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.

Omg. The "try exercise" posts are so fucking pointless, ignorant and stupid

Yes maybe exercise helps in some cases to a certain extent but if you read this lady story it is a lot more chronic and complex. Do you really think a little bit of exercise is going to help or that she hasn't already thought of it?

Are you part of the micro biome gang as well?

There's plenty of indication that the majority of the positive effect of antidepressants is placebo (you can start here https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0050045 if you want a link to a study). That side of things is not really in debate (although the extent/nature of the true drug effects are).

I agree that that would be OK if it weren't for a number of other issues. These include:

• substantial side effects (e.g., sexual side effects)
• many people finding it difficult to come off the drugs when they want to (it's taken years of campaigning for this to be acknowledged)
• the message "this problem is chemical", which can take the focus off other causes (which there is ultimately a lot more evidence for).

OP, there are plenty of people who find antidepressants helpful (statistically, most of the effect will.be placebo - participants in the trials get 75% as positive results in the placebo arm - but that doesn't mean it's not real) and I'm not saying not to try them (cautiously) if you want.

But please be aware that there are downsides to these highly profitable and well-marketed products.

Sending you all the very best.

Oh OP I’ve been there - you poor thing. I spent months refusing Citalopram. I was exercising, meditating, taking vitamin D - everything I could think of. A friend finally pushed me to try it and thank god she did. I’m me, without the exhausting, overwhelming background noise of constant anxiety. The struggle has stopped.

I could literally kiss that little pill before I take it now.

Thank you FlamingFlamingFluff, that really is encouraging, I am glad to hear that it has helped you so much.

Thank you. I find it so upsetting when people suggest exercise to be the cure all for mental health issues as though none of us have tried such simple measures.

@RarkMuffalo there are also meta analysis studies that show that AD’s do have a clinically significant affect over and above placebo. Depression and anxiety are multi-factorial and the idea that it is largely due to a neurotransmitter imbalance is no longer well supported although this is still a widely held belief among many people but AD medication does also promote new cell growth in the brain with longer term use which is thought to be responsible for the therapeutic effect Placebos can have a very powerful effect and in some cases produce reported side effects quite similar to the drug they are being compared with. There is also evidence that depression will spontaneously resolve without treatment in some people and I fully agree that AD medication can be prescribed too quickly however if you have symptoms that are not improving with all other interventions tried they can be very helpful. You are also correct that withdrawal from these drugs can be very difficult and the royal college of psychiatrists have updated their guidelines to say that very slow gradual tapering off is needed but my recent experience with my own GP did not reflect this and I withdrew from sertraline far too quickly and really struggled.

I’ve suffered with chronic anxiety over the years, I exercise religiously, mindfulness, meditation, brilliant diet, cut back on drinking, prioritisedsleep, took lots of supplements, had cbt/EMDR. The only things that have worked for me finally this summer after reaching breaking point was starting escitalopram, upping my HRT to the right level plus talking therapy (CBT). EsCitalopram comes in a droplet liquid so you can literally start on 1 mg, I upped by 1 milligram every 3 to 7 days depending on how I was feeling and if I was feeling any side-effects I paused there for a few days longer (I need one or two doses of diazepam at points to get me over the worst of the side effects is starting taking them). I’ve now reached 10 mg and feel better than I ever have done, just like the old me. The antidepressants gave me the opportunity to fully engage in therapy for the very first time, having had multiple courses of CBT and similar over the years. It’s been life changing for me. Having been very resistant to taking them before. Good luck x

Op I am in a similar situation so you have my sympathy I am 47 peri menopausal but I am on hrt I have ibs wake up each morning needing the toilet and it's not pleasant. I am dealing with a horrendous family situation and have awful anxiety i feel dizzy like I am going to pass out driving to work constantly on edge and feeling sick

I have been offered sertraline and propanol by the gp but my anxiety is stopping me from taking them which is stupid i know but I am scared of the side effects I was referred by the gp for counselling months ago but haven't heard anything yet so will look to go private in the new year

Hi @Outrageousbehaviour
I have a very good old friend - known her well over 40 years from when we were teenagers. She has suffered from anxiety and low mood yet always exercised and eaten well. In her mid to late forties she lost her mum and was grief stricken. She went on anti depressants and has stayed on them now for over 10 years and has just been different ever since. The last 10 years she’s just been less low mood, less worried about every day stuff and more appreciative of her “on paper” great life. Her normal state now is calm. Looking back - we both think that even when she was young she probably just needed more help to regulate hormones.
It sounds like you’re really struggling OP and I would definitely try a medical route at this point. If you have funds try and see a psychiatrist who can prescribe with more time and attention. Good luck and I hope 2025 brings you peace.

Thank you, it's very reassuring to hear these things have helped. I like the idea of the liquid version so I can do this low and slow.
Can I ask how the diazepam helped with the side effects? What side effects did you experience with the medications?

You really have my complete and utter sympathy. It's awful isn't it? I feel as though this has creeped I to every corner of my life.
I truly hope you manage to find something that helps you. Good luck.