Mediation issues/where to go next?

[Allegraj]

I'm new here, so hello everyone! I need advice on a situation I'm in regarding my psychiatrist and medication. I'm 21 years old and I suffer from crippling general and social anxiety. I have a part time job (retail) which is torture for me. I live at home because I can't work enough to support myself. I have basically no friends and when I'm not at work, I'm at home. I was supposed to go back to college this fall but I couldn't do it because of fear. I fixate on my worries and they have overtaken every free second of my life, and keep me from sleeping at night. I finally decided I'd have enough and decided to see psychiatrist. I had seen her once before when I was suffering from extreme depression, but I had already gotten antidepressants from my GP so the visit was short and sweet. A few months later I felt better so I tapered off of the SSRI.
So at my first visit with my psych I explained to her all the way my anxiety is affecting my life and holding me back. She didn't ask me any questions except how often I felt anxious and I said all the time. She never gave me an official diagnosis. I told her I wanted something to take "as-needed" for my anxiety, and that I did not want an SSRI because of the side effects I had faced on them (I tried both Celexa and Zoloft) last year. She gave me two options. Buspirone (I didn't want to take something twice a day) and gabapentin (off-label use for anxiety, it's mainly used for seizures and nerve pain). She also recommended I see a therapist (which I am going to once I can coordinate it with my work schedule).
The gabapentin does not work for me. At first it simply made me feel loopy/stoned. I feel zero anxiety reducing effects. I had started on the 100mg capsules so within a few days I had her up me to the 300mg ones. I still felt very little and on top of that it gave me horrible swollen glands in my neck which made my whole jaw sore. I called her to let her know and she said she had never heard of that side effect (um, it's on the list) and offered me buspirone again or hydroxyzine. I told her I don't think an antihistamine would work for me because it would put me to sleep and she basically said she didn't know what else to suggest.
I feel horrible, discouraged, and tonight I've realized that the gabapentin is actually making me very depressed and borderline suicidal, which I haven't been in over a year. I don't know if I should try to work with her more and see if she can do anything else for me as far as medication (I have an appointment this Wednesday), or if I should toss in my cards and find someone else. I'm just terrified to stand up to her or suggest any medication. But I know going to a different psych could take months and I can't wait much longer, my life is in shambles because of my anxiety. Any suggestions?

[gypsylee]

I'm new here, so hello everyone! I need advice on a situation I'm in regarding my psychiatrist and medication. I'm 21 years old and I suffer from crippling general and social anxiety. I have a part time job (retail) which is torture for me. I live at home because I can't work enough to support myself. I have basically no friends and when I'm not at work, I'm at home. I was supposed to go back to college this fall but I couldn't do it because of fear. I fixate on my worries and they have overtaken every free second of my life, and keep me from sleeping at night. I finally decided I'd have enough and decided to see psychiatrist. I had seen her once before when I was suffering from extreme depression, but I had already gotten antidepressants from my GP so the visit was short and sweet. A few months later I felt better so I tapered off of the SSRI.
So at my first visit with my psych I explained to her all the way my anxiety is affecting my life and holding me back. She didn't ask me any questions except how often I felt anxious and I said all the time. She never gave me an official diagnosis. I told her I wanted something to take "as-needed" for my anxiety, and that I did not want an SSRI because of the side effects I had faced on them (I tried both Celexa and Zoloft) last year. She gave me two options. Buspirone (I didn't want to take something twice a day) and gabapentin (off-label use for anxiety, it's mainly used for seizures and nerve pain). She also recommended I see a therapist (which I am going to once I can coordinate it with my work schedule).
The gabapentin does not work for me. At first it simply made me feel loopy/stoned. I feel zero anxiety reducing effects. I had started on the 100mg capsules so within a few days I had her up me to the 300mg ones. I still felt very little and on top of that it gave me horrible swollen glands in my neck which made my whole jaw sore. I called her to let her know and she said she had never heard of that side effect (um, it's on the list) and offered me buspirone again or hydroxyzine. I told her I don't think an antihistamine would work for me because it would put me to sleep and she basically said she didn't know what else to suggest.
I feel horrible, discouraged, and tonight I've realized that the gabapentin is actually making me very depressed and borderline suicidal, which I haven't been in over a year. I don't know if I should try to work with her more and see if she can do anything else for me as far as medication (I have an appointment this Wednesday), or if I should toss in my cards and find someone else. I'm just terrified to stand up to her or suggest any medication. But I know going to a different psych could take months and I can't wait much longer, my life is in shambles because of my anxiety. Any suggestions?

Hi there, welcome to the forum :)

I've been through all this and unfortunately the only thing that works well (for me) on an "as needed" basis are benzodiazepines - Valium etc. It sounds like your psych is wary of prescribing them for you, which is common because they don't want to risk you getting addicted.

I was addicted to them for ages and it's not fun but yes, they are the only thing (apart from alcohol) which work in that way. You could ask her about it..

Knowing what I know, I'd not try anything else. I'm on an SSRI (Lexapro) and they're the only other thing I had any success with. They do make you feel even worse initially and can take weeks to work though.

Generally I've found I can't rely on any medication (or substance) on an "as needed" basis. It sucks but yeah what's available isn't safe really. Unless you're strong-willed and can use things like benzos sparingly (which I can't).

Hope that helps a bit.

Hang in there..
Gypsy

[Allegraj]

I'm 100% willing to try them, if there's a possibility of them helping. But I honestly don't think my current psych will prescribe them to me and like I said, I'm terrified to ask for any medication that she doesn't offer first, I'm scared of getting lectured. Any suggestions on how I could broach the subject gracefully? Or should I just cut my losses and try a different doctor/psych? I have a GP I could see for medication and I'm still planning on therapy once I get my schedule worked out. I just want to be able to move on in my life and I can't until I am a high functioning human with little anxiety.

[bogmonster]

and that I did not want an SSRI because of the side effects I had faced on them (I tried both Celexa and Zoloft) last year

Hi,

I'm not at all knowledgeable so take anything I say with a pinch of salt :) From my very limited experience I have found a couple of SSRIs that didn't work for me at all and just made me feel terrible and unable to function due to extreme fatigue. I am now on an SNRI that I have just started and it is working well for me so far. I was very reluctant when my psychiatrist suggested as I didn't believe it would work it but decided I would give it a try. From what I have read many people go through a few SSRIs / SNRIs before finding one that will work for them. It is early days so hopefully the side effects will improve but at the moment I have mild headaches, dry mouth, a bit drowsy and sexual dysfunction. And while all that sucks a bit I am currently free of the racing thoughts that were driving me crazy. For me this is a sacrifice I am willing to make as I was in complete despair.

Of course another solution may work much better for you, all I am saying is that you may be ruling out SSRIs / SNRIs whilst there may still be mileage down that route?

BM

[gypsylee]

I'm 100% willing to try them, if there's a possibility of them helping. But I honestly don't think my current psych will prescribe them to me and like I said, I'm terrified to ask for any medication that she doesn't offer first, I'm scared of getting lectured. Any suggestions on how I could broach the subject gracefully? Or should I just cut my losses and try a different doctor/psych? I have a GP I could see for medication and I'm still planning on therapy once I get my schedule worked out. I just want to be able to move on in my life and I can't until I am a high functioning human with little anxiety.

It doesn't sound like you feel very comfortable with her? I know what you mean about getting lectured - I don't even bother asking doctors for benzos anymore even if my anxiety is terrible.

Anyway, you could tell her you posted online about your anxiety and someone suggested you need something like Valium. But they won't make you a "high functioning human with little anxiety" :) they actually make it worse if you take them all the time.

A lot of people here do take benzos though.. I just have a very addictive personality so I'm not a good person to have them. So I'd suggest it to her and if she lectures you then cut your losses. There's no point seeing someone who makes you feel even worse.

Also, what someone said above is a good point - maybe you shouldn't give up on SSRI/SNRIs? They aren't a quick fix like benzos but much better long-term. You could try taking both until the SSRI kicks in..