Just need an e-hug

[Citydeer]

Having the worst week with my anxiety in months. I increased from 50mg sertra to 75mg a week ago yesterday, all was fine for the first few days and then I came down with a head cold. I've now mostly recovered in the past 1-2 days from the head cold but my anxiety is horrendous today. I feel shaky, nervous, sick to the stomach, exhausted, close to tears and have been having the most vivid nightmares... I had intended to up my dose to 100mg today as planned with my GP but I don't think I can go through with it right now.

I get confused because surely if the small dose increase was going to give me any side effects, it would have done so in the first 1-2 days... not the 6th day. Maybe it's just my head cold that made my anxiety worse and not the increase at all

I'm glad it is nearly the weekend at least. I hope everyone has a good one x

[Bigboyuk]

Citydeer and you here's a Virtual hugCheers

[panic_down_under]

I get confused because surely if the small dose increase was going to give me any side effects, it would have done so in the first 1-2 days

Not necessarily as it can take nearly a week for sertraline plasma levels to build to the new steady level.

Maybe it's just my head cold that made my anxiety worse and not the increase at all

It may well have done. An immune system in overdrive can trigger or worsen anxiety and depression. In several respects, anxiety and depression are immune system disorders. People on immune system boosting meds like interferon to treat viral infections and some cancers are now often also prescribed a SSRI because of this. Immune system proteins can also reduce the effectiveness of antidepressants.

And as requested

[Citydeer]

Thanks, both

3 panic attacks this weekend, just going to keep pushing through and hope things get better..haven't been this bad since i first got mentally ill six months ago. took 5mg valium earlier tonight during my panic attack, it didn't do anything (which is annoying because i don't think i take it enough to build up a tolerance, only around 2 times a week) so a few hours later I took another 2mg. I feel a bit calmer now but my arms and feet are still tingling which is weird and a new sensation.

I don't really understand the thing about the blood plasma levels, I thought that after a week that it is a good thing to reach the new steady level, as that is usually the time it is recommended to increase again?? if i'm only just starting to get the side effects now, should i wait longer than my dr said to increase to 100mg? i'm worried my panic might shoot through the roof if i do..

[panic_down_under]

I don't really understand the thing about the blood plasma levels, I thought that after a week that it is a good thing to reach the new steady level, as that is usually the time it is recommended to increase again?? if i'm only just starting to get the side effects now, should i wait longer than my dr said to increase to 100mg? i'm worried my panic might shoot through the roof if i do..

No, there is no advantage in delaying upping the dose. My point about the plasma levels is that it may take a while for levels to reach/cross your individual side-effects trigger point. They don't necessarily start immediately.

[MyNameIsTerry]

I've had colds when at my worst and sen my anxiety greatly reduce. Then when the cold ends, the anxiety rebounds back very quickly.

So, another possibility is that if you are like me, the illness might have killed the anxiety off in the early stage where the med is building up to steady-state. Then the cold abates and being at steady-state brings the side effects back into play.

From my tme here reading threads on the meds board I've seen people who suffer more in the period leading up to steady-state but also people who were fine in that period to then find they struggle once reaching steady-state. I really wouldn't put too much on this, side effects are just expected in the first weeks.

[Citydeer]

I've had colds when at my worst and sen my anxiety greatly reduce. Then when the cold ends, the anxiety rebounds back very quickly.

So, another possibility is that if you are like me, the illness might have killed the anxiety off in the early stage where the med is building up to steady-state. Then the cold abates and being at steady-state brings the side effects back into play.

From my tme here reading threads on the meds board I've seen people who suffer more in the period leading up to steady-state but also people who were fine in that period to then find they struggle once reaching steady-state. I really wouldn't put too much on this, side effects are just expected in the first weeks.

Interesting! Why do you think your anxiety is less when you are sick? Because your body is too busy dealing with the new illness? I ended up feeling a bit better the week following my cold, so I upped from 75mg to 100mg - which was now a week ago. All was fine for the first 5 days but the past two nights I have had bad anxious sleeps..v unfortunate as I normally sleep right through like a baby. So perhaps you're right about the side effects coming post steady-stage. Either way I hope it calms down soon, 3 months now since I started on 50mg and I had hoped by this stage I'd feel even a slight improvement. Had a panic attack tonight watching tv at home out of the blue... so ridiculous. I've had such an enjoyable week both at work and socially. Seems like it's only when I'm not busy that I get panicked, but I don't want to live my life distracting myself just to get by.


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[MyNameIsTerry]

This probably explains my experience:

https://www.psychologytoday.com/blog...he-common-cold

Having a crossover into a short mild depression like period would mean my GAD symptoms decreasing. On my med I've had loads of mood swings (solved later by high strength Omega 3) and during the low moods much of my GAD would decrease.

But I've also seen people on here say the opposite, colds trigger anxiety. One factor in this is going to be HA as those sufferers are bound to see new symptoms and start to fear everything up to cancers & brain tumours, which I've seen plenty of on colds posts. But I wouldn't be able to say I've seen more anxiety with a cold limited to HAers alone.

It sounds like you are one of the people who finds the side effects come more as you reach more stable levels of a med. Reaching this point means a more constant volume in your blood plasma so it makes sense this is when side effects would be more expected.

I know it's distressing and demoralising but try to hang onto the fact you can have good periods. That gives you a head start compared to if your anxiety was 24/7.

[Citydeer]

That article was really interesting Terry. It still blows my mind how the body and mind are so connected. What brand of omega 3 supplements do you buy in the UK? I've started taking wild fish oil from holland and Barrett, as well as probiotics.

I think the increased dose of 100mg Sertra has helped, I've been on the higher dose for 3 weeks now (having started on 50mg 3 months ago). I find it hard to know whether to attribute my mood improvements to the meds tho, how do you really know it's not other changes in your life that have helped?! I have also actively controlled my thoughts for the first time this past month, and been in a stable routine for the first time in a long time. So maybe it's just that which has helped. Guess I'll never know. My anxiety is definitely very minimal on a day to day basis lately though.

Had a panic attack last night though, it wasn't as bad as the type I used to get before sertra. It was purely physical, I got really worked up because my partner hadn't come home yet from a night out and I hadn't heard from him so I was worried he was hurt or something, I threw up, violently shook for 10 minutes then I was fine again. I am surprised this attack was still able to happen on Sertra, I thought it would have prevented that escalation. Or maybe it's just helped my overall mood. The attack was definitely less intense mentally than the ones I used to have pre serta. Now instead of feeling like the world is ending or that I was going insane or dying, I just felt really physically sick.

Sorry I know no one will probably be able to make sense of what I'm rambling on about. Guess it just feels good to write it down somewhere. Hope everyone has an excellent weekend xx


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[panic_down_under]

What brand of omega 3 supplements do you buy in the UK? I've started taking wild fish oil from holland and Barrett, as well as probiotics.

The EPA (eicosapentaenoic acid) fatty acid seems to be more important than DHA (docosahexaenoic acid) so if you can find a brand with a higher EPA to DHA ratio for around the same price as the others that would be the one to go for.

Also fish oil can go rancid if not handled correctly before being capsuled so, imho, it pays to cut open a capsule from a new batch to check the freshness. The oil should have a mild fishy smell and taste. If it has a strong odour it has probably oxidised. Rancid oil is a health hazard.

Had a panic attack last night though, it wasn't as bad as the type I used to get before sertra. It was purely physical, I got really worked up because my partner hadn't come home yet from a night out and I hadn't heard from him so I was worried he was hurt or something, I threw up, violently shook for 10 minutes then I was fine again. I am surprised this attack was still able to happen on Sertra

Antidepressants don't, or at least shouldn't, block appropriate anxiety and the attack may have been a normal reaction in the circumstances so don't beat yourself up about it. The recent dose increase may also have played a part.