What to do now...?

[Mindprison]

Hello everyone, was hoping some of you with more experience than myself could give me some advice.

I'm 27 and have had Generalized Anxiety Disorder since I was 19. It started mainly with health focused worries but the doctor felt that I overthink most things, so generalized anxiety it is.

I went through a really rough patch for those first 2 years, starting on Citalopram 10mg and working up to 40mg while also being on Propranolol for a very short amount of time to get me through the worst of it (cardiac symptoms were causing me the most distress).

From then until now I had maybe 3 panic attacks, two of them severe and one not so much. While the anxiety never really went away and manifested in very mild to moderate symptoms such as tight chest, breathlessness etc, my biggest problem for 4 years was clinical depression due to bullying at work.

While I quit my job last year for health reasons, the doctor felt that citalopram was no longer helping me and suggested trying something else, Mirtazapine 15mg working up to max dose if required.

I've been on them for about 9 months now and the dose has gone up and down like a yoyo, but more on that later.

My anxiety has reached its peak since last December where my health worries began to completely overwhelm me in daily life. I went straight back to the way I used to be when I first had panic attacks and convinced myself that I had every ailment under the sun.

While i've now come to terms with the fact that my anxiety is causing all my current problems and symptoms, i'm finding it very difficult to keep it under control.

The Mirtazapine isn't helping with anything except maybe for my sleep (which I don't get a lot of anyway due to me jerking awake with rapid heart rate and light flashes due to anxiety). And I got it into my head a couple of months ago that I was going to get serotonin syndrome despite me never having it on all the years I was on anti-depressants. This all happened because the doctor prescribed Buspirone, which I didn't take because I read the leaflet, saw serotonin syndrome and catastrophised.

Even now, my mirtazapine is down to 30mg and there are periods of time where I only take it every second day because my anxiety about medication is so bad. I know it's wrong and will probably cause more problems than it solves...but that's the long and short of my anxiety troubles, it's totally corrupted my thought process.

I'm seeing a psychiatrist, explained all my problems right down to the anxiety from taking medication and the solution was to recommend my doctor prescribe me Pregabalin (telling me firmly not to read the leaflet or side effects).

Since that appointment, i've had two major panic attacks, one of them where I couldn't feel anything from the neck down because my nerves were so shot they went completely numb.

To be quite honest, i'm sick of medication, or rather i'm sick of taking medication that I don't feel is helping the ailment i'm suffering from, crippling anxiety.

I once did CBT for depression and while I probably didn't invest in it as much as I should have, I did find it quite useful.

I suppose i'm just wondering what everyone elses experiences are on Mirtazapine and whether i'd be better off on something else, and also if CBT would be beneficial if i've already had it before for something else.

Stuck in a rut here guys and would whole heartedly appreciate any advice you can give me because I feel like i'm just driving the doctors completely barmy.

Many thanks

[Bill]

A little story for you which might sound silly but bear with it because there is a point to it as it's what I feel happens to a lot of people, including me too years ago.

Firstly though, I think health anxiety must be one of the most common symptoms of anxiety these days for what I think is the following reason -

A parrot is flying around in the forest literally as free as a bird but he one day his food runs out so has to venture closer to mankind until one day he's caught and put in a cage.

The owner looks after him by giving him food and water but he no longer has any freedom. The parrot spends all day every day sifting through the seed the owner provides, deciding which is edible and which he has to put to one side. Although he's being cared for by his owner, his only chore is sorting his feed within his cage.

The parrot gets so frustrated that he can no longer be free, he gets very depressed. He tries to ignore his depressed state by attempting to focus on sorting his feed but spending day in, day out just sorting his feed becomes very mundane. He finds himself depressed from loss of freedom and then combined with the boredom of sorting his feed, he starts feeling very stressed because he can see no way out of his situation. He becomes a very depressed and very stressed parrot just surviving in a cage with only a mundane chore to keep his mind occupied.

As time goes by, he finds his mind wandering but not on to happy thoughts because he is feeling so depressed and stressed. Instead he starts looking at his feathers, and one by one he finds fault with each one. He becomes worried by every tiny imperfection he finds in each feather so gradually one by one he starts pulling his feathers out until he becomes a very depressed, stressed and now completely bald parrot.

However, even after he's lost all his feathers, he then starts looking at himself further, analysing every tiny detail about his body from head to feet and finds he just can't help himself.

One day though the owner accidently leaves the cage door open so the parrot hops out and walks to freedom. Well, he can't fly because he's pulled all his feathers out. He hops out of the house and fids somewhere where he feels safe. However, this place he finds safe, he cannot leave because there are too many cats prowling around his shelter so again, although he's somewhere he feels safe, he's still trapped, still depressed, still stressed and still analysing himself.

As time goes by though, his feathers grow back and he finds himself able to fly once more. He takes off and flies back to the forest. He's free and able to enjoy himself doing all the things that makes him happy. In time, he no longer feels depressed and no longer stressed. In fact he's so busy with so many things he enjoys occupying his mind that he forgets all about analysing himself too. He simply doesn't have time because he's too busy enjoying himself.

So, picture yourself as the parrot, going to work doing a job you don't enjoy, that could be mundane, stressful or depressing, finding yourself with too much time to think, dwelling on constant negative thoughts, worries and fears because of your depressed state, longing to be free but when freedom arrives, you find yourself trapped at home with nothing to keep your mind occupied...until one day you find that enjoyable interesting job that keeps your mind occupied.

Anxiety Loves a bored stressed depressed mind. It thrives on attention but it hates the mind that is happy and too occupied enjoying itself doing something that is really interesting. Anxiety can't compete with that.

As for me, I tried most ad's but none had any lasting effect. The dose kept being increased each time they lost their effect and the reason was because the underlying causes weren't being addressed which were my job and home life which were causing me so much stress making me so depressed. Only when I sorted things did I learn how to manage my anxiety.

When we feel stressed and depressed, these feelings make anxiety symptoms and worries feel more real because anxiety thrives on the fuel we feel like that, and that's why I think so many people suffer from health anxiety because so many people feel trapped in jobs that are too stressful and don't enjoy. For instance, how many people look forward to Mondays on here and I would be surprised if there were that many.

One last thought, I do feel medications can help us along the road to recovery but the best chance of finding a way to live without them is to focus on the underlying causes of an individuals anxiety because I feel there's always a cause for everyone. In your case, it sounds like it was the bullying but if you find a job you enjoy with friendly colleagues I think you'll soon find yourself in a happier place. That's what worked for me.

[Panicer]

Hi Bill

Great story and advice, I'll keep the parrot story for future reference :)

[snowghost57]

Bill,

That is an awesome story. I will have to remember this. You know what's really funny? I have a white front amazon parrot. She has been my buddy for 23 years and I'll think of this story every time I look at her.

What an inspiring story to keep our minds busy and not to dwell on our bodies, minds and troubles.

Do you know who the author is or where in originated from? Just curious.

[Mindprison]

Thanks for the replies all!

Really enjoyed the parrot story, a fitting analogy for the struggles many of us face in daily life!

I think I just need to accept that while things are bad now, it won't last forever. The frustrations from this condition have just had me on edge and it's not done me any favours.

Many thanks for the advice, hopefully this story will reach others too as it's a good one!

[Bill]

It was just a little story I made up in the hope it would help others to understand what can happen sometimes. You'll find other little stories I've written on here too if they're of any help to you.

Something I forgot to elaborate on more last night is the following -

Going back to our parrot. When the owner accidently leaves the cage door open, he hops out to escape but because he's pulled all his feathers out he can't fly so he hops to somewhere where he feels safe away from all the cats that are prowling around.

However, this place he feels safe in is actually another cage of partly his own making so instead of being free, he's still imprisoned. Once more he's trapped, afraid to go outside because he can't fly and fears being caught by the cats. Every time he even thinks of attempting to leave his safe place, he feels he can't breathe, has a tight chest and sweats. In other words he feels panic.

His place of safety is in reality his cell where he feels trapped and because he feels trapped he feels stressed and that stress creates tension so he tightens all his muscles up without realising it and that results in panic symptoms. These symptoms then make him worry so he starts pulling his feathers out again because he keeps finding imperfections that worry him so in the end he finds himself in an anxiety cycle that keeps him imprisoned in the place he feels safe which has actually become his new partly self-inflicted cage.

In other words, when we find stress at work becomes too much, we take sick leave to stay home to avoid the stress but sometimes if we stay at home and dwell on anxiety and all the symptoms it creates, we can imprison ourselves in a place where we feel safe by not giving our feathers a chance to grow back because we're constantly looking for something to worry about which is why when we take sick leave, I feel as soon as you're able, you should try to find interesting or enjoyable interests to keep the mind busy. Distraction is one good technique because anxiety hates being ignored.

It's the same as someone walking along the street to work as they have countless times before. They get to work, have a really busy day and come home to relax. Day in, day out, it's the same ritual. Each day they do so well that their boss asks them to do just a little bit more which the person is happy to do to further their career.

One day they go into work, they sit at their desk, start to do what they've always done before when suddenly they feel they can't breathe. They break out in a sweat worrying what's wrong with them but they carry on doing their job. Later that day they have to go to a meeting in a small room, and once more they feel they can't breathe so they make an excuse to go to the bathroom to escape. The small room made them feel trapped because of the stress they're under in their work but they don't realise this.

The following morning they wake in a sweat, fearing that the same things will happen again at work. However, they manage to get to work but again the feelings surface. This time though the person feels too ill to stay so they go home and take sick leave. They feel safe at home but in time the feelings start to surface again and they worry so much about these symptoms that their anxiety starts to control their life. They're now too afraid to go out because of the traumas they experienced at work and the fear they now feel at attempting to leave their place of safety.

From being in a cage at work, they're now in a cage at home.

However, all is not lost because in time with small steps they overcome their fear of going out, and they end up being able to go back to work again. However, this time they have learnt to remember their limitations and the signs when they're exceeding them.

Remember, if we fly too hard and allow ourselves to be pushed beyond our limits, we'll fall out the sky and end up in one cage or another until we learn how to fly again.

Too much stress equals panic. Panic equals anxiety. Anxiety equals fear. Fear equals a cage and feeling trapped. A cage and feeling trapped equals stress...and so on.

Re-building confidence, remembering our limits and recognising signs of panic can help us escape and stay well.