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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Cseagraves on April 2, 2009, at 18:03:23
Hi to all.
Here are several questions and would appreciate all opinions.
After much reading, researching, experimenting I'm pretty much clueless as to what will work anymore or if anything really will at all.
For someone like me with extreme GAD, SAD, agoraphobia, PTSD, (am in constant flight or fight mode, adrenaline is pumping 24 hours a day) I really don't know what to do anymore. Have read several past post from years back and have seen pretty much the same thing over and over.
Over the past 10 years I have tried Zoloft (was first med), Paxil, Wellbutrin, Effexor (briefly), Lexapro and probably one or two more that I can't remember anymore. Also, anxieties were not as severe then as they are now.
Had really looked into maoi's, but because of my allergies, I have to rely on allergy and cold medicines alot and to be honest, I don't see where they work for an extended period of time either. It seems like they take longer to find proper dosage with several weeks of ups and downs and they have just as many side effects, just maybe different from ssri's. (maois would have to be my very last resort). And do they really work all that much better in comparison to ssris? Honestly? I see them pooping out on people here all the time also.
There was also a 3 year period when I wasn't on any meds at all and was O.K. up until last February when the anxieties started back and then things slowly progressed into major anxiety and agoraphobia and fear. I feel like something triggered this and shot me into this flight or fright response and now I can't get out of it.
Looked into 5-htp, doesn't seem like it works all that well either. Has anyone had a good experience with 5-htp? Do you really think that after being on anti-depressants that we always have to be on them? Are we then in a continual search to find something else when one poops out?
When anxieties and fears are as extreme as mine, does that mean a low seratonin level? I remember when I first started taking Zoloft years ago, it mellowed me out so well, but I was only taking it to control anger, not for anxiety.
Now my anxieties are so through the roof. Racing thoughts start about an hour after I wake up in the morning and stay that way until I take a xanax to stop them for a period of time, but do not want to build up a tolerance to them because other benzos are not as effective for me. Pdoc just started me back on Zoloft at my request, but have just now gone up to 50 mgs, so not really feeling anything as of yet. I asked for it because it still seems like the one that is geared toward anxiety, depression and phobia.
The only time I am calm is when I take 1.5 xanax at night and 15 mgs of remeron to go to sleep. I also take 200mgs of L-theanine and 750 mgs. of GABA. (I think I read somewhere that I shouldn't be taking GABA).
Can't take more remeron as it makes me feel horrible and I start getting nasty side effects. (headaches and ringing in ears)
Am I just going to be spending the rest of my life chasing a med to stop this? Have tried CBT also, which was a joke considering how intense I am right now. Have tried meditation, which I still do and it helps briefly, reiki, you name it as far as trying to calm down the mind thing.
These anxieties and fears did not get bad until this last year. So I know at some point my brain was capable of dealing with issues. I can't figure out what happened and why anti-depressants aren't working, but I do feel like I just need to find a way to retrain my brain.
My thought when all of this started was to get on something to make all of the anxieties and fears shut down long enough for me to work things out in therapy, but I can't seem to find anything to make them stop at this point.
I read on some previous post about permanent brain damage from meds. Really? Can our brains ever heal on there own? When I was reading up on the 5-htp, from what I read it is supposed to bring seratonin levels back up naturally. Is it worth a shot or should I just stick it out with the zoloft? I have to ask myself is it worth going through this torture everyday of shaking and constant paranoia for about a year to see if my brain can straighten itself out or am I permanately at the mercy of relying on meds the rest of my life that might or might not work.
I also take plenty of vitamins and supplements. Have always been a major health nut so getting the right supplements is not the issue here.
I am starting Neurolinguistic Therapy tomorrow. I found a therapist who is willing to come to my house. I've read alot about it and it seems like it is intense but is supposed to be geared for symptoms like mine. I am willing to try anything at this point.
Don't get me wrong, I'm not giving up, maybe someone could give some suggestions. I admit that I don't have alot of patience at this point because I just want my life back. It seems like everything was ripped away from me so suddenly and my life came to a dead halt. I at least would like to be able to get out of the house without a panic attack. I want my motivation back. I want to want to do things again like clean my house, or go for a walk, or get dressed and put on make-up. I wasn't depressed until all of this other stuff started. If I can get past this other stuff, I think the depression part will lift on its own.
Please, if someone has advice tell me. (Sorry if I sound whiney. I'm actually just really pissy).
Thanks!
Courtney
Posted by Phillipa on April 2, 2009, at 18:39:32
In reply to Is there any hope?, posted by Cseagraves on April 2, 2009, at 18:03:23
Courtney have you ever added a mood stabalizer into the mix with the racing thoughts could you be bipolar? What do you think? Love Phillipa sorry you're so miserable. I do know the feeling.
Posted by Cseagraves on April 2, 2009, at 18:59:41
In reply to Re: Is there any hope? » Cseagraves, posted by Phillipa on April 2, 2009, at 18:39:32
Hi Phillipa,
I have tried Lithium orotate. I know that I am not bi-polar. It didn't seem to help the anxieties much, but would be willing to try it again if I could find something to help stablize the anxieties.
Courtney :-)
Posted by TriedEveryDrug on April 2, 2009, at 19:55:09
In reply to Is there any hope?, posted by Cseagraves on April 2, 2009, at 18:03:23
Abilify took a huge chunk out of the desipramine-induced SAD/GAD I had. (I was taking 2mg or so).
Have you tried that?
Posted by desolationrower on April 2, 2009, at 20:28:34
In reply to Re: Is there any hope? » Cseagraves, posted by TriedEveryDrug on April 2, 2009, at 19:55:09
I don't know muhc on allergies, but i htink the main drugs are all antihistamines, which you can take on MAOIs. And i suppose i can't help but be biased but i think they are much stronger, and the long-term side effects are lower.
antipsychotics can help too if everything is just TOO MUCH.
what has helped the most that you've taken?
-d/r
Posted by Cseagraves on April 2, 2009, at 20:30:36
In reply to Re: Is there any hope? » Cseagraves, posted by Phillipa on April 2, 2009, at 18:39:32
Looked up some mood stabilizers. Lamictal looked like a maybe. It got better reviews than Depakote. Seems like side effects are less and would help quiet the mind down if I need it. Will give some more time for Zoloft to work.
Abilify is a anti-psychotic, correct? I've taken seroquel before and had awful reactions so not real wild about another one, but glad it worked well for you.
Thanks,
Courtney
Posted by Garnet71 on April 2, 2009, at 20:52:31
In reply to Is there any hope?, posted by Cseagraves on April 2, 2009, at 18:03:23
Hi,
I really feel your pain, really. I've been in that fight or flight like you describe 24/7 for weeks--months-at a time without treatment. It sux. It uses up all your body's energy to maintain that state-it's exhausting.You mentioned you eat very healthy-do you exercise? I'm sure you understand how that helps anxiety, but just wanted to know whether or not you do. Not the the easiest thing to do when you are in panic mode-especially if you have to venture outdoors. I actually took my Xanax with me on the trail today to walk.
You know when I was at my worst w/anxiety-not sure if this was a coincidence or not-I had been taking a multivitamin w/green tea extract for several months. Like I said, not sure if that affected me, but be careful with your supplments. Have you gone to a psychiatric nutritionist? That might be your best bet. I can't afford one or I would. I don't trust takng supplments I choose for myself--there are nutritions who specialize in the psychology realm...
Yeah, I remember not being allowed to take Xanax (which I don't like to take long term either) and was told to do slow breathing and meditation--yes it is a joke when you are in panic mode.
I'd stay on the Zoloft a little while longer. It's real strange how SSRIs take away my anxiety. My problem, and you didn't mention if you had this or not, was that they also take away my motivation, dopamine. Since you didn't mention this effect, you really should stay in it a bit longer w/the Xanax, then hopefully quit the benzo. Even the Prozac took away anxiety that severe in 2 days. Don't give up on those yet. IF they work for anxiety, you can augment w/something for any subsequent effects if they are not too bad.
You didn't mention if you went for blood tests. That really is a must.
Like you, I've also gone med free for some time, then it comes back. I don't know what the answers are. I do remember though when I was going to psychotherapy with a very experienced PhD - I was med free for a while w/o anxiety. Don't know if this was a coincidence either-but I think psychotherapy is a lot better for severe anxiety suffers than CBT. One therapist tried to help me CBT with panic attacks. It turned out I could no longer see her, because just her trying to help me - focusing on my anxiety - would trigger a huge episode. lol We'd then move outside and walk through the neighborhood, but that didn't help.
Well, for temporary help, I can recommend one thing - take a hot bath in epsom salts. I used to dump 1/2 a carton (the 1/2 gal size) into the water. It's the only thing that put a dent in my anxiety when it was that bad.
I really hope the Zoloft works for you. Please hang in there. :))
Posted by Garnet71 on April 2, 2009, at 20:59:20
In reply to Is there any hope?, posted by Cseagraves on April 2, 2009, at 18:03:23
I forgot to mention - you said how it disappears then comes back...I don't know the circumstances behind your PTSD, but I can tell you something that I noticed and let me knwo what you think.
When I got my worst anxiety ever, I mean adrenaline explostions in my chest and not sleeping for days - it was when my life suddently became easier. No stress-no money problems, my son was doing well, stable home, no boyfriend, no major troubles. The first time in my life I was stress free, it started. I then realized I had been in mini fight or flight most of my life prior to that. I could not adjust to a 'normal' life. Now everone has stressors-but on a scale/tests that I took where you answer yes/no to a long list of items- I had levels that said required hospitalization, but lived like that for years. Well, that's how it initially started. Since then, its varies.
Just something to think about. Did it recently progress because things started going well for you?
Posted by Garnet71 on April 2, 2009, at 21:21:29
In reply to Re: Is there any hope?, posted by desolationrower on April 2, 2009, at 20:28:34
>MAOIs. And i suppose i can't help but be biased but i think they are much stronger, and the long-term side effects are lower.
d/r,
I could have missed the posts, but I don't see too many taking MAOIs for GAD/panic disorder. Do you mean MAOIs for that too?
It seems to me that most are using those for depression-atypical, treatment-resistant, maybe periphial anxiety; like I said, I could be wrong...but even though depresson/anxiety can be interrelated, it seems to be alot different treating symptoms that manifest mainly as anxiety/panic attacks as opposed to symptoms that manifest mainly as depression.
Posted by Cseagraves on April 2, 2009, at 22:21:30
In reply to Re: Is there any hope? » desolationrower, posted by Garnet71 on April 2, 2009, at 21:21:29
Hey Garnet,
Exercising. Believe it or not, I use to exercise all the time. Walking several miles per week and we have a whole gym set up down stairs which I used religiously and loved. Since this started, I will actually start having a anxiety attack at just the thought. I have no idea why. Forced myself on my treadmill one day and was totally freaking out within an hour after finishing.
I think my body is so drained that it only fatigued me more. Have had blood work back in November. Everything showed O.K. Was tested also and diagnosed with adrenal fatigue, so doc said I couldn't do any major work outs because it would stress my adrenals even more. So I have to take things slow and build back up. Just slow walks and maybe some yoga, but have lost so much motivation at this point and am so agoraphobic, walking outside terrifies me. If I could just keep trying to push myself and get my but out onto the street. Sounds so stupid. I don't understand it.
My experience was the opposite. There had been a lot of stressful situations building up to the point before everything in my life locked up and it was a particular situation that was kind of like the cherry on top that caused the total breakdown. I am a chronic worrier and I allowed myself to get emotionally involved with things that I should have kept at a distance. I feel like at that point my stress level just went into overload and topped out.
I agree so much about how the physical stress that accompanies the constant adrenal rush just wears you out.
Had considered maoi's because of suggestions here, but for me, I need to try some other things first, because like I said before. I was never depressed before. Only got depressed because my life has become so altered now. Sux!
Thanks for all the advice. Will keep pushing forward.
Courtney
Posted by desolationrower on April 2, 2009, at 23:58:06
In reply to Re: Is there any hope? » desolationrower, posted by Garnet71 on April 2, 2009, at 21:21:29
> >MAOIs. And i suppose i can't help but be biased but i think they are much stronger, and the long-term side effects are lower.
>
> d/r,
>
> I could have missed the posts, but I don't see too many taking MAOIs for GAD/panic disorder. Do you mean MAOIs for that too?yes. They're pretty much the best drug for anxiety/depression type things except for psychotic depression. I don't think theres been much testing on them specifically, some of the specific disorders weren't created until after they had fallen out of favor, and at the time benzos were still considered good treatments, so there wasn't much need for much else for anxiety. Panic used to be treated with tcas and maois.
> It seems to me that most are using those for depression-atypical, treatment-resistant, maybe periphial anxiety; like I said, I could be wrong...but even though depresson/anxiety can be interrelated, it seems to be alot different treating symptoms that manifest mainly as anxiety/panic attacks as opposed to symptoms that manifest mainly as depression.
>well the 'atypical' specifier refers especially to 'rejection sensitivity', and some of the evidence for them shows those with comorbid anxiety respond better.
i think phenelzine would be a really good idea, its just not worth it to keep trying drugs that don't work. there might be others (clonidine would be quite good for the fight/flight too, but its not an antidepressant), but its a good antidepressant too. A benzo would work too, but even alprazolam isn't a strong AD, and surely thats been tried by now?
-d/r
Posted by Garnet71 on April 3, 2009, at 7:24:44
In reply to Re: Is there any hope?-)MAOIs, posted by desolationrower on April 2, 2009, at 23:58:06
Courney, now would you trust a guy who doesn't give eyes to his smiley faces?
So what do you think? Okay-you go first. If you don't suffer, then I'll try it.lol But seriously- I'd consider trying it if my plan B doesn't work, but I'm afraid of that weight gain that comes with it.
Other people have written numerous times about taking the benzo Klonopin long term for anxiety and that it is safe to take regularly. Did you ever consider that? I was started on that when I first got severe anxiety but it was too sedating for me.
I'm like you-I don't have depression either, except as a byproduct of anxiety.
Posted by myco on April 3, 2009, at 11:30:48
In reply to Is there any hope?, posted by Cseagraves on April 2, 2009, at 18:03:23
Courtney, hun...check your email :o)
Posted by Phillipa on April 3, 2009, at 20:06:53
In reply to Re: Is there any hope? » Cseagraves, posted by myco on April 3, 2009, at 11:30:48
Only anxiety here also. For years low doses of benzos worked right away no waiting either. Love Phillipa
Posted by Zyprexa on April 4, 2009, at 23:15:18
In reply to Is there any hope?, posted by Cseagraves on April 2, 2009, at 18:03:23
I think you should take zyprexa. I have anxiety, PTSD, racing thoughts. You need something that will calm your mind, and the one pill I fully belive in is zyprexa. If not zyprexa you might try a anti-psychotic of some other kind.
Posted by stejoel on April 6, 2009, at 22:28:33
In reply to Is there any hope?, posted by Cseagraves on April 2, 2009, at 18:03:23
I have tried nearly every medication available and for me the best for controlling constant worrying has been Luvox. I don't think it worked wonders for depression or anxiety but if you just want to end the obsessive thoughts that caused the depression and anxiety then I would definitely recommend this medication.
Posted by Phillipa on April 7, 2009, at 19:36:38
In reply to Re: Is there any hope?, posted by stejoel on April 6, 2009, at 22:28:33
How high was your dose? Love Phillipa
Posted by stejoel on April 8, 2009, at 7:12:14
In reply to Re: Is there any hope? » stejoel, posted by Phillipa on April 7, 2009, at 19:36:38
> How high was your dose? Love Phillipa
Around 250-300mg, don't remember exactly.
This is the end of the thread.
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