To ask how to approach this anxiety with my doctor

[beckywiththeshithair39]

I've never been on any type of medication for anxiety before and have been reluctant to try it as my anxiety is intermittent. It tends to only flare up in certain situations - usually when I have to do something or go somewhere out of the ordinary. Unfortunately this has gotten worse over the last few years and it's starting to impact on my life and willingness to do things.

I have spoken to my nurse practitioner before who didn't feel I was 'bad enough' to warrant medication. I specifically asked about beta blockers which I've heard are good for intermittent anxiety rather than something you have to take routinely everyday. She flat out said so and that they cause awful side effects. She recommended therapy instead which I've tried before and it didn't help. I've also tried meditation, change in diet. All the wishy washy stuff that people say will help and it hasn't.

I'm sick of this limiting the things I can do in life. In summer we have a big family holiday planned with dp family and right now I'm terrified about the car journey to the airport, the transfers, the unfamiliar surroundings. I don't know how I'll get through it. I've considered cancelling. This isn't right and I know I need to get a hold of it.

My key symptoms are panic, racing heart, nausea, prickling skin, sweating and an urgent need for the loo which in itself makes the anxiety worse. Can anyone give me any tips on how to approach this with my doctor and what to ask for?

I wouldn’t ask for any specific medication. Let the doctor suggest something. Of course the nurse practitioner is going to say no if you go in wanting beta blockers.

Bypass the nurse and go straight to the doctor for a start. I think you've explained it really well here to be honest so replicate that when you see the gp. Reiterate how much it's affecting your ability to do things and that you're considering cancelling things because of it. I've had beta blockers and the side effects are not "horrendous" although they're not advised if you have asthma. They did give me a bit of a tight chest at times. They did help too. I'm now on Sertraline as I'm also prone to depression and Sertraline is good for both anxiety and depression. I've also had CBT, counselling etc, which all have their place but sometimes it's just chemicals which are needed! Good luck.

There's a website called Doc Ready that helps with advice on how to approach talking about mental health with your doctor, with a checklist and further info - really hope it's helpful to you. :)

www.docready.org/#/home

Thank you for the comments. Of course I won't go in and demand or tell the doctor what I want. They are the experts. I just want to have a bit better understanding of what's available. I know a lot of people who take daily medication but wasn't sure that that sounds right for me because when I'm in my daily familiar routine I'm usually fine.

From my own experience with anxiety I found beta blockers (propranolol) worked well for the physical side effects (fast heart rate, tremors etc) but they don't do anything for the mental side of it. I was on fluoxetine for years as doctors said it will treat the anxiety long term, I hated it. But everyone responds differently to medication so what didn't work for me may work for you. Maybe ask again about the beta blockers. But I've found doctors do tend to suggest antidepressants along with counselling or cbt.

I'm concerned about side effects because I don't want to put these chemicals in my body and experience unwanted side effects for something that only affects me when I'm out of my routine. But that said when it's spoiling things in life that are meant to be enjoyable (holidays, days out, travelling) or impacting on my work (I don't have formal meetings often but really struggle when I do) then I feel I need to do something. That's my dilemma

That was how I felt, like I only needed something sometimes, and I explained that and was eventually prescribed beta blockers. But you need to see what works for you which might mean trying different things.

Btw, I never had any side effects from the propranolol.

I wonder if your GP might prescribe you something just to take when you are doing those occasional things. I have known people prescribed medication to take before they fly for example.

Counselling might also help you to work through what it is that makes you anxious and how to cope with it better.

Have a chat with your GP.

Meant kindly but it is normal to feel anxious in unfamiliar situations. Plan ahead, and allow extra time. Practical things you can do to ease your worries. It is normal to feel these emotions.

@maccaroni I get what you're saying and obviously certain situations can provoke some level of nervousness and anxiety in everyone. But this has gotten out of control for me now. Travelling anywhere by car that is even slightly out of my area sends me into a panic attack. Holidays are a struggle. Work meetings that require travel or going to a new office cause panic attacks. Even going to my dc football matches in unfamiliar places cause it. These are 'normal' things that shouldn't result in anxiety. A lot of it is due to my need to feel I can escape I think. Whenever I go anywhere I need to know where the exit and the toilet are. If I don't then I get into a panic. The toilet thing is due to the anxiety creating the need to use the toilet which is apparently a common side effect of fight or flight panic.

So while I understand that some level of anxiety is normal I feel like this is creating problems for me and my life now.

It’s worth noting that while beta blockers don’t act upon your brain in a psychological way, the way that they can reduce or eliminate physical manifestations of anxiety can help “break the cycle” of anxious thoughts you might be having (which might be amplified by the physical sensations) so they could still help.

Your nurse was very unhelpful and dismissive.

See an actual GP.

I asked for beta blockers yesterday. I wanted a very low dose to try as I have CFS/ME and a long history of anxiety and generally coping terribly with life. It’s really not something I can just think my way out of.

Of course it depends who you get, but this GP was really helpful. She took my pulse and blood pressure to make sure they weren’t already too low.

She prescribed me 10mg tablets of propranolol. I’m going to take the first one this morning. I’m nervous as I can be very sensitive and did really badly on antidepressants.

When I thanked the doctor, she actually thanked me for doing her job for her!

Good luck.

The plan is that I will take them every day, starting with one a day to see how it goes.

I can’t take beta blockers as have mild asthma so I’m on low dose of citalopram. I had the same symptoms you describe and I have to say my meds have got rid of them entirely. Definitely need a chat with a friendly GP - my anxiety rocketed quickly one weekend and it was a terrifying time.

Meant kindly but it is normal to feel anxious in unfamiliar situations. Plan ahead, and allow extra time. Practical things you can do to ease your worries. It is normal to feel these emotions

@maccaroni that's good advice for most people, but some people need more help

OP I've been prescribed diazepam before medical treatment, to relieve anxiety. Would that be suitable for you, just to take very occasionally when you know you're facing a difficult situation?

Your 8.58 post suggests that it’s very debilitating. Tell your GP all this, it’s very common and they will be able to help one way or another.

Sorry to drag this one up again! Just wanted to say I've had a rubbish weekend. Yesterday dp and I took my ds to his football fixture. It was a pitch I hadn't been to before and quite rural. I got really panicky on the way there, started urgently needing the loo then when we got there it looked to begin with like there weren't any facilities. Luckily I found some but that irrational fear and panic was horrendous and I feel quite sure that overthinking and anxiety what makes me need the toilet in the first place. Once I knew where they were I was fine.

I am adamant that I do need something to help with this now as it's clearly affecting simple everyday things. I'm just wondering what they are likely to give me and what will work for me :(

Try these
shop.fiveareas.com/anxiety-control-training-1
shop.fiveareas.com/anxiety-control-training-2

They are free downloads. Put them on your phone and listen with headphones frequently. You might find after a week or so things start to feel a bit easier.

I find walking helps a lot and takes the edge off any anxiety. A good walk everyday and as much as you can throughout the day.

I’m on a low dose of citalopram for anxiety, symptoms very similar to your last post. Constant feeling like I’m going to urgently need the loo. I also have beta blockers but they only stop racing heart etc so I don’t really take them. My doctors give our anti depressants like sweets, but I know a lot of people on them so I’d definitely go and ask a doctor if I was you. Good luck

@MmmMalbec and have you found that these help you? I've never taken any anti anxiety medication so I'm not really sure how they work. Can it change the mindset of overthinking about where a toilet is and the worry of needing the loo? Because more often than not the overthinking and panic is what creates the actual need to go.

I’m on day 5 of propranolol beta blockers 10mg tablets.

I took 1 on each of the first 2 days. Then I went up to 3, spread out from waking to around 3.30pm.

They block adrenaline. I have been feeling reasonably zen, considering my shitty life circumstances. I normally overreact to everything, like a permanent stress response, which is so debilitating.

If you don’t have asthma or diabetes, I think they are worth a go.

I’ve tried loads of different antidepressants over the years, and the side effects were awful.

With these, all I’ve noticed is my digestive system is slightly more ‘vigorous’ so I took a loperamide yesterday.

Oh and I had some long and interesting dreams last night!

Have you tried something like Bach Rescue Remedy or calming tablets before?

I found these helpful for very similar situations. It was like they knocked some sense into me and I was able to talk myself down.

I am currently on sertraline for anxiety but this has been as a result of things happening in my life. The side effects lasted for the first few months and I do feel better but not sure how I'd respond to situations like being in an airport.

@bettycat81 I have tried them before and Kalms too but they don't seem to do anything. Dp keeps suggesting things like that. It feels like other people seem against me going onto medication (nurse practitioner, dp, family) and that makes me wonder if I'm being over the top. Then I have incidents like yesterday in the car and just feel like I can't continue like this.

I get doctor anxiety and last time I wrote a list of all my symptoms/ details in my phone on a list. When I went in I burst into tears (standard!) and handed doc the phone. He was wonderful. While I calmed myself he read the list, we had a good conversation which given he’d read the list he could lead and question. I’d highly recommend it!
I kept the list factual. Not emotional. They in my instance determined the medication I was on was causing/ increasing the symptoms and changed my medication. Good luck.