jab1982: New to antidepressants....

[jab1982]

Hello All,

 

I have had health anxiety for many years. At the end of November 2015 I had a panic attack. I thought maybe I was having heart issues. I went to the doctor and got an EKG and wore a monitor for two days. Everything came out normal. But the week I had to wait for the results was utterly terrible. My heart rate was elevated, I was obsessed with checking my pulse, I had tightness in my chest, I felt awful and my attitude was so negative. At one point in the middle of the night I woke up in a panic and told my partner, "if I am like this forever I will kill myself." This is SO NOT ME! The anxiety continued for about two weeks. I could barely function at work. I went back to my doctor and he suggested lexapro for 6 months. I had been taking ativan which was not helping much. I am a very active, fun loving, healthy eating, successful 33 year old woman. I do live in Alaska, moved here 3 years ago from Texas (a state full of sunshine). I work in the arctic for weeks at a time. I love my job. I have not exactly taken care of myself in terms of supplements like vitamin D or B since I moved to Alaska. 

 

I was very resistant to the medication. Medication scares me especially antidepressants. I have two sisters who believe they need to be on antidepressants for life. I refuse to buy into the lifelong antidepressant deal. But I don't know where to begin. I have been on 10mg lexapro since December 17, 2015. It has worked wonders getting me past the anxiety. Here are my questions:

 

1. I am so afraid the crippling anxiety will return when I taper off the medication. I still focus on my heartbeat at night sometime. The anxiety is not completely gone (it's getting there). Is the anxiety going away or is this just being masked by the lexapro?

2. I want to know what my holistic/alternative treatement options are but I know my doctor will not help me with that. Do I need to look for a holistic clinic? How do I know if an alternative clinic is reputable?

3. When do I know it is the right time to taper off? 

 

Thank you,

 

Jeaneen

[SquirrellyGirl]

Hi Jeaneen, 

 

I just wanted to welcome you to SA.  I'm sure a mod who can answer your questions will come along soon.

 

These drugs "work" by creating altered states of mind, not fixing any kind of imbalance.  Knowing that the body pushes back against these drugs' actions by remodeling the brain, the shorter we are on them the better.  I've heard of six months being thrown around, but again, I'm not sure what the mods will say.

 

Since the Lexapro is acting as a band-aid on the anxiety, there will likely be a re-emergence of the anxiety when you come off.  The drugs are never a cure, and so if anything, they give you time to do some work dealing with the thinking patterns that lead to anxiety. I hesitate to say that because they seem to do something to the brain that makes learning/integrating behavioral work more difficult, IMHO.   If you dig deep enough, there will be a seed of a thought at the bottom of it all.  Cognitive behavior therapy is good for this.  Also mindfulness meditation, Grounding exercises, Emotional Freedom Techniques, and more.  You must get coping mechanisms in place to deal with anxiety on your own and if staying on the meds while you work on that is necessary, then so be it.

 

People in withdrawal are very often plagued by anxiety and depression, and so there are lots of resources in the Symptoms and Self-Care sub-forum.

 

We recommend a 10% taper schedule for coming off of these meds, regardless of how long you have been on them.  See the following to see why:

 

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

Hopefully we can help you on your journey 

 

SG

[KarenB]

Welcome Jeanean,

 

SG  gave you some good answers and links.  Generally speaking, the sooner you can taper, the better.  You ask where to start - Get a copy of Anatomy of an Epidemic and feel reassured about why living drug-free is by far the better option.  Short term, people seem to get a window of help when they start an antidepressant.  Long term, those who never use antidepressants do much better than those who do. 

 

We all have to deal with anxiety/depression at various times in our lives.  But we can do this without drugs.  Rest, appropriate changes in our lives, lots of self-care - all these can help us to nurture ourselves through the hard times.  Then we will gradually move back into good times.  Its an ebb and flow, and we can move with it.

 

So instead of being afraid of the anxiety returning to get you, get focused now on building up those skills (as SG said).  Once you start, you can actually find a lot of strength inside you, just waiting to do it's job. 

 

You may not need a holistic clinic.  That still has the focus of looking to someone else to take charge.  I'd recommend starting by looking inside you, listening to those instincts.  Here's what I wrote to another member about how I've managed depression and anxiety: 

 

I spent a long time feeling desperate about depression, and so I understand those feelings.

 

The long story is in my blog (link in my signature). 

 

The short story is that I've built up a combo of things that together have helped me manage depression.  I think of it as weaving a nest, weaving a held life. 

 

My 'feathers and twigs' include restorative yoga - which also helps you learn to listen to your body; eating whole foods; learning to meditate; finding time to be playful; regular counseling; writing; crying; developing deeper connections with a few close friends and asking for help; resting more; saying 'no' more; singing; dancing...

 

If you start to look, you will be able to build things into your life that uniquely support you.  It will be different to my list.  Eventually you'll be able to spot depressive waves as they approach, and you can be prepared for them.  That way they don't bowl you off your feet so much.   

 

There's no 'single' answer to depression; it requires changing one's life to a nurturing and supportive life.  It requires us to no longer try to push on through.  It requires us to listen to our body and soul, to create quiet places where our thoughts can come out to us, and where we can then acknowledge and respond to them.  

 

The more I've done this, the more the joy in my life has increased.  This is an immense change from where I once was.

 

 

The right time to taper:  Is when you are fairly stable, and have prepared somewhat for a taper.  Could you write a signature with all your drug history - dates and amounts etc?  It's very helpful in establishing when to taper.  Thank you.  Knowing what to expect in w/d is important.  Have a read of What is Withdrawal Syndrom?

You don't want to mistake any w/d anxiety for 'relapse.' 

 

When you are ready, we recommend tapering by no more than 10% of your current dose.  And here are Tips for tapering Lexapro.

 

That's a lot for one day, so have a read through those links and come back to this thread to ask any further questions and discuss your plans.  You'll get lots of support here.

 

Karen.

[Fresh]

Hi Jab , welcome to the site.

 

The longer you take lexapro now , the more your brain will become reliant on it.  

Because of the short length of time you've been taking it , you will be able to taper off much faster than the usual 10% we recommend if you want to stop it now.

 

However , if you continue it for another 4/5 months , you may have to take the slow road in order to avoid serious withdrawal symptoms.

 

Please could you give more information about this:  "I had been taking ativan which was not helping much"

What dose , for how long etc.   You may have been having a paradoxical reaction to the ativan , or w/d symptoms.

We really need more information , otherwise it's just guessing.

 

Best wishes  ,  Fresh

[Petunia]

Welcome jab,

I'm sorry you were put on antidepressants for health anxiety, there are healthier ways to manage this kind of anxiety. There are a lot of non-drug treatments available these days for all kinds of anxiety including panic attacks. SG and Karen mentioned some options, in my opinion cognitive behavioral therapy is the best treatment for thought based anxiety problems.

 

When people want to taper off medications, we usually recommend cutting by no more than 10% each month, but as Fresh wrote, because you have been on lexapro for such a short time, you may be able to stop taking it faster. The longer you stay on it, the more likely you will have difficulties stopping. These are just general observations from what I have learned from my 2+ years of working with people here, on rare occasions, people will experience withdrawal symptoms while trying to stop after just 1 - 2 weeks use.

 

If you want to stop taking your antidepressant now, I suggest you make a 25% cut by taking 3/4 of a tablet daily for a week, monitor yourself for withdrawal symptoms and if you are feeling ok, then make another 25% cut, down to half a tablet daily and wait another week. If you start experiencing withdrawal symptoms, hold until they subside. If you remain feeling ok, you may be able to taper off like this in 3 - 5 weeks.  You might want to cut your last tablet into eighths and take that for a few days before stopping completely to be on the safe side.

 

I don't like advising people to stay on the drug to taper for longer than the time they were actually using the drug for treatment, as this gives the brain more time to adapt to having the altered chemical environment supplied by the drug and causes a potentially more difficult withdrawal process.

 

Like Fresh, I'm also a little concerned about your ativan use, benzodiazapines can be very addictive, with regular use physical dependence can develop in as little as as 2 weeks, then these will also need to be tapered in order to avoid withdrawal symptoms.

 

You might find the work of Dr. Claire Weekes is just what you need to help you address your panic and anxiety symptoms...

The Dr. Claire Weekes Method of Recovering from a Sensitized Nervous System

I'm glad you joined us, you will find a lot of friendly help and support here, please stay in touch, ask any more questions here on your thread and do let us know what you decide.

 

Petunia.

[jab1982]

Thanks everyone,

 

The suggestions have been helpful. I would like to begin tapering. I feel like my anxiety is under control. Work keeps me really busy and diverts my thoughts. I guess I just need to take the leap and begin. I was really interested in this comment:

 

"You don't want to mistake any w/d anxiety for 'relapse.'" -Silver Star

 

I realize there may be some anxiety with the withdrawl among other symptoms. But I am ready to face those. I don't want to take this drug anymore.My doctor recommended a 6 month course but after researching I really just do not want to take it that long. 

 

I was also afraid of getting addicted to ativan so I took it as little as possible when the physical symptoms were at their worst. I was prescribed 1mg tablets. I took an average of 1 per day for about 10 days. I have not taken any ativan since December 18, 2015.

 

I will begin to taper this week and see what happens. I will report back with my findings. 

 

Thank you all again for the support and information!   

[KarenB]

Apologies - when I read your signature I read the dates how us Kiwis use them, so thought you'd been on it since 12th Nov, rather than 11th December. 

 

It sounds like you are well ready to taper.  I mentioned about w/d anxiety because sometimes people start to get w/d symptoms (which can include anxiety) and mistakenly think it is a return of their original condition, which in turn leads them back onto the drug.  If you are aware of what is really going on, then you won't get caught in that trap. 

 

It happened to me in my first few attempts at tapering (when I new nothing about it at all).  As a result I spent about 3 years longer on SSRIs. 

 

You are sounding really strong about what you need to do, which is great to hear.  Let us know how it goes.

 

Karen

[jab1982]

I feel strong but it is making me nervous. I feel super nervous about taking less medication. I'm so scared the anxiety will come back full force and I will be dependent on this medication.

 

I've been working on mindfulness techniques the last few weeks. Yesterday during my exercise I noticed my heart was beating hard and fast. I've been avoiding focusing on my body because I am so hyper aware of my heart beat. This is the only lingering symptom of the anxiety that has not gone away. I got really scared. I was able to take the focus off and get some sleep. But today I notice that I just feel nervous. I can't stop thinking about the tapering and worrying about the anxiety. This is how I ended up with panic issues......by worrying.

 

I try praying, I try diversion techniques, I am trying to be mindful and use meditation. How do I stop worrying about what the worrying will do to me? I can't allow myself to get caught in this cycle again.

 

Other than feeling nervous and worrying I am feeling good so far. A little nausea but that it about it. I am on day 3 of 7.25mg lexapro.

 

Thanks guys!

[Altostrata]

What do you mean by you were prescribed Ativan for the physical symptoms? Physical symptoms of what?

 

It elevated heartrate is normal during exercise. Can you work with a therapist who specializes in anxiety?

 

To taper, you must be able to manage your health anxiety. We suggest systematic tapering by very small amounts, so you can feel in control of the process.

 

However, if you do not feel confident, you are not ready to taper. You're going to have to be in charge, nobody else can do it for you.

[jab1982]

I was not prescribed Ativan for physical symptoms, which I wrote in a previous post. My anxiety produced physical symptoms that kept me from going to work. Those physical symptoms included elevated resting heart rate and other physical manifestations of panic. I took Ativan for the anxiety that was producing physical issues so that I was able to continue working.

 

Also, my previous post mentioned that my heart rate was elevated during my mindfulness exercise. Not physical exercise.

 

So what you're saying is that I should wait to taper until I don't feel anxious at all about tapering? I don't believe I have ever been 100% anxiety free.

 

But thanks for your thoughts!

[KarenB]

I think what Alto is saying is not that you need to be 100% anxiety-free, but that you are feeling confident you can manage any anxiety that comes up as you taper. 

[Altostrata]

If you scare yourself with health anxiety, that will interfere with your taper. It sounds like you need to practice managing your anxiety, possibly working with a counselor, until you feel confident enough to taper.