Anxiety - urgent advice needed

[anxiousagain99]

Not an AIBU but am posting here for traffic. I’m due to speak to my GP tomorrow morning about my anxiety. I’ve been meaning to get an appointment for ages and have finally done it.

I have really bad anxiety, social anxiety (I get very worked up, anxious and nervous before and during social situations),worry about everything and catastrophize. I’m hoping to get some medication to help but am unsure whether to ask for citalopram, propranolol or something else.

I want to go into the conversation fully informed as my GP isn’t particularly helpful and I don’t want to be fobbed off or given the wrong thing.

Is there anyone else out there with similar anxiety issues to me and if so, please could you advise which medication helped you and how?

Escitalopram is favoured a lot more now apparently. It worked really well for me.

I was prescribed with escitalopram recently and have found it pretty effective so far.

I burst into tears at the beginning of my appointment for stress induced anxiety, which probably helped!

I second writing down your symptoms and experiences. I was asked a series of questions about symptoms - these aren't a trap, and not everyone who has anxiety will have all of them. I said there was nothing wrong with my self esteem, for example, and not suicidal.

I would mention that you're anxious about not being taken seriously, and not getting the treatment you need for your condition. I confessed to taking a strong coffee before my appointment because I was so anxious about not being considered ill enough!

I was prescribed Propanolol, only a very small dose, but it works really well.

Your best bet is to book an appointment with another gp if yours doesn't believe in mental health. Maybe the nurse practitioner. I have a history of mental illness, mainly anxiety and have been on meds, cbt, carers to get me out of the house etc in the past. My mental health deteriorated a lot during jan/Feb. Ended up admitting defeat at battling it and went to docs. I was diagnosed with anxiety and depression. Tried sertraline, side effects were horrendous, so tried citralopam and I'm tolerating that, I'm still not well but I have regular f2f apts, reviews and slowly increasing dosage. They have been brilliant, they have a flag on my records so if I need an apt they fit me in.

They did discuss cbt as a first line before meds, but due to my history and because my anxiety/panic attacks is linked to a physical life long condition no amount of cbt etc will help. I was prescribed meds straight away. They are not a quick fix though, I seek help early feb I think it was... tried one, didn't suit. Another... no bad side effects bit still trying to find the correct dose. I'm back tomorrow and expecting another increase or additional meds.

Propanolol is a beta blocker. It works by stopping the cells in your body absorbing adrenalin and so even if you produce loads of adrenalin because you are scared or anxious, it wont produce as much of a physical effect on your body, so less heart racing, breathlessness and scatterbrain-ness

There are a lot of different beta blockers that work in different ways, so if one has side effects that dont sit well with you, you can try another one.

They tend to be fast acting, but if you have been taking them for a while, you body adjusts, so ypu have to wean back off them or you can get a rebound

Citalopram is a SSRI. These are drugs that slow the speed at which your body breaks down serotonin and so as a result it increases serotonin levels in your body. Serotonin is the key hormone that stabilizes our mood, feelings of well-being, and happiness. This hormone impacts your entire body. It enables brain cells and other nervous system cells to communicate with each other. Serotonin also helps with sleeping, eating, and digestion.

It takes 4-6 weeks to get to a level in your body that will impact you and again has to be weaned off. Doctors usually start with a testing dose to see if you get bad side effect and then go up to a active dosage about 2 weeks later. There can be some significant side effects, but some people have none at all. Its very much a trial and error process. There are many other SSRI s that work slightly differently so you might have to try a few before you find the one that suits you

If I were you I would go to the GP and ask if they think you should see a psychiatrist to discuss your symptoms or if they GP is willing to prescribe for you. If GP is willing to prescribe then ask about their thoughts on Beta blockers versus SSRIs versus combination of the two.

Most clinical studies show that they most effective way of tackling anxiety and depression is a combination of drugs AND medication

Good luck OP, dont be fobbed off. Write a list of questions and take notes on what the GP says, you can ask them to repeat stuff, say you dont understand and ask them to try explaining it again. You can also say “so what I am hearing you say is xyz...is that correct”

Thanks @SeaToSki that is so helpful. There’s no way my GP would go into all that detail!

I would also recommend discussing it with the GP. I have severe GAD, mainly around social situations, and unfortunately neither medication nor CBT has helped me in the slightest. However, one or the other (or both) has helped a lot of PPs, so it is worth trying different approaches to find what works for you. I've learned how to live with it and try to control it as best I can, but might try CBT again, or maybe counselling, in the future to try to combat it.

I'm also taking bisoprolol daily which is a beta blocker along side a high bp med.. I rattle

I have had similar enxiety issues. Couldn't bare to spend time with groups of people as I would worry about everything. No medication helped on the long term.
Also what helped for me is to be kinder to myself and put no expectation on myself for social situations, only to be there. No expectation to talk or to interact.no expectation to behave in anyway, no expectation to stay for a certain time, etc.

Meditation is what helped me In the end and self kindness.
I'm still not great socially but I learned to accept that and put no expectation on myself and stopped caring about fitting in on or being liked or even taking part in conversations.

I use propranolol but it's better for specific situations rather than as a regular thing. For me it's job interviews and public speaking. It doesn't take the mental anxiety away but it prevents the physical symptoms and in turn, that helps me stop panicking. No shaking, no wobbling voice or heart pounding.

OP, I've had severe mental health issues most of my adult life. When I see a GP/psychiatrist/psych-nurse, I'm usually so anxious that my mind freezes and I can't get my words out. To get the best out of the appointment, I find it very useful to write a short bullet-point list, which I often have to read out word for word! It works for me every time...My list would include: 1) What symptoms I'm having and for how long I've had them. 2) How these symptoms are affecting my everyday life (relationships/work/sleep/appetite etc). 3) Things I might have tried to help myself (deep breathing, meditation, exercise etc). Please don't be frightened to ask for medication either - I've never yet met a medic who appears offended by this. Finally, for any future appointments, it's sometimes very useful to have your partner/family member/best friend to come into the appointment with you. They can help you enormously with clarifying your concerns to the Doc, as well as remembering what you might have missed from the GP. I never remember everything my Dr says as I'm always anxious and find it hard to focus! Best of luck with your appointment. I hope it works out for you.

Sertraline is particularly good for that.

Escitalopram changed my life. I think I’m on a fairly low dose (10mg) but honestly life is so much easier now. Although beware the first week was horrendous.
I also have a small amount of Diazepam for ‘emergencies’. I’ve probably only had to take about 5 of these in the last year (for panic attacks which happen so rarely now).

I’ve tried CBT before and for me it was useless, but I know I works very well for others. I put off asking for medication for literally years because I felt weird about it, but now I don’t care if I’m on it the rest of my life. It makes life manageable and bearable now so why not?

Well done for making an appointment, you absolutely won’t regret it. Best of luck to you

Propanol did nothing for me and made me feel dizzy and worse. I have no idea why doctors prescribe it for anxiety as it’s not designed for that.
Just my experience though - might work for you
Maybe ask for a hormone check too? Not sure how old you are - but my anxiety issues were hormone related. I’m 38 and peri menopausal

My GP was awful and absolutely refused to give me any medication foe anxiety despite me going in there shaking, in tears and feeling suicidal due to my anxiety. He recommended I 'lay on the floor, breathe deeply, and imagine my limbs sinking into the floor' every time I feel anxious. He also said he feels that if he gave me medication I would get "addicted" to it, despite my being in my early twenties, with no issues surrounding addiction or even hinting at it (only past I'd visited him for, or any GP, being being anxiety and IBS symtoms). It was horrible. He was useless every time I saw him. I managed to gather from another conversation that his view seemed to be that as I'd suffered from anxiety for a long time, he shouldn't really do anything, as I'd inevitably become addicted to whatever kind of treatment he gave me? Because it would end years of suffering? Ugh I get furious now whenever I think about it. I wish I'd stood upto and complained about him at the time.

My point is, OP, definitely don't go in there asking for any kind of medication as some doctors are arseholes and think people want mental health medication just to sort of have a nice time, and I've heard from many other people who had similar experiences as mine - an absolute nightmare getting any MH medication or support despite it being essential, and apparently suggesting medicine will make it less likely they'll prescribe to you Tell him your symptoms, and see what he suggests by himself.

^^he might have thought you were trying to blag some diazepam, which is addictive.
Antidepressants/beta blockers arent addictive. So they can be requested.

People saying not to ask and not to self medicate. You can ASK for certain medications but it doesn't mean that a gp has to or will prescribe them if they dont think they will be suitable. They will just suggest something different.

"I've been feeling ...... for X amount of time, I think I need to be one some X medication because....." then they take it from there.

Or maybe I've just got good gps.

I know this is a bit of a funny angle to come at but if it’s mainly social anxiety perhaps you’re just not a social person? That’s okay. Not everyone is. Why put yourself into situations that just make you feel ill? I’m extremely introverted. I enjoy my own space, I don’t like meeting new people or having lots of friends. I don’t want to go out etc. I have one close friend and apart from my dc and dh I just like being at home. I am 40 now and have spent my whole life trying to live to social expectations etc resulting in me having severe bouts of anxiety and depression (tried Citalopram and other meds) and I realise now that actually I just needed to learn to say no more and put myself first. I haven’t taken any meds for 15 years.

I have nothing against meds at all - my dh has bipolar and wouldn’t be able to work or function at all without medication but sometimes social anxiety is a symptom of trying to fit into a world that isn’t actually your “thing”.

Discuss with GP is best, as many have said. Personally I'm on Propranolol and it suits me, I can take it when I need it and it doesn't have the level of side effects I had with SSRIs (Prozac and Sertraline).

My GP has discussed trying anti-depressants again, but we agreed to stick with Propranolol for the moment - and I think this is important, my GP discussed the options with me and it felt like a joint decision, albeit it one guided by the GP.

Citalopram works for me