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.

If someone had diabetes no one would wouldn't ask them to try exercise, get a good sleep, get out more instead of insulin. Or a broken leg, no one would suggest try walking on it or just rest it.

Medical intervention helps these things and it'll help you.

You don't need to live like this go to GP get the medicine you need.

Just take them as prescribed - your doctor will prescribe and titrate them up at the level appropriate for your current levels of anxiety which could be very different to where TheOliveFInch started out.

If you start at a much lower dose than prescribed, the GP will see that you aren’t improving at the rate expected, so is likely to change the drug over so you could end up with more drugs in your system rather than less if you follow TOF’s advice. This is really one of those situations where it is far better to listen to the medical professionals treating you than random online anecdotes.

NHS mental health support is on its knees, and GP’s appointments are thin on the ground, but at the moment you have successfully got the GP to engage with you, so don’t squander their expertise and experience when it has been offered as you may not find it as easy to get a lot of their engagement.

I take fluoxetine for depression, have done on and off for 30 years without any side effects.

I was also prescribed beta blockers, propranolol, for occasional use when I have severe anxiety.

Both are non addictive but I have accepted that I will probably need them for the rest of my life.

Without them I don’t think I would have the strength to carry on, some people are just prone to anxiety and depression - all the exercise and mindfulness in the world may not help.

I have also had a parent with Dementia and can fully sympathise that this will increase your symptoms.

Please don’t continue to suffer and speak to your doctor - I was fortunate that Fluoxetine worked very quickly for me but know for some people it’s trial and error to find the right medication, but persevere as it could be life changing X

It was my GP advice to start by halving them or even in quarters as she knows how apprehensive I am about these medications and side effects. She is aware that If I go straight in at a higher dose and experience side effects I will give up too soon, I can not afford to care for my mum and feel worse than I already do, that would break me further, so it will have to be low and slow for me.

Sadly you don't need to remind me that mental health services are on their knees, I've been a sufferer for decades, I am all to aware.

Back21970 Thank you, it's encouraging they have helped you over the years. I do wish I had tried earlier.

As you say, for some people, no amount of exercise, healthy eating, breathing, talking therapies etc makes a dent in this type of anxiety. I have tried (and still try) it all, it does not help.

I am sorry you too have a parent with dementia. It's a rotten journey, I never realised before dementia came knocking on our door just how wicked a disease it really is.

I am a MH professional
Do try them OP, they can make a huge difference to your quality of life. You may need to try more than one to get one that’s effective for you but some people respond well to the first one prescribed. They are not addictive. Allow yourself the compassion you deserve and give them a go. You may notice your tummy problems improve if the anxiety is tackled. On an aside, are you neuro-divergent? The only reason I ask if that some ND folk suffer with digestive issues alongside rejection dysphoria and anxiety etc, sometimes ADHD meds can be considered too (also often ND folk are misdiagnosed with clinical depression when they are in fact in burnout)

I was hesitant to take ADS for a long time. But they have been a game changer for my life. I dont have perfect mental health but I don't have daily panic attacks and I'm still here (and some days I wasn't sure I would be.)

I reached a breaking point with my anxiety and was put on Fluoxetine and Propranolol. Life changing, no joke. The first few weeks are rough though so be prepared for that. I wouldn’t alter the dosage you are prescribed, just take it as directed. After 4-6 weeks the effects stabilise and that is when you will really know how it is affecting you.

I take sertraline. Probably saved my life somewhere. Life as I know it anyway. Recently had to up it as I was doing badly at work and had to increase to get in a good enough place to deal with it. I’m having counselling and hope to come off them but if I can’t then that’s fine. I’ve never been addicted to them and my current dose is only 50mg

OP you have my utmost sympathy. I’m 4 years into depression/anxiety. It’s been a long, difficult battle to
get to where I am now where I can function on a reasonable level.

My GPs were useless. However i
finally was referred to a consultant. I take a combination of 4 anti depressant medications. My consultant says that medication is only 30% of the treatment. The rest is down to you in other ways. My saving grace is that I sing in a choir which is known to have benefits for mental health.

I too suffer with stomach problems but that has been a life long thing.

My advice would be to see your GP. If that doesn’t help ask to be referred to Adult Mental
Health. I do hope you get some relief.

Yes my GP recommended starting very low and titrating up so this minimises start up side effects and drop out rate not something I did off my own bat and it is an approach often recommended by GP’s these days. When I was prescribed sertraline many years ago I wasn’t given this advice and to be honest it was brutal

Have you tried hypnotherapy? Solution focused hypnotherapy can be incredibly effective for anxiety.

That said, when I needed it, antidepressants were lifesaving. I really resisted them for a long time. I’m not someone who takes meds. But the difference they made in about 4 days of starting was huge. I took them for a bit over a year and then when I felt I didn’t need them anymore, I stopped. No withdraw, no issues stopping, and that was 4 years ago, I’ve not needed them again since. Please don’t be afraid of trying them. They were the little extra help I needed to get out of the hole I was in so that I could make the changes I needed to be okay long term.

If you haven’t already, also stop drinking alcohol. That made a huge difference as well long term.

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.

Six weeks of therapy is absolutely hopeless when dealing with very long term anxiety and depression - it’s like a plaster on a knife wound. Getting long term therapy on the NHS is nearly impossible and yet it would be much cheaper in the long run in all kinds of ways.

Anti-depressants have their place, they can give a good reduction in symptoms and give you the head space to do the therapeutic work that otherwise would feel intolerable. They can also help you get into better self care practices and help you actually feel the benefit of things like exercise and breathing practices and just break the cycle of constantly feeling anxious. I suspect your tummy issues and anxiety are feeding off each other and making each other worse. Breaking one set of symptoms might help the other to settle.

But what type of therapy? Did you really engage? I’ve been having somatic therapy since the summer and, while it’s really difficult and counter-intuitive (I frequently start sessions thinking ‘Well, that’s nonsense’ and am always exhausted afterwards), I’m finding it really helpful for body-related things. I also recommended it to my brother, who suffers from longtime anxiety and chronic insomnia, and he’s also getting benefit from it. In the most basic terms, it’s about how we experience feelings and emotions in the body.

Seriously?

Just because you are well enough currently to benefit from it, have found a therapist you gel with, and have been able to access enough sessions to make progress doesn’t mean that the OP or anyone else reading this thread hasn’t “really engaged” with their treatment and therefore in some level is responsible for their own poor gut health. Have a word with yourself!

How needlessly aggressive. You know absolutely nothing about my state of mind or body, so there’s really no need for that. The OP is clearly in daily extreme physical distress. I think she would likely benefit enormously from somatic therapy. If, obviously, she finds a good therapist and works hard.

And again with the judgement @HotBath

OP has said she’s had years of talking therapies, and in fact just finished a 6 week course which didn’t help “no matter how much effort she put in”.

You are the one on her thread telling her she needs to “really engage” and “work hard” with your particular preferred brand of therapy with no knowledge or understanding of her state of mind or body.

I don’t think for what it’s worth there is a single form of therapy which works well for everyone - it’s hugely personalised and individual. But I do believe there are therapeutic windows (ie periods when your mental state is good enough to enable you make progress - which may be because medication has helped lift mood) and that the relationship with the therapist is key. Unless all of these conditions are met, working hard doesn’t come into it. And if you are too ill to benefit from the therapy that isn’t a personal failing of not having worked hard enough or not being willing to work hard.

Thank you, I really do need to pluck up the courage to try them.

With regards to ADHD, I think it could be a possibility. I am under a London based neuro-gastro department. Earlier this year I had a consultation with a psychiatrist based with the department, he isn't a ADHD specialist but he did think it was a good idea for me to have an assessment so he recommended my GP referred me. I've been on a waiting list since May.

Don’t wait for this assessment to try anti depressants @Outrageousbehaviour

If AD therapy doesn’t work, that will be useful info for the consultant. Or even if it does.

I have a friend with a diagnosis of ADHD who has been on a waiting list for 6 months for ADHD medication. Apparently there is a shortage of the meds, but also patients need to be closely monitored with lots of appointments to determine the correct dose which means that it can take up to a year from first diagnosis to starting treatment. Its definitely worth trying everything else in the meantime if that might help you feel
better.

Please go to the Gp and start antidepressants .They are a medication just like others and tbh saved my life .Look at mindfulness practices and find a couple that click with you .Wishing you peace in the New Year .

I've spent a small fortune on therapies over the years. I've had counselling, endless CBT, EMDR and seen lots of different hypnotherapist. I love hypnotherapy but it's never really helped me sadly.

I am the same with meds, never have liked taking any kind, even paracetamol as I seem to react to so many although this is probably hyper awareness due to my anxiety more than anything.

I only drink water, probably had 10 alcoholic dri KS in my 51 years and the last was around 10 years ago. Same with caffeine.

That’s good news that you are on the waiting list for an assessment. If the GP referred you via Right to choose you could be seen in a matter of months. In the meantime though do begin the antidepressants, it could give you a much-needed break.

I've had much longer therapies also and paid a small fortune in the past. Sadly I can not afford anything privately ATM as I'm not working due to caring for my mum.

It's a real shame the NHS only offer 6 weeks at a time, I agree that it's counterproductive as people just end up reverting bsck, if they offered longer sessions people would probably benefit for much longer.

I am considering citalopram too, my gp recommended it for me.

Sounds like you have a lot on physically and emotionally. And just when you need to be resilient enough for your mum peri menopause kicks you when you are down.. Physically menopause was ok but it’s shattered my mental health and nearly broke my marriage. The anxiety and low mood is crippling.

As others have said , you have nothing to lose by giving AD a go. And you want to change things. Wish you well OP.