Anxiety, my GP and not sure what to do next

[ChooChooLaverne]

So, I plucked up the courage to go and see my GP about the anxiety that I've had on and off for a few years after finally admitting to myself how much it limits my life and how all my strategies aren't really working.

I can go for periods where I feel fine but at other times I feel anxious about everything. I have panic attacks, mainly situational (eg in restaurants, cinemas), and while I generally cope with this better than I used to sometimes I do really struggle and I waste a lot of time worrying about making plans with people in case I feel panicky so I don't go out/see friends as much as I used to. I manage to hold down a job (just about) and no one really knows how much it affects me, though I have spoken to my boyfriend and a few friends about it a bit.

Anyway, I came away feeling really disappointed after building myself up to admitting it as the GP didn't ask me very much. He just prescribed me propanolol and seemed keen to give me an antidepressant which I refused. I asked about CBT but he wanted me to try propanolol first. I thought I'd give it a go but I've just read the medicine leaflet and, apart from scaring myself silly over the potential side effects (I do realise the irony of this!), it says not to take if you have low blood pressure, which I do. He didn't ask and didn't take my blood pressure.

I'm not sure what to do now. I was really hoping to be referred for some kind of therapy and I'm surprised that this didn't even seem to be an option. Should I go back and tell him about my low blood pressure, have a go at the antidepressants instead (even though I don't want to take them until I've tried therapy) or is there another option?

Any suggestions would be helpful. Thank you.

Propanolol is a standard first line treatment for anxiety. The thing is about the list of side effects is that the drug companies have to "cover their backs" by listing every single thing, so it's best not to take too much notice of them - difficult when you're anxious I know.

Re low blood pressure. Are you on meds for this? When did you last have your BP taken and was there any cause for concern. If not, I don't think you should worry but if low blood pressure has been a cause for concern in the past, I would double check with the GP about taking propanalol. Some ADs are meant to ease the symptoms of anxiety as well which is why the GP was suggesting that, but it sounds like he was in a hurry and wanted you "in and out" in the shortest time possible. I know how this feels, especially when you have had to push yourself to go in the first place. On the other hand about one third of all GP consultations are MH related, so it's very common to them, and they do see about 40 patients a day.

There are loads of books on CBT on Amazon that you could have a look at, which you might find helpful. Mindfulness is the other thing that is meant to be good for anxiety and there are loads of books on that too. Worth a try.

Give the propranolol a go. Did the doc take your bp when you saw him?

It's amazing how it works. I used to take it for flying or other times when I was anxious. More often than not just knowing you have them is good enough and you stop needing to take them. They really break the cycle

I am on propanolol for chronic migraines, but it has actually also worked wonders for my anxiet even though that wasn't the aim at all.

That said, the GP should have taken your BP and be monitoring what it does to your blood pressure because it can make it drop quite a bit. They refuse to let me walk out the door with a new prescription unless someone's taken a BP reading and we raised the dose very slowly. I would call them, explain you've been prescribed propanolol but now that you've read the leaflet it says not to if you have low blood pressure, and can [whoever answers the phone] please check with the doctor?

Thank you for all your replies - it really does help.

Naoko - I phoned the GP surgery and they told me that because I'm only going to take the tablets intermittently, the blood pressure isn't an issue so I will give it a go.

It's daft isn't it really that the thought of taking the medicine that's meant to help with the anxiety is making me feel anxious? I really wish I could just turn my brain off sometimes!

Nana - thank you for your considered message. I'm not on medication for low blood pressure - it's always been low and never caused me any issues, though as I've got older I have to be careful not to get up quickly or I get dizzy! I can understand doctors' enthusiasm for antidepressants but I'm wary about side effects, etc (I really don't like taking medicine if I can help it) and would rather manage without unless I really can't. I thought GPs were all about talking therapies these days but I guess there are waiting lists.

I know it must be a hard job being a GP and hearing the same problems all the time must make you a bit immune to them but it would be such a relief to be able to talk it through properly with someone. I don't really feel I can with my boyfriend/friends. I'm sure in a way that would help me deal with it better.

Riding - the doctor did suggest it might help break the cycle of anxiety I'd got stuck in so that does make sense. Am feeling more positive about giving it a try.

Thanks all again.

You can talk on here choo choo

Thanks Nana.

Have been just about managing it for months but am struggling at the moment. My sister is in an abusive relationship and I'm hoping she's going to leave her partner but her talking about it to me in recent weeks seems to have triggered something (have had abusive relationships myself in the past).

Am finding it difficult to talk to my (lovely) boyfriend about. And on top of this have started worrying about him not wanting to be with me despite him not really doing anything to warrant this - it's difficult to separate out what's caused by the anxiety. I'm worried that I'm feeling so needy I don't want to be a burden to him.

Sadly, the doctor didn't ask me anything really. I'm not sure beta blockers are going to be the answer. Am thinking I might be better off trying to find a counsellor who specialises in abusive relationships as maybe that's where my anxiety stems from.

In my area (and some others from a quick google) the NHS have a "wellbeing service". I found it by googling and referred myself online and then had several telephone consultations before being offered cbt sessions. But I think the service offers other sorts of help -counselling etc. It might be worth trying to find out if there is a wellbeing service in your area and contacting them.

I have been finding the cbt very helpful for dealing with anxiety but for me antidepressants were what got me back to normal when I was really feeling awful - perhaps you shouldn't rule out trying them. Can you see a different GP at the practice? It sounds like you didn't find the GP very supportive and it might be worth trying to discuss the options with another GP who will take the time to discuss with you more, if that is a possibility.

You can self refer to some of the IAPT services. They offer CBT for anxiety in lots of different areas. If you Google you could find your nearest one. AFAIK it is part of the NHS. There can be a long waiting list, but it could be worth a go.