Coping with General Anxiety

Hello all,

New to the forum and looking to ask some questions/get some support. I am a 29 y/o male, work out 6-7 times a week, healthy diet etc. This past month both a psychiatrist and psychologist diagnosed me with Generalized Anxiety Disorder.

Quick background is that I had anxiety/OCD symptoms during my childhood, but most of it went away in high school and college. Even in very stressful law school I managed to keep it together most of the time. After graduating I started running a very stressful business. I was ok for the first 2 years and then my compulsiveness and hectic schedule started giving me sleep problems where I wasn't able to sleep through the night. Doctors told me I was fine but the anxiety was there. The sleep problems somehow dissipated and I kept up my hectic work. During the past 6-8 months I also had several deaths and illnesses in my family which didn't help matters.

In the beginning of May I started to again experience sleep problems, but this time much worse. I couldn't fall asleep or stay asleep. After about a week of misery where I was completely obsessed and freaked out about my lack of sleep (plus some of my other old ocd symptoms were coming back) I went to the doctor and again got a clean bill of physical health. He prescribed me 10 mg ambien for sleep, which got me to sleep but didn't keep me asleep, plus I think it made my anxiety worse. My anxiety was now sky high and I was forced to take a couple of days off work because I was too much of a mess to do much.

I made appointments with a psychiatrist and psychologist. Both agreed that my extremely hectic and compulsive work schedule and life events had exasperated a generalized anxiety disorder that I had to begin with. The pdoc prescribed me .5 mg of klonopin which I could take either once or twice a day. Taking it once a little before bedtime in conjunction with the ambien did help the sleep, although the anxiety was still pretty bad despite better sleep. I switched from ambien to trazodone last week because the pdoc thought it might promote deeper sleep and was not as habit forming as ambien.

So that's where I am at now. Sorry for the long story. Some questions for other members who deal with this:

1) I feel like my anxiety is very up and down for the last 2 weeks. Some days or times of the day are ok and sometimes feel simply overwhelming. I am often not worried about anything in particular, it's just a general feeling of terrible nervousness. Is this normal? Could these highs and lows be related to the meds?
2) I substituted the trazodone for the ambien with mixed results. Does anyone have experience taking trazodone alongside klonopin? If so, before bedtime, how do you space out when you take them and what order do you take them in? I'm still considering switching back to the ambien after some tough nights recently.
3) Some days the anxiety leads to a feeling similar to depression. I think it's because I'm so exhausted from all the anxiety that my mind just cannot get happy or excited about things. It's terrible. I'd really rather not start any new meds for depression. Can anyone relate to this and how do you cope?

Thanks for any and all help and advice.

Thank you for the quick reply! It's wonderful to have an outlet of positive people on a forum like this.

Right now my therapy schedule is one visit with my psychologist every two weeks. I prefer my psychologist to my psychiatrist because I'd like to work through this with talk therapy/CBT. The psychiatrist seems more intent on pushing meds (plus they are a ton more expensive and I do not have coverage). My psychologist is also knowledgable about meds so has been able to give me advice on what is prescribed.

I may use some of the worksheets on this site and work through them with my psychologist at our next session. I am sure he would be open to that.

I also plan on seeing a yoga trainer who can help with meditation and deep breathing exercises. To be honest in the past I never had mush faith in that stuff, but reading some of the comments on this forum has caused me to reconsider.

equinox,

Welcome to the board! Your sleep problems are common among us anxiety sufferers. I fight with this problem when I go through a difficult stretch (like right now).

I have found that writing down on paper, right before bed, "my anxiety/stressors aren't ALL going to be solved right before bed, so we'll deal with them tomorrow". It has taken me several weeks to start to see and believe it, but I can say it has started to work.

Your post sounds very similar to my experiences and many others here i.e.- exhausted physically from the anxiety, depression, etc.

Your approach to this: counseling (CBT), yoga, exercise are great ways to tackle the problem.

Others have suggested benadryl for sleep. This tends to bring on some depression in me, but others have good success with it.

Again, welcome. The members and moderators here are great. I hope this gives you some help today!

Equinox-

I've suffered from GAD for about 15 years now and have not found the right treatment options for me until now.

With that said, my current symptoms include the ability to either get to sleep or stay asleep.

My psychiatrist started me at first on Restoril, then that started to not keep me asleep all night. Then she switched me to trazodone, which gets me to sleep, but unfortunately, I'm waking up at 4am instead of 2am. She told me to take Xanax in conjunction with it.

So, I take the trazadone around 8pm, then the Xanax around 10pm.

I'm looking forward to making progress with my therapist so that I can reduce the amount of meds I need on a daily basis! I am looking forward to the day that I sleep until my alarm goes off, and also sleeping without medication.

Hope this helps.

equinox10 said...
Hello all,

1) I feel like my anxiety is very up and down for the last 2 weeks. Some days or times of the day are ok and sometimes feel simply overwhelming. I am often not worried about anything in particular, it's just a general feeling of terrible nervousness. Is this normal? Could these highs and lows be related to the meds?
2) I substituted the trazodone for the ambien with mixed results. Does anyone have experience taking trazodone alongside klonopin? If so, before bedtime, how do you space out when you take them and what order do you take them in? I'm still considering switching back to the ambien after some tough nights recently.
3) Some days the anxiety leads to a feeling similar to depression. I think it's because I'm so exhausted from all the anxiety that my mind just cannot get happy or excited about things. It's terrible. I'd really rather not start any new meds for depression. Can anyone relate to this and how do you cope?

Thanks for any and all help and advice.

Hi EQ,

Welcome and thanks for sharing your story. Here's a quick response to your questions from my personal point of view.

1> I feel like my anxiety is very up and down for the last 2 weeks. Some days or times of the day are ok and sometimes feel simply overwhelming. I am often not worried about anything in particular, it's just a general feeling of terrible nervousness. Is this normal? Could these highs and lows be related to the meds?

I feel like that too but after some time you will start to get on a more positive trajectory. Today I had just a tiny bit of anxiety come on in the early afternoon, whereas in the heyday of my anxiety I was having a hard time getting out the door in the morning. I don't know if I would call it normal, after all it is anxiety but its not uncommon. I'm not sure if this is related to medication or not. I've made a conscious choice to not take any prescription medication and help myself in other ways. There was a time that I absolutely needed Xanax, so I'm not knocking the help of medication in fact its proven to be exceptionally helpful in conjunction with cognitive behavioral therapy. I would recommend checking out CBT, it is helping me and its shown to be as effective as an SSRI for deaing with both anxiety & depression.

2> I substituted the trazodone for the ambien with mixed results. Does anyone have experience taking trazodone alongside klonopin? If so, before bedtime, how do you space out when you take them and what order do you take them in? I'm still considering switching back to the ambien after some tough nights recently.

I tried ambien but I don't like the feeling of being slowly and purposefully sedated. Plus I would wake up on ambien too and I vaguely remember cooking something at 2AM. I do however have an evening cocktail of 3mg of melatonin (does nothing for me by itself now, but it used to in anxiety-free days) + 2 capsules of bendaryl. For some reason I sleep way better than on ambien.

Although I will say I took a muscle relaxer a friend gave me once and it was heavenly but I don't know if a medical professional would prescribe muscle relaxers for sleep problems.

3) Some days the anxiety leads to a feeling similar to depression. I think it's because I'm so exhausted from all the anxiety that my mind just cannot get happy or excited about things. It's terrible. I'd really rather not start any new meds for depression. Can anyone relate to this and how do you cope?

Yeh I think I get frustrated too, I say to myself "darnit why I am not happy anymore!" or silly things like this. But you have realize, its just a silly thought that's all. I try not to assign meaning or feelings to those kind of passing thoughts, instead of dwelling on what may be distracting in my life, use all that energy to dwell on positive and happy things.

I had a nice afternoon today, was a bit anxious around 3:30 or 4:00, that's when I start getting afternoon sleepy at work so I keep wondering what the hell is wrong with me. It's probably because I work at a fast pace all day, but instead of giving myself a 15 minute break I question myself for being tired, even though I worked straight through lunch and wonder why my eyes hurt after staring at a computer for 8 hours. Well, the simple answer is: I'm tired because I'm working really fast and my eyes hurt because eyes weren't made to stare at computer screens all day. It's not like I'm going to slump over in my chair and sleep or suddenly go blind but my mind might go there - I just have to brush it off.

So, I went home a little earlier than usual and had a fantastic 1.5 hour run to get all the wiggles out. I am now going to take a relaxing shower, curl up with a book, text some friends maybe, hang out on the forum giving unsolicited advice, maybe just maybe pack another box or touch up some wall paint and then have my evening cocktail of pills around 10PM.

The best thing you can do is to start professional therapy and do some self-help CBT. It's making a world of difference to me.

If you don't want the meds, dump them if you think you can handle it. I needed some Xanax in the early weeks of it all but after getting a handle on what anxiety is and how to manage it I stopped taking it cold, it's been about more than a month now without any Xanax. I even went to the dentist and been out in huge public places with oodles of people, things that I thought I'd be anxious about, without any medications. And I survived every time. You can do, with a little positive thinking as corny as it sounds, it's true.

CBT will do you good. Do yourself a favor and get a fantastic self-help book called "The Feeling Good Handbook" by David Burns. The Kindle version is not gonna help you, you'll need to get the paperback version because its an interactive workbook.

Start there and best of luck.

I know what it's like to get too involved with work, but step back my friend. It's life and its going to go on with or without you so involved in work.

Hope you are feeling better soon!

Joshua

equinox10 said...
It's like ideas pop into my head that bother me and instead of just letting them float by, they recur and this frustrates me because I'm like "why won't you just go away??? You don't make sense!"

I once wondered for days why I was compelled to shove a corkscrew in my eye. Yeah, seriously. So I pulled it out the drawer and put it on my eye (closed of course, I'm not that weird) and said to myself "see you are not gonna shove this in your eye now get over it!" and calmly put the corkscrew back.

I sometimes have to do stuff to negate my thoughts which frustrated me even more but it helped to prove to myself that I'm not gonna do crazy stuff like jam a corkscrew in my eye or other totally disturbing gross stuff. No matter what goes on in my head, its just going on in my head. It's not actually happening.

I've been super anxious since I was a kid, like you I think back to things in my childhood and tried to connect the dots. Some dots just can't be connected. I used to have seizures until I was 11 or 12, and then I passed out at a bar last year likely from exhaustion + alcohol. I tried to put the two together, as if for some unexplained reason I might drop at any time. Then I would get all flustered and upset in the mall thinking about it, especially if I was alone, what would happen if I passed out. Well, I just have to tell myself I don't have a cocktail in my hand and I haven't had a seizures for over 20 years.

Talk about irrational thoughts, I once cried an entire afternoon convinced my wife was going to have a miscarriage, after consulting Google about how to read early pregnancy ultrasounds. Big mistake, we just made 28 weeks!

In my case I started having anxiety and panic attacks in February, after a long whirlwind trip to the US, facing my grandparents impending death, and being food poisoned in New York. I think I got slammed with a lot of heavy stuff at one time. I didn't know what it was until early April this year. Then I started reading books and researching.

I took a whole week off in early May and went to a beach resort to read on anxiety and just sit and relax. Even when I was there I was really wound up but I'm glad I took off focused time to work on me.

It's mid-June and I'm feeling better, almost great but not quite there yet. So, it took me about 1 month to kick the pills, and another 2 months or so to get to a place of feeling better. I can go to work without pills and manage my day very well. I'm not 100%, I still get 10-15 minutes of anxiety come at me on a good day and on a more anxious day that happens 2 or 3 times.

But I'm happy, if all I have to deal with is 45 minutes of anxiety every day, even for the rest of my life, I'm good with that because I can manage it. And I feel bad for people like me and you who don't actually know what's going on with them. We are so empowered to know we can change the anxiety landscape. There's a lot of people just trying to do good at work and get by and maybe they don't know its anxiety, like me maybe they just thought it was a high-pressure job. Well, now you know and that's one of the keys to feeling better.

Little by little its been going away on its own as I develop my coping skills and have a more open and honest attitude with myself about anxiety and what might be causing it.

Also I am taking 5-HTP supplements, it works for me, 200mg/day on an empty stomach. It creates seratonin in your gut. Not to be taken with SSRIs as you could OD and die from too much seratonin but generally its going to be quite a lot before it does anythingn bad to you (yeh, I briefly quit 5HTP but then quickly got over the Google warnings and horror stories).

I think as long as you are working on yourself, you are working in the right direction.

Equinox-

I haven't managed my anxiety well over the past 15 years.  I am a textbook example of what not to do.  For years I relied solely on medication, believing in the heart of my being that it was the only thing that could help me.  I would see therapists off and on during high anxiety / depression times, then stop when symptoms improved.  I avoided things that would trigger anxiety, which for me, are major life changes - job, moving, etc, etc.  I stayed in a job that I hated for 10 years because I didn't think I could find another job and didn't want to deal with the anxiety that I knew I would experience with the change.

I had my father, who was a doctor, but not a psychiatrist, write me prescriptions for my medications, and I self-medicated for the bulk of these past 15 years. 

Now, I have reached rock bottom (almost lost my marriage), and am taking a different tack -- I have been seeing a therapist for a year that I trust, and have a psychiatrist that I have just now, allowed to fully manage my medications and will no longer self-medicate.  I am seeing a 2nd therapist for additional help, as my other therapist is moving into an administrative role and has much less time for clinical work, and I need to do some heaving lifting right now. 

I've committed myself to breaking my anxiety issue and not relying on medication solely to fix me.  I've been identifying and working on changing my thought patterns and beliefs.  I've seen some improvement in the past week with my ability to redirect my old 'dark' thought patterns. 

I'm working through the Anxiety and Phobia handbook, and doing as much as can outside of the therapy sessions as I can.

I hadn't done that before.  I would go into therapy, complain about my life, feel better at the end, and rinse and repeat. 

I do a lot of soul searching and thought analysis outside of therapy now on a daily basis, and am hoping it allows me to gain traction on my core issues that really haven't been address in 15 years.

My biggest issue right now is that I wake up each morning around 5 or 6 am.  I can't get back to sleep.  I am trying to work on being at peace with it, that if I go to bed at 10pm, getting up around 5 or 6am is still a healthy amount of sleep.  I also stopped taking the Xanax at night (0.25 or 0.5 mg) before bed this week - about 3 days ago. 

I know that the symptoms will not disappear over night, but I am wanting to feel better - to sleep until my alarm, or on the weekends, to sleep in. 

 

is for the long haul. (Sorry for double post, hit submit by accident)