Anxiety issues but prescribed anti-depressants?

[The-Future]

I've always been a shy person, only had a few friends at school and never really socialised much. I'm now 21 and I still get nervous around people and suffer panic attacks in social settings. I went to a doctor and mentioned how it was affecting my social, work and study commitments and his solution was anti-depressants. I made it quite clear I wasn't depressed but he insisted anxiety and depression go hand in hand and said Endep was the solution.

I have no interest in taking anti-depressants so I'm wondering what other options are there? I asked if it was worth seeing a psychologist and he said not to bother, the anti-depressants will fix the problem.

I tried some of my friends Xanax after researching it online and it has worked wonders, I am a lot more social on it and have suffered no form of panic attacks on it, I've even become a lot more motivated to study and work.

If I try other doctors do you think they will prescribe Xanax or something similar? Or will the keep pushing me for anti-depressants. Personally, I thought this doctor was an old, narrow-minded douchebag or am I wrong?

 

[misk]

lol endep is a popular choice by GPs.
it helped my anxiety a tiny bit but i wasn't able to use it long enough to get full effects due to side effects.

i would try and find an anti-depressant that works before going to benzos (ie. xanax) because it will end badly in a case like this.

see a psychologist first off, they will help to identify the cause or at least narrow down the type of anxiety you have and why, this will have a big impact on which antidepressant is used.

there is alot of antidepressants and even the different antidepressants in the same class have different effects. so it takes some trial and error but you need an evaluation first.

you may not feel depressed, but from what you have said you show some of the signs. anxiety can cause depression even without you realising it.

 

[The-Future]

Well he did make me answer a set of questions and in conclusion he diagnosed me with GAD and Social Anxiety and not depression. I'm just under the impression anti-depressants are prescribed to people that are depressed but maybe I'm wrong. I'd love to see a psychiatrist but I'm not sure if they bulk bill? I'll book an appointment with a different GP tomorrow and see if they can get me a referral.

 

[misk]

after my experience with a psychiatrist, i would see a psychologist who will then report to your GP.

your GP has nothing on a psychologist when it comes to exploring the reasons behind behavior and cognitive processes which can cause these kind of problems.

its not just about finding a label to give your condition, but about giving you medication that will best benefit you whilst working through any issues you have or providing you with education on thought processes and ways to tackle anxiety. you may not need antidepressants, but seeing a psychologist will be a huge benefit.

 

[Divine Moments]

The fact that they're called "antidepressants" is somewhat of a misnomer. They should rather be named by their action (SSRI, SNRI, etc.). The name antidepressant was given from early studies showing this effect, but it's widely accepted now that they are probably even more effective for long-term treatment of anxiety. Your doctor didn't explain it well (although he is correct that anxiety and depression are closely related and frequently comorbid), but "antidepressants" are in fact standard first-line treatment for anxiety.

Benzos are certainly useful in many cases, but in my opinion most people who suffer anxiety (myself included) shouldn't be on regular long-term benzos. Personally, having largely dealt my anxiety through various pscyhological therapies (including psychedelics) I use PRN diazepam (average once per week) which is quite a safe regimen. Our benzo thread probably doesn't cover the harm aspects well, but there are plenty of risks (highly addictive, potentially-lethal withdrawals, dangerous in combination with other depressants, etc.).

I asked if it was worth seeing a psychologist and he said not to bother, the anti-depressants will fix the problem.

Horrible advice. I found a psychologist more beneficial than either antidepressants or a psychiatrist, for both anxiety and depression. Everyone's different though.

If I try other doctors do you think they will prescribe Xanax or something similar? Or will the keep pushing me for anti-depressants. Personally, I thought this doctor was an old, narrow-minded douchebag or am I wrong?

Different GPs will certainly have different approaches, and there are some that will prescribe benzos straight off. Just think hard about if it's what you really want (and maybe antidepressants are worth trying).

I'd love to see a psychiatrist but I'm not sure if they bulk bill?

Some do, some don't, most will for some patients. Really depends. Mine bulk bills all students

 

[Divine Moments]

after my experience with a psychiatrist, i would see a psychologist who will then report to your GP.

your GP has nothing on a psychologist when it comes to exploring the reasons behind behavior and cognitive processes which can cause these kind of problems.

its not just about finding a label to give your condition, but about giving you medication that will best benefit you whilst working through any issues you have or providing you with education on thought processes and ways to tackle anxiety. you may not need antidepressants, but seeing a psychologist will be a huge benefit.

Very good advice, totally agree

 

[tyrael]

Good advice both misk and Divine Moments. Exactly what I was gonna say.

I've just recently been diagnosed with social anxiety border-lining chronic depression and am now on Paroxetine - an SSRI. I was lucky in that my GP I've seen for many years so she knows my level of pharmacological knowledge so were able to a decent, in-depth conversation about them. I was reluctant at first, and we did try multiple anxiolytic benzos, but for various reasons they didn't help me. Now I'm about 6 weeks into the Paroxetine and literally loving life atm! :D

There is always an answer, hang in there! Have a read of this post in OD I just posted. And if you also need a "like-minded" person to chat feel free to PM me!

 

[randomness]

I've always been a shy person, only had a few friends at school and never really socialised much. I'm now 21 and I still get nervous around people and suffer panic attacks in social settings. I went to a doctor and mentioned how it was affecting my social, work and study commitments and his solution was anti-depressants. I made it quite clear I wasn't depressed but he insisted anxiety and depression go hand in hand and said Endep was the solution.

This is a fairly standard procedure which most doctors follow when dealing with anxiety disorders. Anti-depressants and particularly the SSRI class, are considered "front-line treatment" for anxiety disorders. That means doctors will normally try those on a patient first if there is no prior treatment history.

Even if you have no depression, many of these anti-depressants have shown to be clinically effective for treating phobias and anxiety disorders, and they have the least dependency/tolerance profile compared to other treatment options.

Sometimes a patient may have depression and not realise it, which can be a causal factor in anxiety conditions. Or sometimes treating a patient with an anti-depressant has a beneficial effect on brain chemistry that helps alleviate anxiety.

I have no interest in taking anti-depressants so I'm wondering what other options are there? I asked if it was worth seeing a psychologist and he said not to bother, the anti-depressants will fix the problem.

My doctor was exactly the same when I saw him 10 years ago with pretty much the same problem as yourself.

I think unless you have an open minded/trusting doctor who is willing to be flexible and not go strictly "by the book", you will have to take the anti-depressants and go through the various treatment options before they will consider referring you to a psychologist or giving you access to other drugs like benzos.

I tried some of my friends Xanax after researching it online and it has worked wonders, I am a lot more social on it and have suffered no form of panic attacks on it, I've even become a lot more motivated to study and work.

If I try other doctors do you think they will prescribe Xanax or something similar? Or will the keep pushing me for anti-depressants. Personally, I thought this doctor was an old, narrow-minded douchebag or am I wrong?

I don't know what country you're in, but here in the UK I'd say absolutely no way would they would consider it. Benzo's are strictly a no-go option for treating anxiety because of the high risk of dependency and serious withdrawal problems which can be life threatening. They are considered "dirty drugs" by most doctors and no longer used, except in very short-term treatments or extreme cases where a patient has a long history of mental illness and has tried all other options.

When I wanted to go on Valium many years ago, I asked my doctor and he flatly refused, even though we had explored every other drug treatment without any success. Eventually after I said I felt suicidal he agreed to let me have the Valium, only on the condition I signed a disclaimer taking full responsibility and saying that I was going against his professional advice.

I didn't find the Valium took away my shyness or made me less anxious, but it did help me to cope with the physical symptoms and enabled me to get out the house past the fear.

I'm glad Xanax has worked for you, but I'd be worried you would become dependent on it and experience tolerance if you used it daily. You're only young and it seems tragic you should be needing a benzo to function. Perhaps you can use it sparingly and seek a referral to a psychologist to try and improve your social skills and confidence.

My doctor told me once people get onto benzos they often never come off them. He showed me a pile of patient files on benzos some of which he said he been on Valium for over 30 years. In addition to the problem of tolerance and dependency/withdrawal, benzos often have an effect of making you numb emotionally and even dulling the intellect in some cases. I'm not sure if that is the case with Xanax, but it certainly is with Valium if you continue taking it for a long period.

 

[junkie skumbag]

I've always been a shy person, only had a few friends at school and never really socialised much. I'm now 21 and I still get nervous around people and suffer panic attacks in social settings. I went to a doctor and mentioned how it was affecting my social, work and study commitments and his solution was anti-depressants. I made it quite clear I wasn't depressed but he insisted anxiety and depression go hand in hand and said Endep was the solution.

I have no interest in taking anti-depressants so I'm wondering what other options are there? I asked if it was worth seeing a psychologist and he said not to bother, the anti-depressants will fix the problem.

I tried some of my friends Xanax after researching it online and it has worked wonders, I am a lot more social on it and have suffered no form of panic attacks on it, I've even become a lot more motivated to study and work.

If I try other doctors do you think they will prescribe Xanax or something similar? Or will the keep pushing me for anti-depressants. Personally, I thought this doctor was an old, narrow-minded douchebag or am I wrong?

Shit mate i was in the same boat as i was when i was 16.....endpep is bad shit ime cause's faints/fits for me atleast...All my doctor would prescribe me for insomnia and social anxity was anti-D's! i ended up putting my foot down and saying i dont want any more anti-D's there not working for me (this was after about 3-4 months of being fucked around n switching anti-D's) then he put me on valium and it worked bloody wonders bad thing is when u have alot of benzos around u tend to take alot more than you normaly would and end up with a filthy habbit to benzos so watch out mate....i say stick to your doctor.Try the endep and see if it works anti-ds can take weeks before they start taking effect so give em time after a few months if anti-d's arnt working for you put your foot down and say you dont want them anymore and refuse to take them if he dosnt prescribe you xanax move onto another doctor who will......

 

[The-Future]

Thanks for all the advice, I've got an appointment with a psychiatrist on Friday so I'll let you know how it goes. I've had a lot of bad reviews from friends on anti-depressants so I'm going in with a negative view on them but I'm going to try and stay open to it.

I'm not keen on taking something everyday as I don't want to become dependent on anything, I like xanax because I can take it only when I need it e.g. in an uncomfortable social environment or if I can't sleep, which isn't everyday. I've had over 20 bars in the last month or so (with no abuse) and I've been off them for about 2 weeks with no withdrawals.

 

[Fire&Water]

Thanks for all the advice, I've got an appointment with a psychiatrist on Friday so I'll let you know how it goes. I've had a lot of bad reviews from friends on anti-depressants so I'm going in with a negative view on them but I'm going to try and stay open to it.

I'm not keen on taking something everyday as I don't want to become dependent on anything, I like xanax because I can take it only when I need it e.g. in an uncomfortable social environment or if I can't sleep, which isn't everyday. I've had over 20 bars in the last month or so (with no abuse) and I've been off them for about 2 weeks with no withdrawals.

Hpoefully, zanax wont prove to be the (oxys') of benzos...the world knows the
pharmacutical comps. could make a more addictive version, if there was $ in it.
I have been on a low dose of diazepam for years because it works.
There's no proof of loss of intellect...

"If lt's in black & white it must be true"

 

[Divine Moments]

I think unless you have an open minded/trusting doctor who is willing to be flexible and not go strictly "by the book", you will have to take the anti-depressants and go through the various treatment options before they will consider referring you to a psychologist or giving you access to other drugs like benzos.

Going straight to antidepressants without considering a psychologist/counsellor is not "by the book" (i.e. that is not what evidence shows is best, or what doctors are generally taught to do. It's the fucking lazy option )

I don't know what country you're in

This forum is called Australian Drug Discussion and the OP's location is set as Brisbane

 

[footscrazy]

Going straight to antidepressants without considering a psychologist/counsellor is not "by the book" (i.e. that is not what evidence shows is best, or what doctors are generally taught to do. It's the fucking lazy option )

^ I agree with Divine Moments, your doctor gave you shit advice. Social Anxiety is very well treated by cbt, and has one of the highest success rates, but medication is generally considered minimally useful. The advice your doc gave you was pretty much completely wrong. IMO, medications can be useful in social anxiety but it's the cbt work that actually cures or improves the problem. The medication can just give you the boost to actually get out there and do the cognitive and behavioural exercises you need to to make a change.

Actually the only medication with an on label use for social anxiety is nardil, and you're unlikely to get prescribed that given it's an MAOI and they have lots of bad side effects/interactions.

Personally I found mirtazapine useful when I had panic disorder and other anxiety issues, but I know it was the cbt, meditation, exercise etc I did that really changed me. I did a lot of work on it, and it worked.

 

[Peakingwithyou]

Effexor is good for anxiety. Helped me but to get the right anti depressant you will maybe need to try a few before you find the right one for you.

Stay away from Xanax and Valium, thats only short term fix. ANd fuck me Xanax sucks to stop and come off!!!!!

 

[tyrael]

....IMO, medications can be useful in social anxiety but it's the cbt work that actually cures or improves the problem. The medication can just give you the boost to actually get out there and do the cognitive and behavioural exercises you need to to make a change.....

Agreed! I often speak with doctors and nurses (and various other people who are in, or are affected by, the medical profession) and the general consensus is that we live in an age of pill-poppers. "There's a pill for that"-kinda attitude. An common example being something like "I'll just take paracetamol/ibuprofen/insert your analgesic DOC here to fix my headache", where as just sitting in a quiet, darkened room and drinking enough water would/could work just as affectively.

Non-pharmacological alternatives should be investigated along side and/or instead of, during dx'ing a pt - meditation, cognitive therapy, etc.

Now not that this is the case for the OP, most definitely not, and it wasn't the solution in my case. Just making a point

Goodluck The-Future!

 

[belarki]

Personally I found mirtazapine useful when I had panic disorder and other anxiety issues, but I know it was the cbt, meditation, exercise etc I did that really changed me. I did a lot of work on it, and it worked.

Really good advice footsy . You have to invest serious time and effort into managing anxiety. Taking a pill to overcome it will never be anything more than a short term crutch. IMO SSRI's only work well for anxiety when taken as a supplement to therapy & lifestyle change (such as exercise). I also found mirtazapine more effective than effexor, lexapro and zoloft but everyone's different when it comes to subjective benefits from these types of meds.

 

[Mr Blonde]

I too will recommend CBT and a few visits to a psychologist. It will take work on your part, but getting over the challenge and beating your anxiety will be worth it.

As for meds, save the benzodiazepines for when they are really needed. They are powerful, but dangerous, tools.

 

[Jakeperson]

Yeah I was given Mirtazapine for mild depression and severe anxiety and I can say without a doubt that it has not helped either at all.


I found the best thing for me was getting addicted to Phenibut, once I got out of withdrawal I have suffered from a lot less anxiety and the few months spent on it I completely forgot what anxiety felt like.

(edit: I am not suggesting this, as it probably wont work for every one but just showing how some addictive medications can still have benefits)

 

[Sameria]

Can't support what has been said above enough.

I've still got a lot of issues with anxiety but excercise and lifestyle change has gotten me through really rough periods. Benzo's and other drugs on the other hand have done nothing but make the issues worse. Drugs don't fix your problems, they only hide them.

 

[Mr Blonde]

^ Exercise is definitely a good idea for helping to manage with anxiety and stress. I don't have my reference book on me, but it's impact on cortisol and catecholamine levels is beneficial and of course there is the release of endorphins, aka 'runner's high' that comes with it.