Advise needed pronto please

[JosephHitch]

My names Joe,
In the ensuing missive you will see I'm seeking an unambiguous answer to a fairly basic question.But first a brief digression: I'v been taking Citalopram for over a year now ( 30mg) . It's changed my life, crippling anxiety has almost entirely vanished.I'm a new man,well back to the man I was before the dark, malevolent voice of anxiety began to confide in me.
The nature of my enquiry is this. It was my understanding that the SSRI treatment process works as follows: You take the medication until you feel better then carry on taking for sometime until you've recovered fully and then tamper off the medication slowly and your problems should not return ( well the plan is they don't return ). This came up in conversation with my Dr and she said 'yes that's how they work for depression but not when treating anxiety" .She then went on to say that Citalopram or indeed any SSRI just suppresses anxiety and it'll return when I stop the treatment.
So basically that means that how I'm feeling now is not real, just a temporary release ? What ever progress I'v made means nothing as it's only applicable on the drug. This is distressing, I thought I was working towards something? If it's just a quick fix that will go away after stopping taking the medcine what's the point of even starting ? Will I see any benefits if I stop taking the pills or is it like It never happened ? She's really knocked me back abit. My question is really is, is she correct on this ? I dont take gps words on everything, What's your understanding of how the treatment works ?

[Sparkle1984]

My understanding is that as long as you use self-help techniques while you're taking the meds, then hopefully the anxiety won't come back again once you stop taking them. That's why a lot of people do CBT or counselling while they're on the medication, so that they can learn coping methods for the future.
I think what your doctor said is a bit strange - I think as long as you make some lifestyle changes (to reduce your day to day stress levels) and learn coping techniques, you should be fine once you come off the medication.

[potato11]

I think what your GP was (haphazardly!!) trying to say, is that SSRI's are more effective in long-term treatment of depression, as the serotonin levels are improved and thus the person is likely to be happy.

However, if you suffer anxiety AND you haven't learned to alter your actual behaviour (i.e. through CBT, learning not to catastrophise, see everything in black and white thinking etc) then you will faster resume to your old anxious state because the adrenaline and fight/flight mode kick in and quickly make you feel anxious again

I sort of disagree with your GP though as depression may just as likely to return if the person has not adjusted their lifestyle and/or thinking process.

This is why CBT is the gold standard for anxiety treatment. As you say, ssri's lift you up but will not keep you up there. That is ultimately done by you :)

Well done for getting where you are. I recommend the online CBT course in my signature, it's helped a lot of members on here (including me)

all the best to you :)

ps there is also an interesting bit on serotonin and it's purpose/effect on the website "nothingworks" also in my signature. If you don't want to read the whole thing, just click "ctrl and f" then type in serotonin. But I do recommend you read it all, its great

[JosephHitch]

Thank-you. Really appreciate your replies. I had a similar understanding and it's great to have it ratified eloquently by your kind selves. She essentially seem to imply SSRI's do nothing in the long time for anxiety it's just a finite fix.I think her heart was in the right place however these GP's don't realise how their flippant and sometimes ambiguous comments can effect people suffering from anxiety.
Now what I'm mainly concerned with is this sudden horrific revelation Iv read of by the name of 'Prosac Poop-out' or 'Tachyphylaxis' where a SSRI suddenly stops working due to tolerance. I'v only been on about a year and half like I said but now I'v decided to CBT I'm worried this poop out will ocure before I'v have a chance.
You had any experiences with this?
I shall read that link.Thanks

[kittikat]

I definitely agree that a combination of meds and CBT therapy is the key. The therapy will give you the coping stratergies to manage the anxiety should this cause you problems in the future.

You are right that meds alone just mask the issues. Look into self help techniques prior to starting CBT, and remember, we can have a blip at any time too, you need the tools to help you deal with this should it happen.

http://www.getselfhelp.co.uk/index.html

You have done well, stay positive and your best of luck in your recovery.

Kitti :)

[potato11]

I haven't had any experience myself with SSRIs. However, I imagine that it will be unlikely you will become so suddenly resistant to them after 1 year.

SSRIs are basically a way to up the 'happy hormone' to give you a running head start. You can and will overcome anxiety even if you didn't have the aid of medication, through changing your thoughts and lifestyle as required.