Here's my story...

[emanresu]

Hello everyone,

I'm a new member to a forum which I wish I didn't have to sign up for (just like all of us). This is going to be very long but I hope you read it.

Here we go:

Up until I graduated from college, I've been a "normal" person. My senior year of college I had a job lined up for me when I got home in marketing and I was excited to finally graduate and move on. Unfortunately, I graduated at the worst time (in 2009) and my job became no longer available to me. I continued job searching anyway and didn't have any luck finding anything. Tension started to mount. At the time, my step-dad was looking for a new store to open and was working with a commercial real estate company. He told them I was looking for a job and they said they'd be happy to have me once I pass the real estate test. Real estate was something I never had any interest in and I was not excited to do it but my parents were pressuring me to do it and since I'm not one to turn down an opportunity either, I just decided to go with it. Also, the idea of working on strictly commission was not appealing to me at all due to its instability of when my next pay check is. But, I passed the test in the shortest amount of time since I was in a hurry to start working and began working in the city (a commute from Long Island which I was also not thrilled with).

Now, here is where my life changed forever. The day before I started working, it was my friend's birthday and we went to a hibachi place in the city. The whole time I was feeling anxious about working the next day since I was not excited at all. I kept thinking about the next day and I could feel the anxiety getting worse and worse. Also, since we were at this huge table, I was stuck in the middle surrounded by everyone and the heat from the grill was beginning to get overwhelming. It was like sucking all my oxygen it felt like. But I managed to finish my meal anyway. Then my friend was showing me funny videos on his phone and as we were laughing, my heart rate started to get faster and faster. I was starting to feel like I wanted to throw up and couldn't get out easily because so many people were sitting around me. That made things worse. Then I was at the point of absolutely going to throw up no matter how hard I tried not to and asked everyone to please move and I rushed right to the bathroom and threw up my entire 100+ dollar meal. I felt better after but was extremely petrified of what had just happened at dinner. I never experienced that before in my life. We went to a movie after and my anxiety started creeping back AGAIN. The entire movie, I felt a gagging sensation that I was trying to hold back. (This gagging sensation by the way is my only real physical anxiety symptom, but it's absolutely terrible because it inhibits me from being able to speak, laugh or do anything with verbal effort. It feels like a hair trigger).

As many of you know, the first panic attack creates a snowball effect of what-ifs and that's exactly what happened to me. I now associated the place I was going to work (the city) with anxiety. As well as restaurants. For 4 months, every day was a nightmare. I woke up every morning dry heaving in the shower until I puked out bile. This anxiety eventually spread to more and more social situations. I saw a psychiatrist and he prescribed lexapro and xanax, but I hated them, specifically the lexapro as I felt like a zombie and just stuck to xanax in the morning to help me get through the train ride. When I got to work everyday I would just sit at the desk till I calmed down and just tried to do a job I absolutely hated in hopes of closing a deal. The one major deal I was working on for those 4 months eventually fell through and that was it for me. I couldn't handle another second of working for nothing and never knowing when I would get paid (which I never did...I just wasted money on train tickets).

So that was the end of that chapter and like magic, I could feel my anxiety melt away (for the most part). I was still anxious about what was next and going to restaurants with my friends. I eventually found a new job in marketing and did very well in it and even got promoted. Things were going pretty well for me at this time, except for one thing. After leaving the real estate company, I was determined to make my life better. I had always wanted LASIK because I hated my contacts as they always made my eyes dry so I got LASIK to live a life without glasses and contacts. This procedure put me in the worst depression of my life. My day vision was amazing (20/15) but my night vision was terrible. I saw halos and starburts around light sources and my eyes were always so dry. I thought my life was over because I just ruined my most precious sense. Every single night my bad vision made me feel so sad because everything looked ugly. I couldn't enjoy movies anymore and driving was much more difficult. Luckily my case wasn't as severe as others and over time my night vision and dryness got better. It's still not where I wish it were but I've come to accept my new vision and hope that advancement in contacts will be made to correct my remaining problems.

Anyway, after working with my new marketing company for nearly 2 years, I was laid off and the hunt for a new job continued...I found another even better and closer to home marketing job and have been very happy there for almost 6 months now. But last week, my boss told me they want to move me to sales and I feel very scared and anxious to go back to an area I hate (involves everything I don't like: cold calling, speaking on the phone in front of people around me, traveling, presentations). I don't want to do that at all. I like where I'm at. But my boss said they feel I'll do better there and have an opportunity to make more money (which is obviously great). But every day I'm waking up with that feeling I had in real estate where my heart is pounding and I want to throw up. It's terrible. I'm still in marketing for another 2 weeks till we have a meeting about my new position. I don't want to leave my company because it's amazing there and the benefits and location and everything so I don't know what's going to happen. I hate job searching and interviewing and feeling insecure about my job security.

I plan to wait it out and see what the new position actually entails before making any decisions.

Do any of you get the same physical gagging sensation like I do? It causes me to do these weird head ticks as well...it's almost like I do them automatically to stretch out my neck or something to release tension in that area. My family has a history of anxiety. There's many more details that go in and out of this story but that's the core and would be very happy to hear some feedback. My goal is to go out every night like I used to without feeling like I want to throw up. I want to be able to speak and laugh normally without having to stop myself before I pull my "hair trigger." What can I do to get rid of that sensation? I chew gum, take a xanax (only when I feel I really need to) or suck on a mint. I find alcohol makes the sensation worse so I don't drink anymore.

Sorry this is so long. I know long stuff like this sucks to read. But if you made it this far, I thank you!

-Jared

[alankay]

Jared, the very first thing I would consider would be to restart the lexapro at 5mg(if the pdoc Rx'ed 10mg). These meds take time to work and if you were at 10mg, resuming at 5mg may feel better for you. In time your body will get accustomed to the med and you could up the dose to 10mg or as I did, get some of the 5 mg from the doc(via samples or Rx) and go to 7.5mg(by splitting the 5mg tab along with 1/2 a 10mg tab)after a month or so on 5mg. Hold at 7.5 for a 2-4 weeks then go to 10 mg and hold there and give it time. If money is an issue you could just as the doc for celexa(lexapro's brother) which is dirt cheap and go with 10mg for a few weeks, 15mg for a few weeks and then 20 mg and hold there. Again it takes time for these to work so lean on the xanax when you really need it and hold at the 20mg celexa or 10mg lexapro. Either scenario. It made you feel funny but this method minimizes side effects which will pass if given enough time anyway.
Alternatively if you feel that strongly against either, zoloft might be a good choice to go 25mg for a few weeks then to 50mg and hold.
As for the head tics, tremor, racing heart, etc, I use propranolol 20mg-30mg(some need 40mg) and it is great for that. Docs use it commonly for these type "performance anxiety" symptoms. Ask about it. Actors, musicians, execs use them and the doc will know all about it.
Anyway my main point would be to find an SSRI(paxil, prozac, celexa, zoloft) that agrees with you so you can get the benefits of the med. and lower your anxiety. If you give it the chance of a proper trial with a slow upward taper, you might be very glad you did in time. If the med winds up working like I hope you'll find yourself using less xanax and a beta blocker like propranolol in general as your anxiety improves. You might need a touch higher dose of the ssri in time but that's down the road and might not be needed.
Yep the stomach/digestive tract is a common issue with anxiety as the separate nervous system(link below) that controls the digestive tract is strongly influenced by CNS high activity(anxiety/stress) and would get better with lowered anxiety. http://en.wikipedia.org/wiki/Enteric_nervous_system
Print this post out and ask you doc about my suggestions if you feel like it.
PM me any time. Alankay.

[emanresu]

Hi, thanks for your note. The biggest problem I had with Lexapro was that it killed my sex drive. Same with Zoloft. I was on them for weeks and they may have helped with my anxiety but the lack of sex drive was just terrible obviously. A situational drug like xanax I find to be more helpful. I was on propanolol as beta blockers tend to be the safest drug for these kinds of situations but it didn't help me at all. I had to take 4 10 mg to feel a little help. I told my doctor and he said 40 mg is way too much. So I just stuck with .5mg xanax. My panic attacks can get so powerful that I feel they just override my medication sometime. And my symptom of gagging isn't like nausea. I don't feel physically sick in my stomach. I just feel like I want to throw up like when you stick your finger down your throat. I hate it so much because I can't talk or laugh because like I said, it feels like a hair trigger where I will just dry heave right then and there. I need to literally stop talking and hold my mouth shut. It's so embarrassing. I was out with my friends yesterday and it happened. I was actually feeling good in the beginning of the night and talking to my friend just fine, then we started talking about work and of course I got anxious and the gagging feeling started. He must have noticed my change in talking as I started talking really slow with skipped words. And this doesn't just come and go like most panic attacks. It can and does last the entire night. If I walk in cold, windy air like it was last night, the same feeling happens.

[alankay]

Jared, does this(sexual sides) happen at 5mg as well? Often, though most claim sexual sides never go away but I heard and read different on forums(sometimes they do pass). In any case if the ssri class of meds just can't be tolerated at any dose, ask about the TCA Remeron or perhaps Trazodone. Remeron has a tendency to lack the sexual sides. Same strategy for you as you may be sensitive to all meds that act on serotonin. Slow upward taper. Remeron often makes you sleepy so often taken at night but the sleepiness often passses with time.
As for the beat blocker. Ask about Atenolol. It is a different beta blocker. Particularly good for racing heart and commonly prescribed. I used it for years but since I am runner, my pulse was too low to keep using it so we switched to propranol since it has a shorther haf life and so less likely to cause me issues and so far, it's great for me if used at the right dose.
Just some thoughts for you to perhaps ask your doc about. PM me any time. Alankay.