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View Full Version : Can constantly worrying due to anxiety lead to not worrying or caring at all?



purple9812
04-29-2014, 08:13 AM
Hi everyone.
I'm currently a 21 year old student in my third year of uni. I have been constantly worried and stressed since I was a child and have constantly been suffering from anxiety/depression. My constant worry usually motivates me to study, and at school I ended up doing quite well in my GCSEs, achieving 1 A*, 9As and 2 Bs.

However, during Sixth Form I felt like I couldn't cope and spiralled downhill. I didn't do that well in my AS levels, and found it particularly difficult from September to January of my A levels in the second year of Sixth Form. I even considered dropping out, or dropping one of my subjects. The teachers were aware of how I was feeling. In the end I couldn't bring myself to do my Chemistry coursework, so I ended up getting 0 marks for 15% of the module. I also ended up failing my exams at Christmas since I had really bad brain fog and couldn't concentrate at all. I had to retake my Christmas exams during the summer. In the end I did ok, achieving an A and two Cs, but I know I could have done better. I was prescribed 10mg of Citalopram for one or two months during my A levels, but I think the dosage was too low because it didn't help at all.

I struggled in my first and second years of uni as I was constantly worried and stressed, and seriously considered dropping out, but I worked hard and managed to achieve a 1st in both first and second years. I was also prescribed Citalopram occasionally for a few months.

I'm now in my third year, and have also been finding it really difficult to cope. Since October I have been unable to bring myself to do my dissertation, and have done absolutely ANYTHING to avoid it. My supervisor was aware how much I was struggling. In mid February I told him I kept putting it off and hadn't been able to get much done, and that I wasn't getting much sleep because I was constantly worrying about everything. My dissertation is due in tomorrow, but I am nowhere near finishing and haven't touched it in months. I thought maybe I'd be able to pull myself together and get it done before the deadline, but in mid March my lymph nodes swelled up in my neck and around my right ear, even though I had no signs of infection, which made me really anxious and because I was worrying so much I still couldn't bring myself to do any of my dissertation. I waited about two weeks before I went to the doctor's about it. They told me not to worry too much about it, but about a week later I realised I had lost a lot of weight. I had dropped from my usual weight of about 7 stone 11 to 6 stone 11, and looked practically skeletal. Over the next month I was constantly thinking about my lymph nodes and touching them. Due to the weight loss and swollen lymph nodes, I was convinced I had lymphoma. I broke down in tears and ended up getting driven in to A&E at one point, as I wanted to get checked out in case I had something seriously wrong with me. However, they told me it could take 3 hours to see a doctor, and even then they might not do anything. In the end I went back home and rang up an emergency doctor the next day, who advised me to see my GP. I saw my GP again who arranged blood tests, but they came back normal and she said it was probably nothing to worry about.

I saw my GP again on the 2nd April, since I was still feeling really anxious and wanted to go back on Citalopram because I couldn't get any uni work done as I was constantly worrying all the time about my lymph nodes. She then prescribed me 20mg Citalopram and I went back home for Easter on the 8th April. I saw my friends around the 10th April, and they could tell I had lost weight and was more distant than usual. However, my anxiety/worry basically disappeared within two weeks of starting the medication, almost to the point that I did not care about anything. I was no longer worrying about my swollen lymph nodes. Despite this, I was still feeling very tired over the Easter holidays (from 7th April - 27th April) and barely managed to do any uni work, even though I had (and still have) mountains of work that need to be doing.

I've sent off forms and a letter from my GP for a 20-day extension for my dissertation, but there is absolutely no WAY it will be done on time, even with an extension, since I have my exams to focus on. As a result of this I am now in the midst of applying for a non-submission, meaning that I will have to delay graduation, even though this is something that I'm really sad about :(. The problem is, although the medication is helping, I've been finding it incredibly hard to revise for my exams and I have a complete lack of motivation to do anything. I'm still able to read through books and take notes (I think), but when I look at what I've done the next day, I can't seem to remember much of what I've written and it seems like I'm not retaining any information. I also keep getting frustrated whenever I read a textbook and want to cry whenever I'm trying to do work. I'm also still tired, and I'm finding it hard to get out of bed in the mornings. I haven't been doing much uni work and have spent a lot of time watching TV or browsing on the computer instead. It's like I can't be bothered anymore.

I'm really frustrated because I want to do well in my degree and I've done really well so far. I've still managed to get good marks in my modules os far this year, so I'm worried that they won't approve my dissertation non-submission. If I can't graduate later, then my dissertation will bring my overall grade down a lot because it's only half-done and what I've written is so bad. I have four exams coming up (starting in two weeks time), but I'm worried I'm going to do really badly in them like I did at Sixth Form. I'm even considering delaying two of my exams so that I take them in August instead.

I don't know whether my tiredness/lack of motivation is due to the side effects of the medication, as I've read online that Citalopram can cause tiredness, or because my dose is too high or something, and my anxiety was coming to the end. Maybe the constant worrying/anxiety from the lymph nodes has triggered a depressive episode, causing me to lose my motivation, so I need an even higher dose? Can this happen? It's like I've gone from one extreme to the other. The past two days I've taken 10mg instead of 20mg to see if that would help- I think it's made me less tired, but I've still got no motivation to do anything.

Usually I'd be revising so much right now, but I just don't have any motivation! I'm seeing my GP tomorrow although I don't know whether she'll want to change my prescription. does anyone have any thoughts??

Fourteen14
04-29-2014, 08:59 AM
Hi Purple.

To be clear, this is my opinion (I'm non medical) but from what you have described in detail, seems very much like you have been caught between a rock and a hard place.

Firstly, anxiety can make you obsessive about something (in this case making sure your grades were high), but it can also make you withdraw (depression will also fuel this), not necessarily taking a "what's the point" attitude, but more relating to avoiding doing something (in this case your work) putting things off, and being unable to think clearly is one of the most commonly reported phenomena in patients suffering with anxiety.

Secondly, your medication, citalopram is ineffective at 10mgs, this is normally the starting dosage, which is then increased gradually. 10mg would potentially relieve some of the depressive symptoms but certainly wouldn't touch anxiety (more likely increase it).

Also, (SSRI) (citalopram) are not something to be used short term, as in, it takes approx 3 months until the full effects are felt, then a further minimum of 6 months to allow the nervous system to rest and then a further 3 months to wean off them. (9 months minimum).

Citalopram also can, in many cases flatline your mood (it's not simply a case of topping up some kind of magical fluid in the brain) it simply inhibits the re uptake of serotonin in order to stabilise the neurological activity in the brain), often this becomes a plateau of emotion rather than highs/lows, as you are now taking 20mgs this could be what has contributed to your feelings of not really caring one way or the other.

I think you are doing the best thing in delaying your dissertation/graduation, allowing yourself to get well first will enable you to have a fair shot at a good degree class. Otherwise you have wasted the hard work so far.

Regarding the weight loss, as your blood work is clear, it could potentially be the medication (side effects of citalopram are known to increase/decrease weight). Also, stress plays a huge role in metabolism. The Lymph nodes may be raised due to allergens (you mention March which is the start of the pollen season), not everyone gets the typical sneezes and itchy eyes.

The other thing you could consider is speaking to your GP about sertraline (Zoloft) it is another SSRI, in that it is an anti depressant, but citalopram and sertraline are the only ones licensed in the UK to treat anxiety, I've known many people have greater success with sertraline.

Another option as far as meds are concerned would be to consider beta blockers, the only real problem with this is they can result in chronic fatigue (so possibly not good for focus on studies).

I would speak to your GP about the meds, and get them to refer you for CBT (talking therapy), GP's are great for general health problems but often know little about the effective treatment of mental health.

Best of luck :)

purple9812
04-29-2014, 11:53 AM
Hi Purple.

To be clear, this is my opinion (I'm non medical) but from what you have described in detail, seems very much like you have been caught between a rock and a hard place.

Firstly, anxiety can make you obsessive about something (in this case making sure your grades were high), but it can also make you withdraw (depression will also fuel this), not necessarily taking a "what's the point" attitude, but more relating to avoiding doing something (in this case your work) putting things off, and being unable to think clearly is one of the most commonly reported phenomena in patients suffering with anxiety.

Secondly, your medication, citalopram is ineffective at 10mgs, this is normally the starting dosage, which is then increased gradually. 10mg would potentially relieve some of the depressive symptoms but certainly wouldn't touch anxiety (more likely increase it).

Also, (SSRI) (citalopram) are not something to be used short term, as in, it takes approx 3 months until the full effects are felt, then a further minimum of 6 months to allow the nervous system to rest and then a further 3 months to wean off them. (9 months minimum).

Citalopram also can, in many cases flatline your mood (it's not simply a case of topping up some kind of magical fluid in the brain) it simply inhibits the re uptake of serotonin in order to stabilise the neurological activity in the brain), often this becomes a plateau of emotion rather than highs/lows, as you are now taking 20mgs this could be what has contributed to your feelings of not really caring one way or the other.

I think you are doing the best thing in delaying your dissertation/graduation, allowing yourself to get well first will enable you to have a fair shot at a good degree class. Otherwise you have wasted the hard work so far.

Regarding the weight loss, as your blood work is clear, it could potentially be the medication (side effects of citalopram are known to increase/decrease weight). Also, stress plays a huge role in metabolism. The Lymph nodes may be raised due to allergens (you mention March which is the start of the pollen season), not everyone gets the typical sneezes and itchy eyes.

The other thing you could consider is speaking to your GP about sertraline (Zoloft) it is another SSRI, in that it is an anti depressant, but citalopram and sertraline are the only ones licensed in the UK to treat anxiety, I've known many people have greater success with sertraline.

Another option as far as meds are concerned would be to consider beta blockers, the only real problem with this is they can result in chronic fatigue (so possibly not good for focus on studies).

I would speak to your GP about the meds, and get them to refer you for CBT (talking therapy), GP's are great for general health problems but often know little about the effective treatment of mental health.

Best of luck :)


Thanks, I think you might be right about my anxiety causing me to become more withdrawn. Maybe 20 mg is the right dose after all, and I just need more time for it to work. I was on a 20 mg dose for about 3 months last year and it seemed to help. I’m not sure what my weight loss is caused by really, although stress/anxiety is definitely a possibility as my mind was working overtime before. It’s definitely not due to the citalopram though, because all the weight was lost before my prescription began at the beginning of April. I’ve gained 2 or 3 pounds since- that my be due to the citalopram, or just because I’ve been worrying less. I think I might ask my GP tomorrow to arrange for a lymph node biopsy, just in case there is something wrong.

Fourteen14
04-29-2014, 12:02 PM
I'm not sure your GP would opt for an invasive procedure if your blood work is clear.

The recent blood test would include your lymphocyte count (this would show any early signs of infections or potential cancers). If it was anything serious, weight loss would have occurred during the more advanced stages and would definitely show up in your blood results.

It could potentially be related to your thyroid (overactive) for weight loss, this would be a good one to get checked if they haven't already (hyperthyroid can also cause heightened anxiety).

Personally I think, given your age and lack of other symptoms this would be the most likely at the worst case scenario.

It's good that you are regaining the weight.

Keep your head up, it does get better :)

purple9812
04-30-2014, 10:34 AM
I've been on 20 mg citalopram for 4 weeks now, but I'm still finding it really difficult to study. I can't remember anything. I spoke to my GP today, and because i've got two weeks left of my citalopram prescription, she said to come back in two weeks time and she might up the dose to 30 mg depending on how I'm feeling. I'm pretty sure I'm going to delay two of my exams along with my dissertation, so that I'll sit two exams in May and two exams in August. I'm just really worried I'm still not going to be able to do well at all, then all of my hard work will have gone to waste :(( When we sit the exams, we have to sign a page saying that we are 'fit to sit', so if our results are bad we can't subsequently say that we were affected by an illness. It sucks. I spoke to my tutor and he even mentioned suspending my studies to next year, so then I can get the degree that reflects my hard work throughout the course. I don't want to have to wait until next year to sit my exams though, so I'm going to have to sit them this year. I just hope this medication work quickly :S :S

purple9812
04-30-2014, 12:35 PM
This work is impossible, nothing's going in, I hate my life :(