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Re: Scott Racer .... I do get anxious maxime

Posted by Racer on March 27, 2005, at 0:39:40

In reply to Re: Scott Racer .... I do get anxious Phillipa, posted by maxime on March 26, 2005, at 20:33:58

Yeah, when my new pdoc told me that he was dxing me with anxiety, my whole world shifted on its axis. It isn't always apparent to us when we have problems with it. For what it's worth, everything I've read leads me to think of AN as an attempt to self-medicate anxiety -- even the fact that you're only aware of anxiety around food, when in all likelihood it's more widespread than that. (I don't get anxious about food -- I get anxious because I've become so very fat. Same difference, you know?)

And as for cutting, my guess is that it's related to basic animal functioning. In horses, we use something called a twitch to control them in certain situations. When they're too upset to deal with, they can be dangerous, so we get out the twitch for their protection and our own. A twitch is an implement that you use to grab a horse's upper lip, and squeeze it as tight as possible. It generally immobilizes most horses, and the amazing part is that you can see in their eyes when the endorphins start to flow. That effect only lasts about twenty minutes, but they are still calmer after the effect wears off. I'd guess that something similar happens for you when you cut. What's more, just as there are all those jokes about stamping on someone's foot to take their mind off a toothache, that's got to be involved, too, I'd think.

Of course, I've never done it, so I'm just throwing out guesses. You can judge whether they're helpful or not for you.

Have you tried any sort of anxiolytic in the course of your treatment? I'd bet that a medication that targets NE and an anxiolytic might be a good combo for you, with some effect on 5HT. I'm also curious about to what extent you would like to recover from or remit your AN? I know that it bothers you to some extent, but wonder if you're actually interested in recovery? (Hey -- I'm having a hard time right now with the motivation to keep working at it, so I know it's not easy. I'm asking that because there are some meds out there that might be helpful for you if you are wanting recovery.)

Here's another question for you: do you find yourself having problems with obsessive thoughts? That's a characteristic of AN for me, which is why I ask.

Lastly, depending on the current state of you AN, most antidepressants that target 5HT will be unlikely to be helpful. You gotta be eating enough carbohydrate to have enough tryptophan coming in for your body to make the dang stuff -- inhibiting the reuptake of something that ain't there in the first place ain't exactly useful. Walter Kaye did a study a while back showing premorbid abnormalities in the whole 5HT system of ANs, which leads me to believe that SSRIs are not the best first choice for anyone with AN, which is very unfortuntate since the cardiotoxicity of TCAs don't make them good choices, either...

Best luck to you, Maxime, and I do hope things improve for you soon.


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