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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Ilene on January 22, 2003, at 9:24:12
This is a question about something Ritch said in a different thread (Older drugs vs. new drugs) about "apprehensive rumination about the future". I do this all the time, and I have a lot of time on my hands. (Can't work due to depression, don't want to go anywhere or do anything.)
GAD is "general anxiety disorder," right? How is it different from regular anxiety? How do you know you are anxious and/or generally anxious? Seriously. I am so far from normal I don't know whether I would recognize it.
Do ADs or mood stabilizers help? Are there any drugs specifically for GAD?
Posted by ayuda on January 22, 2003, at 11:39:48
In reply to How do you know if you have GAD?, posted by Ilene on January 22, 2003, at 9:24:12
> GAD is "general anxiety disorder," right? How is it different from regular anxiety? How do you know you are anxious and/or generally anxious? Seriously. I am so far from normal I don't know whether I would recognize it.
>
> Do ADs or mood stabilizers help? Are there any drugs specifically for GAD?Ilene --
Like you, I am so far from "normal" that I may be wrong in this, but from my experience, I think that the difference between regular ol' anxiety and GAD is that GAD is not situational, it is constant and obsessive and about almost every aspect of your life, and you have physical as well as emotional reactions often.Such as, you can have anxiety about flying, and every time you think about flying or fly you have anxiety, including panic attacks, but otherwise things don't cause that level of anxiety, or every once in a while you get anxious about the future, but it isn't obsessive and can be related to a certain fear. I tend to think of those as "normal" and not obsessive.
I think of GAD as more an approach to life -- tending to approach almost everything with a heightened level of anxiety, worrying about possible negative outcomes for many of life's tasks, the inability to stand-up for oneself or take a risk or be confrontational because of shaking, increased heartbeat, worry, fear, etc. Or also the inability to just let your life "happen" but to want to control everything because otherwise you will panic if everything does not go "perfectly."
I make these distinctions from the observations of suffering from GAD, then going on medications that make me feel more "normal" in my response to situations that would cause extreme anxiety without the medications. So I distinguish between how I normally react, and how I react while on meds -- like I said, may be right, may not be, but I hope this helps.
As for meds, some of the SSRIs now purport to cover GAD as well, such as Effexor XR and Lexapro. I can personally attest that they do, at least for me. There are other medications that only treat GAD, though since my main diagnosis is depression, my doctors have never treated the GAD alone (except in childhood, when I was on "kiddie tranquilizers"). I've taken Ativan (lorazepam) for anxiety, but that is not considered a maintenance drug by some doctors.
I hope some of this helps. Anxiety is not fun -- I know that is an understatement, but I encounter people, even doctors, who don't understand that you can't just get over a situation on your own, that you have no mechanism for it, because your anxiety has you on edge all the time.
Good luck with your treatment!
Posted by mikhail99 on January 22, 2003, at 14:03:27
In reply to Re: How do you know if you have GAD? » Ilene, posted by ayuda on January 22, 2003, at 11:39:48
> > GAD is "general anxiety disorder," right? How is it different from regular anxiety? How do you know you are anxious and/or generally anxious? Seriously. I am so far from normal I don't know whether I would recognize it.
> >
> > Do ADs or mood stabilizers help? Are there any drugs specifically for GAD?
>
> Ilene --
> Like you, I am so far from "normal" that I may be wrong in this, but from my experience, I think that the difference between regular ol' anxiety and GAD is that GAD is not situational, it is constant and obsessive and about almost every aspect of your life, and you have physical as well as emotional reactions often.I hope you don't mind me jumping in here to agree wholeheartedly with you! GAD is not situational and that's what so frustrating about it. You could be sitting, reading a book or watching tv and you start to realize that you can't concentrate, you have a knot in your stomach and in my case, my breathing gets very difficult. And the thing that really sucks about GAD is that you start to think something is going to happen, it feels intuitive but it really isn't but you can't tell the difference. Does that make sense? And of course, this belief that something awful could happen just increases the anxiety.
>
> Such as, you can have anxiety about flying, and every time you think about flying or fly you have anxiety, including panic attacks, but otherwise things don't cause that level of anxiety, or every once in a while you get anxious about the future, but it isn't obsessive and can be related to a certain fear. I tend to think of those as "normal" and not obsessive.
>
> I think of GAD as more an approach to life -- tending to approach almost everything with a heightened level of anxiety, worrying about possible negative outcomes for many of life's tasks, the inability to stand-up for oneself or take a risk or be confrontational because of shaking, increased heartbeat, worry, fear, etc. Or also the inability to just let your life "happen" but to want to control everything because otherwise you will panic if everything does not go "perfectly."
>
> I make these distinctions from the observations of suffering from GAD, then going on medications that make me feel more "normal" in my response to situations that would cause extreme anxiety without the medications. So I distinguish between how I normally react, and how I react while on meds -- like I said, may be right, may not be, but I hope this helps.
>
> As for meds, some of the SSRIs now purport to cover GAD as well, such as Effexor XR and Lexapro. I can personally attest that they do, at least for me. There are other medications that only treat GAD, though since my main diagnosis is depression, my doctors have never treated the GAD alone (except in childhood, when I was on "kiddie tranquilizers"). I've taken Ativan (lorazepam) for anxiety, but that is not considered a maintenance drug by some doctors.I found paxil very helpful with my GAD but I gained a lot of weight on it so I decided I'd rather be anxious than fat (and I don't mean to sound flippant, it's just true, I'm horribly vain) and stopped taking it. Of course, that isn't the case for everyone.
>
> I hope some of this helps. Anxiety is not fun -- I know that is an understatement, but I encounter people, even doctors, who don't understand that you can't just get over a situation on your own, that you have no mechanism for it, because your anxiety has you on edge all the time.And since it's obsessive, it's so hard to stop the viscious cycle of thinking about the "what ifs" that make you anxious. And you're right, people who don't suffer from it have a very difficult time understanding it. Just ask my husband! :-)
>
> Good luck with your treatment!Ayuda, I think you did a fantastic job describing GAD, there was very little I could think to add except my own experience.
Ilene~Good luck with everything!
Posted by ayuda on January 22, 2003, at 14:35:06
In reply to Re: How do you know if you have GAD? » ayuda, posted by mikhail99 on January 22, 2003, at 14:03:27
Thank you -- it kind of sucks to be good at describing GAD from personal experience! On the other hand, if it wasn't for drugs like the SSRIs and Ativan, I still would not understand -- it's going to sound weird, but -- that I suffer from anxiety. I mean, your world is THE world to you, and until I started on SSRIs, I had no idea of just how much anxiety I lived with. I knew I was "high strung," but now I react so differently! My therapist told me yesterday that she has never seen me so calm (in a year and a half). That is mostly the Lexapro! Although I am still getting upset about things, but it is now more like anger than that "fight-or-flight" feeling.
It actually was better on the Effexor XR, but -- like you said, it sounds shallow -- I gained too much weight. And I do understand that feeling of I'm sacrificing my physical health for my mental health -- it's not vain, being overweight is a health risk. We may think of it as we want to look good, but it is also bad to put on this weight from these meds.
I now use stories of my anxiety to amuse people. Because of it, I would drive boyfriends crazy, I mean absolutely up the wall. Because I nit-picked about everything, made up elaborate schemes for how they were just trying to get on my nerves, and was never able to just enjoy the idea that any of them ever cared about me because my anxieties would not allow me to trust (I eventually called a moratorium on dating to stop driving myself and other people nuts). Then again, none of them ever responded with much sensitivity towards my feelings, which just served to increase my anxiety. I wonder if I would have treated any of them any differently had I had these meds then? So tell your husband that he is lucky that you are aware of your anxiety -- it could be worse!
Posted by mikhail99 on January 22, 2003, at 15:46:31
In reply to Re: How do you know if you have GAD? » mikhail99, posted by ayuda on January 22, 2003, at 14:35:06
> Thank you -- it kind of sucks to be good at describing GAD from personal experience! On the other hand, if it wasn't for drugs like the SSRIs and Ativan, I still would not understand -- it's going to sound weird, but -- that I suffer from anxiety. I mean, your world is THE world to you, and until I started on SSRIs, I had no idea of just how much anxiety I lived with. I knew I was "high strung," but now I react so differently! My therapist told me yesterday that she has never seen me so calm (in a year and a half). That is mostly the Lexapro! Although I am still getting upset about things, but it is now more like anger than that "fight-or-flight" feeling.
>
> It actually was better on the Effexor XR, but -- like you said, it sounds shallow -- I gained too much weight. And I do understand that feeling of I'm sacrificing my physical health for my mental health -- it's not vain, being overweight is a health risk. We may think of it as we want to look good, but it is also bad to put on this weight from these meds.
>
> I now use stories of my anxiety to amuse people. Because of it, I would drive boyfriends crazy, I mean absolutely up the wall. Because I nit-picked about everything, made up elaborate schemes for how they were just trying to get on my nerves, and was never able to just enjoy the idea that any of them ever cared about me because my anxieties would not allow me to trust (I eventually called a moratorium on dating to stop driving myself and other people nuts). Then again, none of them ever responded with much sensitivity towards my feelings, which just served to increase my anxiety. I wonder if I would have treated any of them any differently had I had these meds then? So tell your husband that he is lucky that you are aware of your anxiety -- it could be worse!You're right, it does kind of suck to be able to describe it so well but look at it this way, you've worked hard to get to the bottom of things and now you have a much better understanding of yourself than probably 75% of the population has about themselves. There's much to be said for that!
My therapist took a great deal of time and effort to describe for my husband what it's like to be me (ha!) the other day and he did it so well. He likened it to a physical problem like missing a leg. He said, "You wouldn't be giving her a hard time about not being able to go up the stairs, would you?" It was actually very funny. But he also said that it probably seems like I "choose" to be negative or obsessive but I really can't help it. I think he got through to him on some level but I'm going to have to do a lot of reminding.But anyway, I appreciate you describing the disorder so well, you know it always makes you feel less nuts when someone else is experiencing what you do. Hang in there and take care!
Mik
Posted by JESSsMom on January 22, 2003, at 17:36:17
In reply to Re: How do you know if you have GAD?, posted by mikhail99 on January 22, 2003, at 15:46:31
Wow, what an intelligent group and such excellent decriptions of what GAD is.
My first thought is that when you have GAD, there is just no question about it. It rules your life, social interactions, etc. In my case, it's just so OBVIOUS I have it.
My pdoc has even mentioned that I have one of the worst cases of it he's ever seen <sigh>.
JM
Posted by proud mary on January 23, 2003, at 11:44:48
In reply to Re: How do you know if you have GAD?, posted by JESSsMom on January 22, 2003, at 17:36:17
All, I am going to jump in here (hopefully not offending anyone). I have had GAD for about eight years. It is terrifying. Nothing seems right, in my case, I was sure I was going to die at any moment and everything got so bad I was almost to the point where I couldn't leave the house, but was terrified of being left alone with my three young children. In retrospect, I look back over my life and realize I had a tendency towards it ever since I was a teenager (mine really kicked in at about 35). What made it acute was a combination of a really lousy, nonsupportive marriage, the stress of having three young kids at home with no car, no money and very little contact with the outside world and then, my youngest starting kindergarten. That is my biggest memory--waking up about 3 a.m. every morning and worrying about getting her to school, what dangers lurked in the world for ALL three of them, etc....I would lay in bed and imagine elaborate scenarios of my kids being kidnapped, tourtured, all the way through the funeral! It seems so ridiculous now, but it was so serious and painful at the time.
The other side of the coin was that when I was left alone with them (ie on weekends) I was terrified I would become irrational and hurt them in some way (these were pre-Andrea Yates days). I would call their dad and beg him to come home...the situation was just getting unbearable.
I didn't have insurance, didn't have a primary care-giver, didn't have a clue as to what was going on with me and my brain. I hauled out the yellow pages and started making phone calls to places that seemed like they might be able to give me mental health care. I ended up, at one point, at a clinic that mostly cared for people who lived on the streets and recovering drug addicts. I saw someone after waiting a couple of hours just for the priviliage of being accused of scamming him to try to get a script for xanax. I left that place in tears. To make a long story short, I ended up at a health-science center at one of our local medical schools where I was evaluated and recieved care from a second year resident psychiatrist. She tried me out with a few different meds and we finally settled on zoloft and klonopin. I also was in therapy with her for two years. The relief at finding someone who knew what it was and didn't think I was a freak and actually helped me, provided me with the meds I needed to feel better (what a relief!)saved my life, I think.
I guess the moral of my story is, it CAN get better, there IS help out there for you and if the first or second thing doesn't work, they can keep trying and find something that will help.I am facing different issues now, which I will not go into at this time because I've already written a book.
I have some questions about lexapro, which I've been switched to because my zoloft has stopped working very well, for me....I'll get on about that later...
Posted by ayuda on January 23, 2003, at 21:23:55
In reply to Re: How do you know if you have GAD? » JESSsMom, posted by proud mary on January 23, 2003, at 11:44:48
No offense at all. Seeing other people's stories is a double-edged sword, because I feel relief that someone else understands, but also feel bad that anyone (including me) goes through this stuff. I've been suffering from anxiety and depression since childhood, but it came onto me very hard at age 35. I am curious about the ages of the women here who have had this problem, because I think there is a link between being in your mid-to-late-30s and either an onset or an increase in depression/anxiety, etc. From what I'm reading on these boards, I think there's more to the female chemical system than doctors know.
I don't have children (I knew through my anxiety that I could not make a good mother, I was too terrified to bring a child into this world with all the things that could go wrong!), but my mom went through something very similar to what you describe when my siblings and I were little, and she got next to no sleep, took speed to stay awake to worry about us. Her mother was called a "worrier." I was always called "high strung." It's interesting to see the way anxiety manifests itself and how it has been so misunderstood. And people don't understand how awful you feel inside, not just mentally, but physically, too.
It's great to have the treatment, but I worry about not affording the medications in the future, since I know now what it feels like to not be anxious, and then to not have the meds and go through all that is hard. I hope that you are able to stay on the meds, I don't think we can say enough about quality of life here.
> All, I am going to jump in here (hopefully not offending anyone). I have had GAD for about eight years. It is terrifying. Nothing seems right, in my case, I was sure I was going to die at any moment and everything got so bad I was almost to the point where I couldn't leave the house, but was terrified of being left alone with my three young children. In retrospect, I look back over my life and realize I had a tendency towards it ever since I was a teenager (mine really kicked in at about 35). What made it acute was a combination of a really lousy, nonsupportive marriage, the stress of having three young kids at home with no car, no money and very little contact with the outside world and then, my youngest starting kindergarten. That is my biggest memory--waking up about 3 a.m. every morning and worrying about getting her to school, what dangers lurked in the world for ALL three of them, etc....I would lay in bed and imagine elaborate scenarios of my kids being kidnapped, tourtured, all the way through the funeral! It seems so ridiculous now, but it was so serious and painful at the time.
> The other side of the coin was that when I was left alone with them (ie on weekends) I was terrified I would become irrational and hurt them in some way (these were pre-Andrea Yates days). I would call their dad and beg him to come home...the situation was just getting unbearable.
> I didn't have insurance, didn't have a primary care-giver, didn't have a clue as to what was going on with me and my brain. I hauled out the yellow pages and started making phone calls to places that seemed like they might be able to give me mental health care. I ended up, at one point, at a clinic that mostly cared for people who lived on the streets and recovering drug addicts. I saw someone after waiting a couple of hours just for the priviliage of being accused of scamming him to try to get a script for xanax. I left that place in tears. To make a long story short, I ended up at a health-science center at one of our local medical schools where I was evaluated and recieved care from a second year resident psychiatrist. She tried me out with a few different meds and we finally settled on zoloft and klonopin. I also was in therapy with her for two years. The relief at finding someone who knew what it was and didn't think I was a freak and actually helped me, provided me with the meds I needed to feel better (what a relief!)saved my life, I think.
> I guess the moral of my story is, it CAN get better, there IS help out there for you and if the first or second thing doesn't work, they can keep trying and find something that will help.
>
> I am facing different issues now, which I will not go into at this time because I've already written a book.
> I have some questions about lexapro, which I've been switched to because my zoloft has stopped working very well, for me....I'll get on about that later...
>
Posted by Ilene on January 24, 2003, at 23:36:23
In reply to Re: How do you know if you have GAD? » JESSsMom, posted by proud mary on January 23, 2003, at 11:44:48
... What made it acute was a combination of a really lousy, nonsupportive marriage, the stress of having three young kids at home with no car, no money and very little contact with the outside world and then, my youngest starting kindergarten. ...
I ended up at a health-science center at one of our local medical schools where I was evaluated and recieved care from a second year resident psychiatrist. She tried me out with a few different meds and we finally settled on zoloft and klonopin. I also was in therapy with her for two years. The relief at finding someone who knew what it was and didn't think I was a freak and actually helped me, provided me with the meds I needed to feel better (what a relief!)saved my life, I think.
> I guess the moral of my story is, it CAN get better, there IS help out there for you and if the first or second thing doesn't work, they can keep trying and find something that will help.
>
> I am facing different issues now, which I will not go into at this time because I've already written a book.
> I have some questions about lexapro, which I've been switched to because my zoloft has stopped working very well, for me....I'll get on about that later...
>I think being alone with 3 kids esp. when they are very young is hard for *anyone*. Plus all the stuff with no money, no car, no husband (figuratively if not literally).
Do you worry about the effect your condition is having or has had on your kids? I have been somewhat better lately, but I still spend a lot of time in my room with the door closed, mostly staring at the ceiling. Even at my best I can't really get after the kids to do their homework, pick up after themselves, and so on. Sometimes I think I'm like an alcoholic--not exactly passed out, but not exactly *there* either. Plus I am very irritable.
Are you still married?
This is the end of the thread.
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