Help! Need Advice!!!

[Pandora]

Hey Guys...

Wow, it feels like I haven't started a thread in a long time! I need your guys' help, so any and all advice would be appreciated!

Here's some background: I have HORRIBLE anxiety. It's completely irrational. Here's an example: I donate plasma every now and then to make some extra money. One time I went in I was dopesick and my pulse was 102, and you have to be under 100 to donate. Every time since then I get SO nervous that my pulse is going to be high that I start shaking and when they take my pulse it's usually up to around 140 beats/min. I can't calm myself down or talk myself out it. Once I went in there after taking 1 mg xanax and 2 shots of vodka and my pulse was STILL fucking 137 beats/min! This kind of thing happens to me multiple times a day...I get incredibly nervous, feel like the world is closing in on me, like I'm suffocating and can't breathe. There are times I can't leave the house. It's affecting my every day life. When I lie down to go to sleep, my heart starts racing. I never sleep. I miss work, I miss classes, I can't get anything done. I'm a total disaster, and it's really starting to fuck with me.

I went to my primary care doctor a few months ago about it, and she scripted me 30 1 mg ativan and zoloft. The zoloft is shit. I don't really have adverse reactions to it other than sometimes feeling groggy and robot-like, but I really don't want to be on it. I liked the ativan, but it really wasn't strong enough. She referred me to a psychiatrist, but he wasn't in network, so I had to look around. I found a mental health clinic nearby and scheduled an appointment. I was able to get in with not a psychiatrist, but a psychotherapist. Anyone know the difference? I went on their website, and turns out she's not an MD, but a Nurse Practioner. Now, I know NP's can still write scripts. Would this be like a psychiatrist and therapist wrapped into one? Will she not write me scripts at all? What's your take?

Also, what could I say to get off the zoloft and at least get the same script of Ativan continued? Ideally, I'd like to move up to Xanax or Klonipin. I only take it when I need it, I really don't get any type of euphoria or enjoy abusing it. At normal and even high doses it just helps me calm down (and I have zero tolerance to benzos). Never had a problem with them, and I've used them a lot in the past for anxiety. What could I say to get moved to one of those instead of the ativan?

Please respond with ANY advice or comments, I really need help here guys! I'm such a wreck and it's awful. Also, if any of you have any other good suggestions for dealing with this type of anxiety, please let me know. Thanks guys.

-Pandora

[resorcinol]

You could always keep taking the zoloft Rx and just not take the drug. That would look better than angling for just benzos.

To get klonopin you could say that you heard it was better for controlling anxiety around the clock than ativan is (which is true), and that you need more consistent anxiety relief.

[Pandora]

You could always keep taking the zoloft Rx and just not take the drug. That would look better than angling for just benzos.

To get klonopin you could say that you heard it was better for controlling anxiety around the clock than ativan is (which is true), and that you need more consistent anxiety relief.

You're one of the people I was hoping would respond! I know you are very knowledgeable about benzos. It's not bad to name specific drugs like that? Yeah, I can do that with the zoloft. It's pretty cheap. I was figured I should go that route.

Thanks for the response. How do you go about controlling your anxiety? What have you found to be the most effective? It's just getting really out of control for me these days.

[Papa Verine]

Hey Pandora, you don't have to ask for specific drugs. Just say that the Ativan worked well but it only worked for a couple hours and then you'd be very anxious again. And, of course, you didn't want to take more then prescribed so you were still suffering anxiety in between doses. This kinda' talk should get you some Klonopin, or at least more Ativan, to be taken 3X a day or something like that...

Next time you go to donate plasma, I'd suggest you take A big dose of benzos. Not so much that you're stubbling around drooling, but with enough, you're blood pressure/heart rate has to go down. Maybe what you took last time wasn't a high enough dose.

[nick]

If your anxiety is really messing up your life maybe try and find some one offering CBT.It's supposed to be far more effective for anxiety.There's obviously no benzos involved,but "they" say it works.

Guess it depends what you are looking for.

[Pandora]

If your anxiety is really messing up your life maybe try and find some one offering CBT.It's supposed to be far more effective for anxiety.There's obviously no benzos involved,but "they" say it works.

Guess it depends what you are looking for.

What is CBT? Sorry, I'm in the dark here! :confused:

[nick]

What is CBT? Sorry, I'm in the dark here! :confused:

Cognitive behavioural therapy.It's like concentrated psychotherapy that aims to control and alleviate the problem rather than understand and "cure" it.

[resorcinol]

You don't have to name Klonopin specifically as some docs get uppity about that for sure. Just mentioning that you wish you had something that lasted longer is a more stealth way of asking for klonopin, since any doc in the US will think "klonopin" if a patient wants a longer acting benzo. US docs don't like valium.

Klonopin is a godsend for preventing panic attacks from even happening, but it is a commitment as it's difficult to stop taking. For generalized anxiety which it sounds like you have I'm not quite sure how well long-acting benzo anxiolytics work.

I second the CBT option .... even if you still want benzos, you can use them WITH CBT for greater effectiveness of both methods.

I needed klonopin to get my panic attacks under control, but for social phobia, it took intensive CBT to cure it. Only MAOIs are highly effective pharmacotherapy for that particular anxiety disorder and taking an MAOI rules out ever taking too many other drugs. For more generalized anxiety I'm not really sure what the best way would be for managing it. It might vary from person to person... especially when it comes to benzos. Some find that benzos are less effective for generalized anxiety than for panic disorder.

[Narkotikon]

CBT is Congnitive Behavioral Therapy. It's particularly useful for anxiety disorders, like Generalized Anxiety Disorder, which it sounds like you have, Obsessive-Compulsive Disorder (OCD), which I have, and Social Phobias and things like that.

Basically, it helps you confront and re-examine your fears. For instance, for OCD, it would help you by confronting your fears and thinking of ways to cope with it other than doing compulsive rituals to aleviate the anxiety. So, rather than counting to a certain number over and over, for example, it would teach you other ways to deal with it.

I think Resorcinol has had good luck with CBT in conjunction with social phobia / anxiety. I think he said it worked really well.

I think that they can prescribe benzos for cases like that, but of course your history (if it's known by the doctor) is going to work against you. Ideally you should be honest, but benzos are contraindicated for people with substance abuse histories. So, if you really feel you need them, I'd lie and say you have no problems with substances. Horrible, but what are you supposed to do?

They will likely insist that you still take some type of anti-depressant, which is what they commonly use for GAD now, although I agree in that they don't work really well. They certainly don't work worth shit for OCD in my opinion.

They say the best course of action is a combination of both meds AND therapy, like CBT. The combination is supposed to work better than either alone.

As for the psychiatrist v. psychologist v. psychotherapist, here's the difference. A psychiatrist is an MD who's specialty is psychiatry. They can and will most likely prescribe meds, and can occasionally do therapy too. Although, in honesty, it's more likely for most psychiatrists to refer you to a therapist / counselor / psychologist for the therapy part. Generally, psychiatrists are there for the meds and meds alone.

A psychologist is basically a therapist with a doctorate in psychology. They can NOT write for meds because they are not an MD. I've been to a few psychologists, and a lot of therapists in the past, and really the only difference to me is that psychologists tend to be more clinical. Very into diagnoses and psychological testing and using precise terms. Therapists, on the other hand, tend to only have a Masters Degree in Social Work or Psychology or something like that, and tend to be more relaxed I guess is the word. Less focused on using the "correct" words and more into actually talking to the patient. I guess I find plain therapists more laid-back than psychologists. Less stuffy.

Now, a psychotherapist (I'm guessing) is more like a psychologist and less like a psychiatrist, but I could be wrong about that. If it's a nurse practitioner, I'm guessing they could write for meds, but I think they'd be more likely to focus on the therapy part.

If you're really wanting to get on some kind of benzo for GAD, I'd suggest K-pins like you said. It's got a longer half-life than Ativan, and would be better for all-day relief. Ativan is shorter in duration and better for immediate, short-term relief of anxiety, like a panic attack. I would not recommend Xanax either, because of it's short half-life. I'd say you'd want something like Klonopin or Valium with an intermediate to long half-life.

But, in order to get those, you're probably going to have to play the game, which means most likely going to see the therapist / counselor / psychologist, and also at least taking the script for the anti-depressant. Of course you don't have to have it filled or take it, but you shouldn't refuse the script. That will be a big red flag. The use of antidepressants is really the norm for anxiety now, unless it's something like panic attack, and even then they use antidepressants for maintenance of panic attack, and the benzos are really only used for when you're actually having one to calm you down.

Edit: If you choose to do the therapy thing, be sure to ask when you call if they do CBT. Not all therapists do. Some specialize in psychoanalytic (or other forms of therapy), which I find very useless for me. To me, the psychoanalytic approach is what most people think of when they think of therapy. You lie down on a couch and confess your sins. That kind of thing. Basically, you do all the talking and the therapist helps you figure things out. Well, that's not very helpful if you already know why you are the way you are. I mean, if you know why you're angry or pissed off, that's not going to be very helpful.

If you don't know why you're angry or pissed off, it would be. But, I think for people who know why things are fucked up, and have a general sense of what's wrong, going the CBT or similar route is better, because it can help you deal / cope with it in healthier / different ways. I mean, if you already know why you're anxious, I just feel like CBT would be better. When I went to a therapist who did the psychoanalytic thing, I felt very frustrated. I did all the talking and all she did was basically repeat what I just said. That wasn't very helpful. I needed her to help me think of ways to deal with things differently, which she said she couldn't do. How useless.

Also, in terms of psychologists v. therapist / counselor, the therapist / counselor is most always going to be less expensive than a psychologist.

[SeVeN]

I'd keep looking for a Doctor (and/ or therapist) that is covered under your ins. or whatever health plan you have. In my experience mental health clinics suck by and large.

Also as far as getting xanax or something. It some what depends on what youve told your Doctor already. If you told them you have anxiety often then thats why they gave you a longer lasting benzo such as ativan (possibly). I'd tell your Doc that you do have anxieties often and that you do have panic attacks but you don't like the idea of having to take meds unless its on an as need basis. Then they will Probably give you Klonopin.

Tell them that when your not anxious you feel a lot of stress lifted off and you noticed your mood has improved and you are functioning "normal" again and doing things you use to do and getting joy from them mood has improved since being on the meds. Tell them youve had some side effects etc etc about the zoloft that you don't like (look them up) and also tell them you have studied up on the medicines, which the Docs like (but act somewhat naive so they feel they are helping you and you are trying to learn whats best for you).

Good luck. Also tell them that you have been practicing Breathing techniques and other CBT (but tell them specifically what they are and probably don't say CBT) Id tell the Doc that these things help you but its taken a lot of practice and they don't always work, but sometimes they make your condition more bareable.

Again good luck and let us know how these things go.

[Pandora]

Thanks for all of the responses guys.

In my experience, the benzo's really help so that is my MAIN goal. My biggest worry is that a psychotherapist is going to be hesistant to write me benzos since she's not an actual psychiatrist.

So, I don't mind a bit of acting. What is the best thing to say to get benzos...this is what I have so far:

I have these horrible anxiety episodes to the point that it's affecting my daily life massively, and just seems to keep getting worse. I've had problems in the past, and saw a psychiatrist for it. I was on prozac for around three months but it gave me abdominal issues and didn't help much. The zoloft I've been on has made me feel a little more even-keyed, but I still have anxiety attacks throughout the day. It will be over nothing, but is also often triggered by certain stressful events (being a full-time student, family issues, etc.). I'll feel like the world is crashing into me, my heartbeat soars (include the plasma donation story possibly?), and I feel like I'm suffocating. Often I'll be in tears and feel like I'm incapable of doing anything. I can't sleep, I have lost over 20 pounds due to loss of appetite,, and it's affecting my grades and school because certain days it's so bad I'm afraid to leave the house. I also get really anxious around large groups of people and often have to leave in the middle of a freak-out. My previous doctor prescribed me ativan and zoloft. The ativan worked well, but I felt like it just didn't last long enough, and I would end up feel super anxious again for the rest of the day and not be able to take my other one until I could go to sleep at night since I didin't want to take more than reccomended, and with how bad my insomnia has gotten I really needed that one before bed.

How does that sound? Obviously I'll try to make it a little more concise so the doctor doesn't feel like I'm exaggerating and going on endlessly, that might look fishy too.

Are there any symptoms I should modify, not mention, or exaggerate more in order to script for benzos? What are the main symptoms that would really aid in a benzo script (even if I didn't mention them I'm sure I forgot one, and I don't mind tacking on/taking off a few symptoms for good measure, sadly to admit, I'm an awesome scammer.

Thanks again for all the responses guys, keep 'em coming! I really appreciate it, and love you all!:D

Love ya!
~Pandora~

[alowishus]

How much you get for a pint of blood now a days anyhoo?

Patches thinks I need $$$$.

[resorcinol]

What you plan to say sounds pretty good. You could maybe benefit from saying that sometimes the anxiety culminates in a panic attack (but describe the symptoms and let the doc say that they're panic attacks). I think you've got a decent shot at getting klonopin.

[Pandora]

They will likely insist that you still take some type of anti-depressant, which is what they commonly use for GAD now, although I agree in that they don't work really well. They certainly don't work worth shit for OCD in my opinion.

They say the best course of action is a combination of both meds AND therapy, like CBT. The combination is supposed to work better than either alone.

As for the psychiatrist v. psychologist v. psychotherapist, here's the difference. A psychiatrist is an MD who's specialty is psychiatry. They can and will most likely prescribe meds, and can occasionally do therapy too. Although, in honesty, it's more likely for most psychiatrists to refer you to a therapist / counselor / psychologist for the therapy part. Generally, psychiatrists are there for the meds and meds alone.

A psychologist is basically a therapist with a doctorate in psychology. They can NOT write for meds because they are not an MD. I've been to a few psychologists, and a lot of therapists in the past, and really the only difference to me is that psychologists tend to be more clinical. Very into diagnoses and psychological testing and using precise terms. Therapists, on the other hand, tend to only have a Masters Degree in Social Work or Psychology or something like that, and tend to be more relaxed I guess is the word. Less focused on using the "correct" words and more into actually talking to the patient. I guess I find plain therapists more laid-back than psychologists. Less stuffy.

Now, a psychotherapist (I'm guessing) is more like a psychologist and less like a psychiatrist, but I could be wrong about that. If it's a nurse practitioner, I'm guessing they could write for meds, but I think they'd be more likely to focus on the therapy part.

If you're really wanting to get on some kind of benzo for GAD, I'd suggest K-pins like you said. It's got a longer half-life than Ativan, and would be better for all-day relief. Ativan is shorter in duration and better for immediate, short-term relief of anxiety, like a panic attack. I would not recommend Xanax either, because of it's short half-life. I'd say you'd want something like Klonopin or Valium with an intermediate to long half-life.

But, in order to get those, you're probably going to have to play the game, which means most likely going to see the therapist / counselor / psychologist, and also at least taking the script for the anti-depressant. Of course you don't have to have it filled or take it, but you shouldn't refuse the script. That will be a big red flag. The use of antidepressants is really the norm for anxiety now, unless it's something like panic attack, and even then they use antidepressants for maintenance of panic attack, and the benzos are really only used for when you're actually having one to calm you down.

Edit: If you choose to do the therapy thing, be sure to ask when you call if they do CBT. Not all therapists do. Some specialize in psychoanalytic (or other forms of therapy), which I find very useless for me. To me, the psychoanalytic approach is what most people think of when they think of therapy. You lie down on a couch and confess your sins. That kind of thing. Basically, you do all the talking and the therapist helps you figure things out. Well, that's not very helpful if you already know why you are the way you are. I mean, if you know why you're angry or pissed off, that's not going to be very helpful.

If you don't know why you're angry or pissed off, it would be. But, I think for people who know why things are fucked up, and have a general sense of what's wrong, going the CBT or similar route is better, because it can help you deal / cope with it in healthier / different ways. I mean, if you already know why you're anxious, I just feel like CBT would be better. When I went to a therapist who did the psychoanalytic thing, I felt very frustrated. I did all the talking and all she did was basically repeat what I just said. That wasn't very helpful. I needed her to help me think of ways to deal with things differently, which she said she couldn't do. How useless.

Also, in terms of psychologists v. therapist / counselor, the therapist / counselor is most always going to be less expensive than a psychologist.

Thanks so much for the awesome response, Narko! So it sounds like I have GAD? What's the difference between GAD and panic disorder? I don't feel anxious 100% of the time, but I get multiple panic attacks a day and they're just debilitating.

How much you get for a pint of blood now a days anyhoo?

Patches thinks I need $$$$.

Not nearly enough! My arm is dark purple b/c the people there don't know what they're doing and are idiots. My entire fucking arm! I don't use needles, but now everyone is going to think I do! Go figure, when it finally starts getting warmer! Anyway, it's by weight. 1st donation is 35, 2nd is 40. After that you make 20-25 the first day and then 30-35 the second day of the SAME WEEK. There are $5 bonuses on the 5th and 7th days of each month.

On that, anyone have advice for how to get rid of dark purple bruises from them digging around in my arm with a huge 00 gauge needle. LOL okay maybe that's exaggerating, but it's like 5 inches long!

And you have to pass a ton of health screening and stuff, no tats or piercings in the last year, many things not in the last year. If you're interested, I'd make sure you're eligible before you go in and wait.

What you plan to say sounds pretty good. You could maybe benefit from saying that sometimes the anxiety culminates in a panic attack (but describe the symptoms and let the doc say that they're panic attacks). I think you've got a decent shot at getting klonopin.

Thanks for all your help, I really appreciate it!

Thanks everyone! And more and all advice would be deeply appreciated. My appointment is tomorrow at 3.

EDIT: Also, just so you guys know, I have no record of substance abuse in my medical history, so that won't be a problem. My worry is, will it be hard to work through my issues with a therapist if they don't know about my substance abuse? It's a huge part of who I am, and does lead to a good deal of anxiety on its own (when I run out, which is quite often).

I have suffered from anxiety for a good portion of my life. Saw a psychiatrist and therapist in high school because I used to cut myself when my anxiety got too bad, had lots of issues with depression, etc. It also runs in my family. My aunt's been on xanax and something else for over 20 years. My mother and grandmother also have horrible anxiety. There are also several people on my dad's side with depression, substance abuse, bipolar disorder, OCD and anxiety. I have a big family, but still. The genetic odds are definitely not in my favor. Is this a good thing to tell the doc as well?

[pain-pateint]

Klonpin plus exercise will work wonders UNTIL you can find a good CBT therapist or clinic and get some traction from their technicques. CBT is great and Klonopin loses effectiveness very quickly. CBT certainly made me feel that I am OKAY and GOOD just being me and gave me a sense of control over me while letting me let go of the things I cannot control, just like that old prayer of St. Francis -- CBT = wisdom to know the difference.:D

[Pandora]

Klonpin plus exercise will work wonders UNTIL you can find a good CBT therapist or clinic and get some traction from their technicques. CBT is great and Klonopin loses effectiveness very quickly. CBT certainly made me feel that I am OKAY and GOOD just being me and gave me a sense of control over me while letting me let go of the things I cannot control, just like that old prayer of St. Francis -- CBT = wisdom to know the difference.:D

I will for SURE ask about the CBT tomorrow when I go in.

Also, I forgot to add. I've tried every natural remedy I could possibly think of for anxiety. I started exercising regularly, didn't help. Stopped consuming any sort of caffeine. Have tried OTC remedies for sleep like diphenhidramine and valerian root. None of these things have made a difference for neither my anxiety nor my insomnia.

[Narkotikon]

Generalized Anxiety Disorder is just that, a general sense of anxiety. It's not really that anything in particular makes you anxious, it's just that you're anxious. It can be debilitating just like panic disorder or OCD or something like that, but the difference is what makes you anxious I guess. People with OCD have anxiety but it focuses on obsessions (the anxiety) and ritualistic compulsions (hand washing, counting, arranging things a certain way, etc. to aleviate the anxiety...the rituals / compulsions get rid of the anxiety, at least temporarily). Panic attack is just that, it's a sudden onset of intense anxiety, which can just come on by itself or can be prompted. I find that anxiety is usually worse when you're under a lot of stress. The more stressful your life is, the worse your anxiety will be. So, it can help to try to get rid of some of the stress in your life, etc.

I tend to think of it like this:

OCD is sort of like a short-circuit in the brain. Whereas a normal person can wash their hands once and feel like they're clean, a person with OCD can stand at the sink and wash their hands several times before they feel like they're clean. The fear of germs would be the anxiety / obsession, and the repeated hand washing would be the ritual they use to get rid of that anxiety, but it can (and usually does) take several times washing their hands before they feel clean. It's like the brain has a short circuit in it and in order to complete the circuit they have to do it several times. It's like they wash their hands once, and they don't get that sense that their hands are clean, even though they are. It's not logical. It's very much focused on the feeling and the need to feel clean or whatever their particular obsessions and compulsions might be.

I think of panic attack as sort of a grand mal seizure. It's like one minute you're normal, and then all of a sudden BAM, you're in a panic attack just like a person would have a major seizure.

On the other hand, I tend to think of Generalized Anxiety Disorder (GAD) as sort of a petite mal seizure, where it's a seizure but not quite on the level of a major seizure. Rather than one major seizure, it's like you have several small ones throughout the day. Several things throughout the day can set off the anxiety. It's like you're never at a baseline "normal" level I guess. And I know that normal is a subjective term, and means different things for everyone, but I guess I think of people with anxiety as always being at an elevated / higher-than-normal baseline level when it comes to brain activity or something like that. They're just anxious all the time whereas a "normal" person would still get anxious, but not peak quite as high as the anxious person would, if that makes any sense.

[Pandora]

Generalized Anxiety Disorder is just that, a general sense of anxiety. It's not really that anything in particular makes you anxious, it's just that you're anxious. It can be debilitating just like panic disorder or OCD or something like that, but the difference is what makes you anxious I guess. People with OCD have anxiety but it focuses on obsessions (the anxiety) and ritualistic compulsions (hand washing, counting, arranging things a certain way, etc. to aleviate the anxiety...the rituals / compulsions get rid of the anxiety, at least temporarily). Panic attack is just that, it's a sudden onset of intense anxiety, which can just come on by itself or can be prompted. I find that anxiety is usually worse when you're under a lot of stress. The more stressful your life is, the worse your anxiety will be. So, it can help to try to get rid of some of the stress in your life, etc.

I tend to think of it like this:

OCD is sort of like a short-circuit in the brain. Whereas a normal person can wash their hands once and feel like they're clean, a person with OCD can stand at the sink and wash their hands several times before they feel like they're clean. The fear of germs would be the anxiety / obsession, and the repeated hand washing would be the ritual they use to get rid of that anxiety, but it can (and usually does) take several times washing their hands before they feel clean. It's like the brain has a short circuit in it and in order to complete the circuit they have to do it several times. It's like they wash their hands once, and they don't get that sense that their hands are clean, even though they are. It's not logical. It's very much focused on the feeling and the need to feel clean or whatever their particular obsessions and compulsions might be.

I think of panic attack as sort of a grand mal seizure. It's like one minute you're normal, and then all of a sudden BAM, you're in a panic attack just like a person would have a major seizure.

On the other hand, I tend to think of Generalized Anxiety Disorder (GAD) as sort of a petite mal seizure, where it's a seizure but not quite on the level of a major seizure. Rather than one major seizure, it's like you have several small ones throughout the day. Several things throughout the day can set off the anxiety. It's like you're never at a baseline "normal" level I guess. And I know that normal is a subjective term, and means different things for everyone, but I guess I think of people with anxiety as always being at an elevated / higher-than-normal baseline level when it comes to brain activity or something like that. They're just anxious all the time whereas a "normal" person would still get anxious, but not peak quite as high as the anxious person would, if that makes any sense.

That makes a lot of sense. Very well put. Thanks so much for all the time you put into writing that. I think I agree with you in that I do have a general sense of anxiety, but on top of that I also get the "grand mal" panic attacks out of nowhere. Sometimes they're prompted by certain things, but it's usually completely irrational, and I just feel like the world is closing in on me. So GAD along with very bad panic attacks, is that still GAD?

Again, thank you SO much, you've been really helpful! I appreciate it greatly.

I'll let you all know how the appointment goes tomorrow and I'll go from there! Any other advice anyone has is more than welcome!

-Pandora

[Ragdoll]

You've received some terrific advice here. I'll add mine: Zoloft is AWFUL for anxiety. I've been on all the ssri's (I do mean all of them). I was on Zoloft for over a year at some point and the stuff is NOT for people prone to anxiety. My own anxiety was severe enough when I started the Z.; after I went off the stuff my anxiety was even worse (I believe, as a result of the Z.) Celexa seems better for anxiety, although I haven't found or heard of any of the ssri's being the elixer for anxiety most MD's claim they are. For depression, yes. But for anxiety, nah.

[Narkotikon]

Another SSRI they tend to like to use for anxiety and panic attacks is Paxil. It's used for the maintenance of panic and anxiety disorders. They also use it for OCD.

I think SSRI's can possibly help some if a lack of serotonin is the cause of their anxiety, but I don't think it helps everyone. They don't even really know what causes anxiety. I mean, a use of SSRI's would indicate that it's somehow related to serotonin, which may be true for some, and not for others. They also don't really know for sure whether or not SSRI's affect serotonin. They only suspect they do. At least that's what the PDR always says about SSRI's. It's always something like "the 'suspected' mode of action is on serotonin" or something like that. But, again, they don't really know for sure.

Another thing about SSRI's and anxiety is that one of the side-effects of SSRI's, especially during the initial phases of treatment, is anxiety. The SSRI's can actually cause anxiety as a side-effect, which may or may not go away.

Another anti-depressant they may use is Effexor, which is an atypical antidepressant that supposedly works on either serotonin and norepinephrine OR norepinephrine and dopamine. I don't remember which it is. I think I've read that Effexor has a chemical structure similar to opiates, but if that is true, it certainly won't cause an opiate-like high. I've taken it before, and even though I didn't know it was sort of structurally similar to opiates at the time, it certainly wasn't something that got me high. It was just like a regular SSRI to me. If I remember correctly, I think the Effexor caused a little more initial anxiety in me than Prozac or the SSRI's did, which would make sense since it affects norepinephrine / noradrenaline.

[Pandora]

Hello my Lovely Opio Friends,

Please! I Need Your Help/Advice Again Urgently!
I have a doctor appointment tomorrow morning and need your help! I realized I was babbling after I read through this, so I put the more important parts in bold for those who don't feel like reading my babble.

So, I had my doctor appointment and it went well. I got a script for Paxil, which hasn't done anything but give me killer headaches. At first I wasn't going to take them, but I figured I'd at least give it a TRY for a couple of months despite the side effects just in case I was one of those lucky few that SSRIs do actually work for. So far, nothing, and it's been a month. I know it may take a bit longer, so I'm going to give ita little more time just to see. If I don't see any results,

Anyway, back to my point. I also got a great benzo script for my first one IMO: 60 .5 mg xanax, 2x a day as needed for anxeity. He was pretty adamant, however, about not using it for prevention, but only using it when I feel a panic attack coming on. So is it reasonable for me to say I'm having more than 2 panic attacks a day and need more? Sometimes I literally do, and the dose I'm on defnitely helps, but I can still get a partial panic attack after taking my prescribed dose. As I mentioned before, especially at the plasma place, I get nervous my pulse is going to be high (how ridiculous is that?) and I start panicking, can't talk myself down, and my pulse still goes up to 130 at times. I feel like 1 mg 3x a day would be perfect, but that's a HUGE jump to make and would any doc be cool with that?

It's really affecting my day to day life. My boyfriend is about to leave me because he just can't handle my massive mood swings and panic attacks. The panic attacks drain me so much I get so edgy and irratable and end up taking it out on him because we live together. I got threatened to be fired at my job (I work with kids at a school) because of my "inconsistency" and "tone" with the children. It was really stupid stuff, like me saying a child was "being fussy" in a negative tone and sometimes getting too edgy and panicked which the children can sense, they claim. They're a weird center with odd philosophies in my opinion that are nothing like how most children are raised. Anyway, when I have a panic attack, or am just having a really bad day with a lot of really bad anxeity which I don't even know where it comes from, it's just mentally draining to the point where I'm not "there" like I should be when working wiht young children.

So, my main question is, can I even reasonably expect a dose increase since this is only my second visit? What should I say about the effectiveness of the xanax? What could I say, if it's possible, to get as large of an increase in my dose as possble?

I really need your help here, guys. The xanax, when I take the doses I was describing, 1 mg 3x a day as needed, I can actually function, and feel normal, like I used to when I was younger and didn't worry about every little thing every waking second of my life, and it's even worse when I'm dopesick, which is quite often, as you can imagine.

So please let me know what you think about the above questions, mostly what I should say to the doctor and what I can expect.

Thank you SO much in advance for anyone who can help me. I'll love you forever! :D

Love <3,
Pandora

[EleusisII]

Wait, I thought that... Meh, nevermind...

I guess we're dealing with two seperate issues here.
1: Getting more meds.
2: Getting stronger meds.

I'd deal with them one at a time, and option 2 is the easiest. Seeing as the halflife of xanax is over 8 hours, it makes more sense to give a stronger dosage, rather than giving you more.

So just tell him that SOMETIMES you get more than two panicattacks a day, and most importantly, that you still get "partial" panicattacks. It might be a good idea to keep a journal over them, whether real or imagined, that you can show him. He'll get half a hardon from seeing what a responsible patient you are, and draw a big far smiley in his "Increase meds" column.

Good luck... We wouldn't want your boyfriend to leave you afterall...

[chopstix]

I understand your dilemma Pandora, but I'd suggest thinking really hard about daily benzo use, trust me, they don't work forever and the wd makes kicking opi's seem like a walk in the fucking park.. I'm long down the benzo road and desperate to get off of them, but it's a long ways back...

Can you get some counseling? Does weed help? There's gotta be something better than *daily* benzo use, occasional is fine but daily is a whole 'nother game..