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Upcoming appointment for anxiety

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Anxiety & Panic Disorders
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Posted 11/7/2018 12:04 AM (GMT 0)
Hi I've been having anxiety symptoms for about two years now with occasional relief. I am currently struggling with it again and decided it's time to see a psychiatrist and possibly try something different. I have been having health anxiety, inability to enjoy my favorite activities, feeling mentally drained, loss of appetite, and a few other things that aren't quite so bothersome.

I have been on paxil for almost a decade for depression and recently ativan or xanax as needed for acute worsening of symptoms and it's just not really cutting it. I have tried effexor in the past but it made my stomach hurt and I stopped taking it. I have a close relative that took cymbalta and it worked for them which is also an snri. Maybe that might agree with me better than the effexor did. I am really open to any suggestions to get the best out of my upcoming appointment with the psychiatrist for this awful feeling we have in common.
Posted 11/7/2018 5:21 PM (GMT 0)
Hi adubb!

I am sorry that you are currently facing challenges in your management regimen. After 10 yrs it is not uncommon to experience an inefficacy issue with one's A/D. Therefore, it is good that you are consulting with a P-doc to get the help you need!

As far as your Rx goes...you may discuss an increase, an add-on...or yes, a new med altogether. You and the doctor will decide the best route for you to take once you've had your intake appointment.

Talking also about starting/revisiting therapy and self help that you can work daily will also be of great value...so be sure to talk about all you can do, behaviorally speaking as well!

Wising you the best! Let us know how your appointment goes okay?

Talk soon,

S.C.
Posted 11/7/2018 6:33 PM (GMT 0)
Thanks Scaredy Cat. I am hopeful that things can get better with the right medication and possibly getting back into talk therapy. The close relative I mentioned went through some mental health issues but medication helped them get back to a good state of mind. I hope my psychiatrist gets me to that point in the near future. Does physical stress like another current illness exacerbate anxiety? I think I may be having worsening of symptoms when my crohn's disease is more active.

I read some of the pinned Resources links and that helped me remember those breathing exercises. Some other good info there as well.

I see your sig says you recovered from panic syndrome due to cognitive behavioral therapy, if i read that correctly. That's awesome! Did you need any medication at all?

Post Edited (adubb) : 11/7/2018 12:00:02 PM (GMT-7)

Posted 11/7/2018 7:06 PM (GMT 0)
I was given a prescription for an SSRI by my doctor, along with the therapy referral. I help onto the script, because I wanted to see how the therapy panned out for me first.

It turned out that the CBT was sufficient to help me manage and eventually stop (with the occasional rare/sneaky one) the attacks.

However, looking back, I think that if I had started the medication...that I may have saved myself a lot of challenging days/weeks, during which I was barely hanging in there whilst waiting for my therapy skills to develop.

I think that a combination of meds and therapy is a winning one for many people...but encourage everyone to take the management path that they and their health professional agree on, and are most comfortable with!

We are cheering you on while you find yours....so keep us updated.

S.C.
Posted 11/8/2018 10:48 PM (GMT 0)
I appreciate your responses S.C. It makes me feel good to have support here as I am going through this.

I just got back from my Psychiatrist appointment and gave her a thorough history with experience with anxiety and any info I thought might be relevant for my treatment. She was very considerate of my situation and recommended that I try Lexapro. She said it's a more calming medicine that is also an SSRI like the paxil I have been taking. She said I will be more likely to tolerate switching to the Lexapro than to try an SNRI like cymbalta. I will be starting a low dose of 5mg and as long as everything goes well they will bump it up to 10mg in one month.

I forgot to ask her about CBT but I will try to remember to do that for my one month follow up. It's comforting to have a plan for now. I am also glad to have a knowledgeable doctor looking after me. Thanks for listening.
Posted 11/9/2018 5:36 PM (GMT 0)
Good! I am so gald to hear that you have started your management regimen and that you are feeling relieved already. smile

Update us as to how you are doing, so we can keep you encouraged!

Keep us the great work!

S.C.
Posted 11/9/2018 10:33 PM (GMT 0)
good plan -if the lex is to strong for you-you can try its weaker form called celexa . starting lex at 5 is a good idea. I was started at 10 and it was too strong. it is a calming ssri ican say that .
Posted 11/10/2018 12:33 AM (GMT 0)
I took the first dose of Lexapro a couple of hours ago. That's nice to hear dan. I need some help achieving calmness right now. I have the Xanax for acute symptoms but that is a powerful drug and it really makes me drowsy and I can sleep for a very long time if I take enough of it. I try to be careful with how often I use it. I only need .25 to .5 to curb an anxiety spike.

I have tried several antidepressants over the years but that was just for depression. I was first on Paxil and that really helped, but getting over the first couple of weeks was rough. After several months my body adjusted to it it wasn't quite as strong of an effect, but I was feeling well. I then tried others like Celexa and didn't notice much of a difference so just stuck with Paxil. I was on Paxil at 40mg for a while but the sexual side effects were annoying so I went to 20mg and didn't notice any side effects. If I end up on a higher dose of Lexapro I would tolerate the sexual side effects for a while as long as my anxiety improves. If I do well on it for a while and get this anxiety under control maybe I could go to a lower dose in the future. I hear it can be six months or longer of feeling well until you should consider a lower dose or even discontinuing the medication. I'd just be happy with whatever makes me feel like myself.
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