I'm having a bit of a rubbish day so would appreciate any advice. After a long wait to see a gp regarding my anxiety which is really affecting me I wasn't allowed a prescription for an antidepressant as the gp believes that a non medicated route is the best.
Normally I just take beta blockers but I'm struggling with low mood and anxiety more than usual. I explained that I am saving up for a private assessment for autism and told him that I believe that sensory overload and general fear of social interaction due to being crap at it is the main factor in my panic attacks.
Has anyone found that medication has helped them or should I suck it up and resign myself to the fate of being permanently anxious for ever?
I've tried CBT on four separate occasions and it hasn't worked for me at all so I am a little pessimistic about talking therapies in general.
Anti-depressants don't have a good success rate generally and most GP's are making a move away from prescribing them (in favour of talking therapies and other non-medicated routes) and they're generally thought to be even less effective for ASD. Others here will know more about all of that than me as I don't have much experience of them. All I can say about them is that they're generally about 'fixing' a chemical imbalance in the brain - ASD and social anxiety aren't caused by a chemical imbalance in the brain.
I don't think that means that you should be expected to "suck it up" though, your anxiety is still very real and IS caused by other things, such as those you identified. Having already been able to identify those things, I think talking therapy would be useful.
I haven't tried CBT but I found EMDR useful as a talking therapy. It allowed me to vent, helped me to get another perspective on things, was a relief to be able to talk without feeling judged, and helped me feel in control of my own reactions to certain things. I didn't get on well with the visualisation side of it and my therapist was happy to leave that out once I explained that I was uncomfortable with it. I think the success, or otherwise, of these types of therapies depends a lot on who you get mind you! Mine was able and willing to work with what I was comfortable with rather than sticking to a prescribed idea of how the sessions should run, which also helped me to feel in control of the process.
Thanks for your really helpful advice. I've not heard of EMDR before so will look into it.
Anti-depressants are not the answer, although they have their uses at certain critical times. You're far better off learning coping strategies which can be effective but take time to learn. Once you have to rely on chemical interventions it can be very hard to come off them and you simply give yourself more problems to overcome. It's a question of finding the right kind of therapist for you and that you 'click' with, something which is much easier said than done. The way you think about your problems can powerfully affect how they affect you so it's well worth persevering and trying to discover the right approach for you.
I've tried at least half a dozen antidepressants, and none have them have helped. At least that I've noticed - you get told that they take 4-6 weeks to 'kick in' (some time after the brain has adjusted by 'receptor downregulation'), so some of them I've given up on after 3 months. They've had effects starting and stopping (generally SSRIs make me sleep more even if I don't need it and suppress dreaming, and then when I stop the rebound gives me vivid dreams).
lostmyway said:The way you think about your problems can powerfully affect how they affect you so it's well worth persevering and trying to discover the right approach for you.
Aye to that. It's a shame CBT hasn't helped. My problems with CBT have been that a lot relies on knowing how I'm feeling in response to events, and being 'alexithymic', I can't actually work that out separate from the event. Someone else might be able to tell me my emotional state better than I can.
Part of the 'behavioural' component of CBT should really include 'graduated exposure therapy', which is quite successful for phobias. If this consists of steps like 'I will attend this event for at least 2 minutes, even just to observe', 'I will go, and can leave after I've said hello to two people', this may be best practised by a social worker rather than in a consulting room. It desensitises you so after a while your heart isn't beating so fast. I'd be interested to know how the GP reacts to the idea of exposure therapy for social phobias and anxiety. Also, are there any physical things you can do to avoid the sensory overload, like sound-cancelling headphones? Back in the 1980s if I was invited out, I'd sometimes joke I was autistic to exaggerate my relative lack of interaction (little did I know). I don't think it's much to be embarrassed about - the headphones would be an obvious physical sign, an embarrassment to master.
I like Moomins, and Snork Maidens, and even Fillyjonks.
I don't know why you'd take Anti-depressants for Anxiety anyway - Benzodiazapines are usually best for doing that. Not that I'm recommending it, reliance on tablets, or medication. Isn't a great way to go, and should definitely be a LAST resort, as it can mess up the problem worse.Anxiety is hard, I struggle and have done for quite a while, but tablets I believe worsened my condition, and It didn't sort the underlying conditions, which was my ASD, and the stress it was causing me. I found person centred counselling was very useful, and would recommend it, it helped me cope with some underlying problems, as well as finding different solutions and knowledge into NT people's mind.
Anti-depressants are generally formulated to rectify 'imbalances' for an NT neurological template - which we don't have. They've never worked for me. I think, too, that GPs generally have little understanding of 'anxiety' as it applies to NDs. It's of a completely different order.
I've found CBT to be mildly helpful. There is also CBT that's adapted for NDs. I'd ask about that.
The most helpful thing for me has always been peer support - such as on these forums. 'Talking', in that sense, helps me to feel that I'm no longer alone with this condition, and the various ways in which it manifests in my life. I tend now to shy away from any kind of therapy designed to 'correct' me, or 'better adapt' me to coping in an NT world. Why should I change to suit them? Why can't they change to accept me instead?
Easier said than done, of course. Sorry... I'm not that helpful, as I'm feeling pretty low myself at the moment.
That question occurred to me, but I didn't ask it. Why 'anti depressants for anxiety', Moomin5? You do also mention low mood. (They also used to say that beta-blockers caused depression, but the evidence doesn't seem to be there any more.)
As a historical side-note, the psychiatrist Dr David Healy said the reason the SSRIs were marketed as antidepressants rather than anxiolytics is because of the reputation of the benzodiazepines as 'addictive'. Where there wasn't a benzo dependency problem, like Japan, the SSRIs were actually sold as anti-anxiety medications. Nowadays, GPs may be more comfortable prescribing Z-drugs like zopiclone than benzodiazepines, despite them having similar effects (short-term as against the several weeks of lead time for SSRIs). At least I know the associated feeling of being dosed up with diazepam at the dentists, which I find similar to being drunk.
Although as I say, I never found ADs helpful, I can think of one person who I think was autistic who found 'the light went on' after a couple of months on SSRIs (whether that was a coincidence is hard to say, as always with ADs). I also know a self-described depressive who found benzodiazepines very helpful, so long as they were only used short-term in response to specific anxiety. What's your regimen with the beta blockers; when do you take them? (I am not a doctor, as should be obvious.)
Cassandro said:Nowadays, GPs may be more comfortable prescribing Z-drugs like zopiclone than benzodiazepines, despite them having similar effects (short-term as against the several weeks of lead time for SSRIs).
I thought Zopiclone was a sleeping tablet. Mind you, ADs used to make me feel sleepy. In fact, just generally doped out.
I was also once prescribed beta-blockers for anxiety. Again, though, they didn't seem to work.
I'm going to see my GP tomorrow. I know I'm in a bad time of year, with all the anniversaries, but I need something to shake off this prevailing sense of emptiness and lack of motivation. I can't seem to focus on anything at all, and am having morbid preoccupations. I just want to sleep. I'm trying not to drink, which I know will snap me back in again - but only temporarily, and the cumulative effect will be worse. I've no idea what my GP will prescribe, though, or suggest. I really don't even know what to say or ask for. I feel I'm like this for life now, whatever they say or do.
If I go on ADs, I'll need to tell my employer, and it'll probably mean I'll have to curtail many activities there. I ought be be sick, really. I'm not well. But I can't go through the whole DWP regime again. It nearly sent me over the edge last time.
I’m on a daily dose 45mg Mirtazapine, the psychiatrist told me I should stay on it for a year. I’m feeling rather listless on it. I’ve been told that I could supplement this with sertraline.
This is my first contact with mental health services, so I don’t really know what the efficacy of other methods would be.
My mood has improved slightly.
Martian Tom said:I thought Zopiclone was a sleeping tablet.
You're probably right. Benzodiazepines are listed as both hypnotics and anxiolytics in the British National Formulary. Again drug companies don't want to risk marketing something as anti-anxiety.
Sorry you're having these empty feelings. I used to get that, and heaviness as well. Good luck with the GP appointment. Is it some personnel requirement that you tell employers about treatment?