Anxiety Mamas - a ?

[BlsdMama]

I love someone who deals with anxiety - high anxiety.  And she's been through a lot of trauma this year with the loss of long awaited babies and just stress.

 

She's been prescribed meds but she's super anxious about actually taking them - like addiction, how she'll feel, etc.  I think these are all very legitimate concerns but her anxiety is really changing who she is and how she functions.  I'm all for the meds if they help, kwim?  But what does one do about anxiety about anxiety meds?  And are there non- addictive meds?

 

 

[Pawz4me]

I've been on Lexapo for anxiety twice. The first time I was on the brand name, the second time was several years after the first and a generic was available. I took it each time for about a year due to very stressful life events. I had zero trouble coming off of it either time. Anxiety can be debilitating, and it often feeds on itself (as in your friend being anxious about medication). But IME the right medicine is a truly wonderful thing that can give you your life back. 

[Guest]

I would tell her she can worry about the dependency issues, if there are any, once she has control of her life and body again. The benefits to her probably far outweigh the risks. And some medications are more gentle than others. Hugs to her!

[BlsdMama]

She's just a really strong person and I think she thinks this makes her weak.  Honestly?  Honestly what she went through this year could have killed some people.  Her anxiety is the result of something that would have crippled a normal person.  I wish she could see herself with the eyes I see her with.  :( :(

[MotherGoose]

Any SSRIs, which is what she's likely to be prescribed, are not addictive. They do not make you feel high, they make you feel normal. There will be a withdrawal period if you stop taking therm suddenly, but it's not like an addiction. People who are addicted to anxiety meds are on Valium, Xanax, etc., which I would imagine she's not being prescribed unless it's for the very very short term to give the longer acting meds time to kick in. Valium and Xanax make you feel more like things are great and I can deal with it, even if that's not true. I'm not familiar with the latest in anxiety meds, but I would imagine she's being prescribed things like lexapro, Effexor, Prozac, Paxil, Zoloft. Those are not addictive. They make your brain able to shut off the crazy anxiety response long enough to deal with life in a rational manner, not in a crazy high manner.

[GoodGrief]

I don't have anxiety, but have much experience with multiple close family members who deal with the issue.

 

Honestly, the meds CAN be a problem. They are not a magic elixir, there can be weird side effects, and doctors are not always great about helping people work through this stuff. Her concerns are warranted.

 

On the other hand, untreated anxiety can become paralyzing. If she is relatively recently postpartum, that adds another level of complication.

 

Is she doing any talk therapy specific to the problem? In my experience, learning specific coping skills from a specialist is absolutely the most helpful thing one can do. Judicious use of meds with a provider that is willing to do the hard work with the client to figure out what is helpful or not is a great adjunct. Tossing meds at the problem with no other therapy is treading on dangerous ground.

Edited August 25, 2016 by Gr8lander

[poppy]

Anxiety messes with the ability to be rational. Once she is on the meds, it will be easier to assess their value.  I know that sounds like a crazy thing but it is really honestly true.  Many, many women take them short term. I feel it's a little like miscarriages: everyone knows a few women who've experienced it, but no one talks about it. (Which is, of course, reasonable, especially for miscarriages.... BTDT).  Just saying, it is normal. It's a treatment that is known to be effective.

 

I would encourage her to ramp up slowly BUT take an effective dose for her issue...... not the bare minimum.

Edited August 26, 2016 by poppy

[heartlikealion]

I don't really understand how anxiety meds work. I mean, if I'm anxious about something, does the medicine just make they physical aspects of anxiety subside? Wouldn't I still be anxious about it if I have my reasons? I was recommended to take them but haven't. I totally get being anxious about it.

 

 

[sbgrace]

If she has been prescribed an SSRI, it isn't addictive. Paxil can have some weird stuff coming off, so it's not a great first choice in my opinion. She will feel less anxious and be better able to make treatment choices, like cognitive behavioral therapy, after she has medication. It doesn't have to be forever. The SSRI's do take a while to work, hopefully the doctor made that clear. Things like xanax do have addictive potential, and need to be short term. Hopefully her doctor is talking about an SSRI instead.

 

Heartlikealion, there is a physical component to anxiety. The medication will help that and lessen the anxiety, so coping with whatever circumstances and getting help/learning coping mechanisms such as through Cognitive Behavioral Therapy will be easier for you once the physical component is less.

Edited August 26, 2016 by sbgrace

[gardenmom5]

I have a very anxious kiddo. as in debilitating anxiety.   I take him to a naturopath, so we do supplements.

we've played with a few over the years to see how he reacts, some are more effective than others.

now, we've got him on a cocktail that has been phenomenal for him. (observers have noticed the difference.)  another anxious (and super skeptical) child started taking the same cocktail and admits it's helping.

 

these are non-addicting, safe for a child - and work.

 

douglas laboratories ashwagandha 600mg 2x per day  (this brand has a higher percentage of withanolids than others.)

pure encapsulations bacopa monniera (they were in conjunction with each other.) 1 @  2x per day

 

if it's anticipated he'll have a particularly stressful day - I give him gaba and l-theanine.

 

we've also recently started him on phosphytidylserine in anticipation of a major transition.  (non-soy).  she wanted him to take integrative theraputics, but at 500mg 2x per day, the cost was prohibitive.  I've got him on it, and I've noticed he is thinking more clearly.  still playing with brands and getting his dose up. (start low)

[gardenmom5]

 . Paxil can have some weird stuff coming off,

 

I've talked with people I know irl who've have absolute horror stories of how difficult it was to get off paxil.  (one girl had to open the capsule, and count the grains and reduce by one each day.)  I think it's over prescribed for what is chemically not what it is meant to treat.

I was on it for 18months.  I would start having side effects (heart palps, etc.) - would reduce my dose,and the effects would go away. for awhile.  it was my body's way to telling me I wasn't tolerating it.  even though all the literature says you need to stay on ssri's for 24 months to prevent a recurrence, my body simply said "you're done".  and I had to quit.

the heart palps were in addition to an absolute INability to sleep.  I was exhausted, so tired I wanted to cry and i. could. not. sleep!  killed the libido too.

Now, I take 5htp.  I'll stick with it thanks.  (I have a genetic predisposition, plus hypothyroid. glare.)

 

[luuknam]

Things like xanax do have addictive potential, and need to be short term.

 

They don't *need* to be short term. But if they're long term there is the potential for increased tolerance, i.e. the same dose becoming less effective over time. And of course dependence. But both are avoidable if you don't take them all the time. You could probably take xanax once a week indefinitely without ever having one of those issues (but I'm not a doctor). Long term use of benzodiazepines can cause other problems though (memory issues etc), but for some people that trade-off is worth it. If I take klonopin every day for a week or two it seems to reduce my baseline anxiety so I then need it less often for quite a while. Of course, some people are more likely to become addicted to, well, anything, than other people, so if there's any (family or personal) history of alcoholism or other addictions it's probably better to stay away from the benzodiazepines.

 

Aside from SSRIs, there's also buspirone, which works in only about half of all people, and because of that is prescribed way too infrequently imo. It's also not addictive. There's also hydroxyzine, which is an antihistamine, and also not addictive.

[HSmomof2]

They don't *need* to be short term. But if they're long term there is the potential for increased tolerance, i.e. the same dose becoming less effective over time. And of course dependence. But both are avoidable if you don't take them all the time. You could probably take xanax once a week indefinitely without ever having one of those issues (but I'm not a doctor). Long term use of benzodiazepines can cause other problems though (memory issues etc), but for some people that trade-off is worth it. If I take klonopin every day for a week or two it seems to reduce my baseline anxiety so I then need it less often for quite a while. Of course, some people are more likely to become addicted to, well, anything, than other people, so if there's any (family or personal) history of alcoholism or other addictions it's probably better to stay away from the benzodiazepines.

 

Aside from SSRIs, there's also buspirone, which works in only about half of all people, and because of that is prescribed way too infrequently imo. It's also not addictive. There's also hydroxyzine, which is an antihistamine, and also not addictive.

I agree that the benzodiazepines *can* be used long term, if used carefully. I have horrible PMS- related panic attacks. I take a very small dose of klonopin for 5 days/month. I've done this for over a decade and never needed an additional amount or had any tolerance problems. I also doubt this small amount will cause any long-term problems, but it has greatly improved my quality of life and ability to function during PMS.

[Guest]

In side effect land I'd take a benzo long before an ssri, for what it is worth. It depends on the specific characteristics of the anxiety as to what medication will be a good fit but truthfully when you're so debilitated you can't get out of the spiral the drugs become like an oxygen mask - they give you a chance.

 

She may find she likes them longer term or just as needed with flares, but feet of side effects and dependency can come with the anxiety and become a really sick cycle of needing the meds and being afraid of the meds all at once. I still would try everything before an ssri because of how they totally mess up seratonin signaling in the brain, but that's me.

[gardenmom5]

years ago, a dr gave me xanax to "use as needed".  so, one day I'd take it, and the next I'd be twice as bad.  the guy actually made me feel like he thought I was a hypochondriac.  I was in really rough shape at the time too.  I needed someone else to help me find a dr who'd actually help. the next dr put me on paxil - and I was on it for 18 months.  I had issues with it, but it helped stabilize me.

[luuknam]

years ago, a dr gave me xanax to "use as needed".  so, one day I'd take it, and the next I'd be twice as bad.

 

FWIW, I've met psychiatrists who don't like xanax for that reason. Xanax has a shorter half-life than some of the other benzodiazepines.

[mellifera33]

I don't really understand how anxiety meds work. I mean, if I'm anxious about something, does the medicine just make they physical aspects of anxiety subside? Wouldn't I still be anxious about it if I have my reasons? I was recommended to take them but haven't. I totally get being anxious about it.

 

There are lots of different meds used for anxiety, with different mechanisms, some of which are still unknown. If you have external stressors causing anxiety, meds can take the edge off, but they would mostly get you into a headspace in which you can work on the stressors using some type of coping technique. For something like OCD, where the reasons are anxiety are some type of mental glitch or getting stuck, the meds can tamp down the constant obsessions enough for therapy to work. 

 

For panic attacks, I actually prefer to use a class of drugs that hasn't been talked about here, beta blockers, because they do work strictly on physical anxiety symptoms. At this point I know what panic attacks are, I've had them for years, so I find the physical symptoms annoying rather than panic-inducing. They seem to come in clusters, so I use the beta blockers to "reset" my body back to normal. 

 

 

Edited August 26, 2016 by mellifera33

[poppy]

I don't really understand how anxiety meds work. I mean, if I'm anxious about something, does the medicine just make they physical aspects of anxiety subside? Wouldn't I still be anxious about it if I have my reasons? I was recommended to take them but haven't. I totally get being anxious about it.

 

When I was at my worst, I would think for about 14 hours a day about how it was very likely I was going to die of ______.

For example, as a child, I thought I'd die of nuclear fallout poisoning or asbestos exposure.  (Was not actually exposed to asbestos).

Doesn't matter that these were irrational fears.  They were still always there, constantly humming in my mind.

Or I would be afraid whenever my parents drove off, they'd like be kidnapped.  Or drive off a bridge and drown. Every time they left I would watch their car until I couldn't see it anymore so I could remember the last time I saw them.

 

I had fears as an adult I don't want to talk about because they can still trigger if I  think about it too much.

 

Technically this is OCD. 

 

You say "If I have my reason"- well I put off treatment for years because I thought it was smarter to be on my guard rather than numbed to the risks in life. HA!  I was numbed to life because of my fears. 

 

Yoga, meditation, diet changes, didn't work, adding "failed to self treat" to the constnat dread.  For me? SSRIs made life bearable. They changed everything. I can see what's worth worrying about  and what I can discard because there's nothing I can do about it.  People who say they wouldn't use them, haven't walked a mile in my shoes. 

[GoodGrief]

 CBT therapy is a standard first treatment.

 

If CBT isn't helping after 12 or so sessions, it's entirely appropriate to look at meds.

 

Meds can make it possible for CBT to be effective.

 

Ask me how I know! 

 

I agree :-) Unfortunately, docs are quicker to use the meds first (for one thing, it can be tough to identify a provider for CBT, the client often gets overwhelmed with the identification process, and generally docs aren't going to do that work for them.)

[MomatHWTK]

Anxiety about the meds is keeping her from taking the meds that could help with the anxiety. If she goes on medication and improves, she can talk to her doctor about easing off. It is VERY difficult to know you need the medication when you are at the bottom of the pit.