Questions regarding Anxiety

[Renz Envy]

Hey guys, it's been a while.

I have a few questions regarding anxiety developed through recreational drug usage. To begin, I have always suffered some form of anxiety, but it began worsening post alcohol and amphetamine use.

Neurotoxicity to the NMDA receptor is a trademark of anxiety, correct?

However I have also read that damage to the serotonin system is also a cause. I believe I may have done a bit of both as I have used ecstasy in the past. As well as a brief period of almost daily alcohol use and then recently, a weekly use of GHB.

I'm trying to find the main cause of my anxiety as I use amphetamine to study, however even in small doses the drug causes my mind to wander off into worrying thoughts that a heart attack could happen out of the blue despite me being fairly athletic with no history of high blood pressure or heart disease. In higher doses the drug can cause uncontrollable panic attacks, leaving me breathing out of a plastic bag next to a Blood pressure monitor for 2-3 hours.

I will probably consult my doctor about getting a beta-blocker/benzodiazepine to help the problem, however it would mean a lot if anyone could clarify the theory that serotonin down-regulation causes anxiety.

Thank you.
-Renz Envy

 

[sekio]

My rule of thumb is that damage to the actual physical structure of the brain ("damage to the serotonin system" if you will) is essentially imperceptible until it reaches such a level that you are a walking zombie.

Unless you are a compusive abuser of MDMA you should be worried only about the psychological causes of your anxiety and not any underlying physical causes aside from those you can actually do anything about such as transient monoamine depletion.

Amphetamine is known to be anxiogenic. I bet you 10:1 that simply being on amph uis the cause of your ills.

Realistically you should consider abstinence from amphetamines and other recreational drugs if you find that they induce anxiety. The reason I say so is twofold. First off these drugs are known to cause anxirty like I stated before, but also because if you are led to the conclusion that your "receptors are dmaaged" there is essentially nothing you can do other than go into a depressive spiral of trying new supplements and treatments to "regrow" things your body is already naturally regrowing. Concurrent to this last point is the fact that most people don't have access to the tools to diagnose "receptor damage" (i.e. a PET scanner and the right radioligands plus an older reference dataset from before drug damage occured) so it's impossible to say with any certainty "oh yes Renz you have lost 66% of your NMDA capacity and 40% of your serotonin 2a receptors". The human brain just doesn't work that way.

This question of yours has been asked so many times that it kind of gets on my nerves now. And I'
ve yet to see anypone come back and actually say "yes I have lost my serotonin neurons, here is a PET scan to prove it".

 

[Renz Envy]

Thank you for your response.

The suddenness of the development of panic and anxiety is what provokes my question. I know the "serotonin" issue gets asked a lot, I have tried my best to answer it myself, yet fall short of any technical answer.

I have been over a month sober recently, from everything, even caffeine. After 2 weeks it was as if I forgot how psychoactive substances felt.

I am still left with this uncomfortable problem during amphetamine use. I'll see if another board can help me get over the problem as I do not want to use a beta-blocker or benzo to "solve" it.

 

[negrogesic]

Just to clarify, have you experienced any of these panic episodes when not on amphetamine?

Is your 'baseline' anxiety heightened as well, or is it largely episodic in nature?

GHB has a rather insidious tendency to closely mimic acute anxiety-panic disorders after discontinuation from days of consecutive abuse. Unlike opioid or BZD withdrawal syndromes, withdrawal from short-term GHB can occur with no 'apparent' discontinuation syndrome, which makes the resulting panic states appear to be not directly correlated to its use.

Point is (and as Sekio explained): Given your use of amphetamine and GHB, it is premature to look much further unless the issue remains in absence of said variables. And as Sekio also mentioned, 'measurable' damage is highly unlikely, and in the unlikely event that any such damage is apparent and clinically relevant, you are generally speaking, fucked.

My advice would be to:

1. Discontinue frequent or consecutive GHB use
2. Evaluate your 'usage' of amphetamine
3. Do not combat amphetamine induced anxiety with BZDs, as that is a battle almost never won in the medium to long-term
4. Avoid inducing sleep with EtOH after amphetamine use (the resultant may resemble 'sleep', yet hardly qualifies as rest)

 

[SNR]

My rule of thumb is that damage to the actual physical structure of the brain ("damage to the serotonin system" if you will) is essentially imperceptible until it reaches such a level that you are a walking zombie.
--
Unless you are a compusive abuser of MDMA you should be worried only about the psychological causes of your anxiety and not any underlying physical causes aside from those you can actually do anything about such as transient monoamine depletion.
--
Amphetamine is known to be anxiogenic. I bet you 10:1 that simply being on amph uis the cause of your ills.
--

Agreed.
Renz Envy, do you use street amphetamine or a prescription amphetamine?

I have been doing some serious research into recreational drugs and anxiety and their connections (SERIOUSLY, I have too much time on my hands.. Ion channels, receptors I had previously never heard of, you name it) and I strongly feel that anxiety is not only a physiological symptom (What I mean here is that I feel that recurring anxiety might result from adaptations from long term stress and psychological changes because of negative thought patterns). I suggest you take some time and sit down and have a talk with yourself. Work on putting some awareness into your day to day activities (Not trying to preach to you). Whenever you feel anxiety or panic, think quickly about what you were doing immediately before this happened. Think of your heart rate, your thought patterns, experiences earlier that day, etc. On days you do not have anxiety, think about what thoughts were absent or present that are/are not when you have anxiety. And keep yourself out of those vicious "thought loops" (Amphetamine definitely makes it harder to stop/stay out of them).

I know it seems like anxiety comes out of random at times, but I think that (except in some people) anxiety ALWAYS has a root if you trace your thought patterns far enough.
Also, don't be afraid to consult your doctor.

PM me if you would like to talk more.

Hope I helped a bit!

~snr

 

[Renz Envy]

My anxiety is only caused by racing thoughts of having a heart attack while on a stimulant. Originally amphetamine opened up my ability to talk to people and I generally felt invincible.

I have a prescription to vyvanse. I do not use street amphetamine.

Off of any drugs, I do not have anxiety.

The only time GHB has ever given me anxiety is when I attempted to abuse it and had to cold-turkey use. But never did I think I was going to die, it was merely a very uncomfortable, introverted feeling.

 

[sekio]

My anxiety is only caused by racing thoughts of having a heart attack while on a stimulant.

This is normal for some individuals, I think it relates to the elevated levels of norepinephrine released by stimulants.

On second thought, however, it's most likely psychological because the same problem occurs for some users of cannabis. And I don't think THC is that good at elevating postsynaptic NE.

If you are taking "normal" doses and you are otherwise healthy as regards cardiovascular stuff, you should just make an effort to not worry about your heart rate as it can become a psychophisological downwards spiral ("Is my heart beating too fast?" -> anxiety -> hyperventilation, elevated h/r and b/p -> "Oh my god my heart is beating too fast I'm gonna die" -> more anxiety -> more h/r and b/p etc.) Benzos are the go-to band aid because they are very effective at dispelling worries (i.e. making you not give a fuck)

There was actually another thread on the 'staged effects' of amphetamine. It seems pretty normal that some people initially have a wonderful time but after continued usage find that amph is way too anxiogenic or fraught with side effects.

 

[SNR]

This is normal for some individuals, I think it relates to the elevated levels of norepinephrine released by stimulants.

On second thought, however, it's most likely psychological because the same problem occurs for some users of cannabis. And I don't think THC is that good at elevating postsynaptic NE.

This is something I went over in said studies. Cannabinoids play with dopamine and glutamate levels (Presynaptic block of neurotransmitter relase). Dopamine and glutamate play a strong role in feelings of dread. I think that cannabinoids could flip the "switch" between desire and dread to dread, in some people.

I hate to bring this up in this thread as it is not entirely relevant, but it is ADD..

http://www.jneurosci.org/content/31/36/12866.abstract
http://ns.umich.edu/new/releases/6634
http://www.ncbi.nlm.nih.gov/pubmed/21900565



EDIT: Also, to the OP, have you tried methylphenidate?

 

[Limpet_Chicken]

And if anyone hasn't mentioned it already, and reading, I didn't see it, beta blockers are or can be DANGEROUS to mix with stimulants, block the beta receptors, the released (nor)adrenaline has to go somewhere. That somewhere is alpha1/alpha2 receptors, the former when agonized result in vasoconstriction.

A safer option would be a drug such as clonidine or tizanidine (the two are similar, although clonidine is much longer acting, and much more effective as a hypotensive agent) These rather than blocking the majority of adrenoreceptors serve as the autoreceptor for (nor)adrenaline (someone please do correct me if I am wrong in the belief that release of both is inhibited, and it is only noradrenaline)

Autoreceptors are located presynaptically, and in most cases reduce release of the appropriate neurotransmitter, so by binding to alpha2 adrenoreceptors the release of said neurotransmitter is blocked, by in effect 'tricking' the body's negative feedback mechanism into 'thinking' there is too much floating around, better reduce the release.

I find either of them very effective anxiolytics, and effective at squashing any hint of sensory overload (I'm autistic...and yes, I like it that way..just not overloading or being a fair bit photo-sensitive...) before its ever even given birth) and these would be far safer than a beta-blocker (although there exist a few subtype selective ones which may not present such a danger, but lets not go there, as there exists potential for fuckups)

and I mean the pharmacological as opposed to (mostly)....to a degree... the human variety

 

[Renz Envy]

Yes, I've used methylphenidate in the past, however I do not like it