View Full Version : Medication or not?
I decided to place this thread here because I wanted to raise a concern of mine to those who do and don't take medications.
I know some people wouldn't be without their ad's and I'm sure that if they feel more capable as a result of taking them then that's all well and good as we all just want to be able to get on with our lives by whichever means suits us best.
It's when anxiety sufferers are prescribed medications but they feel worse as a result that concerns me.
I know that when an anxiety sufferer goes to see a doctor, the doctor feels they "have" to offer something to ease the symptoms so they look up their ad's as being the quick option because to treat anxiety long term means therapy which often they can't prescribe because of long waiting lists.
However, ad's do often alieviate anxiety symptoms allowing a sufferer to feel better able to cope but I do feel they mask the underlying issues like putting a plaster over a septic wound because it's only when the wound is treated that the problem heals completely.
Anyway, that's a side issue to the point of this thread. What concerns me is IF or "when" medication side-effects mimic anxiety symptoms leading us to believe it's actually our anxiety that's got worse.
To give you an example of my concern.....
A person finds themself under a lot of stress at work and after a long period of trying to cope with the stress, they suddenly suffer a panic attack. They can't see what's caused this so they go to see their doctor who as a quick fix can only prescribe an ad. The person then goes away thinking this pill will then cure them of their panics and anxiety but for weeks after they feel worse. They put it down to their anxiety thinking that they must be really ill so they go back to the doctor who then increases their ad dose.
The symptoms though get worse. They feel more anxious, feel palpitations, can't sleep, feel agitated, get headaches, have nightmares, suffer diarrhoea, nausea, abdominal pains, a dry mouth, sweating, dizziness, loss of appetite, confusion, hallucinations, shaking, pins and needles, feel more depressed, even wanting to self-harm or feeling suicidal etc which the anxiety sufferer attributes to their original anxiety when in actual fact ALL of those problems listed above "can" be caused by side-effects of their medication. If you don't believe me, read your leaflet and I Know that some, if not all, will be listed on there.
I know side-effects "don't always occur" and that some people do find they help, and it's not those I have a concern about. It's when side-effects mimic anxiety symptoms confusing the sufferer into thinking they need a higher dose because they're getting "more" ill when they're not.
You see, going back to my example, the sufferers anxiety was brought by the stress of their job. They may end up losing the job but then they are no longer suffering the stress from their job either so they may not even need medication but the medications can actually make someone feel they Do need them. It becomes a spiral and a trap because once we start down the road of medications IF they don't suit us, we can end up feeling worse as a result and also find it difficult to stop taking them.
For those who don't know me, I have tried Alot of medications and I found that for example diazepam caused my panic attacks, seroxat caused me nightmares and pins and needles etc. I found that once I gradually came off them I felt much better because by then all the issues that had been causing me stress had long since past. I feel quite sure it was the medications that prolonged my anxiety symptoms because they only ever lifted my mood but never cured my anxiety.
Please don't misunderstand me though because I do know that medications DO help some people and that they CAN help. It's when they have a reverse effect that worries me because reading peoples posts on here I can actually see that it is "possible" that their symptoms are being made worse by their meds.
A couple of additional thoughts to consider - what is anxiety? Anxiety is "worry". Worry is caused by "fear". Fear is caused by "stress". Stress can be caused by events in our past or in the present such as in our jobs. How then can a med cure us?
How do meds work on anxiety? They're called anti-depressants for a reason - because as the name suggests they lift a persons mood which is why I feel they work best on someone who is feeling "clinically depressed" rather than feeling depressed due to anxiety.
What I'm trying to say is don't view medications as a cure because the causes to anxiety are created by our own minds caused by lack of confidence, sensitivity, too much stress in our past or present etc.
I'm just trying to raise awareness to the fact that meds "can" mimic anxiety symptoms which can force us down the wrong path so that we end up feeling worse and not better.
The reason for this new thread is because I read a post by "LONELY" and I realised that all the symptoms described "could" be being caused by their meds.
I don't want people thinking I'm against meds though because I'm not when they are actually benefiting people. It's just when the side effects mimic anxiety symptoms and so mislead people that concerns me because they "can" end up preventing a sufferers recovery.
There was alot of talk about Seroxat and the harm it "can" cause. The same I feel "can" be said of other meds.
Finally, as an example, take a look at these side effects for venlafaxine and you'll understand my concerns. How many of these "can" also be caused by anxiety???.........
Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain. IBS?
Dry mouth. Tension?
Difficulty in sleeping (insomnia). Worries?
Sleepiness. Worries?
Dizziness. Panics?
Sweating. Panics?
Nervousness. Fear?
Weakness or loss of strength (asthenia). Panic?
Sexual problems. Stress?
Headache. Tension?
Loss of appetite. Nerves?
Weight changes. Worry?
Pain in the muscles and joints. Tension?
Abnormal dreams. Worries?
Agitation and anxiety. Stress?
Confusion. Stress?
Pins and needles (paraesthesia). Panics?
Tremor. Stress?
Awareness of your heartbeat (palpitations). Panics???????
Visual disturbances. Stress?
Abnormal heart beats (arrhythmias). Panics???????
There are others I've not listed.
Don't just assume your symptoms ARE just anxiety and if in doubt, see your doctor especially if anxiety symptoms worsen after taking meds. Like I say though, meds CAN help sufferer feel better. Just be aware that the reverse can also happen.:hugs:
Very insightful post Bill.
I am on meds and have been since October 07. At the time I guess I did need something to get me through, and as you say in your post, I thought take these and I'll be better. I'm now in a position where thankfully the panic attacks are under control but I still experience many of the symptoms mentioned in your post.
Now I wonder is it still the anxiety or are these side affects from the drugs I take ? Would I, over the passage of time, have improved without the medication ? Now I'll never know.
In hindsight I wish I hadn't gone down the meds route, and I guess soon the dr will suggest it's time to come off them and I wonder how I will cope with that.
I think, like many others, that medication should be one of the last resorts after cbt etc, instead of being the first thing offered by so many dr.s.
Regards
Goodlife
Crystaltips
08-01-09, 16:42
I have refused any meds because I want to beat this and get rid once and for all.
I agree with your point about meds being a sticking plaster, and to get rid of anxiety you need to get to the cause of it. I have just started my counselling and I believe in her totally and hope that she can sort me out. I have tried kalms, and found they did stop me shaking at times when it has been bad... But did it really, or did I want to think it had?!
I know my Doctor is rather cross with me for not taking any meds, as I know she wants me back at work, but my counsellor has agree to go along with me. She just says it will take longer....
Anxious_gal
08-01-09, 18:00
I see meds as a band aid in some cases.
but for depression I think meds can really help because sometimes you need medication to get you out of bad spell.
what I don't like is doctor's giving you medication and NO therapy!
thats just crazy! the amount of medication i was offered for my anxiety is ridicules, I wasn't offered or even recommend to go to therapy.
i think no one should be allowed certain medication without therapy, be it meditation class's, positivity class's, counseling, group activities.
thing is there's not much therapy and alternative therapy available in my town!
but i do see a councillor
Crystaltips
08-01-09, 18:43
I started my counselling this week - she said 'I wish I had got my hands on you sooner!'
The doc tried to arrange NHS, but the earliest date was 22 jan - this was from the start of December. I am doing it private now.
great post bill. everything you said makes a whole lot of sense. i know the first time i was on meds that i only got better when i eventually stopped taking them. i went downhill again last august though after about 6 pretty ok years of no panic attacks and what did i do... yes straight back on the meds again even though i had bad experiences with dem the first time. so after taking 20mg of prozac a day for 3 months it was put up to 40mg per day because i was getting worse rather than better. so now they said while i was waiting for that to kick in i should take xanax if i felt panic (which i swore i would never take again after the 1st time because i got addicted to them) and then i was prescribed sleeping tabs for night time called stillnoct which im now also told are addictive. at the moment im not sure what symtoms are connected to what. i would just like to say 2 things to any one reading this... 1. think very wisly before agreeing to take meds prescribed by either a psycs or a gp when its to do with anxiety or panic attacks and 2. just take another couple of minutes to read bill's post again as there is a wealth of imformation in it. kind regards henry
Vanilla Sky
08-01-09, 21:00
Interesting post and probably a lot of truth in it but i feel its a viscouis circle. You feel so bad for days, weeks, hours so if you are given something to stop it, even if it is short term, you take it just for a bit of peace. If you go to the docs in a state what are they meant to do? An unsympathetic doc i went to said she would refer me for counselling, when did i get an appointment... 6 weeks later.. what was i meant to do for the next hour never mind the next 6 weeks... when i did get there i went for 6 sessions and it never helped me one little bit. Perhaps if the gp had given me something to calm me i may have been in a better frame of mind for the counselling. It transpired that the counseller spoke to my gp because she felt i wasnt responding and then i was offered medication. I suppose that gp was being cautious , i understand that but i went through hell and i did need something to ' get the ball rolling' . So i feel that meds are nessecery in a lot of cases of anxiety and depression. It needs to be monotored carefully by our gps and i feel that doctors need more training with mental health issues. Some of them need more people skills as well. I do see what your saying about meds but whats the alternative? Paige
Hi GoodLife. You picked up on the best points in the opening post which has saved me a lot of typing for once.
I can partly from experience and partly as a devils advocate throw up some reverse arguments though:
I used to work in a high stress environment and was mostly OK with that. I now beleive that this active-stress (as opposed to frustration-stress) actually blocked the anxiety that was underlying some of my problems at the time. I repeated this recently when a period of high stress and unavoidable planning & organising blocked a lot of my current GAD. Which has returned now the active-stress is far less.
Similarly there were some situations that threw me into a strong depression in June which completely immobilised me. The Meds (escitalopram) seem to have eliminated that depression only leaving me with stress and anxiety. I also concluded during some brief CBT that the anxiety is the starting place for me and is why I concluded that I had underlying GAD. For fortunately (?) some write ups of escitalopram suggest it is benefitial to GAD - so it should be helping to some degree by now with the GAD as well.
I suspect the worst issues with prescription of meds is that the doctor looks at someone displaying (and reporting) some of the symptoms from depression, anxiety, stress, panic-attack, "attacks of panic" (which I see as different), and phobia. They usually just throw a med at it. Almost any of the illnesses can lead to some or all of the others. The secondary illness may be more obvious than the original one too. The NHS also pushes them to prescribe the an obvious and cheap medication. I count myself as lucky to be given escitalopram rather than citalopram - but on the flip side some sources and doctors claim there is no difference even though the maximum approved dosage is very different. There are meds that are better with each of the illnesses so the doctor and NHS are probably failing us all more by prescribing at random or on price rather than finding the best drug for the underlying problem of that patient!
On the flip side in many regions you may not get CBT on the NHS, or it may be a long wait. I got an initial interview fairly quickly and by a quirk of fate joined a group course the next day! But that was still a month or two after I saw the doctor. If someone is immobilised or has to cope with something they will gain from a pill quicker than they will get any other help, even if we recognise that an SSRI takes weeks to stabilise and give a reliable benefit. The course also only lasted six hours and probably only 5 of that was real after allowing for tea breaks and exit surveys. And thats it. Job done according to the NHS.
Coming off pills is another minefield. Many GPs seem to get the process wrong. Years ago my Dad was left on Ritalin for many years. Then they got obsessed with getting him off them. By then he was both adicted and emotionally dependant on the pill. It also seemed to work for him! But the edicts now said get him off it might be adictive. Well duuh - it was too late and so they made a pensioner keep going cold turkey. It never worked and even when he was free of the pill he was never really the same again. So this tale cuts both ways - both take care coming off and take care at what you take for an extended period.
Pills are not the answer - they are a a tool. Used well tools are good. Used badly tools are dangerous.
fantastic post bill. i couldnt agree with you more. i do believe also that med are not the answer in allot if cases.in my case i think meds have made my anxiety worse
debera
x x
freakedout
09-01-09, 01:02
Thanks for the post Bill,
I will read it when I havent got the attention span of a fly!
Freaky
Thank you for the replies. They've made interesting reading and have raised some good points.
I think one of the problems regarding mental conditions is that they are "invisible" and as a psychiatrist once admitted to me, it was trial and error to determine exactly what I was suffering from.
in the same way, this invisibility also causes the stigma with others who have never suffered anxiety like us.
If someone injures themselves or comes down with an illness, it is far easier for the doctors to prescribe something they know will cure it but when it comes to conditions such as anxiety it becomes far more difficult to treat so in some ways I sympathise with doctors because they want to help but the only 2 options they have are medication and therapy.
What Paige says is quite right. When we feel really ill, we often do need something to alleviate the symptoms so that we are better able to then tackle the underlying issues causing our anxiety so I would agree that if a sufferer feels they do need something then there's bo reason why they shouldn't be allowed to take a med because it could be what they need to get through the intensity of the anxiety at the beginning.
Some people find they can function much better taking a med long term and that's not a problem because it's a personal choice and feeling well enough to cope by whatever means is all that really matters.
What I feel is wrong is when sufferers are "left" on them without the therapy they need and then their anxiety is made worse by the med side effects that mimic anxiety making them think and feel they're more ill than they actually are.
My own feeling is that at the outset people have the option of meds or not. If they feel they do really need something then something should be offered. If they actually feel a benefit from them then they should be allowed to keep taking them (the modern non-addictive types) until, if or when, they feel they want to try coping without.
I think meds can be a great help in the short term as Mishel says. Longer term I feel is more debatable for a couple of reasons. Firstly, anxiety always occurs for a reason and once those reasons are tackled such as stress at work or issues in our past, then the need for meds may no longer be actually necessary. Secondly, although meds can be of benefit and these days non-addictive, we can actually become addicted to them because our anxiety then creates a fear of attempting to cope without because psychologically we've become reliant on them as a "safety net" and so attempting to come off them can raise anxiety levels making us feel our anxiety is returning which is something Goodlife has highlighted....I guess soon the dr will suggest it's time to come off them and I wonder how I will cope with that.
Of course there is the other debate as Crystaltips says...I have tried kalms, and found they did stop me shaking at times when it has been bad... But did it really, or did I want to think it had?! The same could be said of meds - how much our mind plays a part. However, I do feel that if someone feels they just can't cope without, then there's no harm done in trying something, especially in the short term.
I used to work in a high stress environment and was mostly OK with that. I now beleive that this active-stress (as opposed to frustration-stress) actually blocked the anxiety that was underlying some of my problems at the time. I repeated this recently when a period of high stress and unavoidable planning & organising blocked a lot of my current GAD. Which has returned now the active-stress is far less.
Kev, I think what you're describing is what I call "boredom stress". We all need things to keep the mind occupied and a certain amount of stress is said to be healthy but when we don't have enough to think about, our minds will then begin to focus on negative thoughts such as with GAD.
The Meds (escitalopram) seem to have eliminated that depression only leaving me with stress and anxiety. This is what I feel - that we feel more capable because the ad's have lifted our mood so indirectly easing our fear.
Sadly there are still long waiting lists for CBT but I know also it may not suit everyone. I feel that different types of anxiety require a different therapy. For instance, CBT could be used for agoraphobia, counselling for emotional stress and a psychologist could help with work stress options etc.
My mother-in-law has been left on diazepam for so many years now that she'll never be able to come off them so I can understand what you're saying about your Dad. He should have been left as he was better on them.
Going back to the med debate - I think what you say at the end of your post sums it up nicely - Pills are not the answer - they are a a tool. Used well tools are good. Used badly tools are dangerous. We all should be made aware that meds "can" help and that often we do need their support to get through the worst spells but that they can also complicate matters or actually make us worse. The trouble is it's often very difficult for even ourselves to determine whether they're doing us good or as Debs says not.
Personally, I went through a very bad spell at work and at home and was prescribed ad's. On the whole each of them lifted my mood but the effects never lasted so as a last resort they gave me ECT. Looking back now, I know all of my problems were caused by pure anxiety and that meds actually made me feel worse. A strange thing to say perhaps but "because" I was prescribed tablets, it made me feel I was actually "ill" so I became absorbed in my "illness" looking for ways to "cure" it. It was only a few years later that I realised all my problems were stress-related and that stress had caused my anxiety to be so bad.
These days I cope fine without meds and now I realise there are much better ways of learning to cope with anxiety but that it does take time and meds can play a part on that road to recovery.
One last thing. When we suffer from anxiety, when we're prescribed meds, we are too afraid to read the leaflet enclosed because of all the side-effects listed which reading then triggers our anxiety symptoms. However, if after we start the meds and say we can't sleep, we put it down to our anxiety so then the doc increases the meds! It is SO important to be aware what is being caused by side-effects and what are actual anxiety symptoms because we can end up hindering our own recovery. Of course there is the other issue that often we won't ask the doc when we're unsure because we don't like being a burden but they can't help unless we tell them "everything".
As Kev says, be very careful with meds and try to think if there is an actual reason behind a symptom and if not, tell the doc in case it's the meds. If then you do still feel you need something, another one will be offered until hopefully the right therapy can be provided.:hugs:
Bill
Brilliant first post and second one is good too.
Kevin, dreadful story about your poor father. Citalapram and Escitalapram are very similar medications - Escitalapram (Cipralex) has had some isomers taken out or something so the side effect profile is lower. 10mg Escitalapram is equal to 20mg Citalapram. Doctors are meant to follow NICE guidelines and Citalapram is recommended first drug to try because of its' apparent low side effect profile.
The medication merry-go-round; I've been on it for years. I've tried to come off anti depressants many many times and always had to go back on them. I think all ssris carry a withdrawal syndrome and Seroxat was the worst for me when I went into "withdrawal syndrome" when I came off it.
Hey Bill, you had to cite Venlaflaxine!!! Nah, I'm not worried really, in fact the side effects for me on this med were less than with the oh so wonderful Citalapram.
Side effects of these medications are many and various - drug companies, by law have to report every single adverse effect a patient has complained of. I was told this by the makers of Duloxetine.
In my experience when you complain to your gp/psychiatrist about adverse effects from your medication they usually tell you that "you feel like that with anxiety/depression anyway". This is annoying. I suffered bad side effects with all the meds I have had ranging from being very breathless (plus lots of other nasty effects) with Citalapram - to severe low back ache on Sertraline. When I complained about this back ache to the psychiatrist (my back had been examined by a doctor by the way) - he would not have it that the sertraline was causing it. I actually did my own research on the medication and there were quite a few reports of back ache on that medication.
Having been on anti depressants for many years now I think they stop panic attacks but keep anxiety alive. I don't think that the medications work for me now, certainly not on the depression side - I think I have become immune actually. However, when I come off these medications I am much much worse so I have no choice but to stay on them - for life I guess. Don't anyone tell me they are not addictive because they are.
My advice to anyone suffering anxiety/depression is to do everything in your power to alleviate your symptoms by other means before taking medication. If you have tried everything and you still have a high level of anxiety/depression and you can't cope with daily life then it's time for meds.
I would also advise people to try to come off when they feel they can and not stay on them for long long periods. I think my own "addiction/dependence" on these medications came from being left on the very first one I ever took for too long. What happens then is when you come off you can get withdrawal symptoms - even as long as a couple of months after you have stopped taking the drug. So.............. then you have to go back on the medication. So, it is a medication merry go round so to speak.
If I knew years ago what I know now about these medications I would have been very very wary. I now think that for anxiety Diazepam would be a better choice to give someone in the short term. Yes I know it's very addictive but I do feel it is less harmful in the longrun than anti depressants.
Bill, what y ou say about there being an underlying reason for the anxiety/depression is absolutely right as far as I'm concerned. The anxiety is alerting us to something being not right in our lives that we should act on. The problem is that when you have suffered anxiety for many years you have already developed the "fear of fear" and this now is secondary to the underlying cause. So, you now find yourself inflicted with an anxiety condition and that something in your life that may be making you unhappy is not easy to tackle because your anxiety condition limits you in so many ways.
To sum it up, anti depressants are no cure (my own shrink told me they only stop symptoms getting worse) - they are no magic wands - don't go on them unless you really cannot cope with life.
These medications do save lives and do help lots of people, I personally do not believe that you should suffer acute anxiety - I certainly couldn't and so if a med helps then I say take it. For people who can live pretty normal lives with their anxiety and get by well then I say don't take them. There are different degrees of anxiety and one or two panic attacks whilst driving along a motorway on a dark night does not constitute an anxiety state.
Wow! Yvonne, you talk sense - and lots of it!! You know your meds.
*Hugs*
Yes, Yvonne's many wise words are based on experience so those who are looking for good advice should read every word she's written.
By the way, I only chose venlafaxine as an example because of "Lonely"'s post as the symptoms they listed made me suspect that they were actually being caused by the meds which then triggered my concerns on a broader scale because I could relate Lonely's post to my own past experiences.
You're always praising me Yvonne but you should try reading some of your own posts!!!:winks: :hugs:
The only thing I'd add is that some meds do ease anxiety symptoms but others can make us feel a whole lot worse by presenting new symptoms that then can increase our anxiety levels such as seroxat that caused me nightmares and shouting in my sleep.
Think on this....If you're confronted by a lion, would taking a pill make your anxiety go away or should you find a spear to prove to yourself you can defeat it? After all, our anxieties are created by lions in our modern lifestyles and personal emotional history, and our modern day spears are confidence and self belief in our own abilities.:hugs:
Oooooh that Smiley's a lovely girlxxxxxxxxxxxxx
Bill, when I have the knowledge you do of this illness then I will be a very wise woman indeed. Your posts also come from your own experiences and my god it shows. You can always tell by people's posts whether they have suffered high levels of anxiety and depression by the way they write. Your posts make so much sense because the truth is, you have been there, done it, and worn the T shirt so to speak.
You're right Bill, some meds do ease anxiety symptoms (I'm referring to anti depressants not tranqs) - and some can make the anxiety worse. I am reluctant to increase my Venlaflaxine even if the shrink would agree to it because the Noradreneline in the med could make the anx worse.
Bill, now that lion you're referring to..... I'm going to challenge you a wee bit here (in the nicest possible wayxxx) - IF, confronted by that lion I quickly shoved a load of diazepam down my throat, or if I swigged half a bottle of whiskey then I would, I think, be too sedated to run, get me spear, or do much at all. I would get mauled obviously.
Re; fight or flight: We can't run from the supermarket queue, we can't beat the anxiety with a big stick (cos it's not an object or tiger), we have to stand there and disobey all our human instincts when facing fear. Going back to that tiger which now is the supermarket queue - we have to stand there whilst that tiger is growling and snarling and we have to tolerate it knowing that any minute he's going to bite our head off!!!!!!!!!!!!!!!
I want your comments here Bill because I know you can answer this. I guess we have to unlearn our human instinct to run and just tell ourselves that the lion is only a pussycat.
interesting post bill,
ive long thought and told my shrink that a/d are not really the best for my social anxiety,im on clonazepam which for me is a life saver -gets me out/working/kinda normal if u want to put it that way..the only a/d im willing to try now is nardil,as its been classed as the gold standard for SA. all the other 8 ive triedmade me worse like your symptoms list pointed out.
I totaly agree with the above but going off on a slight tangent I don't understand why all PA's and anxiety tend to be linked to our inbuilt fight or flight response to danger .
A lot of us suffer from symptoms such as Dizziness,Nausia or vomitting,feeling feint - how is that going to help when being attacked by a tiger or whatever ?.
In fact I was in a situation the other day when I had to suddenly defend myself against a crowd of drunken youths but I didn't for a second experience any of the symptoms I would have during a unprovoked PA.
Decca
eeyorelover
13-01-09, 22:50
Anxiety is caused by the brain's reaction to what it perceives as a threat. The sympathetic nervous system takes over and sends out loads of stress hormones so that we would be able to either run or to fight the threat. That doesn't mean that there IS a real threat of danger only that we perceive it to be something dangerous - in some cases there isn't a real danger trigger, for instance when someone says 'I was just sitting there and "poof" a had a panic attack - but somewhere in the back of the mind the signal is still being sent regardless of whether it is a conscious thought or not.
The physical symptoms that we have are a direct result of the chemical changes our bodies go thru do to the release of these chemicals.
Personally I don't take medications because I've had awful side effects and now am a total medication phob!!!
On my own I've been able to face the anxiety head on and make some head way BUT recently with learning more in my college courses I have thought about trying an SSRI to try to balance the serotonin levels in my brain which is supposed to help with panic/anxiety. I still have loads of research to do on the subject so I'm not informed enough to give an opinion on this yet tho.
I do think that meds are a good way to try to get the physical symptoms somewhat under control but in my opinion meds should be used in concert with therapy to discover the underlying cause of the anxiety and address it.
While side effects are a problem especially because they can mimic the physical symptoms that anxiety brings about, the idea of ruling out meds because of side effects seems, to me, to be throwing the baby out with the bath water so to speak.
As with any illness medication is a hit and miss concept. What works for one may reek havoc with another. The same can be said of medication across the board and not just with meds that treat anxiety, but, one would never say that someone shouldn't take medication for a heart condition, for example, due to the chance of side effects from it. The only difference is that treating a heart condition with medication can eleviate the condition itself, I don't believe that medicating anxiety cures anxiety, only, as I stated before, it can be used to get past the physical symptoms so that therapy can take place.
Sorry not replied sooner.
A few points to cover here. Firstly though, I think our minds confuse us so often prevent us from understanding how they're actually working because we feel the symptoms but the mind hides the real causes and so throws us off the scent which in doing so, often creates us more problems than solves. I'll try to explain my thoughts on it.
The question you raise Yvonne links in with Deccas experiences.
Re; fight or flight: We can't run from the supermarket queue, we can't beat the anxiety with a big stick (cos it's not an object or tiger), we have to stand there and disobey all our human instincts when facing fear. Going back to that tiger which now is the supermarket queue - we have to stand there whilst that tiger is growling and snarling and we have to tolerate it knowing that any minute he's going to bite our head off!!!!!!!!!!!!!!!
Deccas question...
I don't understand why all PA's and anxiety tend to be linked to our inbuilt fight or flight response to danger .
A lot of us suffer from symptoms such as Dizziness,Nausia or vomitting,feeling feint - how is that going to help when being attacked by a tiger or whatever ?.
In fact I was in a situation the other day when I had to suddenly defend myself against a crowd of drunken youths but I didn't for a second experience any of the symptoms I would have during a unprovoked PA.
Firstly, it's as Sandy says...
Anxiety is caused by the brain's reaction to what it perceives as a threat. The sympathetic nervous system takes over and sends out loads of stress hormones so that we would be able to either run or to fight the threat. That doesn't mean that there IS a real threat of danger only that we perceive it to be something dangerous - in some cases there isn't a real danger trigger, for instance when someone says 'I was just sitting there and "poof" a had a panic attack - but somewhere in the back of the mind the signal is still being sent regardless of whether it is a conscious thought or not.
The physical symptoms that we have are a direct result of the chemical changes our bodies go thru do to the release of these chemicals.
But I think there's more I can add....
When we take medications for anxiety, we're not actually trying to treat our thoughts that create the symptoms but the symptoms themselves. However, these symptoms are actually "perfectly natural". They occur for a reason as Sandy says to create adrenalin to enable the body to fight or take flight.
However, if we are confronted by an "actual" danger, we don't think about how the chemical reactions make us "feel" because we have no time to "think" because our minds are occupied with surviving the situation. Our "spear" is our adrenalin in this case because adrenalin helps us to survive. It's occurs naturally within us.
However, in this modern age we don't normally have to confront tigers or lions but we often are faced with "real danger". Remember the saying "We often think it'll be worse than it actually is"? It's because the more time we have to "think", the more adrenalin the body produses but without an outlet, the symptoms just get worse until they create panic.
An agoraphobic will often experience panics when they try to go out, not because there is an actual danger to face, but because in their minds they have created a "lion" because their lion is their fear of panic which isn't "real". The symptoms "feel" real and "are" real" but it's the mind that has created them from a "perceived" danger being "a fear of feeling fear" (feeling anxious symptoms).
What I feel we are actually trying to do when we take meds is to stop anxious symptoms because they frighten us. However, what happens when we're about to take an exam, go for a driving test? We feel anxious because we fear failing. So what's the difference? Well, an exam or a driving test are actual "events" which once over, the anxious symptoms subside because the fear has been confronted and is now past. They are in a way "modern day lions".
Whether it's a lion or the dentists, we will still experience anxiety symptoms but often we take meds because the symptoms in themselves frighten us even though they happen for a perfectly natural reason but our minds confuse us into thinking we're "ill" when we're not! The symptoms will subside naturally once the fear or event has past.
However, I can hear you saying "what about the supermarket"? Well, this is where the mind also confuses us. When we're in a supermarket there is no "real" danger but we react in the same way as we would in the dentists or on a crowded bus. The reason is because we feel "trapped" which you could still call a "lion" because it creates fear but the lion "isn't a real event".
To try to explain, if our minds become overloaded with stress, whether it's due to stress at work or home, this stress creates a lion within our minds by causing fear and thereby creating the adrenalin we would need if we were faced by an "actual lion or event". The trouble is that because it's not an actual event, the adrenalin remains in our body and so it builds up with nowhere to go because we can't use it to fight or take flight.
We also have "time to think". This thinking time makes us focus on the symptoms that the adrenalin creates and the more we dwell on how we feel, the more we bring on panic because the adrenalin gets out of control.
The next time we are in a crowded place, our minds then have an automatic response because the original anxious symptoms frightened us so much thus creating our fear of experiencing fear which in actual fact is a normal reaction to "stress". It's just that in this modern age, if we are confronted by "daily lions" at work, the body builds up so much adrenalin where nowhere to go that we become on constant alert which is then triggered in situations where we feel "trapped".
However, it's not just stress at work or at home that can cause panics. It can also be stresses from our past that have created "emotional stress". Again though, this stress causes a "sensitivity to crowded situations" which is different from "actual events".
If we have time to think, we will focus on the symptoms our minds create through a rush of adrenalin but if we are suddenly confronted by a lion, we won't have time to think. We'll use the adrenalin to fight or take flight.
When we're in a supermarket or experience a panic attack for no obvious reason that we can "see" such as a lion, the symptoms that our minds create frighten us into thinking we're "ill" Because we can't see an "actual danger" and that's how our minds confuse us.
Therefore, because we feel so ill, we see the doctor who then tries to prescribe medications which are actually trying to counteract the adrenailn the mind produces "naturally". In other words, it's like trying to stop ourselves blinking!!! The difference being, blinking doesn't scare us but an adrenalin rush does. We just don't realise that anxious symptoms are natural and are being created naturally so the mind confuses us into thinking we're ill. It's really nerves that have grown out of control due to bad experiences or constant stress.
This fear of being ill then creates more adrenalin causing us to feel even more ill making us worry even more producing a cycle.
I know some will say there is a difference between panics and nerves before an event and there is but in actual fact the only real difference is that panics are produced by nerves that have got "out of control" because the causes are created by irrational fears and worries in our minds or by constant stresses in our lives rather than an actual lion or event.
Sensitivity, lack of confidence, bad experiences, perfectionism, being a worrier, all play their part. This modern day world creates alot of stress in so many ways and when we have a vulnerable makeup, these stresses will often end up in creating our panics but our minds make us think we must be "ill" when the reactions actually occur naturally. It's because in this modern day that we have great diffilculty releasing our stresses that we experience panic because they've grown out of control which frighten us into thinking we're ill and so feeling we need meds for something that is produced naturally.
We often use meds as our way to cope with the daily stresses that actually cause our panics but if we could live on a desert island we'd probably lead much more relaxed lives so never feel "ill" enough to have to take meds.
I'm not sure if everyone would agree with what I've said but it's what I believe to be true having suffered panics, stress and personal lions myself so I hope at least something in there makes some sense.:hugs:
tigger1964
14-01-09, 07:17
Hi Bill,
I to have chosen not to take medication this time round due to the fact that the last time i tried so many anti depressants that didnt work and i ended up on diazepam and it took ages to come of them. I have had this over 15 months now, and i am lucky enough to be receiving cbt on the 26th Jan.
Bill
Now that's what I call a reply. Superb post, utterly brilliant in fact.
The way you explain it Bill in easy to understand language and every word is complete fact. You explain so well how anxiety comes to claim us when we've suffered too much stress and how the mind then reacts to the symptoms it so hates.
I do think however that when anxiety and depression are out of control and a person is not functioning normally i.e. not eating, sleeping having constant anxiety then they must be helped. Medication is the only answer because people cannot tolerate their symptoms and if these symptoms are so severe then what damage is that doing to the person.
Meds do have to be used when a patient is acutely anxious or depressed - this is to prevent the patient from getting any worse and maybe harming themselves or whatever.
The meds are not good long term in my opinion - and i should know - then again what else can a doctor do. A bad migraine cannot be tolerated by someone and so they take a pain killer - the anxious depressed patient is also in great pain.
One last thing, the lion that comes to get you in the supermarket although only perceived is causing the same fear symptoms - telling oneself that he isn't real does not work when anxiety is built in as it is for most of us.
Anyway, that's all - just to repeat what I said earlier - that man Bill doesn't half know his stuff.
For Bill xxxxxxxxxxxxxxxxxxx
I resisted meds when my anxiety was acute as I just didn't want to be 'that person' - however in the end it was brought home to me that I needed to take them (albeit briefly) to break the cycle of panic, worrying about panic and then some more panic!
I have only ever used them to get through a single day, rather than as my solution to anxiety and I do think that I'm all the better for it.
To get control of the anxiety you have to treat it like a physical illness - if you had RSI from typing or a bad back from heavy lifting then you'd give yourself time to get better, then change how you approached things - with anxiety we so often expect to just get better, without making changes to the lives that caused it in the first place! Meds can only help us cope, but they won't stop the causes of anxiety....
I'm sorry, I didn't mean to imply that people shouldn't take meds because I know that when things become "out of control", we often do need something to help us get back on track to ease the worst of the symptoms so that we feel better able to confront or come to terms with the stresses in our lives that have caused the spiral.
I can remember that when I was in despair, taking od's and selfharming, that I felt I really did need something to help me cope and in the beginning meds probably did help to ease my worst symptoms.
It's as we said in the beginning of this thread that it's when people are left on meds and they're gradually increased without the underlying causes being treated that things "can" be made worse, but not always.
For instance, just as Sharon has mentioned, I too was given diazepam and left on it for 3 years with the dose gradually increased to its maximum. If I hadn't asked to come off them I would have been left and probably always remained addicted to them because of their addictive nature.
Diazepam works best as "one off" tablets for when we need something to sedate us but I found that by taking them every day they just lost their effect and I just became addicted. In fact I'm sure some of my anxiety symptoms were actually created by them.
I know diazepam is one of the old breed of medications but I still feel that even the new breed can cause problems in the long term in our attempt to learn to cope with our anxieties.
I just feel there is a failure in the system due to lack of resources where people are left on meds because therapies are so difficult to obtain and by leaving people on meds more problems "can" result or people are left thinking they'll always need meds when it's possible if an individual wishes to be able to live without meds in the long term once the stresses in their lives are addressed.
I can also remember where I used to work in a large company where alot of staff were taking ad's simply because they were being put under too much pressure because the company wanted to save costs by getting staff to do more than was humanly possible. It was only after I became "ill" myself that I realised just how many others were suffering the same. They were simply too afraid to share because they feared it would reflect badly on them making them less likely to be considered for promotion or even losing their jobs. Making money was more important than peoples health.
I read in the paper today that there is proof that open planned offices make people "sick" because of their lack of "space" for each individual member of staff so the staff become over stressed because of the layout combined with the pressures of their workload.
I can remember reading peoples posts on here saying that they wondered if they suffer from social phobia because of the stress they feel when placed too close to colleagues. It raises the question - do they suffer from social phobia or do they suffer social phobia because of their working environment? I honestly don't know the answer myself but maybe its something to think about if anyone is in this situation? I'd be interested!:shrug:
Anyway, this modern age causes us so many stresses and often combined with our types of personality we sometimes actually make ourselves ill without realising it and then wonder why we feel so ill. For instance, most people on here are probably very conscientious, they want to do a good job and feel responsible themselves so they don't delegate and gradually take on more and more until they become overloaded. The bosses are more than happy to keep loading more work on staff who are willing so sometimes we can be our own worst enemy by not remembering we have limits.
I forget who it was at mo but someone was saying how they felt they were a failure for asking for help. If we don't ask for help though we can make ourselves ill by taking on too much.
Once we forget our limits and feel too ill to cope we're forced to take sick leave which possibly could be prevented if we say "no" to more work than we can cope with. I know though that sometimes it feels impossible but my view is which is more important - our job or our health?
Sometimes if we're in a job that is making us feel ill, rather than consider medications, we should look for a job where we'd feel happier. I think though that often fear prevents us from making change so we become too afraid to try another job because the present job makes us fear we couldn't cope. Also to change jobs means learning something new and to change is alot of hassle we feel we can't cope with.
It's curious that whether we're in a job feeling over stressed or in a relationship feeling the same way, that often the years of constant pressure can make us feel too ill and incapable to make changes so fear keeps us suffering under the same boulder which is why I think change should be made sooner rather than later because with time it feels too difficult so end up taking meds instead to cope with the situation fear stops us from changing. I guess I should know!
telling oneself that he isn't real does not work when anxiety is built in as it is for most of us.
Sorry, gone off at a tangent! There is a saying dear Yvonne "It is never too old for an old dog to learn new tricks!" (No, I'm not calling you a b...h!!!:D ) I believe with the right therapy, taking the right measures, making changes to our lifestyle and tcorrecting the way we think, it is More than possible to learn how to cope with anxiety - it often just takes time! I know you won't believe me though! lol
Picture this......you're walking along a street when you see an old injured dog. You try to approach it but it snarls and growls at you. If you try to get too close, it tries to bite you so you call the RSPCA who capture it and take it back to their kennels. Later you find that this dogs injuries have been caused by mental and physical abuse by its previous owners. You then realise that it tried to attack you out of fear because the dog now associates all humans with pain. However, the RSPCA take good care of it, they feed it and look after it, treat it with kindness, love and comfort, they gain the dogs trust by proving to it that not all humans are evil and that some genuinely do care. The dog gradually begins to realise this and after a year or twos treatment it becomes the most relaxed friendly dog you could meet.
We are no different to this dog and so with the "right" care and treatment we too can rebuild our confidence after years of abuse and neglect.
Human beings with good hearts should never be ignored and allowed to suffer in a world that is often too uncaring to notice the special people who are in need of comfort and support because the world would be a much poorer place to live without them.:hugs:
when the doctor came out to see me at home last week he signed me off work for a week and said he could give me medication, i stated that i don't want it. I don't want to become reliant on taking medication every day. The way i see it is that my head is a puzzle that has broken and all the pieces need putting back in the right place so it can be clear again and no amount of meds can put that puzzle back together.
Please correct me if i am wrong.
C x
Citalapram and Escitalapram are very similar medications - Escitalapram (Cipralex) has had some isomers taken out or something so the side effect profile is lower. 10mg Escitalapram is equal to 20mg Citalapram. Doctors are meant to follow NICE guidelines and Citalapram is recommended first drug to try because of its' apparent low side effect profile.
That's a couple of the things I've found interesting during my reading/research and even in posts here. Some (even professionals) say their is little practical difference and Esc' was only created to protect the patent earnings. Others say that Esc' is much cleaner in terms of side effects.
Interstingly Wikipedia, drugs.com and other sources distinguish between the two in some detail: Esc' is approved for the treatment of major depressive disorder and generalized anxiety disorder; other indications include social anxiety disorder, panic disorder and obsessive-compulsive disorder. Whereas Cit' is listed only for the symptoms of major depression, and sometimes for social anxiety disorder and panic disorder.
As I understand it the biggest difference is that Cit' is available in unlicenced forms (very cheap) whereas Esc' is more expensive as its still under patent. This may suggest why NICE prefer Cit' so much. Online (and not necessarily legally into the UK) the price of an equivalent dose of Esc' is about 150% of Cit'.
I'm sorry, I didn't mean to imply that people shouldn't take meds because I know that when things become "out of control", we often do need something to help us get back on track to ease the worst of the symptoms so that we feel better able to confront or come to terms with the stresses in our lives that have caused the spiral.
Well said Bill. Your posts got better as you went along.
When I went to CBT I described my situation as being like standing a room with a fire starting in the corner. At that point you need some help if you cannot take sensible action yourself. It may not even matter exactly what help it is - so long as its sensible. In that situation its the wrong time to worry where the fire (illness) came from or why, how to put the room back together later or where you could live instead. You need some immediate effective help.
I see you took this thinking on board during your posts, or made your agreement with it clearer. The flaws lie with the system rather than the meds. If a GP has only a few minutes how will they even pick a pill or a dosage for a patient. They either break the rules on time given or follow the NICE guidelines slavishly. The latter is in the interest of the NHS and not the patient. They then leave people on pills for months/years until they randomly sign up to panics that they have to take them off them. By which time its probably rather late and potentially dangerous. In a paid system its probably worse eg. Americans seem to end up with an inexcusable pile of pills or cannot afford any (or the most appropriate) in the first place.
teeshirt:suntanner
15-01-09, 18:27
i was offered some anti-depressants to manage my panic attacks - but when i googled the name and read the list of sideaffects (which my GP did say to be aware of) - when it listed all my symptoms or the experience of having a panic attack (whcih i was having about 3 or 4 a week of) i thought hmmm why would i take something that will make me feel the things i want to avoid more of the time? so i decided to find out more about ways in which i can help myself e.g breathing helps some me
Taking medication or not is a personal decision, and people need to evaluate for themselves what they want to do
Taking medication or not is a personal decision, and people need to evaluate for themselves what they want to do
This is what I've always believed that it is a personal decision whether to take meds or not because it really depends on the individual if they feel they really do need something or feel "ok" enough to carry on coping without.
Having taken many different types of ad, there are issues surrounding meds and the system itself that concern me which is why I raised the subject because I wanted to try and raise awareness of the complications that "can" result because of meds.
One point I need to make clear is that I regard "true" depression as a different animal to anxiety because I feel that an anxiety sufferer will normally suffer from a "depressed state" due to their anxiety whereas "true" depression can exist on it's own. Therefore, regarding someone who suffers from "true" depression, I feel they really should consider taking an ad because I feel they can be very effective for "true" depression. What I mean by "true" depression is when there is no obvious cause to the depression and often this type of depression can present itself in entirely different ways compared to a depressed state brought on by anxiety.
This is why I feel ad's can ease an anxiety sufferers anxiety because the ad's work on improving a persons mood but if the underlying anxiety is still there left untreated, meds can complicate a sufferers recovery.
However, I honestly don't know about the scientific trials as to whether ad's are actually supposed to be effective on anxiety alone but due to my experiences of ad's I just have my doubts.
These doubts combined with the system, I feel could result in confusing a sufferer as to what's actually causing their anxiety and so muddy their path to recovery.
When we have a sudden onset (often due to a long build up of pressures we haven't noticed) we will see a doctor asking for help. We will normally put our faith in our doctor to do the right thing to help us and so sometimes will follow their advice blindly thinking that whatever they offer will "cure" us because we often don't know ourselves what is actually wrong with us. Even the poor doctor will base their diagnosis on what we tell them so if we say we're feeling really depressed they'll prescribe a pill to lift our mood.
I do actually sympathise with doctors because they have limited time and especially in years gone by they were often not trained enough in mental health with their only option being a pill to cure all. Hopefully though times are changing and that more anxiety sufferers will receive the help they really need.
Anyway, once someone is given an ad, they will often presume it'll cure their anxiety so when it doesn't they go back to the doctor who will increase the dose. When things often still don't improve, the doctor will then try another ad until there are no other ad's to try.
My main concern which is why I raised this issue about ad's is as has been said above - i was offered some anti-depressants to manage my panic attacks - but when i googled the name and read the list of sideaffects (which my GP did say to be aware of) - when it listed all my symptoms or the experience of having a panic attack (whcih i was having about 3 or 4 a week of) i thought hmmm why would i take something that will make me feel the things i want to avoid more of the time?
Doctors know about medications and their side effects but often they don't say anything until the patient goes back to complain about a new symptom. However, this is fine when it comes to physical ailments but as has been said above what if the side effects mimc what the patient is already suffering from and that we confuse side effects as being "new" symptoms that we connect with anxiety??? This is where I feel the danger lie but sufferers are often totally unaware because often an anxiery sufferer is too afraid to read the leaflet that lists side effects.
I'm not saying though that this always happens but I believe that it can and does happen on occasions which results in hindering recovery.
For instance, I've read posts on here where people have complained of new symptoms which they then ask if they're normal for anxiety and often they are but because they have only surfaced after they've started taking a particular med, who can really say what's actually caused them so the path can get very confusing and the sufferer ends up feeling worse.
If we really do feel we need a med then I feel its fine to take something in the "short term" but to just be aware that new symptoms "could" be as a result of these meds and so a sufferer shouldn't be confused into thinking they're getting worse.
Personally I wish I had never been pursuaded down the meds route but my "old school" doc who orignally prescribed diazepam for me probably didn't know any better but I did become addicted to them. I've found that the new doctors will often spend more time to try and find out what's really going on and may not be so forceful in pescribing meds because they know they're not the cure and they can confuse things are make thngs worse, but the option is there if a sufferer really feels they need something.
It's sad to say though that to learn to cope with anxiety, we first need to learn the causes and about "us" so it takes time when we really want the feelings to stop immediately so will want meds just to keep us sailing in our every day storms we're trying to survive in.
My best "ad" was my psychologist who showed me a way to safety but everything else I've learnt I've had to learn for myself.
You know...in my teens and even into my thirties, I suffered from anxiety in various forms, OCD, IBS, panics, phobias etc but it was only when my problems forced me to resign from my job when I started selfharming, taking od's, was prescribed ad's and given ECT once etc, that I actually realised my symptoms actually had names!!! Up until then I always thought it was "just" me because I kept it to myself and the subject was never talked about! Crazy a!:shrug:
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