Tuesday, December 2, 2008

The anxiety medication dilemma

I had an appointment with C. yesterday. Like last week, she mentioned medications again. Not really so much for depression, but rather anxiety and to help me clear my brain.

It's an understandable suggestion. I've made some progress of my original goals in seeking her counsel, however, it's
very slow. She knows and reminds me I only have ten sessions through insurance, and she wants to be able to help me. I can of course continue to still see her after ten sessions, it's just I'd have to pay out of pocket.

The last few weeks, I have not thought much about the whole future/career oriented decisions in my life. I'm sure part of it is avoidance (though I
know I need to get a grip on it), but really it's that my mind has been more riddled with holiday stress and guilt. My father's wife even wanted to pay a plane ticket for me to visit at Christmas. I politely said no and responded that I may be able to visit at New Year or in January when things are less busy.

Even though I haven't had any more
meltdown sessions, maybe that is part of my fear--that that will happen again. I know this issue isn't going to go away nor is it getting better. This is especially evident since my anxiety has increased which for me just ramps up my exercising habits. It doesn't even make sense, because I'm not really even thinking about it and my dad has surprisingly not brought up the issue in three weeks. That's a record for him since every conversation normally started out with "so have you thought more about your future? Have you put those applications in for grad school?" I told this to C. and how I knew it was really difficult for him not to say anything, and her reply was "so what," reminding me it was not of my concern.

In the past, I've been on anti-depressants unsuccessfully. No, I haven't tried every one in the book, but enough to feel hesitant about them. I've only had major side effects from one, but the rest didn't do anything for me. Maybe it was dosing, maybe it was impatience, maybe it was all the wrong psychiatrists. I know I could easily just go to my nurse practitioner whom I see for just routine check ups and ask for prescription A or B and she would hand it to me without any questions. That can be a good and bad thing--a) you get what you want, but b) it might not be what you need per se.

So righ t now, I'm sitting on the fence. I told C. I'd think about it--week number 2 here for that same line. I know she is hoping I give it a try, at least to perhaps speed up the process and let me think without such an overwhelmness if nothing else. However, with anxiety medications (not immediate ones like Xanax), they take 8-12 weeks or longer to kick in. My impatience with medications doesn't bode well for this fact.

Her goal for me, or at least what she feels like she can to do help me is to have all the information there (I've made a list of many options) and BREATHE, rather than having everything simply float around in my head which at the moment is where it is.

I told her that somehow I felt like I should be able to "tough" this out. Her reply, "
I think you've already done that. You've toughed it out enough."

As I left and was still saying how unsure I was of medications, her reply was, "
what I know is that you don't want to be in this place any longer." So the truth, but so hard to move out of the box.


Kim said...

I completely understand your dilemma. Like you, I could use some help in the anxiety department. Things aren't so bad that meds are an obvious solution. It's presented to me as something that may "take the edge off." Sigh. I've also tried antidepressants before and have had horrible results. I'm told that's because my problem isn't with serotonin (which is what SSRIs address); it's with dopamine. I guess lots of studies link anorexia and dopamine, so maybe there's something to that. Anyway, let me know what you decide. Whatever you decide, nothing is set in stone. Good luck :)

Tiptoe said...

Kim, thanks for sharing your experience and thoughts. I have read about the dopamine/anorexia link. But Drs. still go the SSRI route which recently proved to be just as good as the first generation meds according to a few studies.

I still haven't decided yet. I think there is some part of me that offers hope for a medication to work, but another part that doesn't want to have to deal with the waiting time. That, and just the pure anxiety of even calling a psychiatrist takes a lot out of me as well.

Anonymous said...

I wish I could be of help with this one, but I think the meds issue is always a very personal choice based on circumstance and luck. Luck being the operative word.

I've been told numerous times that I have a problem with anxiety, but the most amusing thing is I actually have very good anxiety coping mechanisms, and only get anxious around psychiatrists, and from being on numerous unsuitable pills and potions!

It's a tough call, and i don't think using a med to help a problem is weak or unnecessary provided it is an adjunct, not a mask to the problem. If there seems no reasonable way of being able to declutter the things in your life which cause you anxiety, then perhaps a little medicinal help whilst you get back on your feet might be of use. That said, if you have a life filled with an unnaturally large amount of stressers, then anxiety is a natural defence mechanism, no?

Lola x

Gaining Back My Life said...

It is a tough decision to make; I chose to go on them because my panic attacks were throughout the week, sometimes more than one a day. It has made a HUGE difference in my life. My Dr. even suggested taking 1/2 when I woke up in the middle of the night unable to sleep, as my thoughts were racing.

Finally, after trying I don't know how many meds, I can sleep most of the time. But every body is different, and it's a personal decision. Don't let the 'stigma' of having to take another med bother you, though. Quality of life is what the end result is all about.

Tiptoe said...

Lola, I agree that adjunct therapy is the way to go than solely just medication. And I'd definitely be doing something like that.

I do have stressors in my life (who doesn't really?), and anxiety, well, could be looked at as a defense mechanism. Though I think it's what you do with it--does the anxiety help me move past the stressor or just keep me in place?

GBML, even though I'm all for no stigma and all, I still feel funny about meds for me. You're right that quality of life is important.

Kyla said...

hon, you are in a tough situation. Meds are so different for everyone, so I can't tell you what to do. I can tell you that I was very resistant to taking them, but when I ended up "giving in" they helped me a lot. My dietitian compares it to a diabetic not taking her insulin. BUT I absolutely sympathize with your reservations and will not judge your decision either way. That said, my journey with meds has not been perfect. I've done my share of switching around to find the right prescription, which is a pain. Like I said, it's diff for everyone, whcih I'm sure you know...I hope you are able to come to a decision that brings you peace and wellness.

Tiptoe said...

Kyla, thanks for sharing your experiences. Meds are tough decisions. I'm still weighing the costs but leaning towards meds as an option, maybe hoping I could find a good psychiatrist I actually liked and got along with.