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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by sgoose on January 22, 2004, at 17:51:41
I am now 23 (male) and have a life of anxiety and related problems. My official diagnoses have been Generalized Anxiety Disorder, Panic Disorder, Agoraphobia and ADD(inattentive). I've had this stuff all of my life along with some sort of low mood which is obviously a result. I'm writing here for advice because I am at a critical point and feel that I am in severe danger of becoming a permanent failure. I couldn't deal with school, and developed phobias. I used to have panic attacks every morning, severe ones. I believe I had suffered deep trauma from this. I had problems when in my home but never the CRUSHING panic/anxiety when out with people. I was treated starting at 17 in 1998 and through prozac and klonopin I finished high school but my attempts at college were miserable. I dropped the prozac and remained in the klonopin for a while after. The prozac just blunted me and I was still stuck with anxiety and an extra 30-40lbs. Between different stints I went on with no meds and it was always miserable. I still can't figure out why I haven't just stayed on klonopin all along. I think it's because doctors see it as a dead end, which is NOT the truth for someone who has suffered life long. I'm on my 2nd psychiatrist now and he has dx'd me with ADD and put me on Adderall and insisted to not use Klonopin. It helped for a while but after about 2-3 months I feel the anxiety has "gotten around it" and the only thing it does is help me be more physically active and perhaps have more drive. My problem is so out of control that my treatment has been compromised because I can not talk out loud realistically about my severe anxiety when in the chair across from the doctor. Just recently after all of this suffering have I realized that I am just sitting there complaining about side effects of the anxiety/fear/etc etc. I need my anxiety treated... I'm doing poorly in almost every way. I can't work, my car is broken down and I'm lucky to even have a roof over my head at my parents house. I have never abused substances habitually. I smoked some weed off and on, mushrooms a few times, and worst of all was one half acid hit at the age of 15. I feel the early acid experience exposed me to even MORE anxiety in a young kid who was already maxed out. I have done many hours of psychotherapy and I have had patience with the drugs. I just want to get better.. I want to have a job, a girlfriend, maybe even a house of my own some day. It all seems impossible right now.. sometimes it's hard to believe I have felt so awful for my entire life..the good times were brief and always ended with my gripping on until the very end. This syndrome has pulled me away from other people, including my very own friends and family. SSRI's haven't worked.. I tried several. Klonopin and Adderall are the only things I have tried that really diminished the anxiety but have only experienced one med at a time and not a combo for more than a few days. I tried a few times taking the Klonopin 2mg at a time after taking .5mg 2 or 3 times a day for a few years (building some sort of tolerance) and it was the BEST effect I have ever had and best I have felt. I remember feeling like I had gone from thousands of layers of thought and tension down to just a few and I was natural. What do you think? I have been reading groups like this for years and it's way past time I got up the "nerve" to post.
THANK YOU
Posted by dowchild on January 22, 2004, at 18:57:31
In reply to Anxiety, etc. Need Advice!, posted by sgoose on January 22, 2004, at 17:51:41
Can't comment on the med mix, others here probably have more experience. But I have learned a few tricks that might be of help.
But first, let me congratulate you on reaching out to others.
And second, you will never be a failure - life has dealt you a situation that most others would wilt under. You still have a sense of direction, and goals you want to achieve. Only thing standing in your way is anxiety, and it has to have roots somewhere.
What I do for anxiety, is to make a list of what is right in your life, and what you enjoy without feeling anxious.
Make another list of stuff you enjoy, but that has a little anxiety.
Forget for now the wicked anxiety stuff - it can wait.
When anxious, do something from the first list.
When not anxious, do something from the second list.
I'll bet that the stuff that was on the second list, finds it's way to the first, soon enough.
Try belly breathing - belly goes out when you inhale, belly goes in when you exhale. Pay attention to your breathing, try to slow it down, and take huge breaths, slowly.
You can do this walking, too - perhaps very early morning might be the best time.
I make a concoction of camomile and mint tea, with honey. Seems to take the edge off.
Avoid caffeine in any form ( maybe exception of chocolate?) Green tea has a little caffeine, but is not so bad as the 15 cups of strong coffee I used to drink. Each day.
Let me know if this helps - it will take a while, tho.
Oh, these are all meditation techniques, in case you want to check that out. Search for Zen or Chan on the web. Taoism might work out too.
Talk about visualization exercises with your pdoc - that might help limiting the panic, by using your own imagination to fight the anxiety.
Others will probably have better advice.
dowchild
Posted by BackOfClass on January 22, 2004, at 19:19:05
In reply to Anxiety, etc. Need Advice!, posted by sgoose on January 22, 2004, at 17:51:41
I am also a 23 male and can relate to just about everything in your post. It as though I was reading my life story! I usually don't have a lot to say and being in your same boat is no exception. You are not alone and remember there are people in a lot worse state then you. They have jobs and are coping with their disabilities. I know that sounds cliché but my mom reminds me that every time I feel hopeless and it helps me by knowing that I am not alone. You say that you have tried Klonopin and Adderall, but not both. That may be the mistake. If you have Social Phobia and ADD, like I do, a stimulant and Klonopin, I can attest, work great when taken together. Your doctor may believe that they don’t work when combined because one is an upper and the other is a downer, but that is false thinking. Also, he may think your ADD has resulted in your Social Phobia. You should attack the anxiety first and continue the treatment for ADD. I think a long term therapy on Klonopin, up to 6mg a day, but this amount for me is dependent on the amount of Adderall/Dexedrine. The less Adderall taken the less Klonopin may be needed. If you can get it, Dexedrine is a better stimulant for anxiety sufferers, in my opinion, because it has little increase in anxiety when compared to Adderall. For me, I don’t know why, but the stimulants have a unique way of decreasing anxiety but increasing it as well. It takes a good combo of a stimulant and a benzo to balance things out – be flexible. You might want to add Luvox to the mix, because you may have obsessive thinking, but any SSRI combined with a stimulant and Klonopin can make things better. Maybe talk to your doctor about putting you on an anti-psychotic at night, but be warned that if taken during the day you will be an zombie. Be warned that Zyprexa is not a good substitute for Klonopin – your doctor may think so – just say no and run. An anti-psychotic can help when augmented, but for Social Phobia, I have never heard of it working alone. Anyway, that is all I have to say! I know it is a lot to swallow and some may be garbage, but remember, I am in the same boat, so be nice!
Posted by sgoose on January 22, 2004, at 20:14:08
In reply to Re: Anxiety, etc. Need Advice!, posted by dowchild on January 22, 2004, at 18:57:31
I'm really working on this stuff, especially breathing. My challenge is that I have chronic year round indoor/outdoor allergies. I dare say that almost everything improves for me when using a nasal strip such as ones athletes use to open the passages.
> Can't comment on the med mix, others here probably have more experience. But I have learned a few tricks that might be of help.
> But first, let me congratulate you on reaching out to others.
> And second, you will never be a failure - life has dealt you a situation that most others would wilt under. You still have a sense of direction, and goals you want to achieve. Only thing standing in your way is anxiety, and it has to have roots somewhere.
> What I do for anxiety, is to make a list of what is right in your life, and what you enjoy without feeling anxious.
> Make another list of stuff you enjoy, but that has a little anxiety.
> Forget for now the wicked anxiety stuff - it can wait.
> When anxious, do something from the first list.
> When not anxious, do something from the second list.
> I'll bet that the stuff that was on the second list, finds it's way to the first, soon enough.
> Try belly breathing - belly goes out when you inhale, belly goes in when you exhale. Pay attention to your breathing, try to slow it down, and take huge breaths, slowly.
> You can do this walking, too - perhaps very early morning might be the best time.
> I make a concoction of camomile and mint tea, with honey. Seems to take the edge off.
> Avoid caffeine in any form ( maybe exception of chocolate?) Green tea has a little caffeine, but is not so bad as the 15 cups of strong coffee I used to drink. Each day.
> Let me know if this helps - it will take a while, tho.
> Oh, these are all meditation techniques, in case you want to check that out. Search for Zen or Chan on the web. Taoism might work out too.
> Talk about visualization exercises with your pdoc - that might help limiting the panic, by using your own imagination to fight the anxiety.
> Others will probably have better advice.
> dowchild
Posted by sgoose on January 22, 2004, at 20:21:07
In reply to Anxiety, etc. Need Advice!, posted by BackOfClass on January 22, 2004, at 19:19:05
It's clear to me that I need to speak up about what I want. The problem I have faced is I have this idea that if I name drugs I will be seen as drug seeking. I should have insisted on adding the klonopin because it had been so effective in the past. At this point in my life I really don't care about "addiction" or wearing my body down from pills because it's nothing more grim than not living any kind of a decent life. My opinion is that the people who are so concerned with perserving themselves are the people who haven't faced the misery every day.
Thanks
> I am also a 23 male and can relate to just about everything in your post. It as though I was reading my life story! I usually don't have a lot to say and being in your same boat is no exception. You are not alone and remember there are people in a lot worse state then you. They have jobs and are coping with their disabilities. I know that sounds cliché but my mom reminds me that every time I feel hopeless and it helps me by knowing that I am not alone. You say that you have tried Klonopin and Adderall, but not both. That may be the mistake. If you have Social Phobia and ADD, like I do, a stimulant and Klonopin, I can attest, work great when taken together. Your doctor may believe that they don?t work when combined because one is an upper and the other is a downer, but that is false thinking. Also, he may think your ADD has resulted in your Social Phobia. You should attack the anxiety first and continue the treatment for ADD. I think a long term therapy on Klonopin, up to 6mg a day, but this amount for me is dependent on the amount of Adderall/Dexedrine. The less Adderall taken the less Klonopin may be needed. If you can get it, Dexedrine is a better stimulant for anxiety sufferers, in my opinion, because it has little increase in anxiety when compared to Adderall. For me, I don?t know why, but the stimulants have a unique way of decreasing anxiety but increasing it as well. It takes a good combo of a stimulant and a benzo to balance things out ? be flexible. You might want to add Luvox to the mix, because you may have obsessive thinking, but any SSRI combined with a stimulant and Klonopin can make things better. Maybe talk to your doctor about putting you on an anti-psychotic at night, but be warned that if taken during the day you will be an zombie. Be warned that Zyprexa is not a good substitute for Klonopin ? your doctor may think so ? just say no and run. An anti-psychotic can help when augmented, but for Social Phobia, I have never heard of it working alone. Anyway, that is all I have to say! I know it is a lot to swallow and some may be garbage, but remember, I am in the same boat, so be nice!
Posted by dowchild on January 23, 2004, at 12:15:03
In reply to Anxiety, etc. Need Advice!, posted by sgoose on January 22, 2004, at 17:51:41
Oh, allergies too!
I took desensitising shots for about a year, and it helped.
But it also involved a regime of a rotary diversified diet, no sugar, yeast, fungi, caffeine, and alcohol. And exercise, heavy exercise ( I used early morning when the pollens were trapped by dew.
It helped, and I was feeling pretty good, till I stopped ( got married, which later proved to be a mistake).
Might want to seek out a clinical ecologist.
Allergies can cause massive brain fog, anxiety, depression, mania, the list goes on.
You may elect to rule that out, too.
I live in a house with three other ppl that all suffer from environmental sensitivity. One of our members turns into a gibbering puddle when exposed to perfume.
This is another avenue to expore.
Hope this helps, too!
Posted by Wildman on January 23, 2004, at 13:53:16
In reply to Re: Anxiety, etc. Need Advice!, posted by sgoose on January 22, 2004, at 20:21:07
> It's clear to me that I need to speak up about what I want. The problem I have faced is I have this idea that if I name drugs I will be seen as drug seeking. I should have insisted on adding the klonopin because it had been so effective in the past. At this point in my life I really don't care about "addiction" or wearing my body down from pills because it's nothing more grim than not living any kind of a decent life.
Interesting that you mention "speaking up about what you want" and that you are concerned about being labeled as "drug seeking" by your pdoc.I have the same concerns, even though I _don't_ yet know what the next med I should try is. I'm currently on Lex (week 6) and while I know I should be patient and wait until week 10+ before really deciding if it is worth the side effects, I am researching options.
I've taken a bit of Ativan to battle some of the side effects of Lex (works well for that), but feel that if I had it every day, that I would be helping the "baseline" anxiety that I am saddled with. Is klonopin something to bring up to the pdoc? When he gave me the Ativan, he told me he expected that Rx to last six months. So, he expects 30 1mg tabs to last for 25 weeks. That's only one per week, unfortunately.
If I had one 1mg per _day_ I would be comfortable. The last thing I want is to be thought of as "drug seeking", as he deals with a lot of addiction issues in his other clients. the doc knows I've dabbled in rec drugs in the past and still smoke pot regularly (but I think he smokes pot also -he said his wife still does) and I'd wager 10:1 that he's tried every drug that _I've_ every tried (recreationally). (I am surprised about this amount of self-disclosure on his part, but
So, I'm torn here.
Posted by sgoose on January 23, 2004, at 14:53:29
In reply to Re: Anxiety, etc. Need Advice!, posted by Wildman on January 23, 2004, at 13:53:16
All of this comes down to what I have experienced in six years of "treatment": The level of care UNLESS you have $$$$ is disgusting and inadequate. The doctors I have seen who have offices in the more wealthy towns here are MUCH more likely to write scripts for the controlled substances such as adderall and klonopin. Low income/no money/young male.. whatever = association with drug abuse and problems for these doctors. Obviously they sleep easier knowing that the privledged people of our society are less likely to be "busted" or do something "stupid" with controlled substances. Stereotypes. What about the CHRONIC sufferers whose lack of treatment has thrown them to poverty and further complications? There are exceptions but this is what I have seen as the average. This leads to the problem of overprescribed SSRI's. IMO, people suffering from severe and chronic anxiety will gain little to NO benefit from treatment with SSRI's. The only benefit I see from SSRI's is when combo'd with a benzo such as klonopin. The problem with klonopin is that it has long since gone generic, so there isn't one big drug company pushing it hard to doctors right now with fancy literature pamphlets and all expenses paid trips to where-ever or an all day outing at the country club. It is that and the label of "addicting" .. I've said it before and will say again that addiction to a few mg's of Klonopin each day is NOTHING compared to the alternatives that untreated chronic anxiety can lead you to. If your doctor will prescribe you klonopin to take evey day KEEP THAT DOCTOR no matter what the cost. Trust me.. I have been to the point of getting 360 Klonopin in one bottle and then the complete opposite. The only reason I'm not with that Doctor is that I couldn't pay over $100 for each visit out of my pocket.
Keep Fighting
> Interesting that you mention "speaking up about what you want" and that you are concerned about being labeled as "drug seeking" by your pdoc.
>
> I have the same concerns, even though I _don't_ yet know what the next med I should try is. I'm currently on Lex (week 6) and while I know I should be patient and wait until week 10+ before really deciding if it is worth the side effects, I am researching options.
>
> I've taken a bit of Ativan to battle some of the side effects of Lex (works well for that), but feel that if I had it every day, that I would be helping the "baseline" anxiety that I am saddled with. Is klonopin something to bring up to the pdoc? When he gave me the Ativan, he told me he expected that Rx to last six months. So, he expects 30 1mg tabs to last for 25 weeks. That's only one per week, unfortunately.
>
> If I had one 1mg per _day_ I would be comfortable. The last thing I want is to be thought of as "drug seeking", as he deals with a lot of addiction issues in his other clients. the doc knows I've dabbled in rec drugs in the past and still smoke pot regularly (but I think he smokes pot also -he said his wife still does) and I'd wager 10:1 that he's tried every drug that _I've_ every tried (recreationally). (I am surprised about this amount of self-disclosure on his part, but
>
> So, I'm torn here.
Posted by BackOfClass on January 23, 2004, at 17:25:10
In reply to Re: Anxiety, etc. Need Advice!, posted by sgoose on January 22, 2004, at 20:21:07
I understand what you mean by being looked upon as a drug seeker. Doctors don't like it when patients know about the medications (never use the word drug)that they perscibe. I would suggest that you visit your doctor with your mom/dad - only if she/he will say good things about you, like you are responsible, etc. I would mention that you have had these symptoms for a long time and you have learned that there are medications to treat them. Tell how each med has helped you in the past. Stress that the anxiety is dibilitating - provide examples and tell him that Klonopin has worked successfully in the past and demand you be put back on it because "you just want to feel normal."
Posted by Paulinecfny on January 23, 2004, at 17:49:47
In reply to Anxiety, etc. Need Advice!, posted by sgoose on January 22, 2004, at 17:51:41
I met a professor who said that hypoglycemia (low sugar) is the cause of anxiety and the cure is to take NO SUGAR (including simple carbs). Complex carbs are ok; like one baked potato a day. He recommends fish and vegetable diet. No diet soda either because the body might think its sugar. Whe your blood sugar level drops, thats when the body dumps adrenalin in the system which causes the anxiety. You can request material (brochure and tape) from him if you're interested. I've been weaning myself off sugar but not completely as he prescribes. Also, the anxiety can be caused by other allergens, if its not the sugar. The brochure explains everything. Its pretty hard though to follow a no sugar diet, for me. So although I only get attacks once a week now (which is a great improvement, but still not good enough as far as finding work), I still have to completely be off sugar to see if the anxiety will go away in 2 weeks (as the professor claims).
Here's the professor's contact information about anxiety and hypoglycemia:
Anxiety & Hypoglycemia Study Group
Source of Life Center
22 West 34th St.
Manhattan, NY
(212) 479-7805
Posted by Wildman on January 24, 2004, at 14:21:49
In reply to Re: Anxiety, etc. Need Advice!, posted by Paulinecfny on January 23, 2004, at 17:49:47
>
> I met a professor who said that hypoglycemia (low sugar) is the cause of anxiety and the cure is to take NO SUGAR (including simple carbs). Complex carbs are ok; like one baked potato a day. He recommends...I do have issues regarding my blood sugar and have to eat meals at very regular intervals otherwise I turn into what has been described "The Hulk" (w/o the green color). I really do freak out when I'm hungry.
I'm pretty sure my baseline anxiety level is not blood sugar related, although it can aggravate it at times. I've never been diagnosed as hypo- or hyper-gylcemic, just very sensitive to being the slightest bit hungry.
Posted by Wildman on January 24, 2004, at 14:42:38
In reply to Re: Anxiety, etc. Need Advice! }} Wildman, posted by sgoose on January 23, 2004, at 14:53:29
> All of this comes down to what I have experienced in six years of "treatment": The level of care UNLESS you have $$$$ is disgusting and inadequate.
I am self-employed and pay this entirely out of pocket. In fact, this pdoc doesn't even take insurance. His sessions are $130/hr, but I negotiated $100/hr, as he is a friend of a friend.
I make a good living, so paying this is not killing me.>The doctors I have seen who have offices in the more wealthy towns here are MUCH more likely to write scripts for the controlled substances such as adderall and klonopin. Low income/no money/young male.. whatever = association with drug abuse and problems for these doctors.
I am 37 and professional (IT industry), and I don't think he thinks I am likely to abuse it, although he's not known for handing out meds like candy.
> ..this leads to the problem of overprescribed SSRI's. IMO, people suffering from severe and chronic anxiety will gain little to NO benefit from treatment with SSRI's.
I do suffer from (mild, I think) depression in addition to the anxiety.
>The only benefit I see from SSRI's is when combo'd with a benzo such as klonopin.
Thanks for your vote on that combo. Since I currently have PRN Ativan, how does the klonopin compare? How are the effects different? I presume they are 80% the same as Ativan, as they are both benzos.
> .. I've said it before and will say again that addiction to a few mg's of Klonopin each day is NOTHING compared to the alternatives that untreated chronic anxiety can lead you to.
I am at a loss to describe by current level of anxiety, as I really have nothing to compare it to. It's _not_ debilitating, I function pretty well in general, but I have had trouble coping with the anxiety more in the last 6 months. This anxiety/depression I've been experiencing is GETTING OLD. I want it to go away!
The Lex is helping with my depression and my irritability... I need something to address the anxiety as well.
>If your doctor will prescribe you klonopin to take evey day KEEP THAT DOCTOR no matter what the cost.
That's what I think. Meds can be darn handy.
Posted by Sebastian on January 24, 2004, at 14:43:18
In reply to Anxiety, etc. Need Advice!, posted by sgoose on January 22, 2004, at 17:51:41
They don't want to give you more Klonopin because it is addictive. Try a different anxiety med. I take zyprexa which realy works good for anxiety in the long run. I was like you in high school, pot mushrooms acid, anxiety just going to school. I got over the anxiety when I smoked pot all the time. They used to pick on me off and on in school. Which is why I got anxous going to school and seeing the people. I feared school. A year after school and I went psychotic, the best med I took for it was 10 mg zyprexa. It helped me through college and jobs. and kept me out of psychosis and anxiety, especialy when I was suicidely depressed. If that was what I was, I was atleast wondering if I was suicidal, not that I belived I was. Soon as I want back on zyprexa those thoughts left my mind. I still take zyprexa 5 years later. I also take 60 mg celexa for depression. 2-3/100 mg wellbutrins for energy. zyprexa works instantly for my anxiety and panic. 2 hours after. I don't fear people as much on it , or myself.
Posted by Sebastian on January 24, 2004, at 14:46:07
In reply to Re: Anxiety, etc. Need Advice!, posted by sgoose on January 22, 2004, at 20:21:07
Your doctor might be willing to listen to what you want in the way of medicine. That helps them to determine what is best for you.
Posted by Wildman on January 24, 2004, at 14:58:15
In reply to Re: Anxiety, etc. Need Advice!, posted by BackOfClass on January 23, 2004, at 17:25:10
> Doctors don't like it when patients know about the medications (never use the word drug)that they perscibe.
I have been reading this forum intently so that I have a better grip of the _language_ used to describe what people experience. That has been highly useful for me. I told my pdoc of my reading and how I learning the "vocabulary" of depression and anxiety so that I may better communicate what I live with day to day. I don't think that the pdoc would think I'm fishing around for meds just because I have knowledge - it's my nature to want to be educated on stuff like this.
> I would suggest that you visit your doctor with your mom/dad
Well, I'm 37 and married with 3 kids, so I think my pdoc would be chuckling if I showed up with my folks... :)
I'm still interested in knowing more about klonopin, as I've never taken it, but read about it quite a bit here....
Posted by sgoose on January 24, 2004, at 15:57:40
In reply to Re: Anxiety, etc. Need Advice! » BackOfClass, posted by Wildman on January 24, 2004, at 14:58:15
Wildman.. I'm short on time to reply right now but I will say this: you need to at least give Klonopin a try. There is a reason why people on forums such as these call it the "silver bullet" ..it is especially effective in a combo of one or two other meds depending on the condition(s). I have gained a lot of confidence this weekend to be firm when talking with my Dr. on Monday.
THANKS
> I'm still interested in knowing more about klonopin, as I've never taken it, but read about it quite a bit here....
>
>
This is the end of the thread.
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