Need so much advice. Have so many questions..

Hi, I am new to this site and I'm just hoping there is someone out there who can help me. Before I proceed with my current problem I will tell a little about myself.
My name is Michael and I am 20 years old. I've been born and raised here in Florida. For the past 4 years I have suffered from debilitating anxiety and panic disorder.
It started out with common symptoms but over the years due to my own fears and no real help it has spiraled out of control. I am definitely agoraphobic as well a hypochondriac. I don't leave my house too much and I don't have a social life. I wouldn't be complaining if that made things any easier. I don't have a job and I don't drive. I dropped out of high school because of the panic attacks but luckily I recently got my ged. My persistent hypochondriasis is probably due to the fact that my anxiety and panic has manifested in TONS of physical symptoms over the years. Varieties of terrifying headaches,dizziness,near syncope,palpitations,strange sensations,depersonalization,pseudo-seizure, and most recently I have a feeling I might be getting high blood pressure. The only thing that seems to help when I am nearing a panic attack is a Klonopin which doctors won't even prescribe me because of the dangers of addiction so i get the from my mom. Don't worry, addiction is not a problem for me because I am actually scared of medications so I tend to only take Klonopin when I am at the point where I feel it's in my best interest as well as my family's so I don't have another mental breakdown.

NOW, here is my current problem.. I have been on 10 mg of Escitalopram (Lexapro) for 2-3 years now. In the very beginning it seemed to help but for the longest time now it hasn't helped me become the person I need to be. I am seeing a new psychiatrist now and yesterday she prescribed me Venlafaxine ER (Effexor). She told me to discontinue my Lexapro which is scary to me for several reasons. I have experienced withdrawals from Lexapro in the past after not taking it for a week and they were nightmarish. I thought I asked all the questions that I needed to when I was at my appt but now that I have these meds in my hands I realized that my psych didn't even say anything about a tapering schedule! She just said to discontinue.. I am supposed to start taking this medication tonight but now I am just unsure of myself. It's probably just because I am terrified of medications, specifically these long term ssri's and snri's. I've heard the horror stories and I've also heard the few successes. The main reason I am so scared of meds is because when I was 17 my old psych prescribed me something called Latuda. I had a horrible reaction to it. The following four days were filled with suffering and I was eventually taken for emergency detention at a mental health facility against my own will. I want to believe in this psychiatrist but I've only just met her and I can't help the fact that I am just plain scared. I'm scared of everything. I was a normal kid for the majority of my life but since I was 16 it's been downhill for seemingly no reason. I apologize for straying from the main topic of this thread, my mind just travels as I type.

Anyways, if there is anyone willing to give advice in regards to the medication problem or my whole problem in general it would be much appreciated. I do have many more questions but I suppose they should be for different threads. Thank you in advance

Hey Michael,

To begin with, many people find Lexapro difficult to wean off, and find that switching to a similar dosage of the original SSRI, Prozac, stabilising for a while; say 2 weeks, then tapering off Prozac at 75% for 2 weeks, 50% for another 2 weeks, and finally 25% for the last 2 weeks has far milder withdrawal effects.

Some people find the SNRI, Effexor impossible to wean off due to the severity of their withdrawal symptoms, and are on it for life.

A previous post about antidepressants follows:

Antidepressants/anxiolytics either don't work for, cause side effects, or lose efficacy, over time, with a considerable proportion of people; probably more than 50%. See: http://articles.mercola.com/sites/ar...interview.aspx & http://suiciderateup.wordpress.com

Doctors and psychiatrists rely too much these days on medications, and are overly influenced by the sales reps of the drug companies, who profile them psychologically, and study their prescribing record, then provide inducements / freebies, and possibly payments to lecture, or attend lectures. Or it may be a nice meal, or a day out on the rep's boat, creating feelings of indebtedness and a desire, perhaps not even consciously, to reciprocate by prescribing those brands recommended to them.

See: http://drbenkim.com/articles/sick-he...are-system.htm Use the Mercola.com SEARCH BAR, about how drug company money has corrupted psychiatry, & view: http://articles.mercola.com/sites/ar...ur-doctor.aspx People who ask their doctor for a certain brand have it prescribed 70% of the time, hence the huge media campaigns - see http://www.naturalnews.com/010315_ad...s_doctors.html

The feedback that I have received here is that antidepressants work, if they do, by blunting the emotions. Many users describe it as "zombification", or emotional deadness. They produce side effects in around 25% - 30% of cases, and they can sometimes (rarely) include the possibility of permanent inorgasmia, (inability to achieve orgasm: "I haven't tried zoloft, but since the very first lexapro tablet I ever took, I have never had an orgasm again. And I came off it a year ago".) or even the permanent loss of the ability for a male to achieve an erection, which is something they don't advertise.

Although they may limit the lows, they also limit the excitement, and joys of life. That effect is far less pronounced with St. John's wort, and may be unnoticeable. Antidepressants have demonstrated increased rates of suicide, homicide, and aberrant behaviour, especially in people under the age of around 24 - 25. Note the warnings on the label/insert, or at www.drugs.com The wort carries no such risks, and side effects are rarer, generally much milder, and never permanent., so why take an unnecessary risk? I suggest that such people immediately adopt the core treatments shown at * http://your-mental-health.weebly.com/b.html (anxiety is addressed on pages 1, & i, with panic attacks on page h) and consider using the herbal remedies, or OTHER supplements. If antidepressants are offered, say "thank you very much" and pocket the prescription, but don't fill it until giving the natural & alternative treatments a trial period of at least 3, and preferably 6 months. Antidepressants will still be available, if required, (unlikely) but it's best to avoid the risks, and side effects.
Psychiatrist: Anti-depressants not for kids:- http://au.news.y a h o o.com/a/-/latest/10122373/psychiatrist-anti-depressants-not-for-kids/ (remove the spaces in y a h o o).

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So, your psychiatrist has been indoctrinated in her medical training, quite possibly deliberately misinformed by sales reps, and her insurance coverage is limited to prescribing certain medications for specific disorders. I'm unaware of her age, experience, or how busy her schedule is and how much pressure she is under, but to my mind a psychiatrist who advises abrupt discontinuation of a SSRI like Lexapro which has been taken long term, is highly suspect.

Have you ever consulted a clinical psychologist who employs Cognitive Behavio(u)ral Therapy, using exposure therapy for agoraphobia, and provides an anti-panic attack breathing method, and recommends progressive muscle relaxation, acupressure tapping / EFT, or meditation for anxiety? Google: "clinical psychologists, CBT, (your location)" and I suggest having an initial appointment with 3, before deciding on which one you prefer.

Previous relevant posts are:

AGORAPHOBIA: http://anxietyforum.net/forum/showth...994#post224994

ANXIETY - GENERALISED ANXIETY DISORDER: http://anxietyforum.net/forum/showth...989#post223989

ANXIETY or PANIC ATTACKS: http://anxietyforum.net/forum/showth...006#post220006

HYPOCHONDRIA: http://anxietyforum.net/forum/showth...afew-questions

DEPERSONALIZATION / DEREALIZATION: http://anxietyforum.net/forum/showth...381#post223381

VITAMIN D: http://anxietyforum.net/forum/showth...obbly-eyesight

HERBAL ANXIOLYTICS: http://anxietyforum.net/forum/showth...415#post225415 (I don't recommend kratom, and SJW can be tried for anxiety, but is more for depression, and takes weeks to become effective, even if * Perika, Jarsin, or Kira are used).

It's impossible for me to know if the following applies in your case:

From http://www.vitamindwiki.com/Handout+...-+Gominak+2012 by neurologist, Dr. S Gominak:

"If you have a neurologic problem that is severe enough to see a neurologist, you probably do not heal your body in sleep as perfectly as you once did. Most of us who have headaches, tremor, balance difficulties, vertigo, burning in the feet, depression, body pain, or memory loss have abnormal sleep and, surprisingly, fixing the sleep can fix the neurologic problem". Read the web page in full.

An insufficiency of vitamin D can result in secondary deficiencies of B group vitamins, which are a known cause of anxiety, as is magnesium deficiency, which may apply in up to 80% of Americans.

The fact that you suffer from agoraphobia leads me to believe that you may have a vitamin D deficiency. There is a long thread here at http://anxietyforum.net/forum/showth...hlight=vitamin

Note that most doctors would regard lower levels of vitamin D as being acceptable than those recommended by Dr. John Cannell of the vitamin D council, or Professor Michael Holick, a former member, and an expert in vitamin D.

Read: "Why are doctors reluctant to accept vitamin D", at:
http://www.vitamindwiki.com/Why+are+...cept+vitamin+D and in particular:
"Would you be opposed to my getting more vitamin D", at:
http://www.vitamindwiki.com/tiki-index.php?page_id=3162

SUN EXPOSURE TIMES: http://www.vitamindwiki.com/Overview+Skin+and+vitamin+D (sensible sun exposure is preferable to vitamin D3 supplementation, if possible).

My target range is now 60 ng/ml (150 nmol/lit) to 70 ng/nl (175 nmol/lit), as recommedned by both Drs. Gominak and Mercola, and to ensure adequate cofactors, I also take a multivitamin / mineral / ubiquinol / amino acids, etc. supplement called Total Balance (men's version) from xtend-life.com although a good quality one like Suisse, from pharmacies or supermarkets would suffice in your case.

If using a RECOMMENDED * brand of St. John's Wort (take with meals to avoid possible stomach upsets) view the websites about it on page B*, and if also using UP TO 50mg of 5-htp daily - http://www.foodforthebrain.org/conte...d_Content=1635 refers- in addition, (or UP TO 200mg of 5-htp if NOT using the wort. I note with interest that in the study referred to, 300 mg of 5-htp was used) take with a very low protein meal, to maximise the amount crossing the blood/brain barrier, with no, or extremely little protein 2 hrs before, to 2 hrs afterwards. I suggest beginning with 50 mg on the first day, and if no adverse reaction, keep increasing it until reaching the desired level, to let your system accustom itself to it gradually. Google maximum safe dosage. Alternatively, use SAMe (S-adenosy-L-methionine) but nothing else. Has the advantage of working more quickly than St John's wort. Use only the butanedisulfonate form in enteric-coated tablets, or in capsules. The usual dosage is 400 to 1,600 milligrams daily, taken on an empty stomach. Take lower doses (under 800 milligrams) once a day, a half hour before the morning meal. Split higher doses, taking the second a half hour before lunch.

Hoping something in the above helps.

Wow thank you so much for responding Nowuccas. You really seem to know your stuff! I am so grateful that you have provided me with so much research material. I honestly just want to know and practice what is best for my body and seek the correct treatment. I'm beginning to think these long term ssri's are just not worth the risk the more I read about them! My father always told me to not doubt the professionals but I always do. I can't help it. The thing is, I have never had severe depression. My main illnesses are Severe anxiety and panic attacks. Why are these medications used to treat both illnesses? I am not a doctor so I do not understand the correlation between anxiety and depression. I was wondering if there are medications just used to treat the anxiety and the closest thing to that has been benzos which already have so much controversy around them. Although Klonopin does help me sometimes as previously stated and I would never abuse the drug.

I appreciate you taking the time to suggest more natural possible treatments like more vitamin D and multivitamins or supplements. I'm not sure what ubiquinol is but a doctor gave me something called dimethyl glycine or DMG when I was 16 which didn't really help with anxiety at all but I took it for months. Again thank you for such great sources of information I will look through these. I have never been to a clinical psychologist and have never went through congnitive behavioural therapy or exposure therapy. I have never been taught any breathing methods. I have never heard of progressive muscle relaxation but the accupressure sounds interesting. Are these all things a clinical psychologist can do?? I am just so uneducated on these things. The mental health industry hasn't exactly educated me or helped me too much these past years out of the numerous psychiatrists I've been to. I will definitely not be taking the effexor tonight, instead I will talk with my psychiatrist before I possibly endanger myself from discontinuing my lexapro without tapering as well as commiting myself to yet another long term medication that I might not be able to ever get off of. I definitely need to look into a clinical psychologist and I need to educate myself more. Thank you so much

My suggestion would be to see another Psychiatrist to get a second opinion. I know what my Psychiatrist would have done..he would have increased the Lexapro to 20 mg to see if that offered relief before he switched to another one. If you are that afraid, you may need a higher dose. I recently went up from 10 mg to 20 mg and it has made a huge difference. Of course, I still have some anxiety but it's better. Effexor may prove to be a better medication for you. I'm not sure why you were given Latuda? Did anyone say you have bipolar? Each of us is different and each of us responds better to different medications. I know that some medications are so similar, say Zoloft and Lexapro, that you really may not need to taper it off because they are quite similar. Effexor is a bit different, so I am unsure. Anyway, it certainly can't hurt to go get another opinion, even if it's just a general doc because what I've found is they know a little bit about these medications too. They see so many patients on them. I wish not taking the Lexapro was even an option for me but it is not.

SSRIs perform only slightly better, statistically in double blind studies than a placebo, yet that small difference is what enables them to be promoted in advertisements, and make pharmaceutical companies many billions of dollars in profits, and lobbying of politicians has resulted in them having the law changed, and removed any chance of successful law suits in the case of death, or other adverse consequences. That is one of the reasons why I usually recommend first trying natural, complementary, and / or alternative treatments, although not in all cases, such as psychosis, or suicidal intent, which doesn't often apply to anxiety spectrum disorders.

SSRIs were initially prescribed to treat depression, then a number of people suffering from both depression and anxiety reported that they also helped with anxiety, so prescribers often prefer them to benzodiazepenes, the long term use of which results in a much increased risk of dementia.

Medications such as antipsychotics or mood stabilisers may be necessary, such as in bipolar disorder, or schizophreniform disorders, or even in major depression with psychosis. Some psychiatrists and doctors even prescribe Seroquel, which may cause diabetes, to treat insomnia.

Anxiety and depression are often comorbid; they may have the same cause, or one may result from the other

Below is some of the material that I have collected over the years:

LEXAPRO:
I had a friend who died of kidney failure using lexapro for a continued long use of it. Below I have listed some side effects*. I would have my Doctor change it immediately! Some drugs lose effectiveness and cause adverse reactions from prolonged use. Please contact your Doctor soon!
http://au.answers.y a h o o.com/activity?show=1UayjdpVaa

From Y!A: by perfecti... Member since: http://au.answers.y a h o o.com/my/profile;_…
I haven't tried zoloft, but since the very first lexapro tablet I ever took, I have never had an orgasm again. And I came off it a year ago.

Just personally I tried one pill it was called lexapro I had anxiety depression but after taking the pill I didnt feel just anxious depressed I felt totally nutty I didnt know what to do with myself i was lying in my mums lap like a baby saying I dont know what to do with myself to make it stop - the lexapro drug that was and im 37 no baby. I was so out out it I was vomiting and I couldent see straight. It took about a week for me to feel normal again and even for my vision to stop flickering These drugs can be extremely dangerous.
http://au.answers.y a h o o.com/activity?show=wDjbMugJaa

* See http://www.theroadback.org/lexapro_side_effects.aspx

If you are interested, PM me and I'll send you the rest.

Psychiatrists are generally very time poor, and need to limit the length of a consultation, often to 10 minutes. Even if they are aware of some of the techniques in Cognitive Behavioural Therapy, or EFT, etc., they just don't have the time to instruct their patients in them.

Below are some:

Practise a relaxation method, daily, and when needed, such as: (free) http://www.drcoxconsulting.com/managing-stress.html or http://altmedicine.about.com/cs/mind...Meditation.htm or http://www.wikihow.com/Meditate or Yoga Nidra*.

They will enable you to emotionally centre yourself, when practiced regularly, and are valuable methods of helping you through life's bad patches. Learn them at least a few hours apart, and preferably on different days, in the morning, or early afternoon. Use the one you find most effective. A minimum of 10 mns is recommended; 15 is better, and 20 is ideally preferred.


A VISUAL TECHNIQUE:

Sit comfortably in a quiet room, at a comfortable temperature, with fingertips facing upwards. Ensure clothing and footwear are not restrictive. Gaze at a burning candle in a quiet, darkened room for 20 minutes (you can use a crystal, egg, mandala, religious symbol, or anything else of a similar nature you may prefer). Any stray thoughts entering your mind should be noted, without pursuing them, and your attention then gently refocused on the gazing process.


A VERSION OF MINDFULNESS BREATHING:

Sit, or recline comfortably in a quiet, darkened room, but not in pitch darkness. Clothing and footwear should not be restrictive, and it should be at a comfortable temperature. Your fingertips should be facing upwards. Focus your attention at the place where your breath enters and leaves your body, preferably breathing regularly, through your nose. Any stray thoughts coming into your mind should be noted, then gently refocus your attention on your breathing. This should be done for at least 15 minutes, but 20 is better, preferably in the morning, and again in the early afternoon, or evening, as it is easy to drift off to sleep while meditating, if tired.


* YOGA NIDRA: See http://anxietyforum.net/forum/showth...951#post224951


EFT:
Give the Meridian Tapping Technique / EFT a good tryout, to see if it helps you. It is free via mercola.com or www.tapping.com (13 free videos), or www.eftuniverse.com or www.emofree.com or one of the many YouTube videos. Google: "YouTube; EFT videos".
Professionally instructed is generally preferable (Google: therapists; EFT; [your location] ). - There is a version for use in public places at http://eft.mercola.com (if you like, you can claim to have a headache, as you employ the acupressure massage / tapping on your temples, but you would then be restricted to subvocalising: saying it to yourself in your mind: "Even though I have anxiety, I deeply and completely accept myself)."


COGNITIVE DISTORTIONS: http://anxietyforum.net/forum/showth...089#post224089

Much more about them and ways to combat them may be found in: "Feeling Good." The New Mood Therapy. Harper Collins.1999. ( updated sequel to his US bestseller about treating depression & anxiety; very comprehensive), by David D. Burns, M.D., from your bookstore, Amazon.com, or BarnesAndNoble.com

Cognitive distortions are one of the things that you would learn about in Cognitive Behavioural Therapy, if you have around 6 months and a good therapist; it's unlikely that you would learn about them from psychiatrists.