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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by babak on February 28, 2003, at 5:05:03
There is a nasty symptom to my illness that I would like to know if anyone else has.
Let me first tell you that I am currently on maximum doses of Effexor and Mirtazapine. My symptoms have got worse since I’ve had ECT. The doctors say that it can’t be ECT but it could be the anaesthetic. I don’t really care which one and anyway I have been like this practically since my depression started in 1986.
I have a lot of muscular tension, especially at the back of my. It creeks every time I move it side to side. However when I do relax, be it by going to sauna or taking a muscle relaxant or Valium, after a couple of hours I get anxiety attacks and consequently the tension returns. To me it feels like as if my body is not allowed to relax, which is a terrible thing.
All the anti-anxiety drugs make feel tired and sleepy and when I wake up my body is tense again. I don’t want to feel tired and sleepy I want to be awake and relaxed but my body seems not to be able to handle this.
Anti-depressants like Effexor stop the anxiety but don’t help with the tension. In fact if anything they seem to increases it, well at least in my case. It appears as if one of the effect/side effects of the ECT and/or the anaesthetic has been to reduce my body’s capacity to maintain the tension which used to keep anxiety at bay. And off course the older I get this capacity is reduced anyway.
I suppose I have had to accept tension as a norm so that I won’t feel anxious. This is exactly what my body was doing before I had a break down triggering my depression. I think my body just couldn’t keep it up.
I have noticed this in others. I have a friend which always seems tense, but he wasn’t aware of it until it got so bad that he was having spasms in bed just before falling asleep. His doctor gave him a low dose of Amitriptyline. He thought it was great and said that he hadn’t felt so relaxed in years. But when the Amitriptyline course was finished he started feeling really anxious. He thought that he was hooked on Amitriptyline. I tried to convince him other wise but he wouldn’t have it and has subscribed to the idea that all medications to do with the nervous system are “unnatural” and people shouldn’t take them. He has since gradually regained his “normal” state of tension.
It seems to me that anti-depressants like Effexor block the receptors which react to whatever chemical is causing the anxiety in the brain. Surely it would be better if there was a drug which stopped the production of this chemical in the first place, so the body wouldn’t have to maintain a state of tension.
Posted by KrissyP on February 28, 2003, at 12:22:51
In reply to anxiety attack and relaxation, posted by babak on February 28, 2003, at 5:05:03
I hear you here. I do experience tension a lot, and the "creeking" you talk about. I personally think it is because I try 1) to rush through everything, thinking I can get all things done in one day, 2) because I'm trying to learn that I can't control everything and everyone, and 3) That I am too hard on me. I literally got my dad's GENES and my mom's JEANS-if you know what I mean here. I had ECT-9 of them, the 10th one I refused. I have lost quite a bit of the 2 or 3 years before of my memory. I do find that regular massages do help a little, but the tension comes back. Try taking a moment and just relaxing your body, visualization, and/or really breathe out and at the same time "mentally" release that tension-whatever it takes my friend. Hope this helped?
All the Best,
Kristen
I have a lot of muscular tension, especially at the back of my. It creeks every time I move it side to side.
Posted by jflange on February 28, 2003, at 13:15:35
In reply to anxiety attack and relaxation, posted by babak on February 28, 2003, at 5:05:03
babak:
I have experienced the same kind of muscle tension you describe in conjunction with my anxiety. The anxiety itself was causing me to tense up unconsciously and the muscles in my neck, back, chest, and stomach were strained, sore, and stiff. Naturally the pain and annoyance of this muscle tension, and the consequent inability to breathe deeply and fully acted as another contributing factor to my anxiety.
There could be several reasons why you are experiencing this tension and I think you should not have to live with it. Valium and other benzos are good for the short-term but like you said, they tend to produce rebound anxiety and tension if you only take them intermittently. Effexor and the SSRIs made this muscle tension worse for me. I have never tried ECT, so I cannot comment on that.
I found two things to be helpful: 1. magnesium and calcium, at a 2/1 ratio, to relieve the muscle tension. Taking them in a 1/2 ratio can be calming mentally, but will not really do much for your muscle tension. 2. taking an anti-anxiety drug like buspar that inhibits the firing rate of 5-HT-containing neurons, cutting down on the ssri/snri induced muscle tension (at least in my experience). Buspar works well with Remeron as an anti-anxiety combo, but I have no idea what these two will do with Effexor in the mix.
Good luck to you,
jflange
Posted by babak on February 28, 2003, at 14:11:04
In reply to Re: anxiety attack and relaxation » babak, posted by KrissyP on February 28, 2003, at 12:22:51
I am sorry Kristen but I think I didn't myself quite clear. My point is that it doesn't matter how I relieve the tension; relaxing my body, visualization or what ever. The point is that as soon as I relax I get anxiety attacks. That is why I don't want (dare) to relax because the anxiety attack which proceeds any relaxation I get is a lot worse than the tension.
My question is: do you get anxiety attacks as soon as you relax?
This is what is freaking me out because I think it is a real catch 22. I can’t relax because as soon as I relax I get anxiety attacks. I am depressed and tiered because of all this tension I have to carry around, but I can’t get rid of the tension because I get anxiety attack. Do you see what I mean?
Posted by babak on February 28, 2003, at 14:35:45
In reply to Re: anxiety attack and relaxation, posted by jflange on February 28, 2003, at 13:15:35
Thanks jflange for your advice I'll have a go, but do you see my dilemma?
I don't take a lot Benzos like Valium. So I don't think it is a rebound anxiety in that sense. I think this is the source of my illness. Not being able to relax because of anxiety attacks. Most of the time I don't want (dare) to relax becasue the anxiety that is bound to follow is a lot worse than the tension.
Benzos reduce your concentration and as I said make you feel drowsy.
Posted by KrissyP on February 28, 2003, at 16:37:04
In reply to Re: anxiety attack and relaxation » KrissyP, posted by babak on February 28, 2003, at 14:11:04
Ahhhhhhh I apologize. I understand what you are saying now. I'm sorry. ABSOULTELY-ME?-RELAX? It makes me more anxious like "dang-I should be doing something" I see exactly what you mean-yes and I am sorry you are going through this-I know in reality that doesn't help but I hope it does just a little? Did you tell me what meds you are taking? Can I start there? I'd like to try and help you with this and share. Please post again:)
Kristen
My point is that it doesn't matter how I relieve the tension; relaxing my body, visualization or what ever. The point is that as soon as I relax I get anxiety attacks. That is why I don't want (dare) to relax because the anxiety attack which proceeds any relaxation I get is a lot worse than the tension.
>
> My question is: do you get anxiety attacks as soon as you relax?
>
> This is what is freaking me out because I think it is a real catch 22. I can’t relax because as soon as I relax I get anxiety attacks. I am depressed and tiered because of all this tension I have to carry around, but I can’t get rid of the tension because I get anxiety attack. Do you see what I mean?
Posted by babak on March 1, 2003, at 14:22:14
In reply to Re: anxiety attack and relaxation » babak, posted by KrissyP on February 28, 2003, at 16:37:04
Thanks Kristen. I am currently on 300mg Venlafaxine and 45mg of Remeron. I can’t increase the Effexor because of headaches.
It seems to me your difficulty with post relaxation anxiety is somewhat psychological in as much as you are aware of the why you start getting anxious. At least this is how it seems to you which is what is important. The vicious circle in my case appears physical, i. e. I am not aware of any feelings of guilt about being relaxed when the anxiety surfaces. If there is any psychological dynamics involved it is certainly not accessible to my consciousness. Even if there is one; when eight years of therapy couldn’t recover it into my consciousness and at least partially under control then it might as well not be there and be considered physical for all intents and purposes, if you catch my drift.
I just wished there was a drug which stopped the production of whatever chemical there is that creates anxiety. Then may be I could relax and get the psychological benefits of relaxation which will hopefully create a positive self fuelling spiral. You know? The more I relax the more confident I get, the more confident I become the less chance of being gripped by anxiety and the less chance of anxiety the easier I can relax and so on. Why do all these spirals have to be negative, going downward instead of up?
Posted by worrier on March 5, 2003, at 17:58:45
In reply to Re: anxiety attack and relaxation » babak, posted by KrissyP on February 28, 2003, at 16:37:04
Well, interesting to know that there is someone else out there like me. I know exactly what you mean...my worst anxiety and/or panic attacks always occur during "down time" (when I make an effort to relax...meditate,deep breathing, even watching something mindless on tv. Therefore the idea of trying to or allowing myself to relax is scarey. Catch 22 is right. I've tried numerous antidepressants and they've all made everything much worse, especially the SSRIs. Way too much serotonin and it nearly killed me. Xanax is the only thing that has helped so far. I really don't find that it makes me dull or fuzzy. The constant anxiety is much more debilitating. Don't know if this is going to pan out to mean anything, but my md recently checked my plasma cortisol levels and found they were over twice normal. A 24 hr urine cortisol test also was high. She's referred me to an endocrinologist who I will see the end of next month. Maybe this will provide some clues. Anyway, let me know if you come up with anything that helps. Being afraid to relax is really a hassle. Best wishes, worrier.
Posted by babak on March 6, 2003, at 14:53:30
In reply to Re: anxiety attack and relaxation » KrissyP, posted by worrier on March 5, 2003, at 17:58:45
Xanax does help and it is the best amongst the Benzos but still makes me sleepy.
Like me, do you find that SSRIs or SNRIs increase muscle tension? I mean they do help with anxiety but I feel as if they do it by increasing the tension that holds the anxiety in check. I think this is what my own body was doing on its own before it fell apart.
And what you said about cortisol levels is interesting too, because ECT's adverse side-effect can be a lot worse for people with high levels of cortisol. I don't know if they checked my cortisol levels but I had to give up on ECT because of side effects. May be I should have mine checked out too.
Please let me know if that proves to be a clue.
Posted by worrier on March 6, 2003, at 21:23:36
In reply to Re: anxiety attack and relaxation » worrier, posted by babak on March 6, 2003, at 14:53:30
> Xanax does help and it is the best amongst the Benzos but still makes me sleepy.
>
> Like me, do you find that SSRIs or SNRIs increase muscle tension? I mean they do help with anxiety but I feel as if they do it by increasing the tension that holds the anxiety in check. I think this is what my own body was doing on its own before it fell apart.
>
> And what you said about cortisol levels is interesting too, because ECT's adverse side-effect can be a lot worse for people with high levels of cortisol. I don't know if they checked my cortisol levels but I had to give up on ECT because of side effects. May be I should have mine checked out too.
>
> Please let me know if that proves to be a clue.
>>In my case the SSRIs made me really agitated and so physically wired that I literally had to be up pacing the floor or doing something active in order to avoid going completely over the edge. Paxil was the worst, actually sent me to the ER...it was like the worst panic attack ever times 100. Too bad the xanax makes you sleepy. Have you tried valium? It will probably make you sleepy as well, but it has more muscle relaxant properties than some of the other benzos. My pdoc is considering switching me to it because of physical symptoms I have.The constant muscle tension, jaw clenching, teeth grinding all night etc. But we're going to wait until the results are in on the cortisol thing before changing anything. I'll let you know what happens. Hang in there. Worrier.
Posted by KrissyP on March 7, 2003, at 1:14:05
In reply to Re: anxiety attack and relaxation » babak, posted by worrier on March 6, 2003, at 21:23:36
Hi worrier:-)
Just wanted to wish you the best on the results of the cortisol thing:-) Paxil sent me to the ER too-Manic as heck-NOT FUN-I hear you!
Keep us posted,
Just wanted to share,
Kristen
-------------------------------------------------In my case the SSRIs made me really agitated and so physically wired that I literally had to be up pacing the floor or doing something active in order to avoid going completely over the edge. Paxil was the worst, actually sent me to the ER...it was like the worst panic attack ever times 100. Too bad the xanax makes you sleepy. Have you tried valium? It will probably make you sleepy as well, but it has more muscle relaxant properties than some of the other benzos. My pdoc is considering switching me to it because of physical symptoms I have.The constant muscle tension, jaw clenching, teeth grinding all night etc. But we're going to wait until the results are in on the cortisol thing before changing anything. I'll let you know what happens. Hang in there. Worrier.
Posted by Madge on March 7, 2003, at 22:16:40
In reply to Re: anxiety attack and relaxation » worrier, posted by KrissyP on March 7, 2003, at 1:14:05
I am so sorry to hear that you have such terrible anxiety even on Remeron. I have anxiety too, especially social anxiety, and both Remeron and Paxil have helped with that. I also take Klonopin which is also a benzo and it is great for anxiety and tenseness. If the SSRI's are making you manic, have you been diagnosed as Bi-polar? Certain AD's can trigger the manic phase when there has never been one present, so although your doctor may have ethought you just had major depression, you may actually have bi-polar or Bi polarII which is a milder mania.
Just some thoughts to consider. I am switching from Remeron to Wellbutrin because of the weight gain. Wellbutrin for some decreases anxiety, and I am finding that taking the Wellbutrin with klonopin and the Remeron is uplifting, not anxiety producing.
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