back to the least side effects with the Zoloft. I was at my heaviest weight during this time, probably due to a combination of stress and the medication and poor habits, poor diet etc.

A few months ago I started Effexor. For the first time, I feel so fantastic. It's not a pill solving my problems, it's fixing whatever is wrong with my brain chemistry so I can have an amazing day. I know I won't be on them forever. My life has slowly been getting under control. It's just taking several years to do so as I manage high stress situations like setting up my career, the kids being so needy but slowly gaining independence, etc. Shockingly, I have also lost 20 lbs recently. My bras were fitting better so I stepped on a scale in over 15 months and I swore it was broken. I don't think it's directly the meds. My toddler has had major separation anxiety since September and will only let me take him to bed, no one else. I end up falling asleep with him at 9 pm and waking up with him at 7 am for half the nights. I read somewhere that getting more sleep can help one lose weight and I think that is partly what happened. But I have also finally been able to let myself sleep and not panic awake at 1 am like I used to do when I'd take the kids to bed in the past. I'd wake up and then spend from 1 am to 3 am feeling anxious that I didn't get through my tasks for the day/week/year but then not actually get anything done. So it's possible that switching to Effexor helped tame that little bit of anxiety I would have MOTN and allowed me to sleep better. 

Someone said above that the side effects if you don't take the Effexor are not good. I went out of town for 3 days last month and forgot to bring my bottle of medication. On the third day, I woke up feeling nauseous and was vomitting all day. The last time I felt like that was when I was pregnant with DD and I was 1000% certain I was not pregnant. My friend gave me some Alkaselzer which helped and I was able to eat something and keep it down and fly home but now I try to stay vigilant and remember to take it every day.

[agnes]

I think it might be a good time for you to start.

For me it was when I literally could not stop crying. During a short span of time, some friends and family passed away. Work was overwhelming and a trigger. I had a hard time falling asleep just thinking and analyzing, staying asleep, and then I'd wake up early for no reason and start over. My brain would not rest.

Honestly though, I wish I would have started when I was younger. After changing jobs and starting Zoloft, I felt even better than my regular normal. I didn't realize how much general anxiety I had lived with my whole life. I handle things so much better now. Like I don't fly off the handle with anger. I don't burst into tears for no good reason. I don't fight with my H as much. I don't have this feeling of impending doom. Sure, there's times I still have some anxiety but not nearly as bad and not even close to as often.

[Monica Geller]

Mine started as PPD/ PPA: I couldn’t stop crying; I had no joy; I was convinced nothing would be good again; and I felt like I couldn’t breathe from the constant pressure in my chest.

I started Zoloft and within about 2 weeks I could feel an difference and after a month a started feeling like myself again. Just when I was about to talk to my doc and therapist about weaning off my DH had his seizure and brain tumor. Major setback because I now have PTSD. I recently upped my dose slightly and I’m again starting to feel more like myself.

I hope as things improve with covid and my DH continues to improve I’ll be able to consider weaning off again. But living in constant flight-fight-freeze is terrible. And it’s taking a long time to recover.

[goldengirlz]

I started medication when I couldn’t function without it.

I take an uncommon medication regimen: buspirone and Lamictal. Neither is associated with weight gain. Just bringing that up because you may have other options if you stop responding to an SSRI or can’t tolerate one.

My psychiatrist ultimately wants to wean me off one or both, so you also don’t necessarily need to be treated forever. Buspar doesn’t work for everyone but it’s much easier to get on and off of than an SSRI in terms of withdrawal side effects.

[skidunks]

I started taking meds when it was interfering with enjoying life with my kids. I should have started earlier.
I had horrible visions of what would happen if my house caught on fire when DH was gone. Like, which kid would I choose? Things like that and it was horrible. I realized I had been dealing with anxiety off and on my whole life. I was also having anxiety attacks at work but brushing them off as overreacting. I started Lexapro and stayed on that for a few years before I switched to Celexa. During the pandemic I added Buspirone and I think it’s a good mix for me.

[cville]

When you know, you know. For me, 2 years of therapy got me so so far, but still I needed something else.

FWIW, I didn't gain any weight on zoloft.

[formerlyak]

I first went on celexa when I went through my divorce 12 years ago. I was in it for about a year. Then I felt a lot better and had a great therapist and so I weaned off it. I’ve done really well with my anxiety since then … until this summer when my dad got really sick. I talked with my doctor and went back on a very low dose. The first month sucked because my anxiety got worse before it got better. But, it is a lot better now. I can get the reports about my dad and focus on the good parts of them instead of dwelling on the negative (which is how my anxiety tends to work). I also started sleeping better. I haven’t gained any weight since I started it up again.

[Poppy]

I was having a hard time sleeping and also felt very on edge. I could rarely relax enough to show affection to my husband and I had very little patience with my kids. I actually went to a psych primarily to try to treat ADHD, but she wanted to start with treating the anxiety. I am now on Lexapro and I feel SO much better. I have been gaining weight since the pandemic started so I'm not sure if it's changed the trajectory, but I honestly don't really care. I had no idea how bad things were until I felt better.

I have been on antidepressants previously and was able to wean off of them after awhile, and then I was fine for 5 years or so. Medication definitely doesn't have to be a permanent thing. I think it's worth trying if anxiety is affecting your daily life, and you can always reassess later.

[madringal]

I was hospitalized for a Myasthenic Crisis in Oct. I couldn’t breathe or swallow on my own. It happened very quickly and very traumatically, and I almost died.

My anxiety had been getting worse in the months leading up to that, but this sent me right over the edge. I was literally crippled by fear after waking up on a vent and in the subsequent days and weeks that followed. They put me on a combination of Lexapro and colazapan when I was in the ICU and it’s been a Godsend. Realistically, I know that I have to be in crisis for my breathing and swallowing to just stop like that again, and I know the signs of a crisis now. But my brain just can’t seem to get past the feeling of it all going dark and just clinging on to a mental picture of my three girls.

I wish I would have started it sooner - when my GP suggested it. I was literally in her office just crying about how overwhelmed and anxious I was a week before my crisis. But never filled the Rx. I was begging for it in the ICU.

[sequins]

madringal, that sounds so traumatizing. So sorry you had to go through that!!

[lucybrown]

@ mention.

I’m in a similar space and appreciate these threads. I started taking buspirone about 18 months ago. It helps significantly, but I think I may need more.

I had a pretty major depressive episode last fall and took a leave of absence from work. I felt great when I wasn’t working…like myself again. I returned part-time last week and am feeling crummy again. I need to work for financial security, but I also feel overextended with parenting and pandemic life.

I previously tried Lexapro and Zoloft. The related insomnia was worse for my anxiety and depression than going without medication so I’ve been fearful of trying something new. I talked to my dr. And she recommended amitryptaline. I’m also considering Wellbutrin because some family members have had success with it. I also have ADHD and I understand there can be benefits with that.

I’m doing all the things. Talk therapy, cut caffeine. Eat well, exercise. I am a highly sensitive person and easily overstimulated/overwhelmed. Maybe it’s time.