Encouragement Needed Please!

[sadinsa]

Hi everyone,

I will start out by apologizing ahead of time if this post gets too long and I will try not to ramble. I have been suffering with anxiety/panic for about 15 years on/off. I have been on Paxil, Celexa and now Lexapro. I have not been on these meds for the whole time but for the past 6 years I have been on the Lexapro. About 10 years ago I had the worse episode I had ever had. It got to the point of me not being able to sleep, eat (I lost 10 pounds in a month), or do very much of anything. I started seeing a psychiatrist again and he put me on Celexa at the time and Klonopin and Xanax for a very short time as needed (the doc changed it to Lexapro later). At that time I was also diagnosed with panic disorder with agoraphobla. I never got to the point of being homebound but going out was very difficult, I just would experience the anxiety. I went to therapy at this point and we focused on changing my thoughts. A few months went by and I started getting better until I got to the point that I realized I wasn't thinking about my anxiety anymore. I was living life normally like before. I was only taking Lexapro which seemed to help, life was normal. I even took a trip to Brazil about 18 months after this started. I was nervous and I did take Klonopin for the flight but not while I was there in Brazil. The next year I got pregnant and this seemed to bring alot of the same thoughts back, we also lost my mother-in-law during this time. I was off meds for the pregnancy. I got through the pregnancy and even towards the end my anxiety went away, I then was back to normal for a while. I continued to have short periods of episodes where I would get the thought that I would go back to how I was when I hit rock bottom but those times would just last a few weeks to a month or two and I would get over it. My 3rd pregnancy was difficult, I had a panic attack the day I found out. But I got through it and I had been good up until recently. I even took a trip to Europe last year.

Fast forward to the last 6 weeks. I found out I was pregnant with my 4th child right before Christmas. I had a panic attack that night. That started this whole thing over again. I have lost weight, lost sleep, etc. I am fearful again. I don't understand how I could forget all those skills I had learned in the past. It always comes down to me worrying that I am going to get so sick that I will be homebound and that terrifies me. I have 3 children now and I just can't do that. I think about it ALL THE TIME. I know that me dwelling on this is just bringing on the anxiety. But it seems like I anticipate the worse thing and then I get nervous, but the worse never happens. Its like I am waiting for the biggest panic attack in history to happen. My psychiatrist increased my Lexapro to 20 mg. but then I am worried that it is not going to work. He also said for me to take my Xanax as needed. I have never taken Xanax on a regular basis and am afraid that if I start I will see how easy it is to feel better and then it will be easier to convince myself to take it again and again and again. I forgot to mention that I lost the baby a few weeks ago and I thought that my anxiety would go down but it hasn't. I don't know what to do, I feel so lost and scared. I need to go to the grocery store today but am nervous about that. I was out yesterday and felt very nervous and uncomfortable then so now I am worried about the things I have left to do this week. I did have a very good day on Monday, I was out all day and felt very calm. Tuesday was okay, not too bad. Please any advice or encouragement is helpful. Should I go ahead and take the Xanax for a while or just try to go without it and feel the fear. One thing I try to do everyday is get out of the house. Is this a good idea or does it add to my anxiety. Thank you for reading and God Bless.

[alankay]

Sad, fact is anxiety can wax and wane over time(mine does...and many others too). I would stay on the lexapro and just use the xanax "as needed" as long as it allows you to do what you need to do and function normally(pretty much anyway) and safely. If taken sparingly you won't develop tolerance and this will be therapeutic for you. You must continue to get out and about often. It's just is good for you.....period.
I prefer a longer acting benzo but if xanax works for you and your doc is OK with Rxing that, stay with it.
Your anxiety will go up and down with lives' stresses so factor that in. Expect it and accept it. Learn from it and get better at calming yourself. A little positive self talk goes a long way.
So expect some anxiety from time to time, use the xanax "as needed" but make a game(sort of) out of how well you can calm yourself and do without it. It's not good to feel the fear too much unless you're doing some exposure therapy or something. I think you are doing OK. Like you I take valium "as needed" for air trips, meetings, etc, and know it's therapeutic is it's safe and helps me cope while I keep learning to calm myself and does no harm. Just be careful while driving(dose right and you be AOK), etc, and you'll be fine with the xanax.
I think you're doing OK!!! Like allot of us anxious folks...we ALL struggle at times. PM me any time. Alankay.

[sadinsa]

Alankay,

Thanks for your response. I go to the psychiatrist this week and I want to talk to him about my medication. Do you prefer Klonopin over Xanax? I may ask him to prescribe me that instead but I don't know if I should take that instead. Since I went up from 10 mg to 20 mg of the Lexapro a little over week ago I should be feeling the effects of it soon shouldn't I. I had a better day yesterday, I was a little more confident. In your opinion how long does it take to feel the full effects when you increase a medication. I know when I was first put on the Lexapro they said it could take up to 6 weeks to feel the full effect. Is this true when you increase a medication? I am seeing a therapist and we are working on changing my thoughts. It is just so hard to change them sometimes. Thanks for the help.

[alankay]

Sad, it will take some time to get the full benefit from lexapro. I'd stay with it at 20mg to give it a good, fair trial.
The reason I think klonopin might be better for you right now is that you said about your anxiety, "I think about it ALL THE TIME", which sounds more like a general chronic anxiety as opposed to a panic type situation(klonopin can help that too, just xanax is shorter acting and a bit more potent so used more often for panic). Xanax also has some antidepressant effects but you seem, like me, mostly just anxious. If you are anxious more so in general than just when out and about, ask about klonopin for how your feeling right now, "these days" so to speak. See the half life of klonopin is maybe 30+ hours while xanax has a 12 hour half life. Either will do, just a question of what's a better "fit" for the anxiety. General anxiety and some panic can be helped with klonopin. Xanax is a bit better for pure panic situations but docs have their on preferences so just ask and accept what he wants you to take.
It's OK to lean on the benzo during tough periods. I do sometimes. That's what it's for. Just some patients(not you) want to only take pills and not do the other stuff like also taking an SSRI, learning more about anxiety and talking with a counselor, etc, which can lead to problems eventually. If xanax really does it for you stay on it. If you think your anxiety is more general right now klonopin might be a better fit. Your doc can always switch you back in the future if needed. Alankay.

[sadinsa]

Thanks for your help explaining things. I actually have been doing a bit better the past 3 or 4 days. I have even had periods when I realize I wasn't even "worrying". For instance, last night we went out to dinner with some friends and afterwards on the way home I realized I hadn't even been thinking about my anxiety. I was calm and had a really good time. I am having more times like this lately. I still haven't felt the need to take the Xanax, so I am very happy about this. I also have been using these essential oils that are supposed to have calming effects. They are therapeutic grade from Young Living. So I am going to continue to use these on a regular basis. But I know I will also have the Xanax or Klonopin (whichever the doctor decides to prescribe) on hand if it is needed and I will not feel guilty about taking it if needed.

[alankay]

Oils are good as is getting things "off your chest" and learning more about anxiety. Alankay