Don't know where to turn next.

[jimmy_blue]

Hi everybody,

This is my first post in this forum, I have had a quick look around the previous posts and it certainly seems like the right place to be. Feels good to be here!!

I was really hoping that someone might be able to give me some advice. My story is pretty similar to many so I'll try and keep it short (I have a tendancy to waffle so apologies in advance!!)

I'm 28 and have suffered from anxiety and panic for as long as I can remember. I started using alcohol to contain social anxiety when I was 9 years old and drugs quickly followed at 11. By the time I hit 25 I was drinking very heavily and in an awful mess. I do not use drugs and alcohol to curb my anxiety any more and haven't since rehab in 2000.

I spent 18 months in AA but eventually had to leave becuase the levels of anxiety I experienced sitting in a crowded room 3 times a week almost killed me!! I have been seeing a CBT councellor for the last 3 1/2 years and have attended regular expatient and group therapy sessions.

Many aspects of my life have improved as a result of all the therapy and I am grateful for that but my anxiety and panic attacks have only worsened. Until 3 months ago I had become totally agoraphobic and my panic attacks seemed to be constant and without provacation.

I say until three months ago because that is when I really hit another rock bottom. I had become so tired of "facing my fears" and "performing breathing exercises" without any improvement to my anxiety that I had really come to the end of the road. Because of my history of substance abuse I had always tried to take a non drug based treatment route but I had had enough and so visited my GP 3 months ago to see what he could suggest. He prescribed an SSRI called Lustral (Sertraline) which I started taking immediately (he also prescribed Diazapam but I refused to take it).

It only took about 5 days for the drug to kick in and since that time my life has turned on it's head. Although I still have anxiety, it's at about 5% of what it used to be. I have enrolled in 2 classes which I am enjoying very much and spend more time out of the house than in (never thought I'd be saying that!!). For the first time in my life I feel normal, what's more, the CBT is now working!!

The reason for this post is because I have been back to my GP today and he now wants to take me off the Lustral!! I don't understand it!!
Anxiety is rife on my mother's side of the family. At the moment, myself, my brother, my mother, my aunt and my grandmother are all on anxiety medication or undergoing treatment. It's pretty clear that this is inherited put it that way!! 3 1/2 years of CBT haven't dented it so why does he now suddenly think it's all going to be better? I'm really worried because I just can't bear the thought of going back to "that place". I respect him and am grateful for his support but I think he is being very short sighted about it. I now strongly believe that this problem is physical and one that is affecting many members of my family.

I really want to see a specialist and get some tests done but I just don't know what area of the medical profession I should be asking or indeed if there are any tests at all!! If anybody could point me in the right direction or has any comments or suggestions about the above I would be very grateful indeed.

Be brutal, I'm used to it!!

Many thanks all

James

P.S. So much for not waffling!!

[Meg]

Dear James,

Firstly huge congratulations for getting off the alcohol and recreational drugs. You succeeded where many have not.

I'm glad to hear that the Lustral has helped you so much. Have you been on on other SSRI's previously ?
Discuss with your GP why he wants to get you off so quickly when you've seen such enormous benefit - the usual recommended SSRI treatment time is now about 18 months.
Are you on anything that could possibly interact with it ?
Does he simply want to taper the dose down to a maintenance dose perhaps ?
Is he concerned that you may fall foul of drug abuse again- but if so you would have grabbed the valium with both hands ...

It's now generally understood that anxiety may be inherited as well as learned behaviour and you certainly seem to have had good role models so both are likely to be the cause

Regarding seeing a specialist for tests - they can do a range of assessments but apart from testing the amount of panic chemicals in your blood at that given time - there isn't much out there. Some centres are now trialing doing brain imaging but it's certainly not a diagnostic tool yet .

I would have thought a further discussion with your GP would be in order- take questions so you don't get put off.
If no help - then see another GP in your practice.
Discuss with your CBT counsellor - if it's an NHS one they can write a supportive statement of your improvements since Lustral.
If it is a NHS one then you're already registered with your local mental health community team - ask to see one of the specialist nurses or docs.

Let us know how you get on.



Meg

Watch your thoughts, they become your words...
Watch your words, they become your actions... Watch your actions, they become your habits... Watch your habits, they become your character... Watch your character, it becomes your destiny...

[jimmy_blue]

Many thanks Meg for your response.

The appointment hit me pretty hard yesterday and set me spinning a little. You made a lot of realy helpful points for which I am very grateful. I deffinately think that I will write a list of questions to take to my GP next time as I always find myself forgetting what I wanted to say (after having practised the conversation for week before hand normally!!)

I'm not on any other drugs and haven't tried any other SSRI's in sobriety (Prozac a few years ago but it was back in my drinking days so I'm not surprised that it didn't have much of an effect)

Your reply was pretty prophetic actually as I heard back from my GP yesterday afternoon that my appointment with a dual diagnosis specialist has been scheduled for Monday. Have been waiting for a few months but it couldn't have come at a better time. Will feel much happier to have spoken with someone a little more specific to the field.

On reflection, I also don't think that I was giving my GP enough credit. He has been very kind and open minded about the whole sittuation so I will deffinately do as you suggest and appraoch him again. He is not planning to start weaning me off for another 2 months so I have a little time to get my head as straight as possible.

Sincere thanks again for your support and for your kind words.

Jimmy Blue