Sertraline and counselling

[Crystalineknowledge]

I’m on day 7 of 50mg of sertraline and anxiety feels the same or worse with some better moments/days.

I did an initial counselling session for my anxiety and found it’s made me more anxious. It went into childhood etc. would people recommend waiting until the meds stabilise before continuing this? I still feel in a really delicate place with anxiety and panic.

I wouldn't wait unless you feel the anxiety is more than you can bear. Counselling is bound to be disruptive and to generate anxiety in the short- to medium-term.

No. Counselling will start off with heightened anxiety no matter when you start it. Sertraline can also cause this in the first few weeks and is probably the most likely culprit. You just have to push through.

Then in a few weeks your meds will have settled and you'll be getting to know your counsellor and you will start feeling a bit of improvement. Get all the shit bits over with in one go.

How do you feel about the counsellor? Are they nice? Can you imagine talking to then about how you're feeling?

Well I won’t have the same counsellor as that was just the initial assessment to see where to place me. It went into a lot more depth than I was prepared for.

Oh, I see, was it MIND/local equivalent? They want to know the ins and outs of a cats arse, you come out feeling slightly violated if I remember correctly. The actual counselling usually moves a little slower, they just need an idea of what they're dealing with and whether you're likely to jump off a bridge in the immediate future.

The counselling is still uncomfortable to start with but gets easier as you go on.

Yes it was full on, about my childhood. But I really need coping strategies for dealing with this crippling anxiety.

I was taught some techniques by a counsellor that help me with overwhelming anxiety. They're all about calming down the nervous system rather than trying to engage with your thoughts. Apologies if you already know them. They sound a bit out-there but I've found them all useful at different times.

4-6-8 breathing: breathe in for 4, hold for 6, breathe out for 8. Repeat as many times as you can.

Low humming, or making the deepest "vuuuuu" sound you can. Breathe in and repeat.

Slowly breathing in as if through a straw.

Making a v with index and middle finger and then slowly rubbing one finger in front and one just behind your ear, up and down.

Frozen veg packets on your cheekbones.

Doing great big giant steps and front crawl motions with your arms.

Standing on one leg with your eyes closed until you start to wobble. Then on the other.

One hand flat on forehead, the other flat on the back of your head just above the nape of the neck. Hold this position and breathe in and out a few times.

Prune Harris's videos eg the daily energy routine - really good for shifting the horrible uneasy feeling of difficult emotions out of the body.

Hope you can find something that works for you.

Thank you @Bisgedi i will try these.

Is this counselling offered or set up via a GP? I was put on Sertraline and Propanolol, but was never offered counselling. Is that something you have to seek out yourself if you want it?

@MilkToast i sought it out myself. But in my area you can refer yourself for NHS talking therapy but I didn’t find they very helpful previously as I found it was more wellbeing focussed.

I forgot to mention that Elissa Epel's book, The Stress Prescription, is full of evidence-based strategies for managing stress and anxiety.

One tiny thing is about posture - just leaning back (literally physically leaning back!) can help your nervous system relax and reduce anxiety. It definitely helps me (when I remember). She has done a few podcasts that cover a lot of the stuff in the book, too.