Stopping/Controlling Anxiety by Any Method

I have been experiencing anxiety and minor panic attacks at work. I used to drink every weekend and that really helped me manage my anxiety. I have now been off of alcohol for over 2 months and my anxiety has been very bad. I have been in a panic state most of the time that I am at work. Last week I had a panic attack which made me leave work in the middle of my shift. This is the second time that it happened to me. I decided that it is finally time to seek some professional help. I went to my family doctor and he gave me a prescription for Zoloft, 50mg. I have taken it for 5 days so far. I know the drug is not supposed to kick in right away but I have been feeling some intense general anxiety starting with day 2 of treatment. The only thing that helps with the anxiety is to exhaust myself at the gym. The only reason that I gave the SSRI a try is because my parents both swear by them, as they helped both of them overcome their anxiety issues in the past.

I took a disability leave at work to sort out this issue.

Do you still draw a salary during the leave? From work or the government?

If both of your folks swear by SSRIs then they are likely to work for you. Which is good because they seems like the most “mainstream” path you can take, which means little resistance from the medical field. That said, I hear mostly crappy things about SSRIs, and never gave them a fair chance myslef because of the rotten side effects. (I quit them a couple times in, after only days.)

Are you getting professional treatment with regards to CBT or at least talking to a psychologist or therapist, or are the prescribed drugs the only professional help you have received?

Good luck to you!

I am going to get continue to get paid from work, but not 100%. That’s fine because I live with my parents. So far, I went to a walk in clinic after my last panic attack and the doc just prescribed the Zoloft. Tomorrow, I will go to my actual family doctor and have him give me a referral for a psychiatrist. My plan is to find a therapist that can help me through this difficult time. I have been self medicating for many years with the use of marijuana (when I was younger) and alcohol until recently. The thing is that I don’t want to continue drinking as it only masks the anxiety. I don’t want to become an alcoholic. That is why I completely stopped drinking.

The last time I tried to stop drinking was 2 years ago, at that time my social and general anxiety surfaced as well. My family doctor wanted to put me in SSRI’s back then, but I was completely against them. Also at that time, I was mostly getting my panic attacks and anxiety during lectures which were only 3 hours long so it was manageable. Now I have a full time job and have to be on edge 8 hours a day, 5 days a week. Definitely not something that I have been enjoying.

My parents are supporting me through this and so is my girlfriend, who is also a sufferer of anxiety. She convinced me to try the SSRI’s as she told me
it has helped her in the past. Her current coping mechanism though is wine and passion flower extract.

The thing is that I don’t want to have to rely on substances to cope with the anxiety. I have been doing that for too long and I believe that there has to be another way. Working out is a great anxiety relief for me, but my problem is that I have a back injury which keeps me from doing good exercises such as squats and deadlifts. I end up doing mostly high intensity cardio and body weight exercises, which feels great but at the same time I am loosing weight. Not something that I want considering that I am naturally quite skinny. Cardio just makes me shed weight very fast.

In the past I was on SSRI’s for around 6 years off and on. Honestly I felt no difference.

I was told by the doctors and psychiatrist that it would take up to 6 weeks for the full effect of the SSRI’s to kick in but after 6 months I still felt no different.

Right now, the SSRI’s have been giving me more anxiety then I had before, it might all be in my mind but who knows.

Ohh yea, I am also excited about the sexual side effects of the Zoloft. I do have a problem with premature ejaculation, but I have it under control completely, I know how to pace myself to last for a long time. I just feel like with my ability to pace myself and with the delayed ejaculation side effect of the SSRI, I will have super human stamina.

How long have you been taking Zoloft for?

The last SSRI I was taking was for depression and anxiety but it gave me the shakes and tremors. Couldn’t take it before bed or I’d be up all night and If I took it in the morning I’d be a jittering wreck for the rest of the day. Didn’t last long on that one and haven’t touched anti-depressant’s since (that was November last year).

5 days, I am also feeling very anxious and on edge. I don’t have shakes and tremors but I feel like I have a lot of anxious energy that needs to be burned off, I feel as if I have been drinking coffee. Something that I cannot touch because it will make me feel very anxious. I think this effect is supposed to subside so I will try and stick with it for now. Will see what the family doctor will say tomorrow.

You may be experiencing more anxiety when initiating SSRIs. It’s normal for some people to feel worse (more agitated) on SSRIs before feeling better. Make sure to increase dose very slowly. Zoloft/SSRIs may really help with the premature ejaculation. For anxiety, give it a good 3 month shot at a typically effective dose (100-200mg/day). If that doesn’t work you may want to try another SSRI before moving on to other drugs. I have found Lexapro to be a fairly good drug for my anxiety. So subtle and effective that I didn’t realize it was working until my wife pointed it out to me, more recently. My buddy also has GAD and he’s been on Lexapro for 2 years. It’s worked like a charm for him. Zoloft also worked for him but not quite as good as the Lexapro. I think SSRIs may work better for GAD and perhaps performance anxiety than generalized SAD?

So I went to my family doctor and he told me to stop taking the Zoloft. Instead he gave me Cipralex 10 mg. He also gave me Ativan 1mg to take in case I have a panic attack.

I’m sure you know but Cipralex (Canada) is Lexapro (in US). I take 5 mg. I tried 10 mg but found that dose somewhat more agitating. I’ve heard of people with more severe anxiety taking up to 20-30 mg. Just use Ativan only when absolutely necessary because I found I built tolerance to it if I used it too frequently. I think your doctor’s strategy is a real good one. I’m guessing Cipralex daily and ativan when needed and/or until the cipralex kicks in (hopefully it will)?

Exposure therapy for panic and other anxiety is not fun at all, but you sound highly motivated, so you’d be an excellent candidate for giving it a try. For most people with anxiety problems, it is more effective in the long-run than medications. It takes commitment and a willingness to experience a lot of discomfort, though.

EDIT: If you’re lucky and find that a low dose of SSRI (with tolerable side effects) controls your anxiety, then there’s nothing wrong with continuing that indefinitely. I second bohm’s caution about using Ativan. Not only can you build tolerance, but the use of a med like that can strengthen your avoidance response to the physiological cues of anxiety/panic (sorry if that sounds jargony: basically, it can, in some cases, make anxiety and panic and the disabling effects of them even worse).

Lexapro!

That’s the name I couldn’t remember. That was the one that gave me the tremors and made me more anxious.

What was your starting dose and how long were you on it? Many SSRIs especially if started at high doses can be agitating (and increase anxiety) for the first little while. Health professionals are told to warn patients that they may feel slightly worse before feeling better (assuming it works). Starting at a low dose can sometimes help with this.

I started on 10mg daily with food. I was on it for about 8 weeks and I think it may have been a contributing factor to me losing my job because during those 8 weeks things got progressively worse.

For some anxiety disorders dopamine plays a more crucial role in rehabilitation. Serotonin can seem sedating and lend an air of “in-consequence” to your life. Dopamine on the other hand can give you the motivation/confidence to face the problem head on.

For the reason above, wellbutrin/Bupropion is more and more being prescribed for anxiety disorders as it functions as a norepinephrine/dopamine re-uptake inhibitor.

“SSRIs works by re-uptake inhibition- leaving more serotonin in the synapse. It has been raised that this also implies lowering dopamine.”

“Sociability is also closely tied to dopamine neurotransmission. Low D2 receptor-binding is found in people with social anxiety. Traits common to negative schizophrenia (social withdrawal, apathy, anhedonia) are thought to be related to a hypodopaminergic state in certain areas of the brain. In instances of bipolar disorder, manic subjects can become hypersocial, as well as hypersexual. This is credited to an increase in dopamine, because mania can be reduced by dopamine-blocking anti-psychotics.”