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Discouraged with severe Anxiety

Old 10-01-2008, 01:59 PM
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Unhappy Discouraged with severe Anxiety

Hello everyone. This is my first post. I have been researching the internet and found you guys. I have so many questions, and I am really hoping that others with similar experiences will share them with me.

I have been clean for 3 years. I was using meth to self medicate, but didn't know that's what I was doing. Since quitting the illegal drugs, I have sought help for a severe anxiety disorder among other things. I am currently taking medicine to treat the anxiety and also meds for ADHD. Because of my history, ADHD medicines are limited and closely monitored. I have recently started taking Focalin, and it seems to be helping. I have gone off of the ADHD meds before, but I gained weight and so opted to stay on them. I know that's not where my priority should be, but I have history of an eating disorder and fear gaining weight.

At any rate, the anxiety is just so out of control, really. The very worst part of it is that I get hives on my chest and neck, and everyone then knows I am anxious or nevous. Then there is the irregular heartbeat, pounding heart, dizzy, inability to catch my breath, etc...It affects my life! Most frustrating to me is that on illegal drugs, my anxiety went away (even though I was abusing stimulants) and I never had hives. On illegal drugs I was just so personable and social. Now that I am keeping my act clean and trying to work with doctors to treat these conditions, I am nearly a hermit, isolating from social situations where I feel most anxious.

I took Effexor for a year finally leveling out at the max dose, and still not seeing the results. I switched to Wellbutrin and have been taking that for nearly a year, but also was still experiencing so much anxiety. The doctor had increased the dose three weeks ago and for the few days I took the higher dose, I lived in a state of panic. It was awful. I was having to use an old prescription of Adivan that I had never needed before just to manage myself. We realized that the panic was because of the higher dose of Wellbutrin and I went back to the dose I was on before. I found lots of info on the internet about Wellbutrin actually causing anxiety! The anxiety just persists! At work I am often scrutinized and evaluated which only magnifies the issue.

Today, my doctor changed me from Wellbutrin to Luvox. So, starting tomorrow, I will take the Focalin in the am and the Luvox in the pm (gradually weaning off the Wellbutrin over 7 days). If I had it my way, I wouldn't take any meds, but at this point that is not a realistic option. I was just wondering if anyone can offer any insight on the whole situation. I am pretty discouraged even with the possibility of this new med working. I just feel like I'm never going to be right again, and that I am at a disadvantage to the rest of the world out there. When I face situations I can't fix, my depression kicks in. I find comfort in finding others who go through the same things. With a history of drug abuse, I blame myself for bringing all of this on by disrupting my body's natural chemistry.

I have been told that I have an Avoidance Disorder, Anxiety (obviously), ADHD, Depression, and OCD. I guess it's been like that awhile because I remember pulling out all of my eyelashes and eyebrows when I was preteen. I was later told this is trichotellimania, another form of anxiety. I've never particularly enjoyed being in front of a group, but it's gotten significantly worse. And I always feel a burning in my chest. Is there hope that things will get better?

...thanks for letting me share.
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Old 10-01-2008, 04:23 PM
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Yes, there is hope.
Continue to work with your doctor as a partner in your health care. I am glad you are proactive, and research yourself. It is important that we become knowledgeable about our conditions, medications and alternate sources of treatment. For example, exercise is very good for anxiety. So is proper diet.

Indeed, taking care of ourselves physically, mentally, emotionally and spiritually is very important. And it will help us control our anxiety. Have you tried meditation? Yoga or pilates? What is something you would like to learn? Do you treat yourself with kindness? Do you remember to reward yourself, or to pamper yourself occassionally? And are you in touch with your Higher Power?

Take the time to do some good for yourself. Get out of your mind a bit. Explore other aveneues of your life. You'll find that these four areas, physical, mental, emotional and spiritual; along with your medications can help you overcome and deal with your anxieties so much. And if needed, a good therapist is worth their weight in gold, too!

I wish you the best. Please let us know how it's going for you. I look forward to getting to know you as we both grow in our recovery.

Shalom!
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Old 10-01-2008, 04:59 PM
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Welcome to SR and our mental health forum.

I can definately emphasize with your situation as the anxiety that I experience because of my bipolar and PTSD is extremely discouraging at times. Fortunately, like you I partner with my doctor to find the best treatment options for myself. I am not afraid to do research on a medication then ask my doctor questions about it. I am honest with my docs as I know they are only as good as the information they have to work with.

I am glad you are getting off the Welbutrin as that can increase anxiety for many people. You might find once you are off of it that things get better.

Take care.
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Old 10-03-2008, 07:50 AM
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Though I'm not a doctor, the one thing I know about psychiatric drugs is that it is hit and miss. I saw a documentary where a psychiatrist said that unless you have an immediate family member with the same disorder who has success with a particular drug, they basically just guess - hit and miss until they find something that works.

And since so many of these drugs take several weeks before you see results, it can take a long time to find the right medicine and the right dosage.

One thing you can do is keep a drug journal - what you took on that day - what worked - what did not work. That should help your MD nail things down.

And just be patient and communicate with your MD. There's lots of drugs out there and you and your doctor should be able to find the right mix, it just might take some time.
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Old 10-04-2008, 02:13 AM
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Welcome to SR Ushuffle

A lot of people do seem to find both Effexor and Wellbutrin very activating at higher doses; as I understand it, they are not first choice meds to treat anxiety. Anecdotal reports: Wellbutrin should not be taken with caffeine, as the effects of both chemicals are magnified, so maybe you could monitor your caffeine intake while you're weaning off Wellbutrin.

Good luck with the Luvox, keep us posted
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Old 10-04-2008, 10:05 PM
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Welcome Ushuffle,
You got here and you are sharing. And you have made some great progress staying sober.

That
counts
for
a
Lot!!

I have to second Historyteach's ideas about sprituality and exercise.
As for meds, I take strattera and is has helped with ADD and maybe a little with anxiety. Or at least the pounding heart side-effect has made me more aware of anxious thoughts and the need to breath deep and focus on the awareness of my thoughts.
Have you tried some of the natural treatments? I take valarian in a capsule and in tea every day and it helps (some tiredness). And I have also had improvement with the amino acid theanine. TALK to you doctor before taking these or any other herbal/natural treatment.
Writing, or blogging, or taking to a therapist is also very helpful. I have several logbooks full of my 'stuff'.
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Old 10-05-2008, 05:21 AM
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Thanks for all the feedback. You know, I have done some more research on the internet, and I found that Luvox and caffeine DO NOT MIX! In fact, Luvox intensifies caffeine like 8x's it's strength and 6x's longer than caffeine alone...leading to caffeine intoxication. This is not something that my doctor mentioned to me at all. I find that a bit concerning having felt so awkward the last two days...sick almost....being confined to my house and drinking my regular large cup of coffee in the morning with no ill thoughts about it. Anyone know anything else on the matter?
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Old 10-05-2008, 01:24 PM
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Yup Ushuffle, Luvox interferes with caffeine metabolism so your morning coffee hangs around your body for much longer than usual. There was anecdotal evidence ("user reports") of this for a long time, until a specific study proved it a couple of years ago.

Uhmm.... I hate to be blunt. Is your prescribing doctor a psychiatrist? I'm just wondering because his/her choice of meds seems unusual; Wellbutrin and high doses of Effexor are not 1st line choices for the treatment of anxiety. And neither is Luvox . There is this myth floating around that all SSRIs are basically equal. They are not. While they belong in the same family from a chemical point of view, their effects are different in the short and long term.

Luvox is usually prescribed to treat OCD - despite being considered the most sedating SSRI. Paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro) are the *usual* choices used to treat anxiety - that doesn't exclude the possibility that Luvox might help. We are all different and the only way to know what med fits is by trial and error. For example, Wellbutrin *really* helped my anxiety - maybe because my anxiety/panic is secondary to depression.

Good luck


edit: here's the link to the study that shows Luvox-caffeine interactions:
Fluvoxamine impairs single-dose caffeine clearance...[Br J Clin Pharmacol. 2005] - PubMed Result

Simply put, caffeine lingers in your body for longer than usual. Ask your doc about lowering your caffeine intake.

Last edited by Mattcake; 10-05-2008 at 01:28 PM. Reason: added pubmed link
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Old 10-06-2008, 01:59 PM
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If you have anxiety problems you should really try to avoid caffeine no matter what meds you're on. There have been a couple threads on that on this board and from what I remember there was a lot of agreement between those of us who got off caffeine that it helped a lot.

You really need to be in regular therapy, if you're not already. Finding the right meds will be helpful, but there's just no substitute for having someone you can talk to face to face about your anxiety. Your doctor wants to deal with the chemistry making you feel bad, but you also need someone who can help you with the thought processes involved and teach you techniques for dealing with the negative thoughts and feelings.
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Old 10-07-2008, 10:48 AM
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Thanks everyone for the feedback. Having been a meth addict, coffee was always my legal way to wake up, so it's a difficult thing to face giving up caffeine but I have to, right!?! Also, I realized that the Adivan I thought I had was actually Xanax and I have been taking that daily through this ordeal just to avoid the panic attacks. It is such a hopeless felling to feel one of those coming on and then to feel powerless to do anything about it. I am seeing a therapist who is teaching me various things I can do with breathing and different places on my body I can push on to trigger a calming effect. I want to believe in it, but I can't seem to make it work for me yet. Anyway, how long does it take for the full effects of the Luvox to take hold? I will be completely off my Wellbutrin in 1 more day and was just wondering if there will still be changes going on in how I feel after that. I have almost been on the Luvox for a week now. My second question is that if caffeine and Luvox do not mix, what about my ADHD med Focaline. Does it has the same negative effects as caffeine does?
And then I was just wondering, too, if anyone else would see hives on their chest and neck whenever they experienced anxiety? Have you found anything that helps or do I just invest in a ton of turtlenecks?
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Old 10-07-2008, 01:34 PM
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I don't know anything about the drugs you're on, but I can say that the breathing techniques and meditation and other techniques your therapist teaches you require some practice. Just like the meds, they don't always help immediately. I do tai chi and meditation and I started feeling better a couple months after I started doing them daily.
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Old 10-08-2008, 05:49 PM
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Today, I didn't have to take a Xanax! I felt fairly comfortable all day, even with my co-worker out...putting much more responsibility on me. I also had to stand in front of a group and do a short presentation (which I do each week), but this time I was calm and clear headed. This is what sent me into the Panic Attack before, so I felt there was evidence of improvement today, for the first time. Tomorrow is my first day officially off of the Wellbutrin, so I will be interested to see what difference that makes. I am just excited to see a light at the end of the tunnel (maybe). Thanks for everyone here! Oh, and I am making it okay coming off of caffeine, too. 4 days now!
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Old 10-08-2008, 06:42 PM
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That's good news. The question is, what was different today? Did you feel better because you're coming off the wellbutrin, or cause you're off caffeine? Or is it because of the new drugs you're taking? Or is it because of the therapy?

A lot of us have some good days and some bad, but the key to success is figuring out what you did or thought differently on the good days and learning to do or think that every day. One exercise my therapist made me do was write down daily whether it was a good day or a bad day, then write down every event I did or task I had to complete that day. After just a few weeks of that we figured out what kind of situations triggered the anxiety. Once that was fairly clear he was able to give me some pretty good advice on how to train myself on how to deal with the anxiety. So, it's important that when you have a good day that you ask yourself why it was better than the bad days.
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