Well here we go... 150mg

[Paradise10]

Hi Angie, thank you for taking the time to write a message, I have read other threads on here which helped me so much so I'm glad if maybe mine can help anyone even if it's just a little. Your story sounds similar to mine in places as I was also on citalopram but at 20mg and I had been on that dose and in a good place for years, I had some added stress and my doctor put me up to 30mg and I just couldn't tolerate it at all. That was when I switched to Ven. I had a bumpy ride getting on the ven but I stuck with it and on the whole i would say I am in a good place. As you will see from my thread I have had the odd blip along the way and i have managed to ride through these without an increase in medication, that's not to say I wouldn't increase if I thought I needed to. I know people say they want to be on the lowest dose but what's the point if that dose doesn't work for you? My doctor always said I should be on the lowest dose that works for me and I have always gone with that. I also have plans in place for when blips happen. My anxiety always stems from how I feel physically, so if I feel run down and over tired, or if i feel not well, then it triggers my anxiety. And as we know when anxiety gets involved I turn from a functioning member of society into a fruit-loop as I like to call myself.

Right now I am on the fast train to Blip-ville, I came down with flu last week and it totally knocked me off my feet, still not feeling right yet. You could literally set your watch by my anxiety turning up. Plan of action now in place. I told the husband and kids (they are all over 17) what's going on, I have my weekly planner out and filled in for the next week and here I am back on here as i find it really helps to get it all out. I set myself 2 weeks to try and manage it and I know if I need to at the end of the 2 weeks I will chat to my doctor re options re medication. Luckily my plans seem to hold and work so I haven't needed to speak with my doctor in quite some time.

I gave each increase at least 8 weeks so if you are on 75mg and after this time you still don't feel right then I would always suggest that you discuss this with your doctor. I always try and go with what my doctor suggests as I like to think they are trained in what they are doing, if you don't trust your doctor then get one you do trust. Luckily mine is fab.

Not forgetting I also get top notch service from the wonderful Panic Down Under (PDU) That man has given me untold help on here and is a legend!!

I'm always here for a chat so feel free to vent whenever.

Ava xx

[panic_down_under]

I came across this thread by accident and got so involved with it I couldn't stop reading it. I made an account just to reply.

to NMP, Angie

Hope you don't mind me butting it.

I so want to stay on a low dose as this is all getting too much for me. I have only ever had 10mg of Citalopram which I had been on for 15 years. I had a few major life events that caused increased anxiety/depression back in June and for some reason the citalopram did not work???

While I understand the reluctance to take high doses of an antidepressant (AD) taking too little can often be a bad thing. ADs do not directly ease anxiety (or depression) in the way say aspirin does for headaches. These disorders are the emotional expression of a physical brain disorder, atrophy of parts of the two hippocampal regions of the brain caused by high brain stress hormone levels killing hippocampal brain cells and inhibiting the growth of new ones. ADs stimulate the growth of new cells (neurogenesis) and it is these new cells and the connections they form which produce the therapeutic response. For more detailed explanations see: Depression and the Birth and Death of Brain Cells (PDF) and How antidepressant drugs act.

The problem with low doses for most ADs is that plasma levels need to be high enough to saturate around 80% of the serotonin transporters to initiate neurogenesis and this must be a constant as interruptions may increase the risk of the med pooping-out. I suspect this is why the citalopram failed when you most needed it as the minimum recommended dose is 20mg. The recommended minimums are set with the ~80% occupancy rate in mind.

they increased it but it made me so ill and I dont know why that it either.

It is common for AD dose increases to produce significant side-effects for a few weeks. They would likely have soon diminished. It's possible that citalopram may have worked at a higher dose, but it's equally possible that it wouldn't have.

Had a quick change to the Mirt while reducing the Citalopram and all seemed good for a few weeks, then it went down hill.

Mirtazapine is more a very sedating antihistamine than antidepressant and mostly eases anxiety by sedation. It is actually more potent than some of the meds marketed as antihistamines. It seems to work well for some, but it is very prone to poop-out and the powerful carbohydrate cravings it often induces can become a real problem.

Ian

[Paradise10]

Afternoon my lovelies... Well the Big Bloody Blip as I am calling this one is defo in progress!

Spent half the night coughing and finally got some sleep when I propped my pillows up and nodded off sat up, really struggled to get myself going this morning, luckily I only have to commute the dining room for work as we are still working from home due to covid! Normal symptoms going on that would set my anxiety off such as feeling tired, body feels like lead, can't be bothered, everything is an effort kind of stuff, then add in the cough, the headache, and the inability to blow my nose because it's blocked then I have the perfect ingredients for a blip! I had quite a few cold and flu tablets last week so I am wondering if they could have affected my ven? Feel very flat at the minute and my motivation has really run off somewhere!

I tried to have a rational chat with myself earlier and did the whole what would you tell someone else exercise.... I came to the conclusion that I would tell someone else that they clearly have a bug such as a cold or flu and just over a week of having it isn't that long and the symptoms sound normal. I would tell them not to stress, to rest up as I am sure they will be back up and at it fairly soon. Sounds about right doesn't it? Did I believe myself? No, of course not! I know it's more than likely right and it's what anyone would likely say to me. But me, well I'm not a rational human being when anxiety take over. That I do know! Oh and of course, rather than it being a cold or flu I have to analyse every ache and pain that comes with it and decide it could be something else or something sinister. I seem to like a side of HA with my regular anxiety on occasion.

The outcome of all this.... I'm going to give it till the end of this week and reassess the situation. I'm going to keep writing when I need to, I'm going to keep as busy as I can while feeling pants and I am going to keep talking and challenging my thoughts. I am also going to tell myself that I have blipped through many blips previously and always come through it.

Most importantly though, I am going to eat chocolate cake and custard as that's all I fancy eating and my mum is delivering it.... (I may be a grown up with my own kids but I will always be a mammas girl.)

Take care all. Ava x

[panic_down_under]

I had quite a few cold and flu tablets last week so I am wondering if they could have affected my ven?

Maybe, Ava. But another likely candidate is the infection. Both anxiety and depression are arguably symptoms of an auto-immune disease and they often worsen when the immune system is in overdrive. This is so common that patients taking immune system boosting meds such as interferon to treat viral diseases and cancers are now often also routinely prescribed an AD to dampen this response. Immune system proteins may also reduce the effectiveness of antidepressants.

See also:

Immune system may trigger anxiety in response to infection

Is Depression An Infectious Disease?

Immune cells are behind the depression experienced in inflammation

[Paradise10]

Morning all.... It's not been a great couple of days. My HA has been at the forefront of my mind a good 90% of the time and it has kind of taken over. It's all about physical symptoms, how they are affecting my life at that particular time and what they may mean longer term and then the questions what should I do about them, are they anxiety or something else and how do I get rid of them? I guess somewhere in all that there should maybe be a trip to the doctors but the thought of even picking up the phone to them seems something I am not capable of. Crazy isn't it that I actually work in sales and I come across as the most confident person on the planet yet the thought of calling the doctors and trying to sort my health out stops me in fear.

I guess my HA is slightly different in some cases to others in that I don't actively go looking for symptoms when I don't have any, and when I do get them I tend to try and ignore them and hope they go away rather than go to the doctors. I have also gotten really good at not googling symptoms, I learned a while ago not to trust Dr Google and that has been a great thing. It's when the symptoms stick around for a while that it starts to cause me problems.

From a health point of view I am not in the best physical shape to start with, I am 46, a fair bit overweight, I smoked for most of my life but switched to vaping a couple of years ago and with me having an office based job my exercise level is really low. This all most likely makes me a prime candidate for all sorts.
The symptoms I am having at the moment are...

I feel exhausted most of the time and most things are a huge effort as my body feels like lead and heavy. I have no energy.
I also feel like I cant take in enough air sometimes when I breath, like I can't take a deep enough breath. I also can't breath through my nose.
I am also getting aches in my left breast area in like a c shape around the outside, this aches also radiates into my back, this gets worse as the day goes on.

Being the trained medical professional that I am.. (Haha.) I have diagnosed myself with lung cancer. (My nan died from this a couple of years ago and this has preyed on my mind a lot since then.) I keep comparing my symptoms with how she was. I haven't googled anything about lung cancer and this is the first time I have voiced this fear outside my own head. It's just been in there for the last couple of years bouncing around whenever these symptoms come forward.

Wow, I've said it! I have also gone online and booked an appointment to see a doctor for next Friday, I didn't realise you could book an appointment without speaking to anyone. How I am going to get this out of my head and articulated to a doctor I have never met before is beyond me at the present moment, but I guess I have a week to figure that out! Now I have booked the appointment I kind of want to go right now and not have to wait as that is creating a whole bucket full of anxiety in itself.

Ok so my CBT activity planner that I did is telling me I have to update my journal... (Check) and also start getting the Xmas decs out the loft for this mornings tasks so I better get cracking.

It's been a long post this morning but I feel like I have gotten quite a bit out there so I will catch up with you all soon.

Take care, Ava x

[panic_down_under]

How I am going to get this out of my head and articulated to a doctor I have never met before is beyond me at the present moment

Write down what you want to say, just a one or two sentence prompt as a reminder, more if there are more than one factor to a topic and don't forget to take it with you.

The symptoms I am having at the moment are...

I feel exhausted most of the time and most things are a huge effort as my body feels like lead and heavy. I have no energy.
I also feel like I cant take in enough air sometimes when I breath, like I can't take a deep enough breath. I also can't breath through my nose.
I am also getting aches in my left breast area in like a c shape around the outside, this aches also radiates into my back, this gets worse as the day goes on.

These all probably come to down to a lack of fitness and being overweight, Ava. The best thing you can do is get some exercise. Works wonders to anxiety too. You don't have to run a marathon on day one. Just walk 50 feet from your front door and back again. Keep 'rinsing and repeating' 4-5 days a week while slowly extending the distance. Also consider cutting back on the amount of carbohydrates you're eating, especially sugar (and sugar substitutes are nearly as bad). No need to go full evangelical keto, but try avoiding anything that contains more than 4-5% carbs.

Being the trained medical professional that I am.. (Haha.) I have diagnosed myself with lung cancer. (My nan died from this a couple of years ago and this has preyed on my mind a lot since then.)

I doubt you have lung cancer, but consider having an x-ray every 2-3 years from age 50. I had multiple risk factors for lung cancer and that's what saved me. The second or third one picked up the nodule when it was only 10-12mm diameter which made it easy to excise with little risk of having spread. Still cost me half a lung though. By the time symptoms start it is often already far to late which is why only about 12-15% are still alive 5 years after diagnosis. Radiation and chemo can slow it down, but they don't cure that often.

[Paradise10]

Thanks PDU, I will write it all down and take that with me. As you say it is most likely the weight and lack of exercise, as for the carbs I am off my food a bit a the minute so that might help.

So, anxiety is still high and pretty constant at the moment, but I am doing my best to keep busy. Yesterday me and the other half had a right good tidy through the house and clear out, we then put all the christmas decs and the tree up, went to the tip, then went out for a drive around the city looking at all the Christmas Lights. I was completely exhausted when we finished at 8.30pm. We watched a film and then went to sleep. Today I have been pottering around at home, doing a bit of house work. We are going to my parents in an hour or so for Sunday Dinner. Then I will take the dog for a walk when we get back so I can start getting some exercise.

I am off work next week so I think it will be a bit of a challenge as I use work as a distraction but I have accounted for this on my weekly planner so fingers crossed this helps. I read a quote the other week which I really like so I have printed it off and stuck it above my desk. It says... 'Nothing diminishes anxiety faster, than taking action.' I also try to accept or ignore my anxiety as much as possible and just get on.

Ok well that is it for today, take care all. Ava x

[Paradise10]

Morning all, well it's only 8.05 and it's a bad one already. Anxiety has been raging since I woke at 7am.
As per usual, something such as feeling unwell sets all this off and then the anxiety takes over so that it becomes the main problem. I am now in the stage where the anxiety is pretty much 24/7 in some form and I hate it.

Yesterday I got up and took my son to work, then popped out to get a few bits I needed. I then pottered about at home before picking my dad up from work at 1pm and I spent the afternoon at my parents house. Last night I made tea and watched some TV with the husband.

I downloaded a book from the NHS website which is CBT Self Help, started reading that last night too so I will pick this up later today.

I am taking the dog to Wakefield shortly for his operation and mum is coming with me for the drive so that should fill out a few hours. I just hate it when anxiety is this consuming.

I will update more later... Ava x

[Paradise10]

Morning campers, this blip has really taken hold, I'm not sure that it is a blip, it feels like a full on relapse at the moment! I am literally having anxiety 24/7 at quite a high rate, this then peaks into an almost panic attack at certain thoughts. Doesn't seem to be going into a panic attack but it's really not nice feeling like this all day.
It's literally zapping most of my energy.

Yesterday I got up and took my son to work, then went and picked my mum up so we could take the dog to Wakefield for his operation. Took about an hour to get there and I struggled on the drive, once we had dropped the dog off we went for a walk around a nearby garden centre and I felt myself just rushing round and wanting to get out of there. Drove home and I went out to do a few chores like get some tea and take a parcel back, I then went to my parents for a few hours until I picked my son up from work at 5. I came home, did tea, had a bath and watched some TV with my husband. Was really just waiting till I could go to bed. Bed is the only place I can calm myself down.

I am going back to my parents today to put their tree up as I am off work this week. I have also made a promise to myself that today I will tell them everything that is going on, I haven't told any of my family about my health anxiety, they just think that I have my anxiety back. I guess I haven't told them as I am scared to speak about it, I promise I am going to do it and just can't get the words out. Just like I haven't been able to go to the doctors about it. After reading a little of my cbt book I have come to the conclusion that that is keeping a lot of the fear going as I am scared. I am going to speak about this today somehow. I will speak to my parents today and my husband tonight and tell them everything.

I have been readying my CBT book on my kindle but I ordered a hard copy which is coming today. I am keen to start it but I am still reading the first part of the book and I haven't got to that bit yet. I am keen not to increase my medication but I will do if needed.

Well I think that's it for this morning.

I hope anyone reading this is well. Take care. Ava x

[Paradise10]

Morning all, another day on the anxiety train!
Well the anxiety has most certainly moved in for the duration... Joy!! It's literally 24/7.
I would say the anxiety has settled at an 8 for most of the day and then peaks at a ten due to certain thoughts.
I have received my CBT Self Help book and had a read through and I have also scheduled in my first session for tomorrow afternoon. My mum is going to be my therapy buddy/therapist. You have to schedule sessions and do agendas for the sessions, you also have to set goals and do homework between the sessions. Sounds quite complicated but I am sure it will become a bit easier as I go along. I am also at the doctors tomorrow about the pains in my side so fingers crossed he will put my mind at rest a bit. I have a water infection again now, tested this morning so I wonder if that has been making me feel rubbish. I seem to get them all the time.

Going to have to breath through today as I am at the hairdressers at 10.30 this morning and then I have to pick the dog up from the vets at 2.30 which is about an hour away as he has had surgery. I have redone my weekly planner and scheduled in daily exercise which will be new for me, nothing strenuous just a walk round the block each day, and one day a walk to my parents which is about a mile and a half away. I have also scheduled in an online quiz with friends Saturday night.

This is really hard but I am determined to try this before I ask for a medication review as it seems every year I am having to increase the dose. I do wonder how effective the ven actually is for me as I never had to do this on Citalopram and then ven has never really improved my mood.

Oh well another day! Take care all. Ava x

That's about all for now