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Will the GP (for once) actually giving me something for my anxiety?(22 Posts)
I've had anxiety since childhood (watching parents rowing (not on the water you understand!!) was enough to trigger that and I suppose if you wanted to label it, you could describe me as a 'high functioning' anxious person! What I mean by that is I push myself very hard to go out to work and to push myself in what can be called my 'career' - I could settle for much easier jobs but I prefer to push myself not least because I'm the main breadwinner (single parent) and have to meet all of the related financial obligations.
Where you would see my anxiety would be the fact that I compulsively pick my skin so it's damaged and scarred, that if I'm going somewhere not in the normal run of journeys/destinations I plan it out to the nth degree reviewing parking, looking on streetview so I'll recognise the entrance, reviewing the parking costs and payment methods, looking at the route etc etc etc etc.
When I was about 17 I discovered alcohol and the wondrous joy of being so pissed you can be at a distance from your stress and the CONSTANT feeling of heightened concern about everything.
Of course I wasn't diagnosed with this when I was a child and I didn't realise what it was for a long long time. When I had my DS I was off the charts anxious resulting in me trying to control every aspect of his care (never possible with a newborn) and it ramped up to a level I couldn't believe. I would also be anxious if the kids were say jumping on the bed - in CASE they fell off and hurt themselves - again, anxiety level way over and above anything that is normal.
As I say, you'd not necessarily know this is how I am if you see me/met me. But all of this I suppose trying to suppress it is working less and less and my skin picking is going mental and I just feel so hyped up all the time I can barely relax at all. I sleep badly and wake exhausted.
I want to go to the GP to get something medicinal to address this. I'm not depressed - but I do need something to 'take the edge off'.
What is the likelihood of getting beta blockers prescribed or there was another drug someone said on here (darn, can't remember it) that not only does it make you feel calmer but it also helps you sleep, begins with m....
It's just my GPs are often SO averse to actually DOING anything for you it drives me bloody mad. I did go in about anxiety once before and was offered referral to a mental health service but it would have resulted in going to regular sessions for CBT or similar and to be honest, the thought of having to try and organise that, take time off work and so on just makes me even more stressed! I'd like to manage it in another way.
So I guess I'm asking what are the key things I need to get across that are most likely to result in the GP actually taking my request seriously and looking at a prescribing route? What is it that makes them think oh ok this person needs this type of solution and I'm happy to get them it rather than let me suggest other options and not be happy to suggest ones involving drugs?
I know it's never preferable to be put on pills but for myself, it would be preferable to feeling like this every day of my life.
My opinion of medication is it's very good to manage symptoms until you feel able to tackle the problem and reason for the anxiety. That takes time, hard work and a wish to feel better. If you see medication as a long term strategy are you not just sticking a plaster on a gaping wound? Obviously some illnesses/people will need medication long term but it sounds to me like CBT/counselling may be what you might need? Is your GP aware of your anxiery related behaviour? If they dont look at medication as a short term strategy I would ask to see someone else but these days medication tends to be in conjunction with other therapies.
CBT is the front line treatment because randomised controlled trials have supported its use. Your GP is offering you the right treatment. Some services can offer it via telephone, or online, in fact they would be thrilled to as it is cheaper. Why not ring them and see if this is possible?
But in answer to your question, I guess you could just honestly ask what the options are for treating anxiety, and say you don't think talking therapies are for you, but it is seriously affecting your life. Then make an informed choice based on their advice.
I sound like I have a very similar personality to you. My anxiety flared up very badly after meningitis. I was prescribed anti anxiety meds and referred to CBT. It's flared up again a year later and I was given beta blockers and referred to CBT.
My anxiety was so bad initially I needed the meds to be able to engage in the CBT. I literally was so bad I struggled to leave the house.
My GPs have been happy to prescribe meds in conjunction with CBT. I think you maybe need to get over how bad you are feeling. If you almost psych yourself up so you come across as "together" they are more likely to think you are coping and drugs not a sensible option. Be honest and explain you aren't against CBT you just feel so awful that you can't imagine getting there in this state.
All the best. Anxiety is awful, but you can get better.
Thank you. I feel like I'm at the point where waiting weeks for CBT plus the weeks it would take for it to work, are not going to address quickly enough, at this time, the crushing exhaustion that goes with being anxious all the time.
I do absolutely agree with CBT being the premier solution but a. the timing's not right it won't be quick enough and b. unless there are remote access options certainly at the moment, it would be a no go for me at this time (but am certainly not ruling it out for sure).
I think I'm so bloody anxious about going in there and just being turned back round again that I don't know what to say to convince them that I do need some immediate help to get me over a hump. Went in there for neck pain I've had on and off for 30 years. Got told a few (pathetic) neck exercises ("roll your neck, shrug your shoulders) and if that doesn't work well, you'll have to live with it..." !! Actually, it was postural - I had to pay to see my local fantastic physio who sorted the whole thing out for me. So my experience of the GP is that they are largely extremely unhelpful and not wanting to action actual treatments.
Last time I went in about anxiety I had to be assessed at a special panel because that CCG didn't commission MH support for people who skin picked - apparently I would have gotten an immediate referral if I was cutting!
Honestly. I do resent that I look after myself 99% of the time. When I go the GP it's because I've got to the point where I actually need help. And so often I either don't get it or there are barriers and I come out feeling worse than when I went in. Going to the GP could make you feel depressed when you were fine when you went in!
I'm sorry to hear your surgery seems do unsupportive. I guess I'm lucky in that my gp's are amazing. If I were you I'd just go in and say exactly that. I'm not coping. I heed help and am happy to be referred for CBT/counselling or whatever but I need help in the meantime as I'm exhausted/nit sleeping etc. If you go in in 'coping mode' they won't see what's really going on. Can you self refer to IAPT or go private for counselling. Most offer a sliding scale of finances are an issue?
Sometimes you need a bit of medication to lower your anxiety before starting therapy. There's no point in trying to change your mindset when you're totally stressed- it's too difficult to be objective. I'm super anxious and have found streamline to be really helpful. The first 10 days were awful but it's been a revelation since then. I had some diazepam in the first week to help with the symptoms. I hope you get something, anxiety is shit, but it can be addressed.
I think this is part of how I cope is that I do do this 'I'm coping' thing.
However, even that didn't work the last time I went in to see the head GP (female) when I was obviously really really really tired and worn out and she basically criticised me for not going out to exercise (limited opportunity as two kids were 10 and 13 at that time, no one to babysit and most classes dont allow them to join in at those ages), so you should go to exercise with your children (see previous reason) but she had a go at me about that anyway, then she said why don't do yoga (same problem - no one who can have the kids for me to do that and no classes that they could join at their ages at the time) and then when I said well I could I suppose, I used to teach it (but please refer to the previous comment about no one to watch the kids and they're not suitable classes for them at this age) and she accused me of not wanting to do it because I was a snooty beggar because I was a teacher of the subject ! - not true. She then made a note on my record that I was 'negative'!
And at no point did she even consider if I could afford all these fabulous things she was suggesting - which is staggeringly stupid. I found her condescending, insulting and judgmental so it's totally put me off them.
I had asked for diazepam or similar before but was shut straight down Faintly. What is streamline?
Something like propanalol sounds like it would help calm you down.
I have had to start meds as my anxiety is so bad. i am on duloxetine. It made the anxiety 10 times worse for the first 4 weeks and then made it better but I feel permanently hung over.
I'd rather take valium but my GP won't allow that as it's too addictive.
I'm not sure yet if it's worth the side effects or not and it gives me nightmares everyday just before waking.
I guess it's marginally better than the hair raising anxiety, CBT did nothing for me as it can't actually solve the problems that I have.
'Hair raising anxiety' - I know what you mean Mermaid!
I honestly feel (including on MN, possibly not here in the MH forum) that anxiety is looked on by many as something you need to just 'man up' and then it won't be there. I don't think people who don't have it can even imagine how it actually feels day after day after day to feel like this.
You get sympathy if you're bipolar or you have depression or some other MH issue but I often feel that anxiety is to some extent much more overlooked in general and not taken seriously enough. The fact is that with this condition you do actually run a higher chance of heart attack or stroke so it's nothing to be sniffed at.
Not trying to pry Mermaid but what were the types of areas that you feel the CBT wouldn't work for (and please don't answer if it's something thats too personal/revealing etc - just wondered if you were able to expand or not - totally understand if not). I'm certainly not averse to trying it but with working FT and raising two teens on my own with no RL support whatsoever, having to then stack weekly sessions on top of all of that would not be something positive for me, at least not at this point.
I actually can't imagine how it would feel to not feel like this and frankly, if something chemical can just take a little bit of the edge off I think overall on balance, that's not such a bad thing.
Hi, a lot of anti depressants are also good for anxiety, my CPN saidcthis is because they are actually closely related. I'm on Mirtazapine which has taken the edge off and also helps me sleep. Most GPs are reluctant to prescribe diazapam and similar for anything other than very short term as its easy to become addicted.
Do your work offer any support through occupational health? Where I work we can self refer to councelling and they also have a psychologist you can be refered to. I've also found my manager to be very supportive in letting me have appointments during work time. She is basically happy for me to do whatever I need to do to stop me ending up off sick. My DHs occupational health department reccomended that his hours be adjusted to allow him to see his CPN in work time too.
So sorry that you don't have a supportive GP Pollyanna9 I would seriously try to find an alternative one now.
Anxiety meds should help you over the hump but you will need longer term support which CBT may or may not help. It can be hit and miss but is the preferred NHS solution as it is the cheapest therapy apparently. I wish you good luck for the future
Do you know Anxious, work might be able to do something but I'm not sure. I am in a fixed term contract so not sure if OH services would extend to me??
I've booked an appt at the same surgery with a female GP I've never seen there before and will do my best to drill the information through that this is a critical point here before I literally pick all the skin off my hairline. In fact, I almost think I need to not mention this (and put loads of make up on that morning!) because it obfuscates the message - they get fixated on the skin picking (which is only a sub-symptom of the anxiety) when it's the anxiety that needs dealing with.
And I'll happily do CBT but I need to remove some of the anxiety first and I'd be able to find a remote way of accessing it that fits in with my exhausting very tiring life. And I'm sure the tiredness would be better if my sleep was better, it really is pretty rubbish. My best time of the day is after tea when I've had a bath and relaxing. That's it. All other times I'm absolutely shattered and a lot of it is about worrying about lack of income, lack of bloody child support for the last two months that have made that worry all the worse, DD struggling with friendships and stupid immature bitchyness at school and needing to find my next job role. So I feel it's coming to a head for me at the minute.
Thanks Sunshine and thanks everyone for the comments and ideas and sharing of your experiences. I actually can't imagine feeling better than this tbh but I'm concerned because it doesn't get better as I get older, it gets worse.
Ho Pollyanna sorry to hear you are feeling so anxious. It's horrible and I have been there. GPs are not MH experts and some are better than others in terms of their understanding and communication. In terms of diazepam, it can be given short term in patients considered safe physically ( not at risk eg pneumonia) , not interacting with other medications, and short term relief only, and in someone who is not suicidal.it is risky as diazepam etc are addictive, and can cause depression of breathing etc. so it is at the individual GPs discretion if he feels this is safe, and a good idea. Alternative might be an antidepressant , but again a check that the person is not suicidal, and letting them know that Ads can (but don't always )make these feelings worse, usually for a few weeks in which case to immediately seek medical help. I would think see what they say, you don't have to wait for a routine appt, you can ask for the on call doctor, who usually will call you back and then probably ask to see you. It's tricky, but I would think counselling/ CBT would help , I would think it worth considering to go along with the mental health team counselling referral. Have you looked at online mindfulness, mood juice, no panic, Mind website, I think there might be a MInd helpline, and the Samaritans. Don't despair, this will improve, you will get help, but if you feel you need urgent help go through AE or out of hours GP who will get you the crisis team or AE. The GP can refer you direct to the crisis team if he felt you were in distress, it's really best to be honest and discuss with him/ her. All the best
And you can have ongoing regular reviews with a sympathetic GP , say each week, especially while waiting for the referral.
Thanks for that guys. Much appreciated.
I must say I can't imagine it improving but it surely must be able to, I'm not that far gone that I can't see it as a possibility!
Its sad in some ways that I've been happier in two sometimes unhappy relationships than I am now I'm on my own and not having to deal with an other half's shit! At times with the second main love of my life, some quite unpleasant shit, but anyhoo, there it is.
This may sound entirely shallow (it isn't, it's just facts) but if I could get a permanent job that meant I wasn't just living month to month but only just and in constant fear of over-spending (you know, thinking, oh I'll buy a Costa coffee when I'm down the other end of my building and having to feel bad about spending £1.70) such that I had just a coupla hundred quid of genuine spare a month - that would be a load off I can tell you. 'D'XH not paying +£500 of maintenance since 9 days before Xmas has not helped with the financial concerns I've got to say. Then the £1900 boiler replacement 3 days before Xmas which wiped out absolutely all contingency savings has exacerbated my financial anxieties even more. I was alright last year but in order to have A job I've had to take a £27k pay cut over what I earned last year so things are really really tight. Folk shouldn't underestimate the negative impact of constant and unending money worries on people and certainly for me it's really been a big factor in what I'm feeling like at the moment.
DH was on a fixed term contract when he accessed OH, so might be worth looking into, you are still their employee. I can completely understand the money worries and wanting a perminent contract. DH has gone for lower paid part time work to reduce the stress he felt from the fixed term contract. He also took on a lot more stress in the hope of the contract being extended, which made him ill in the end.
Sorry- just realised that bloody predictive text changed sertraline to streamline. :/
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