My symptoms - recognize them?

[seagull]

Hello, I'm new to this forum. In fact it's the first time I've ever been on an Anxiety forum.

The reason I'm here is to reach out and see if anyone else experiences what I do, and perhaps has some advice.

I'm 32 and I've been on meds for about 10 years.
It started towards the end of my university days I was diagnosed with post viral fatigue syndrome - basically I got sick and couldn't get better.
FYI - I experimented with 'speed' and 'e' and I'm convinced this may have triggered my depression and anxiety.
I also drink heavily one or two nights a week.

Anyway, the meds snapped me out of it and I've been on and off them for the last 10 years.

The anxiety and depression have never gone away.

I've had therapy, tried different diets, natural remedies, exercise, stopped drinking, tried various DRs, etc. - lots of different things, but nothing has really helped.

I don't have panic attacks. I have a more general anxiety that lasts for days at a time.

I'm convinced my problem is a physical one, rather than an emotional one.
I've come to this conclusion over many years of observing my anxiety. It is particularly acute when I put my body under duress.

For example my anxiety is highest when:

- I weight train - for days afterwards I am depressed and anxious
- I have a big night out drinking - the hangover is usually OK, but for 2 or 3 days after I am anxious
- I cut down on carbs
- I don't get enough sleep

I've also noticed that I'm much better in the afternoon - sharper, stronger emotionally. It's like it takes 1/2 a day for me to wake up.

For some reason drinking a lot of Orange Juice helps me when I'm feeling anxious.

I am currently taking 30mg of citalopram (selexa) a day in the morning.
It works reasonably well, not amazing - but it's the one that has the least sexual side effects.

Does anyone have any advice? Do you suffer similar symptoms? Do you take citalopram - please let me know.
I'd love to find a way to come off the meds.

Thanks

[Robbed]

I've had therapy, tried different diets, natural remedies, exercise, stopped drinking, tried various DRs, etc. - lots of different things, but nothing has really helped.

You say you tried therapy. But from my experience, there are a couple of problems with therapy. First of all, most therapists are utter incompetents who have never been through depression/anxiety themselves. So they really don't know what works. They are only reciting what they have been taught (if they actually managed to learn it), which in itself is so often flawed. Secondly, therapy is not exactly the most 'patient' process in the world. This, of course, largely results from the fact that most people want to get back on track ASAP. So you hear things like CBT will either work in 16 weeks or not at all. But the truth is that recovery is virtually NEVER quick. ESPECIALLY if you have been suffering for as long as you have. It really IS a matter of sticking with your recovery regimen over the long haul.

In any case, your symptoms match what Dr Claire Weekes calls 'uncomplicated nervous breakdown' to a tee. By this, she means that something bad happened to you at some point in time (ie illness), which caused you stress. And this caused your anxiety problems. But once this initial cause went away, your symptoms didn't (as opposed to complicated nervous breakdown, where the initial cause(s) are ongoing). They remained because you became afraid of them. This caused you more stress, and kept the condition alive. Now, the illness is back in fairly distant history. But fear and stress over your condition continue to keep it alive. So what is the best course of action? It might be best to buy the book 'Complete Self-Help for your Nerves' by Claire Weekes. But the jist of her treatment is that you should first try not to react to your symptoms with fear. Try not to be afraid of them, and realize that they are simply caused by anxiety. You will probably not be able to do this much at first. But with time, acceptance of them will grow. Also, try to live your life as best as you can despite your symptoms. You might not be able to do everything you could before. But you can probably do more than you think. In any case, try not to let your condition severely limit your life. Be patient. Recovery takes time. It won't happen overnight. It probably won't even happen in a couple of months. And finally, accept that there will be good times and bad times during recovery. Sometimes, you will feel bad after feeling good for a time, and for no good reason. Don't despair. And don't try to figure out why it happened. It just did. And it is a completely normal part of recovery. So just be patient. Remember that you have had this problem for quite some time. So it will also take some time to get over it.

[northstar]

hi seagull, welcome to the forum :)

it sounds like you have tried rather a lot of things to help yourself, it's great that you have such a positive attitude rather than just relying on the meds alone to help out. the list you've given of when your anxiety is highest suggesting something to me that you may have already looked at, but just in case you haven't i'll tell you about it. unfortunately it's related to diet lol, and i know you've tried tons of stuff already so i hope this isn't more of the same kind of information.

anyway what you're describing sounds a lot like low blood sugar problems, or hypoglycemia, it is the same thing that i went through and on making a few corrections to my diet i managed to recover from the crippling anxiety i was going through and now a couple of months later my life is so much better, i still have to be careful about what i eat but that's a tiny sacrifice to eat compared to living with anxiety!

anyway, what happens with hypoglycemia is that things like refined carbs or processed foods or other irritants burn up too quickly in our bodies. they keep our blood sugar levels high for only a little while, but as the energy from the food wears off the blood sugars then plummet back down. to compensate for this drop the body releases a host of chemicals including adrenaline that can then result in tons of symptoms including panic attacks and GAD. for me i used to get ringing in my ears, difficulty breathing, sweats, shakes, panic, chest pains, knots in my stomach and all kinds of things. i almost went over the edge with it. if this is happening in your body it can cause a rollercoaster each day with highs and lows of blood sugars making us feel ok at times and absolutely miserable at others.

the reasons i think your problem is related to blood sugar are many. the first one is that you experience the GAD after a night out drinking. this can happen because alcohol plays havoc with your blood sugars, it acts like liquid sugar in the body and if you're drinking a lot of it then the crash is not going to be fun and will take several days to recover. you may also find that you wake up freezing cold in the night/morning after you've been drinking, this is low blood sugar at work. i've found this myself, if i go on a binge and eat loads of things i know i shouldn't it can take several days before i can correct it again and i'll have that vague feeling of anxiety at the pit of my stomach that is associated with GAD. really it's just my body giving out to me lol.

the second thing is that you say your anxiety is bad when you cut down on carbs. i think what you should be doing is trying to eat the right kinds of carbs rather than cutting them out. as far as i'm aware carbs turn into sugar in your body and bloodstream, if you're cutting them out then your blood sugar is just going to be constantly low and you'll feel miserable. the best thing to do is to replace refined carbs with ones that will burn up slowly in your body and keep your blood sugars more stable e.g. replace white bread with wholemeal bread or white pasta with brown pasta.

the reason you may feel better in the afternoon may be because of the fact that at that stage you've been up and eating breakfast and lunch and your blood sugars have had a chance to return to normal after a long night of fasting when you're asleep. you may find that often the anxiety is worse when you wake up, this can be because of the fact that your blood sugars are so low after a night of no food. mornings are still really hard for me, i keep a banana on my bedside locker to eat straight away to tide me over until breakfast. eating a good wholesome breakfast should have you feeling better in the mornings, i usually eat a boiled egg with some wholemeal toast - oh and no tea or coffee in the mornings either, these will only irritate you.

and also the orange juice thing is another hint. fruit juices are full of natural sugar so it's going to top up those low blood sugar levels and help you to feel a bit better. some hypoglycemic articles say it should be avoided but i prefer to have it, it's healthy and small amounts of it can't hurt! i wouldn't suggest you have too much of it though, otherwise it's probably going to cause a similar rollercoaster effect to the alcohol with spikes and dips in the blood sugars.

the best way to manage hypoglycemia is to eat small amouts of wholesome nutritious foods regularly throughout the day to keep your blood sugars stable. the stability may take a little while to happen, especially if this has been going on for years. i found at the beginning i had to eat really really regularly to feel ok, but now it's not so bad. i tend to eat breakfast (never skip it!) then a snack at my desk at work like popcorn/fruit/nuts, then lunch, more snacking, dinner and then another snack before i sleep. combined with the right kinds of foods this eating pattern keeps me feeling fine :) you also have to keep irritant foods to a minimum, so avoiding things like sugar/sodas/refined carbs/coffee/tea/alcohol is advised.

if this bloodsugar rollercoaster has been happening with you for a long time then i wouldn't be surprised if your body is feeling very on edge and worn out. you could try taking a vitamin B supplement if you're not taking one already, it's great for soothing out a stressed out nervous system. make sure it's compatible with your medication.

if your system has been strung out for years i'm not surprised that you feel bad when you can't sleep, rest is vitally important to a healthy nervous sysyem, if you're not getting it then of course you're gonna feel quite bad. i'm not sure about the weight training, but i'm gonna through a theory out there: if your system is quite worn out from the constant blood sugar highs and lows and the adrenaline spikes that go with it then it may be that when you weight train the extra adrenaline that it produces may just be adding to the problem? i'm not in anyway an expert here, it's just a thought, usually exercise is supposed to be beneficial to anxiety. you might want to look into the idea of adrenal fatigue? if you've been unwell for so long it's possible that your adrenal system is feeling the pressure and causing you to feel so strung out. just be aware that adrenal fatigue is more a part of alternative medicine rather than western medicine so your doctor may not entertain the idea. i found the adrenal fatigue information very very helpful though.

ok i think i've written enough for the moment! i hope you haven't heard all this before and have found it useless information, please let me know if it's helpful or not. i'm gonna post a link to an article on hypoglycemia at the bottom of the page for you to get a proper idea of what it is and how to deal with it. let us know how you're doing :)

http://www.anxietyforum.net/forum/viewtopic.php?t=3750

[seagull]

Hi Robbed, Northstar

Thanks so much for your responses. I really appreciate it.

Robbed - I have to say that I agree regarding therapists, and I'd go further and say I've met some very lousy Psychiatrists too.
Regardless, therapy has been helpful, but only so much. My anxiety comes and goes and tends to be cued by physical events, and no amount of reconditioning of the brain, or thought processes has ever been helpful.

Thanks for the reco regarding the Claire Weekes book. I have to point out though that when I look back I think I had slipped into a mild form of anxiety and depression approximately a year or two before I got ill. Perhaps my anxiety and depression caused the illness - I think my body was trying to tell me something.

Northstar - Thankyou so much for your detailed response. I've been working with a really good naturopathic doctor recently (one that I genuinely trust, who has experienced anxiety problems first hand). We are trying lots of different things.
He introduced me to the whole idea of blood sugar issues. I'm no expert but he linked it to my liver based on my history with binge drinking. We also found that I have low levels of vitamin D. I've been working with him on diet and supplements that can help.

The truth is that recently I have been eating a lot more complex carbohydrates and more regularly. I discovered the importance of carbs in general when I did low carb diets and got really anxious. I realised I need regular carbs, and good carbs. So my diet is now much better, and I feel better for it.

I tried some supplements to help regulate my blood sugar levels and help my liver but they didn't really help hence I recently asked the naturopathic dr if we could concentrate on natural supplements that will aid brain chemistry.

So right now I'm on a good diet with a regular intake of complex carbs, I'm taking vitamin D (which I understand plays a role in brain chemistry), cod liver oil, and I've just started 5 HTP. And of course I'm on the citalopram.
The last two days I've felt amazing, very confident, but who knows if it will last. I've had many a false dawn - as you probably know.

He also wants to give me adrenal support to help me in the mornings.

I'm rambling a bit, but in short everything you've described is very similar to what my naturopathic dr has been saying, so it gives me a great amount of comfort to have it confirmed.

I'm going to read the link you pasted in your response. Thanks so much. I've been on the meds so long it's difficult to see a life without them, but I can't bring myself to give up. I'm constantly looking for answers and I'm convinced I'll eventually find them and lead a more normal life.

[seagull]

Hi Robbed, Northstar

Thanks so much for your responses. I really appreciate it.

Robbed - I have to say that I agree regarding therapists, and I'd go further and say I've met some very lousy Psychiatrists too.
Regardless, therapy has been helpful, but only so much. My anxiety comes and goes and tends to be cued by physical events, and no amount of reconditioning of the brain, or thought processes has ever been helpful.

Thanks for the reco regarding the Claire Weekes book. I have to point out though that when I look back I think I had slipped into a mild form of anxiety and depression approximately a year or two before I got ill. Perhaps my anxiety and depression caused the illness - I think my body was trying to tell me something.

Northstar - Thankyou so much for your detailed response. I've been working with a really good naturopathic doctor recently (one that I genuinely trust, who has experienced anxiety problems first hand). We are trying lots of different things.
He introduced me to the whole idea of blood sugar issues. I'm no expert but he linked it to my liver based on my history with binge drinking. We also found that I have low levels of vitamin D. I've been working with him on diet and supplements that can help.

The truth is that recently I have been eating a lot more complex carbohydrates and more regularly. I discovered the importance of carbs in general when I did low carb diets and got really anxious. I realised I need regular carbs, and good carbs. So my diet is now much better, and I feel better for it.

I tried some supplements to help regulate my blood sugar levels and help my liver but they didn't really help hence I recently asked the naturopathic dr if we could concentrate on natural supplements that will aid brain chemistry.

So right now I'm on a good diet with a regular intake of complex carbs, I'm taking vitamin D (which I understand plays a role in brain chemistry), cod liver oil, and I've just started 5 HTP. And of course I'm on the citalopram.
The last two days I've felt amazing, very confident, but who knows if it will last. I've had many a false dawn - as you probably know.

He also wants to give me adrenal support to help me in the mornings.

I'm rambling a bit, but in short everything you've described is very similar to what my naturopathic dr has been saying, so it gives me a great amount of comfort to have it confirmed.

I'm going to read the link you pasted in your response. Thanks so much. I've been on the meds so long it's difficult to see a life without them, but I can't bring myself to give up. I'm constantly looking for answers and I'm convinced I'll eventually find them and lead a more normal life.

[northstar]

seagull it really sounds like you're on the right path, you're doing so many good things for yourself :) i'm really glad you're working with your naturopath along with the meds, i hope that some day you will be able to come off them happily. hopefully if the blood sugar thing is the problem then it will begin to level out for you as you work on the diet and supplements. it may be something you have to watch your whole life, although hopefully it will even out enough for you to not feel so anxious any more. i can't really give you an idea as to how long it took me to sort it out so that i felt normal again, but it did take time. at the beginning i had to eat really quite regularly to feel ok and had to totally avoid irritants like tea and soda. now i don't have to eat quite so often and i can have the odd tea or soda, so things aren't as extreme :)

it sounds like your naturopath is really doing everything he can to help, it's excellent you found such help! please do let me know how you're doing, i'd like to see how things go for you :)