[MePlusYouXx]

What is treatment for anxiety and depression? Im worried about what my treatment will be.. :s


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[Final Fantasy]

(Original post by MePlusYouXx)
What is treatment for anxiety and depression? Im worried about what my treatment will be.. :s


This was posted from The Student Room's iPhone/iPad App

If you have an appointment with your GP or psychiatrist, it will generally go like this:

- You'll talk about yourself and what's been going on (mainly involving what problems you've been experiencing that prevent you from living a normal/healthy life).

- You'll fill out a questionnaire that will roughly determine how bad your condition is.

- If it's your first time at the surgery/practice/medical centre, then you'll likely be booked for a blood test to rule out anything else.

I hope it doesn't sound scary, it's really not. They've heard it all before and will also be asking you questions. Feel free to tell them anything, especially if it's bothering you. It's completely confidential.

Having said that, if the doctor is in a hurry or not very experienced in mental health, is on a tight schedule and/or just wants to get it over with quickly, you'll be prescribed some random SSRI and be on your way. Just telling you how it is. I hope this does not happen to you though.

As for the treatment for anxiety/panic, it varies heavily, and often depends on the doctor, treatment can involve (depending on the severity of the condition!):

- Therapy
- CBT
- Antidepressants (TCA, SSRI etc.)
- Benzodiazepines (short-term treatment)
- Or a combination of any of the above mentioned

For depression, again depending on the severity:

- Therapy
- CBT
- Antidepressants
- Or a combination of any of the above mentioned for depression

Treatment for insomnia, insomnia and anxiety or other related is similar to the treatment for anxiety/panic, but can also include:

- Hypnotics, sedatives (could be a benzodiazepine, non-benzodiazepine or z-drug, antidepressant such as Mirtazapine which is a TCA type) etc.

If you experience physical symtoms such as shaking during your appointment with the doc, try not to worry about it too much (yeah, I know, can't help but worry!), doctors expect this and it's a normal/common symptom of anxiety/panic disorders.

Good luck!

EDIT: Forgot to add, though not as common, and although benzodiazepines have these properties (they are rarely prescribed, Google/wiki it to find out more), you may instead get prescribed muscle relaxers, anxiolytics or even beta-blockers (stop your heart from hammering away all the time). It's ok to be persistent and ask questions - if you don't ask, you don't get. Also be sure to ask about what common side effects to expect (antidepressants can have many) e.g. if you were prescribed mirtazapine you might be knocked out for 2 days and find that you have an odd craving for sugary snacks and get hungry more often. Unfortunately not all doctors tell you what to expect. So ask!

[MePlusYouXx]

(Original post by Final Fantasy)
If you have an appointment with your GP or psychiatrist, it will generally go like this:

- You'll talk about yourself and what's been going on (mainly involving what problems you've been experiencing that prevent you from living a normal/healthy life).

- You'll fill out a questionnaire that will roughly determine how bad your condition is.

- If it's your first time at the surgery/practice/medical centre, then you'll likely be booked for a blood test to rule out anything else.

I hope it doesn't sound scary, it's really not. They've heard it all before and will also be asking you questions. Feel free to tell them anything, especially if it's bothering you. It's completely confidential.

Having said that, if the doctor is in a hurry or not very experienced in mental health, is on a tight schedule and/or just wants to get it over with quickly, you'll be prescribed some random SSRI and be on your way. Just telling you how it is. I hope this does not happen to you though.

As for the treatment for anxiety/panic, it varies heavily, and often depends on the doctor, treatment can involve (depending on the severity of the condition!):

- Therapy
- CBT
- Antidepressants (TCA, SSRI etc.)
- Benzodiazepines (short-term treatment)
- Or a combination of any of the above mentioned

For depression, again depending on the severity:

- Therapy
- CBT
- Antidepressants
- Or a combination of any of the above mentioned for depression

Treatment for insomnia, insomnia and anxiety or other related is similar to the treatment for anxiety/panic, but can also include:

- Hypnotics, sedatives (could be a benzodiazepine, non-benzodiazepine or z-drug, antidepressant such as Mirtazapine which is a TCA type) etc.

If you experience physical symtoms such as shaking during your appointment with the doc, try not to worry about it too much (yeah, I know, can't help but worry!), doctors expect this and it's a normal/common symptom of anxiety/panic disorders.

Good luck!

Thankyou SO much for your help I have an appointment with my GP on Friday x


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[Final Fantasy]

(Original post by MePlusYouXx)
Thankyou SO much for your help I have an appointment with my GP on Friday x


This was posted from The Student Room's iPhone/iPad App

No problem. Btw, I edited my post to add some more info.

[Anonymous]

Hey, this probably sounds wierd as hell but it's really really bothering me at the moment so I was wondering if anyone had experienced anything similar. Sorry if this is a bit long winded but I don't really know how to explain it without giving a bigger picture first!
I'm 21 and first developed problems with anxiety when I was about 10 and started having regular panic attacks. I guess at the time I mainly worried about my health and my family's health. I don't really remember much about the treatment I got for them but I was taught to recognise my physical symptoms as anxiety and got the panic attacks under control. I haven't had a full blown one since I was 12 or 13, but still sometimes get sort of mini anxiety attacks (feels like the start of them, but never reaches a point where I am hyperventilating or anything cos I am aware of what it is and that it will pass), and I don't feel like the internal feelings of worry or anxiety have ever really gone away, although they have repeatedly waxed and waned over time. When I was 16 the worrying started to get much worse again, this time all surrounding body image and social anxiety. Again it waxes and wanes, the anxious feelings are constantly there and I struggle with overthinking but sometimes I can function okay with it niggling away in the background and other times I can't leave the house due to appearance worries/wanting to avoid awkward situations, but even when it is at its worst my physical symptoms are still under control, although I have a tendency to feel low at these times and have been self-harming as a result. I guess this is where my question comes in, I put off going to my GP for 5 years because I was scared they wouldn't believe me because the physical symptoms are not that bad and when I am in my comfort zone I feel ok. When I finally plucked up the courage to go, I was referred to the iapt programme thing and after my assessment with them I've been put straight on the waiting list for some individual CBT which should start in the new year but in the mean time I'm just sitting tight or I might go to my GP when I get back to uni to see if there is a shorter waiting time there than at home (although the worry i'm about to describe might stop me from doing that). I guess because maybe I don't suffer from physical anxiety symptoms I can't control, and I have a pretty good talent for hiding my emotions/worries from others so people might not necessarily be able to tell that anything is wrong, I can't stop thinking what if I don't have an anxiety disorder at all, that somehow i'm lying to myself and others about it and it's something that i've convinced myself I have but don't really? I told two of my closest friends that i've been referred for CBT and since then I feel constantly paranoid that they don't believe me and think i'm a massive liar, or that I exaggerate or attention seek, and then I sort of think what if that is true and start to feel really guilty and stuff, I can't stop thinking about it and i'm dreaming about it and all sorts! Does anyone get what I mean or does that just sound really wierd?

[Dizzycop]

What do you guys do when you feel really, really bad about yourself? Because sometimes, like right now, I feel so so horrible about myself and it's so bad I don't know what to do with myself. I hate myself so much that I want to hurt myself, it feels like cutting myself will make it better I've never done it though. Just what do you do? It's like there's so much tension and stuff going round in my head that I need to do something to sort it out but I don't know what! I might try writing things down... Arghhhhh please help :/

[SheChasesComets]

I started getting bullied aged 11 when I started High School. Not just name-calling, although, it was that. I'm talking pushed to the ground and choked, slapped, hair pulled, stuff stolen and ripped, pushed down a flight of stairs in a shopping centre (no one helped, though I screamed for help), punched in the face, spat on. As high school progressed, the physical violence wasn't so bad, though I was having stuff thrown at me, being kicked, punched, chased home with a golf club by a boy in the year above. I started faking sick to get off school, being scared, all that kind of thing. Flash forward, I'm about to go to college, and dreading it. When I go out, I get horribly panicky - when buying things in shops, when shopping, when talking to adults, when talking to people my own age, having to stand up and talk to friends. I get panic attacks every now and then, mostly during school. Last month, some children spoke to me to tease me and I got so scared I ran into a classroom with some teachers and had to be calmed down.

I know I seem stupid. Does anyone know of anything that can help?

[megfashion]

(Original post by SheChasesComets)
I started getting bullied aged 11 when I started High School. Not just name-calling, although, it was that. I'm talking pushed to the ground and choked, slapped, hair pulled, stuff stolen and ripped, pushed down a flight of stairs in a shopping centre (no one helped, though I screamed for help), punched in the face, spat on. As high school progressed, the physical violence wasn't so bad, though I was having stuff thrown at me, being kicked, punched, chased home with a golf club by a boy in the year above. I started faking sick to get off school, being scared, all that kind of thing. Flash forward, I'm about to go to college, and dreading it. When I go out, I get horribly panicky - when buying things in shops, when shopping, when talking to adults, when talking to people my own age, having to stand up and talk to friends. I get panic attacks every now and then, mostly during school. Last month, some children spoke to me to tease me and I got so scared I ran into a classroom with some teachers and had to be calmed down.

I know I seem stupid. Does anyone know of anything that can help?

Hiya. Feel free to PM at any time.

I was bullied quite badly too, although definately not as bad as yours. Yes theres paranoia sometimes, even if its my best friends talking.

With running out, explain to your teacher or whomever about how you were bullied (you dont have to go into it). There were a couple of times i refused to go to a lesson because of this girl who was very horrible. They understood and gave me work to do.

With shops, go with some friends that you trust. Going on your own.will bring up the bad memories - going with trusted friends will then form new good memories. Then if you do go on your own, the old bad memories may not be as bad.
Are they sort of flashbacks? Just remember that the first flashback is always the worst, but then it gets sooo much easier.

Hugs. Always here to talk if you want x

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[SheChasesComets]

Thank you very much, megfashion. c:

I'm not sure what it is. It's just when I try to buy things, or go in certain places, or do exams, I get this horrible feeling of doom and nausea and sweating, I feel like I'm about to die and such. It passes after some pretty bad fear in about ten minutes. When I'm in places and situations that make me nervous, like social situations, I start to hyperventilate and get really shaky.

I'm going to have to do what you said and go with people I trust. I'm not sure, but certain friends seem to bring it on less than others.

[Final Fantasy]

(Original post by Anonymous)
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(Original post by Dizzycop)
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(Original post by SheChasesComets)
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(Original post by megfashion)
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(Original post by SheChasesComets)
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I've had several years of experience with this is various doctors, treatments etc. (also check my previous post above about what to expect when seeing a doctor).

This is for anxiety/panic and insomnia only!

I strongly recommend making an appointment and then when you get there, no matter had bad it's tearing to say it, no matter the panic you're feeling, even if you're shaking, just tell them everything. Please, just explain what's going on like you are doing here on TSR. They will listen (they may interrupt you, be respectable but do finish your point), once they have a better understanding they will be typing this up on the computer to keep a record of you. You will undergo some tests possible to rule anything else out.

The first line of treatment is SSRIs, in my experiences the side-effects were not worth it, but it does work really well for other people. Me on the other hand am impatient, have tried 2 SSRIs long-term and vowed never again. I've been in the system for a few years, it's only now with reluctance that these university doctors are willing to prescribe drugs that eliminate all symptoms within 30mins (imagine if you will, suddenly all your worries are gone, it's sheer bliss, you no longer care or worry, there's a slight euphoric feeling) these drugs are used generally in short-term treatment. These are short-acting drugs comprising of muscle relaxant properties, anxiolytics, sedatives, hypnotics etc. they are very easy to abuse and become addictive and tolerance builds up rapidly. Over the years, I've gotten to know some doctors and eventually tried these alternatives, given that I have no history of substance abuse.

Also consider the medication Mirtazapine (Google it), it's a bit similar to SSRIs and treats a variety of conditions. In fact, trials showed that it was a bit superior other 12 other SSRIs.

Therapy and CBT never worked for me either which was the other reason.

Don't be afraid to switch doctors for a second opinion. Don't be afraid to insist or lay out all your fears or ask for a short-term treatment alongside a long-term treatment (until these begin taking effect, the short-term treatment meds can then be taken off gradually).

If drugs like benzos were so abused by *****, then they'd be prescribed more often to those who genuinely need them in emergency situations to be taken every now and then, couple of times a month on average. This avoids addiction/reliance/tolerance.

Essentially, research your particular mental health conditions and the treatments for them. I'm not going to list an drug forums, but there's experiences from both sides.

EDIT: Sorry for spelling and grammar mistakes. Post made in a hurry.

[CharFallaria]

Woo

[Final Fantasy]

(Original post by CharFallaria)
Hey guys, I was wondering if any of you can help me with this in terms of getting help as well as academically.

I'm a good student. I go to lectures, do my reading, get my coursework in on time and get good grades for them. I always start revision early. But for some reason, when exams roll around, I experience panic-attack like symptoms and I can no longer concentrate and it's affecting my results.

Crucial days before the exam I am unable to eat or sleep, I am crying hysterically, experiencing chest pains and shallow breathing, shaking, sometimes harming myself and contemplating suicide. No matter how early I prepare, I still feel like I am unable to pass. I have been to exams before and I never used to have much of a problem but since A-levels and university, I've become a wreck.

This year, I was ill during exam period and missed 4 exams out of my 8. The 4 that I did take didn't go that well because of my illness so these last four have had a lot riding on them to bump my grade up. The past week has been the worst. I can't bring myself to revise because I experience these panic attacks.

I have missed one of the exams so far as I felt as if it were a hopeless case to go as I was sure I was going to fail.

I know I am going to receive comments from saying that everyone goes through exam stress but I do really think there must be something wrong with me. I'm not sure who to talk to about it with and what kind of help I can get, and I feel stupid asking for help because, in the end, they're only exams.

Any ideas on who I should approach and how I can help myself? And what should I do about my missed exam? I've probably failed but I'd like to know if there was any way I could appeal to the university about it?

Thanks in advance

Hi CharFallaria.

Most of of what I'm about to tell you, if followed, will relieve all of your problems/symptoms effective immediately (note: not the underlying cause, just the symptoms and provide you with peace of mind). Also note that I am mainly address your anxiety, panic and insomnia (there are different levels of insomnia, but if it's easier to understand, then sleep problems/issues and the inability to sleep as you normally would be able to).

First and foremost, you must make an appointment with a doctor. I recommend, for this purpose, the doctors at your university medical centre. Explain to them all the problems you are currently facing academic wise, and how also how your mental health problems are affecting it. If they do not listen, if they prescribe you with some random SSRI (this is a crucial moment, you can't afford to wait 6 weeks or so for them to work and then probably find that you need to switch to another SSRI if they don't) and tell you to be on your way, then switch doctors. If switching to another university doctor does not work (at the risk of sounding sexist, switch to one of the opposite gender, if that does not work, turn to a non-university doctor, some clinic/surgery outside of university or from your home town/city, otherwise ask the doctor to refer you to someone that is willing to provide quick acting medication as a temporary solution (it's always gonna be temporary sorry, because they are often abused by people, doctors have a reputation, there's forms to fill in, there have been law suits and legal action in the past because of patients becoming addicted... basically benzos and similar drugs have a bad reputation, IMO if used properly and as and when needed they work great).

Once you've seen a doctor, ask for a doctor's note which you may hand in to your faculty office. All universities have a procedure known as 'extenuating circumstances', you must request and complete an extenuating circumstances form and hand it in along with your doctor's note ASAP. It may also help to speak with your university personal tutor (many universities assign students a personal tutor).

Important: Make copies of the doctor's note. The note should include dates, possible medications and current treatment being taken, what the condition(s) is and how long it's expected to last. A signature from both you and your doctor would be fantastic too.

The next thing would be to register for DSA (reason being that the authority will pay for your appointment with the disability assist centres and liaise with them on your behalf). When registering for the DSA, your doctor's note should be proof/evidence, but there will also be a section on the form to write down your own personal statement of what's going on. If you prefer, write this personal account on a word document and print it out (then on the form section just say 'refer to attached documents'... post these by 1st Class or Special Delivery etc. to your home's LA (Local Authority). However all this will be explained when applying for DSA anyway.

After that, the DSA will get back to you to either approve or disprove your application. If approved, the Authority will ask you to contact your disability advisor at your university and arrange an appointment with the Disability Assist services on campus (or near campus for some universities). You can actually register with the disability services whenever you want and ask them to refer you to an assessment centre, but from personal experience it's best done with a doctor involved too. Remember to bring proof/evidence though, this would be your doctor's note.

After that, everything else will become clear to you and once it's all over you can attempt long-term treatment e.g. CBT, therapy, medications. E.g. extended exam times, special provisions and extra resources. A diagnosis on what's really wrong with you (if anything). Exam panel taking consideration of all this when they check your marks etc. etc.

---

Now, for the doctor/treatment part:

It's complicated because you have exams, which pretty much rules out most tranquillisers, sedatives, hypnotics etc. but if they're a couple of weeks away, you should ask to be prescribed a few. Know that no university doctor will prescribe these as a first line of treatment (especially benzodiazepines and that most will insist on SSRIs). You should ask for alternatives such as beta blockers (propranolol) which will stop the physical symptoms such as palpitations and shaking (but not the psychological and mental symptoms). Many doctors are however willing, if pressed, to prescribe non-benzodiazepine drugs called 'Z-drugs', these concentrate more on the receptors that induce sleep. Examples include Zopiclone, but there are better ones too. If you genuinely need to get some sleep, ask for short to medium acting sedatives/hypnotics. An all-in-one medication is Mirtazapine, which like SSRIs, works long-term and short-term, the short-term effects induce sedation and help you sleep (a coffee in the morning will fix any groggy feeling left), in the long-term Mirtazapine will almost eliminate panic attacks, if you give it 2 - 4 weeks.

Sometimes, long-term medications are combined with short-acting medications, and the short-acting ones are stopped taken when the long-term ones begin to work. Take for example, diazepam (brand name Valium) along with Fluoxetine (brand name Prozac). These are just examples for this, I'm not recommending Prozac. Just giving an example of how meds can be combined. In fact, they can further be confined with talk therapy and CBT.

I'm by no means a medical expert or doctor, it's just that I've been in the system for over 3 years and seen a wide range of doctors and treatments. In the end, you'll have to go through the same thing to gain a better understanding of how it works.

Any more questions, let me know.

[Anonymous]

Hello

I've had anxiety in the form of worrying, scared, crying, shaking, chest pains and nerves on and off over the past few years. It seems to be triggered by a change in events such as when I went from the change of college to university the anxiety was bad during the first few weeks of university until I got use to it which I then go back to my normal self. It sort of came back when I had my university exams and driving test so I went to my GP and was prescribed 10 mg of propranolol to take before which seemed to do the trick. However I graduated in July from university and I'm now looking for a full time job for the next year as I wish to do a masters in September 2013 and the anxiety has returned with a vengeance. I've had a few job interviews and I've been a complete mess the week before the interview and during the interview itself. Its got so bad that I've actually ended up not going to one interview because I was crying and shaking. I've been on 40 mg daily of propranolol for the past few weeks and I thought it was working until last week when I found out I had another interview. The anxiety came back and I've been the same since. I really want a job but the anxiety is killing me! and I just can't seem to get past it on my own.

[bullettheory]

Hey guys. I've popped in before but I thought I would come back since I think its a really cool group

My story is I have Emetophobia (fear of sick) and also apparently GAD and Social Anxiety (diagnosed in the past and also recently). Thought I would come and say hello

[puddledancer]

I want to share my story of triump from today, hopefully showing things get good!

Because of a special weekend I was in work 1 to half 9. That's tiring in itself but I had brought spare clothes, got changed and stayed behind in the pub with people for 2 hours.

I got talking to another girl and it turns out she had panic attacks, and was in my medication and I had a really good time. And all I had was a diet coke because and no one scoffed at me because people know I don't drink, although I said its because I don't want to, not that it's because of my meds.

I'm feeling really good and confident and I just hope everyone else here gets a feeling like this soon.

[Watch Key Phone]

(Original post by puddledancer)
I want to share my story of triump from today, hopefully showing things get good!

Because of a special weekend I was in work 1 to half 9. That's tiring in itself but I had brought spare clothes, got changed and stayed behind in the pub with people for 2 hours.

I got talking to another girl and it turns out she had panic attacks, and was in my medication and I had a really good time. And all I had was a diet coke because and no one scoffed at me because people know I don't drink, although I said its because I don't want to, not that it's because of my meds.

I'm feeling really good and confident and I just hope everyone else here gets a feeling like this soon.

Fantastic! You're brightened my day, seeing as I've been feeling terrible recently. I'm really happy for you.

(Original post by bullettheory)
Hey guys. I've popped in before but I thought I would come back since I think its a really cool group

My story is I have Emetophobia (fear of sick) and also apparently GAD and Social Anxiety (diagnosed in the past and also recently). Thought I would come and say hello

Emetophobia here too.

(Original post by Anonymous)
Hello

I've had anxiety in the form of worrying, scared, crying, shaking, chest pains and nerves on and off over the past few years. It seems to be triggered by a change in events such as when I went from the change of college to university the anxiety was bad during the first few weeks of university until I got use to it which I then go back to my normal self. It sort of came back when I had my university exams and driving test so I went to my GP and was prescribed 10 mg of propranolol to take before which seemed to do the trick. However I graduated in July from university and I'm now looking for a full time job for the next year as I wish to do a masters in September 2013 and the anxiety has returned with a vengeance. I've had a few job interviews and I've been a complete mess the week before the interview and during the interview itself. Its got so bad that I've actually ended up not going to one interview because I was crying and shaking. I've been on 40 mg daily of propranolol for the past few weeks and I thought it was working until last week when I found out I had another interview. The anxiety came back and I've been the same since. I really want a job but the anxiety is killing me! and I just can't seem to get past it on my own.

Have you had any kind of therapy? That might hit the spot if the medication alone hasn't been helping as much.

[Riku]

How's everyone doing here? Been a while

I'm currently really, really worried about not being, or at least not feeling,particularly funny. Both because it can lead to boring others and making me dwell on how I feel sometimes.
This is despite watching, reading and listening to quite a lot of supposedly funny stuff lately : /
My therapist reckoned it was difficulty in relationships and social anxiety behind a lot of my concerns which I was projecting onto food when I couldn't face people. My relationship with food is better in that I'm not scared of food anymore but am still very scared of the persistent binging habit...but yeah, most of the time I comfort-eat it's because I feel inadequate around people (family, friends, friends of friends, colleagues, anyone really), and right now I feel my main weaknesses are organisation and humour. Hmmm

[Anonymous]

(Original post by SheChasesComets)
I started getting bullied aged 11 when I started High School. Not just name-calling, although, it was that. I'm talking pushed to the ground and choked, slapped, hair pulled, stuff stolen and ripped, pushed down a flight of stairs in a shopping centre (no one helped, though I screamed for help), punched in the face, spat on. As high school progressed, the physical violence wasn't so bad, though I was having stuff thrown at me, being kicked, punched, chased home with a golf club by a boy in the year above. I started faking sick to get off school, being scared, all that kind of thing. Flash forward, I'm about to go to college, and dreading it. When I go out, I get horribly panicky - when buying things in shops, when shopping, when talking to adults, when talking to people my own age, having to stand up and talk to friends. I get panic attacks every now and then, mostly during school. Last month, some children spoke to me to tease me and I got so scared I ran into a classroom with some teachers and had to be calmed down.

I know I seem stupid. Does anyone know of anything that can help?

I'm sorry that all of that happened to you I suggest you try and get contacts set up with the college asap, you need to speak to the support department and find out what support they offer. They may arrange mentors to meet with you once a week to check how you're doing, or they may be able to provide advice on other things like quieter areas of the college where you can do work which is away from the louder areas. You should try to speak to the support dept. before you start so that you can get help if any problems arise. They will probably be there when you enrol. Good luck with college. When you get the first few days over with, it will be easier

[Anonymous]

(Original post by bullettheory)
Hey guys. I've popped in before but I thought I would come back since I think its a really cool group

My story is I have Emetophobia (fear of sick) and also apparently GAD and Social Anxiety (diagnosed in the past and also recently). Thought I would come and say hello

Hi, I have emetophobia too. If you don't mind me asking, do you fear sick in general (everything about it) or is it specifically watching others/being sick yourself?

[_Shmiley]

(Original post by Anonymous)
Hi, I have emetophobia too. If you don't mind me asking, do you fear sick in general (everything about it) or is it specifically watching others/being sick yourself?

I have this as well. The worst part for me is the sound, I get jumpy if someone just coughs. I will go to great lengths to avoid getting sick myself.


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