Re: Medication or not?
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.
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Kevin, Southend-on-Sea, Essex, UK
Probably GAD & Phobias. Anxiety and renewed Depression medicated (Venlafaxine). Trying to improve.