Long time member here, initially because of health anxiety. Close to 8 years ago started Escitalopram (20mg) + Xanax for some time and it took a couple of months but started feeling better (basically they were a life safer). Continued medication for 2-3 years and then started reducing slowly until going off. However after a couple of months started feeling again anxiety/depression. So I've been on/off for the last couple of years. Last time I got off them was 8 months ago after taking Escitalopram 10mg for a couple of months...I was feeling a bit better, but didn't look like Escitalopram was helping much (maybe the dosage was low).

The last few weeks, especially 10 days, been feeling pretty bad due to some bad situation I found myself. It's more depression, especially catastrophic thinking than anxiety. I start imaging the worst and spiraling down as you well know. It's a bad situation and there's a chance things may go really wrong, but if I would be more rational, that chance would be lower than what I'm thinking. Have been taking 0.5mg Xanax and helps a bit, but not much and I'm thinking of starting back SSRI/SNRI.

My question is if there's on medication that works better for catastrophic thinking or not? Would it be better to start Escitalopram (maybe 5, then 10 and then 20mg) or look for an alternative? I can consult a doctor, but my experience has been that my own feelings and feedback from people who have suffered from something similar are better than what a doctor would suggest.

Thanks a lot