Psycho-Babble Medication Thread 1021

Shown: posts 1 to 7 of 7. This is the beginning of the thread.

 

depression and GAD

Posted by JJ on November 1, 1998, at 21:37:05

I have been taking 300mgs Wellbutrin, 300mgs Trazodone, 25mg Cytomel for 8 years. The doctor added .25mg Alprazolam for my anxiety/panic attacks--I do not hear alarm to go to work, have physical symptoms, and panic when I think of going somewhere. I had taken Alprazloam for one month in 1993. That is the first time that I have never been afraid or thought I was going to die or did not think of committing suicide since I was 4 years old. I did have three head injuries in 1980 when I developed agoraphobia.

The doctor took me off the Alprzolam after 1 month and my anxiety gradually returned. Now, have totally regressed to hurting myself, hate myself, and acted out enough at my job that I am on paid suspension. I am reacting physically (heart, etc.) just thinking about returning to any work.

My doctor increased the Alprazolam to .50 mg a day but I am still not responding. He says that I don't want to be better. I asked about a change in medication. He said I have tried enough, I just need psychotherapy. I have been in therapy since 1988. And, I had understood much of what I can do to effectively work, but I am beginning to lose all hope.

What can I do or use to be better? I would really like to feel that feeling of being able to do something--just leave the house without my irrational fears. I have and do use medication as administered although my doc said I did not when I went to see him after the breakdown. I've tried seeing another doc, but he said there was nothing he could do.

Please help.

 

Re: depression and GAD

Posted by Toby on November 3, 1998, at 14:52:02

In reply to depression and GAD, posted by JJ on November 1, 1998, at 21:37:05

People with panic disorder do not tend to hurt themselves or act out on others, so what else is going on? What's happening when you hurt yourself? What causes you to act out at work? You have had the panic since you were 4 years old, but no agoraphobia until the head injuries? Is that also when the acting out and self harm began?

 

Re: depression and GAD

Posted by Judy Johnson on November 3, 1998, at 16:37:37

In reply to Re: depression and GAD, posted by Toby on November 3, 1998, at 14:52:02

> People with panic disorder do not tend to hurt themselves or act out on others, so what else is going on? What's happening when you hurt yourself? What causes you to act out at work? You have had the panic since you were 4 years old, but no agoraphobia until the head injuries? Is that also when the acting out and self harm began?
I have been suicidal since I was four--laying down on train tracks,etc. I was depressed of and on until 1980 when I had the head injuries and began the panic attacks.

I acted out at work by being non-compliant, withdrawn, argumentative, social isolating myself, talking obsessively about how others were not my friend, and constantly reminding them that I had no friends, and I accussed a teacher of forcing me to do something, etc.

I acted out on the first day of school when I found out my schedule and felt hopeless, that no one would listen to me, etc. I banged my head and dove under the desk when a teacher saw me. I don't think that was a panic attack. I had stopped physically injuring myself in 1991 after bio-feed back. My counselor said I regressed.

I have had panic attacks since 1980, so badly that I cannot leave the house (like now). I cannot go to church unless my friend is there (I have other friends but she is the only one that will get me there.) I don't want to go anywhere, but I am making myself do things and re-phrasing the thoughts, but when it comes to returning to my job, my heart beats fast, legs are jello, palms sweat (like now). These attacks have been on and off about my job since 1995, but I have just made myself work. Right now, I couldn't go back. I've been off work for 3 wks.

Thank you for your interest. I want to go back to work.

jj

 

Re: depression and GAD

Posted by jj on November 3, 1998, at 17:38:45

In reply to Re: depression and GAD, posted by Judy Johnson on November 3, 1998, at 16:37:37

> > People with panic disorder do not tend to hurt themselves or act out on others, so what else is going on? What's happening when you hurt yourself? What causes you to act out at work? You have had the panic since you were 4 years old, but no agoraphobia until the head injuries? Is that also when the acting out and self harm began?
> I have been suicidal since I was four--laying down on train tracks,etc. I was depressed of and on until 1980 when I had the head injuries and began the panic attacks.
> I acted out at work by being non-compliant, withdrawn, argumentative, social isolating myself, talking obsessively about how others were not my friend, and constantly reminding them that I had no friends, and I accussed a teacher of forcing me to do something, etc.
> I acted out on the first day of school when I found out my schedule and felt hopeless, that no one would listen to me, etc. I banged my head and dove under the desk when a teacher saw me. I don't think that was a panic attack. I had stopped physically injuring myself in 1991 after bio-feed back. My counselor said I regressed.
> I have had panic attacks since 1980, so badly that I cannot leave the house (like now). I cannot go to church unless my friend is there (I have other friends but she is the only one that will get me there.) I don't want to go anywhere, but I am making myself do things and re-phrasing the thoughts, but when it comes to returning to my job, my heart beats fast, legs are jello, palms sweat (like now). These attacks have been on and off about my job since 1995, but I have just made myself work. Right now, I couldn't go back. I've been off work for 3 wks.
> Thank you for your interest. I want to go back to work.
> jj

I got suspended from work for telling on myself for doing something wrong. My counselor told me that I was asking for help and that I did not want to go to that job.?
help? jj

 

Re: depression and GAD

Posted by Lisa on November 4, 1998, at 2:32:50

In reply to Re: depression and GAD, posted by jj on November 3, 1998, at 17:38:45

> I have had panic attacks since 1980, so badly that I cannot leave the house (like now). I cannot >go to church unless my friend is there (I have other friends but she is the only one that will get >me there.) I don't want to go anywhere, but I am making myself do things and re-phrasing the >thoughts, but when it comes to returning to my job, my heart beats fast, legs are jello, palms >sweat (like now). These attacks have been on and off about my job since 1995, but I have just >made myself work. Right now, I couldn't go back. I've been off work for 3 wks.

I had the same problems for years — recurring depressions and crippling anxiety. I came a long way concerning the anxiety. Klonopin has worked wonders for me and I have been completely housebound at times. If I remember correctly, you are on Xanax .5mg/day. With the amount of anxiety that you're struggling with, I personally don't believe your dosage is high enough. Get your doctor to increase your meds now. Without some relief, psychotherapy could drastically fail. After you stabilize somewhat, it will be much easier to work at cognitive and exposure therapy. You should *not* be suffering to the extent that you are now. If your doctor refuses to relieve your symptoms, find a new one but beware of doctors that can tend to overmedicate.

> I got suspended from work for telling on myself for doing something wrong. My counselor told >me that I was asking for help and that I did not want to go to that job.?
> help? jj

It's very possible your therapist is correct. When something is causing considerable stress in one's life, the subconscious at times will seek to eradicate that stress. Of course you don't want to lose your job, but your mind, soul, and body do not want to hurt anymore either. I personally have sabotaged (unwillingly) many jobs or relationships in my life due to the inability to handle other stressors. I think your counselor meant that you were asking for help in coping with the anxiety, not with the job.

Lisa

 

Re: depression and GAD

Posted by jj on November 4, 1998, at 12:55:20

In reply to Re: depression and GAD, posted by Lisa on November 4, 1998, at 2:32:50

> > I have had panic attacks since 1980, so badly that I cannot leave the house (like now). I cannot >go to church unless my friend is there (I have other friends but she is the only one that will get >me there.) I don't want to go anywhere, but I am making myself do things and re-phrasing the >thoughts, but when it comes to returning to my job, my heart beats fast, legs are jello, palms >sweat (like now). These attacks have been on and off about my job since 1995, but I have just >made myself work. Right now, I couldn't go back. I've been off work for 3 wks.
> I had the same problems for years — recurring depressions and crippling anxiety. I came a long way concerning the anxiety. Klonopin has worked wonders for me and I have been completely housebound at times. If I remember correctly, you are on Xanax .5mg/day. With the amount of anxiety that you're struggling with, I personally don't believe your dosage is high enough. Get your doctor to increase your meds now. Without some relief, psychotherapy could drastically fail. After you stabilize somewhat, it will be much easier to work at cognitive and exposure therapy. You should *not* be suffering to the extent that you are now. If your doctor refuses to relieve your symptoms, find a new one but beware of doctors that can tend to overmedicate.
> > I got suspended from work for telling on myself for doing something wrong. My counselor told >me that I was asking for help and that I did not want to go to that job.?
> > help? jj
> It's very possible your therapist is correct. When something is causing considerable stress in one's life, the subconscious at times will seek to eradicate that stress. Of course you don't want to lose your job, but your mind, soul, and body do not want to hurt anymore either. I personally have sabotaged (unwillingly) many jobs or relationships in my life due to the inability to handle other stressors. I think your counselor meant that you were asking for help in coping with the anxiety, not with the job.
> Lisa

What I wanted to know about was medication? Could Wellbutrin increase my anxiety? What would I take instead?

Xanax worked before but my doc will not use but .50mg day for about another week. What else could I take?

Thanks Lisa and Toby.

jj

 

Re: depression and GAD

Posted by Toby on November 9, 1998, at 14:55:38

In reply to Re: depression and GAD, posted by jj on November 4, 1998, at 12:55:20

I had an answer last week, but it seems to have gotten lost... perhaps I didn't submit correctly. Anyway, I don't think the Wellbutrin would be causing an increase in anxiety, especially if you've been on it for many years. However, it is not exceptionally good at treating panic attacks by itself. Generally, one of the SSRI's or Tofranil is used for panic attacks with good results. If you haven't been on Paxil or Zoloft before, those would be well worth a try. Some doctors are willing to prescribe a benzodiazepine in small doses while the SSRI is taking effect. If you have been on several medications in the past (maximum dose for at least 12 weeks) without benefit, then perhaps a benzodiazepine is best. I generally go for Klonopin (not so much because it is less abusable, because anybody could abuse anything if they wanted; and besides people with true anxiety tend to be afraid of medications and don't go on to abuse them) because it has a smoother course of action...slow onset, steady release into the body and long duration of action so you don't get withdrawal effects between doses which can feel just like the old panic attacks, and that long duration means you don't have to take it so many times a day to keep the attacks away. Once you find a dose that works, you generally don't need to change the dose for many years because the chemical imbalance has been corrected and generally that is a stable thing. If you haven't been on Paxil, ask the doctor about that. Because it has an annoying tendency to actually cause anxiety in anxious people if you use too high a dose at first, I generally start out with a 10 mg tablet, take half a tablet for a few days, then go up by 5 mg every 3-4 days until 40 mg per day is reached (that seems to be the magic dose for panic, although some people need less, some need a little more). That prevents the pill-induced anxiety. Once you find that it gives you no side effects, you can increase the dose by 10 mg every 3-4 days to reach 40 mg a little faster. Most people get a response pretty quickly.


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