Very high anxiety and very low mood, if all else fails are antidepressants the only way out of this mess?

[Outrageousbehaviour]

I really don't want to enter another year struggling so much with my mental health, it's been so long and I have tried everything except antidepressants as I am terrified of side effects and becoming addicted.

Decades of poor mental health are taking their toll on me. I wake every single morning and go straight into a panic attack, I feel super anxious every morning not helped by the fact that I have awful digestive issues which have blighted my life for 25 years. I literally need the loo as soon as my eyes open and my digestive system is on turbo mode from that point. I have tried absolutely everything to help calm my gut issues and have spent a small fortune consulting with 6 gastroenterologists and dieticians. Doesn't seem to matter what I eat, drink or avoid I still have a bad tummy. I am certain the anxiety is not helping but the more my guts play up the more anxious I get. I somehow need to break that cycle (especially as my dd16 seems to have been one obsessed with her tummy also, I'm sure she's picked this up from me 😥).

I live on edge all day long and have such tension within my body, it can't be good for me. No amount of exercise, relaxation methods, healthy eating, drinking only water etc helps. I worry about everything and anything. I'm exhausted all the time and cry constantly from such low moods.

My anxiety doesn't calm until evening time when I often feel better but I'm still very unsettled because of what is going on in my life. My parents are elderly and mum has Alzheimer's, my dad struggles and relies on me to help out whenever I can. I'm round all the time and I'm drained. I worry constantly about them and am so very depressed watching my dear mum succumb to such a horrible disease. As we enter the 7th year of this misery I can only see mum entering the final stages of this now and it's not going to be pleasant at all, I'm on edge just anticipating it.

I'm also in perimenopause which does not help but I can't take hrt as it makes my endometriosis and adenomyosis pain worse (tried various types). I'm lucky that I'm not experiencing hot flashes and the likes (atm!) but I'm certain this high anxiety is not helped by my hormones either.

I really think I need to try antidepressants, I've been offered Escitalopram but I'm petrified they'll worsen my gut issues or cause dizziness or an out of control feeling. I just about gear myself up to try something then read accounts of people saying antidepressants destroyed their lives or they became so addicted and they couldn't wean off them etc and I'm back to square one.

Can someone help me see clearly over this? I'm frazzled and not thinking straight.

Have you tried running or exercise?

They have saved my life on several occasions. If you try them, you have full autonomy on either to continue or not should you not like side effects. Sounds a bit daft, but it's your anxiety that's stopping you taking them. Try the meds that have been recommended.

I exercise all the time. I fast walk my dog over fields for an hour each day and use my exercise bike. Doesn't help sadly.

Thanks, I really do want to try and it's definitely my anxiety stopping me, I need to override it, somehow.

Venlafaxine. Low dose. Changed my life. Saved my marriage
Will take them forever now. Yes there are side effects . However do help with IBS and fibromyalgia.

I suffered.

I quit drinking, smoking, staying up late. Quit a job that kept me doing crazy hours for low pay. I took up running, I took up meditation.

I felt a bit less frantic but I still had daily panic attacks and very low mood.

so I started Sertraline and my life basically began again at that point.

Generally speaking with anti depressants, you may need to try a few before you find the correct one, so if escitalopram exacerbates your gut issues, they will try something different.

it is true that when you come off anti depressants you do need to do this gradually to avoid side effects and also true that some people need to stay on low dose anti depressants forever to manage their low mood but neither of those things are necessarily bad.

The benefits of improved mental health would seem to me to outweigh the risk of dependency but would also recommend that you have some appropriate therapy at the same time as medication for best outcomes.

I can only speak from my personal experiences.

i was hesitant to take antidepressants, I avoided seeking help because I knew that would be the answer so I kept spiraling downwards and was a mess.

i did all the diet and exercise stuff (and actually did it excessively to “help” and made myself ill!)

Then I bit the bullet and went to the GP, I was given setraline and then referred for mental health support. The first block of support was ‘useless’ and didn’t help but I stuck with the antidepressants and accessed the next level of CBT which for me did work, but I needed the antidepressants to get me in a position where it could work.

after about 18 months I (with gp support) weaned off the antidepressants. 3 years down the line I still need an occasional propanol but generally speaking I am in a stable enough situation to be able to use other methods to help me stabilise when I feel a dip coming.

I don’t know what’s around the corner but if I need them again I would take them.

I started to suffer this around 45 years old. I could have written your post.

A month ago (despite having endo) I started a low dose HRT, 1 pump Oestrogen a day and one Utrogestan a day and my stomach immediately settled down. No morning panic, I sit and feel calm and collected. Most importantly my gut settled and I no longer have that churning, anxious feeling that leads to repeated toilet visits.

For 3 weeks now I’ve just been to the loo once in the morning and that’s it. No being afraid to leave the house where there may not be a toilet, no having to make repeated visits to the loo when visitors call (due to social anxiety).

Give it a go OP, it’s worth a try.

I discovered I had hashimoto hyperthyroidism when my son got diagnosed with coeliac disease and hashimotos. It's hereditary. My mum had a thyroid issue but I hadn't realised there was a chance me and kids could have one too.

He had terrible stomach issues and anxiety and had been told it was ibs and anxiety for years but finally tested positive for coeliac. Often people with it test negative as you have to eat loads of wheat and gluten products in order to test positive. But around 80% of people with hashimotos improve symptoms with a gluten free diet.

I'm mentioning this because for me the symptoms included depression, irrational anxiety, stomach ache, constipation, aching joints, difficulty sleeping, feeling cold and old. He had worse symptoms with bleeding gut and horrendous upset tum too.

All these improved with the right level of Levothyroxine and HRT meds (as I'm also menopausal)

My son hasn't needed levo yet but going gluten free has resolved almost all of his symptoms too

Have you had any talking therapy? Some is useless but some excellent. Do you have any idea where the anxiety comes from? Childhood probably.

I'm in a similar boat to you down to DM having dementia. For me it's my skin that suffers not my guts but gets to be a vicious circle with mental and physical health. I'm having EMDR and it's been so helpful.

I wouldn't be scared of antidepressants and have used them once in the past when v bad but imo if you don t address the underlying reasons for your issues it'll always pop up again.

But if that's not relevant to you and anti depressants are the answer then I don't think you should think of it as becoming addicted.

We don't say diabetics are addicted to insulin.

We don't say people with high blood pressure are addicted to ramipril.

If you have an imbalance in serotonins that means you need medication to feel well then you should take it and not feel that it is a negative

I hope you find something that is right for you in the new year 😊

Anti depressants are there to help. If you had broken your leg, people wouldn't say 'try mindfulness ' . It is accepted that you should have a pot on and take painkillers and use crutches. Mental health is linked to brain chemicals and one of the best ways to get better is to take medicine to rebalance those chemicals. I used to avoid 'drugs' in treating illness and it was pointed out to me how silly I was being. It was an eye opening moment for me. Of course you should take drugs to get yourself better. Sometimes with antidepressants you need to try a few types to get the one that is right for you. Good Luck with this. I think it could really help you.

I started on mirtzapine 18 months ago. Now on 7.5mg, down from 15mg as it did give me terrible leg cramps at tye higher dose.
It has changed my life for the better hugely. Honestly if I could have my life over again, I would recognise depression earlier and taken anti depressants earlier.

This video is helpful at explaining morning anxiety;

I am certain the anxiety is not helping but the more my guts play up the more anxious I get.

Yes, you are right. Being anxious fires up your 'fight or flight' response aka your sympathetic nervous system - this video explains what happens in your body; the digestive system being most one of the main casualities.

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Finding the origin of your decades of poor mental health would be really helpful in changing your thought patterns but simply knowing the way you think is not set in stone is a good start.

I have tried hrt. Tried the patches and then the Dane regine as you have but it caused so much pain. I also have a failed uterine ablation so that doesn't help at all, as soon as my uterus contracts I'm in agony. My gynae concluded that hrt is not suitable for me sadly.

I've been on antidepressants a few separate times in my life. Some helped me more than others. One made me put on weight but saved my life. I was also given diazapam (not technically an anti depressant I don't think?) That was the only one which could be addictive and they only gave me 3. Not been on any for a decade now but would if I needed to again. Don't fear the meds!

I've had a biopsy for coeliac disease (was eating full gluten at the time), it came back negative. I've also had two blood tests over a ten year period, both negative. I no longer eat gluten products as it helps a bit but not enough sadly.

My sister has thyroid issues and parathyroid disease. I did think at one point that could be my issues but I've been checked and my thyroid levels come back as ok.

Your gut issues may well be related to your anxiety.
Try the anti depressants. You can always come off them or try a different one if need be.
I took Fluoxetine for pnd years ago. Felt so much better after 2 weeks and was weaned off them 6 months later.
You have nothing to lose by tryIng them.

I have gone through decades of talking therapies, just finished a 6 week course, sadly it doesn't help no matter who much effort I put into it.

I genuinely feel at this point my anxiety is driven by all the issues going on in my life. I used to be able to control it with meditation, exercise and from using the coping tools I've gained from years of therapy (I took have had EMDR) but it's not cutting it this time, not at all.

Perimenopause is definitely not helping either.

I'm sorry you have dementia in your life also, not much fun is it?

Your cortisol levels are highest in the morning which is why anxiety is worst on waking , I started Escitalopram around 6 weeks ago and it is working well for anxiety and I have found it very gentle in terms of side effects the key thing is to take very tiny doses to start with and gradually build up, I started with just 2.5mg . Breathwork to activate your parasympathetic nervous system is also very helpful for anxiety and you could try it as soon as you wake up physiological sighing, 4-7-8 , coherent breathing or box breathing can all help and there are lots of apps or videos on YouTube, iBreathe is a free simple breathing app with some preset programmes but you can also customise it as well

Can you get advice on getting carers in for your mum.

Nobody wants them and your parents will resist but ask them to try so you get a break as you're exhausted, and once they have them they are a godsend.

Try acupuncture or Chinese herbal medicine. I got prescribed something called something like happy wanderer and it really took the edge off my nerves. PS They are not dodgy (or psychoactive despite the name) when prescribed by a qualified practitioner.

I got acupuncture and herbal tablets from mine. They are tiny tablets so I started on just one then two morning and night and worked up to three (the proper dose) so I was confident they had no unfortunate side effects,

Really helped me. I come out so relaxed I wondered if I should be driving a moving vehicle!

Thank you.

Does the Escitalopram come in tablet form? I'm hoping to break it in half and start low and slow as you say.

Yes the Escitalopram does come as tablets and a liquid form, I was given 10mg tablets that are scored in the middle so easy to break in half , I then used a pill cutter to break them in half again , there are also 5mg tablets but they are not scored so don’t know how easy they are to split. This video is an anaesthetist showing how quickly breathing exercises can start to reduce anxiety

I do them regularly as part of breathwork meditation or if I wake up feeling anxious. Good luck in getting this under control

OP antidepressants aren’t ‘addictive’ per se, unless you are including the benzodiazepines, which aren’t actually antidepressants.
What happens is that you need to wean down on them rather than stop taking them cold turkey so that your brain can adapt to the changing levels of chemicals. If you have been on a high dose for a long time then this takes longer but doctors recognise this; you’re not an addict!

I think you need to try them. Sounds like you are really suffering. You have nothing to lose. If one doesn’t work, there are plenty of others to try. Remember the best thing for happy healthy children is a happy healthy parent. I wish you all the best in the world! Xx