View Full Version : When meds don't work, what else is there?
Hmmmmm...
So, I have great difficulty eating/drinking, due to a few choking episodes within the past 12 months. Lost a ton of weight (not literally) about 4 stones, so far lost 7lbs in the past 10 days. The initial choking was hopefully just a blip, but as I suffer with a panic/anxiety disorder, this has grabbed that situation, and run with it, to a point where I am barely eating or drinking. If Im lucky, and on a good day I am getting between 500-800 calories a day, this is helped with complan which I can get down very early in the morning, as the anxiety hasnt built up as much by 7am.
Been on 2x5mg Diazepam since October, and today its been put up to 3x5mg daily by my psychiatrist. This is due to antipsychotics, ssri's, dosulepin, amitriptyline etc making no difference whatsoever.
I am also not sleeping, so she has prescribed Zopiclone 7.5mg, this is because at bedtime my mind cannot shut off as I am consumed by this swallowing issue. Not sure how long I am to take these for, but I have only been getting 4-5 hours of interrupted sleep a night for ages, and lack of sleep makes me so much worse.
Regarding Diazepam, I would only take 3 per day if needed, I sometimes get by on 1 per day, and rarely none, so no issues with addiction/dependancy as yet.
Anyway, my point is where do I go from here?
My proper CBT is starting next week, I see a speech therapist for it also, I have Physio booked in but waiting for that, think thats going to teach breathing to keep myself calm, and breathing whilst eating. Also having to see my doctor every 2 weeks now due to the huge and constant weight loss. Then Psych every month unless I need her then I can ring.
Is it the assorted therapy thats going to sort me out do you think, or am I going to have to taste every medication there is before I actually get somewhere?
I just dont know where I am anymore, Im sick of trying different meds all the time, and am glad its just Diazepam for now to keep me calm, though I will stop this as soon as possible, and have done so before with no bad effect.
I just really dont know where I am or what im doing anymore, life is becoming a blur of appointments, meds, and anxiety, and I just want to get back to normal.
How long were you on each AD?
SSRI's not too long, they sent my anxiety through the roof and I couldnt cope.
Amitriptyline a month, no effect whatsoever, didnt even help with sleep at 20mg, Dosulepin a week, had to have the liquid version because I cant swallow the tablet, and the liquid causes tongue and throat to go completely numb. Not a good idea for someone with my problems and I couldnt continue it as it made me panic.
Dazza I think the therapies and physio may be the way forward for you. SSRI's had the same effect on me but I am fine with Dosulepin.
the general rule for ADs is if you didn't stick with them for 2 months, you won't have seen it through. Some people take 8 weeks for the meds to start working. I was given meds but, like you but after half a pill I had horrific side effects. I wanted to be better then, not have to wait for weeks to see if it worked so I'm going medication free. I don't really like the idea of meds for myself but other people have sworn by them. If you can get through the anxiety side effects then you would see the effects after a couple of months.
I don't believe people need medication to get better, meds should be used as a crutch as you work on healing yourself. If they don't work then you can still get through it without them. CBT should be great, it helped me loads.
Annie, weirdly I feel worse when taking AD's. With them they make me feel ill, but do not touch my anxiety. With the dreaded diazepam, I feel like the normal me, but slightly less anxious, and I much prefer that, even though it isnt the way forward, at the moment it is the only answer because all other meds just make me worse and have lead to a severe lack of sleep. I cant remember the last time I had a restful sleep, and a good nights sleep always makes the next day easier. Am going to get the Zopiclone tomorrow and give it a try, but will cut it in half, I dont want to get hooked on it.
---------- Post added at 21:52 ---------- Previous post was at 21:47 ----------
The problem is Pancho, they have let this go on for 12 months now, I started to get slightly better last summer, but happened again in October and its worse now than ever. I think SSRI's could possibly help, but the anxiety kills me because it goes through the roof and I cant cope. I did mention to my doctor that if she gave me a high dose of diazepam initially with them, like 20mg morning, and 10mg evening, for a month, then cut down the diazepam in month 2 etc, id probably get through the added anxiety and be ok on an SSRI once its settled into my system, but they wont do it, and if they wont do it then I cant take them because SSRI's initially make me feel like I am going insane, they make me manic, panic, and feel like hell.
I very rarely get more than 5 hours sleep tonight and I am a person who really needs sleep. the more tired I am the more anxious I am. I bought one of those pillows with speakers in and downloaded some sleep therapy music. It has helped me to get to sleep easier but I still don't always stay asleep for long.
I have one Annie, they help me get to sleep, but are no use 30 minutes later when I wake up :doh: My problem is, I wake up around 5am, and feel wide awake, because I know my anxiety is low when I first get up, so I eat/drink as much as possible in the first 30 minutes of waking, then after that the day gets worse. So because I know I can eat if Im up early, its making me wake up all the time, and get up just to eat and drink. I usually cannot eat or drink after around 2pm because the anxiety has built up too much by then.
---------- Post added at 22:06 ---------- Previous post was at 21:57 ----------
With regards to CBT, I cant understand how it works. If I talk about my problems, like I am here now, it makes me feel worse. Im currently struggling to swallow my own saliva because Im here talking about it all, so discussing it at length with my psychotherapist concerns me greatly.
You can't avoid discussing your problems all your life. CBT is about looking at your problems objectively and getting used to the sensations of fear so that you are no longer scared. It breaks the cycle of fear. They will look at your choking problem and how it is related to fear. CBT will also show you how to manage a panic attack. It is the most effective treatment.
Cbt doesn't work like that. It helps to change your thought patterns so you don't feel anxious and feel positive instead. You have trust the process and work hard at it, but it works, believe me. So sorry you are doing it so rough at the mo. Earlier this year I couldn't eat and gagged at every mouthful from anxiety. I also lost some weight. Counselling has helped me. There is a website with some help modules that you can work through at your own time that found amazingly helpful too. I will post a link when I'm back at my laptop. Big hugs your way xx
---------- Post added at 12:18 ---------- Previous post was at 11:25 ----------
Link to workbook modules for you ya http://www.cci.health.wa.gov.au/resources/consumers.cfm
Just scroll down and click on the ones that you think might be useful for you.
Hello Dazza. I can offer you reassurance about CBT. It's true it does involve talking about things we would rather not do. In my experience though, whilst therapy, CBT & counselling have taken me out of my comfort zone at times, I have gained in confidence along the way. Several good things have come of it, not least being able to share my fears with someone I could trust & who always had my best interests at heart. I knew that no matter what I said, no matter how awful I felt or even if I felt utterly stupid, they were there for me in a supportive & non-judgemental capacity.
I felt so much better each time I braved going outside my comfort zone. It helped me feel relief that I wasn't going crazy, that there were reasons behind how I felt. That also I could find ways of changing my heavier & views for the better.
It has been a gradual process in which, if you like, I went on a journey with my therapist or latterly my counsellor. In each case, it happened at a natural pace that suited me. Knowing I had someone to lean on & support me when dealing with difficult things made all the difference.
Although it makes you feel uncomfortable, you are able to explore things in a way you never thought possible. As a result, with the help of a health professional, you begin to understand what is behind the difficulties u r experiencing. Then you can begin to challenge the "logic" behind it all.
Gradually you are able to overcome the difficulties as you become skilled in identifying unrealistic thoughts & behaviours. You learn new, more balanced ways of looking at things & this helps you manage triggering situations more easily.As I say, knowing you have someone behind you as you make this journey really does make all the difference.
I'm really glad you have help lined up. Indeed you may feel bombarded by appointments & at times it'll feel like alot to take in, but you will be moving in the right direction. All the energy you are using just to cope at the moment can instead be used in a positive & healing way for you. I really feel that with the help you are getting, you will be able to make progress.
I could not have managed CBT on my own, even if I could understand the logic, it wouldn't have been possible for me to work some of it out. I suppose that's why it helps when someone points you in the right direction. It really is possible to get better & I found not only did CBT etc help me with the difficulties I had, it has continued to help me ever since.
I have used previously & am currently on fluoxetine. It's benefitted me not only by balancing my moods better but also for anger issues, especially in relation to pmt & my hormones generally. Of course we are all different & one persons experiences with meds doesn't always sound like the next persons. It can take time in that respect to identify what works for each of us individually.
The important thing is that whilst you will no doubt feel let down by all this help taking so long to come (& I believe you have every right to feel that way)... At least now you have help coming & very much the right kind of help. CBT really is beneficial. You will need support along the way so keep on posting here as everyone will be really happy to help you on this journey, not least of all....little old me.:)
---------- Post added at 21:35 ---------- Previous post was at 21:15 ----------
Lilharry; thank you for sharing this link. I just found some really good stuff about procrastination that I am sure is going to be really helpful to me. http://www.cci.health.wa.gov.au/resources/consumers.cfm
Thanks Tessar, thats a lovely post and very informative. You have all offered good advice, and I am really grateful, I honestly think at the moment that I will never get better, which is ridiculous, but rational thought isnt my friend at the minute.
I had an idea that I want to present to my doctor on Thursday, it will take a bit of persistance, and arm twisting, but I think it might help me.
When I have taken SSRI's in the past they make me feel like I am losing my mind, but its because it makes my anxiety shoot sky high, and thats what I cant cope with, which makes me stop taking them, but I have come up with a plan.
I think if I can get past maybe 2 months of taking them, I do believe they might work for me, if not for the eating part (this needs therapy as well as meds) then at least for my GAD, and a little relief from that will help, my mood is so low all the time that I need something to give it a bit of a lift.
Psychiatrist has prescribed 3x5mg Diazepam daily at the minute, but I want 20mg for my plan so bearing this in mind.
If my doctor prescribes Sertraline again, which she will if I ask for it, I think this might help.
Month 1
Morning 1x10mg Sertraline + 10mg Diazepam (to take away the extreme anxiety the SSRI will cause me)
Afternoon 1x5mg Diazepam
Evening 1x5mg Diazepam
Month 2
The same depending on the state of my anxiety caused by the sertraline.
Month 3 - The same, but hopefully down to 10mg a day as the sertraline should be in my system by then and fully working.
Month 4 - Possibly 5mg Diazepam a day if needed.
I would need the Diazepam afternoon and evening because I have been on it for 12 months daily now, so it only gives me maybe 4 hours relief, then the anxiety would surface again. No worries about dependancy though, Im not dependant or addicted yet, and really dont think I will after all this time.
I think this could work, it just means a slight increase in Diazepam to allow the sertraline extra anxiety effects to dissipate.
Anyone think this might help me to get onto SSRI's and allow them to get into my system and help me, by using the higher Diazepam initially to ward off the side effects?
I dreamed up this plan during the early hours because once again I wasnt sleeping.
Link to workbook modules for you ya http://www.cci.health.wa.gov.au/resources/consumers.cfm
Just scroll down and click on the ones that you think might be useful for you.
I just have to say thank you again for pointing us in the direction of this link.
What a brilliant website this is; the workbooks/modules are really packed with sound & well written information from what I have seen at a glance.
I strongly recommend anyone with issues they are struggling with has a look as the site covers many many issues. I have looked at procrastination & assertiveness for starters.
It doesnt matter whether you are in counselling, therapy or not. Because for each issue covered, there is background information about the problem, then it progresses to ways of challenging the issue and maintaining the new skills or viewpoints etc. Even if you just read the explanations & dont work on changing anything, it really is a good insight.
My experience post-therapy is that the more you read about things you would like to change, the better your understanding. I find that topping up what I learned in therapy (including CBT) helps to maintain a balance in my life that might not be there were I to stop reminding myself how CBT works & also that I can still change things I feel might never change for me.
In some ways, learning and reading about conditions is no different to gaining any type of knowledge. Be it something you need to learn to pass an exam or perhaps even trivia that you learn through life which helps you answer questions in a quiz.
Thanks again Lilharry for the tip I really appreciate it.
---------- Post added at 13:34 ---------- Previous post was at 13:30 ----------
Thanks Tessar, thats a lovely post and very informative. You have all offered good advice, and I am really grateful, I honestly think at the moment that I will never get better, which is ridiculous, but rational thought isnt my friend at the minute.
I had an idea that I want to present to my doctor on Thursday, it will take a bit of persistance, and arm twisting, but I think it might help me.
Hello Dazza, I'm wondering how you are now as it's been a few days since you were posting in this thread. I dont know if you got to look at any of the informaiton on the link that Lilharry put up but I am finding it really good. Also I appreciate what you said about my post as I am working on appreciating myself more & I'm starting to keep a note of things where I've been able to help someone. I think I spent most of my childhood feeling useless because my family treated me that was (I was a bit of a target). But now I am introducing a new idea to myself that actually I'm ok. So, lemme know how you are wont you....???!!! By the way, it's nearly the weekend yipeeee......
Hi Tessar.
Just spoken to Doctor on the phone actually, we are trying this meds routine from tomorrow, just off to pick the tablets up in a short while (after Dickinsons Real Deal on +1 lol). She is really pleased that I am willing to try the Sertraline (+20mg Diazepam over the day) I am terrified that they will make me worse, but she said the Diazepam will help ease the anxiety, and we are going to see each other every Friday to assess how its working, so she is giving me a weeks dose at a time. She is very against Diazepam, but Im going to need it to get thru the first month or so of Sertraline, so I am very pleased she can see this, and that I will hopefully get off the Diazepam as soon as the Sertraline has settled. I now hate Diazepam, but will use it for the right reasons this time, then kick it to the curb :)
I bookmarked that link, then forgot all about it :blush: but at 10pm tonight I will be on it, on my ipad in bed, I will be relaxed then and able to take some stuff in.
As for appreciating yourself :hugs:it always amazes me how no matter how bad you lot feel, and what issues you all have, you are still always there for others. We know how crap life can be at times, but we all still attempt to help each other, and that just shows what compassionate people we all are. We all deserve a pat on the back, and we all need to realise that with the help of each other, we will get there one day, and all have great lives :yahoo:
Good Luck with the new meds routine Dazza :) I have heard a few people on sert say how much better it has made them so I hope it works good for you :)
Ive just picked them up Annie, and am feeling very positive at the moment. Fast forward about 16 hours and Im sure I will feel like hell and be climbing the walls :roflmao:but I have to do something other than linger on Diazepam, so fingers crossed. I have finally realised I need to do something for myself, instead of expecting everyone else to pick up the pieces and put up my with moods :whistles: so I am currently hopeful. Cant say I will feel the same this time tomorrow, but who knows eh :wacko:
Will keep my fingers crossed for you and hopefully you won't be climbing walls. Maybe we should send you a Spiderman suit just in case :unsure:
What makes you think I don't already have one :D
Well there you go Dazza...you are organised already, I expect you have a Superman one too :D
Boxers, slippers, dressing gown and cup, but not the full suit. Can't be wearing my pants inside out, that's just weird :blush:
When my son was 4 I bought him a Superman outfit and it is all he ever wanted to wear. I had to wash it while he slept and have it ready the next morning. Now he is 23 and has an adult sized Superman outfit :D
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