Is it possible that certain cases of general anxiety disorder require mediction?

I have GAD with acute panic attacks. After much experimentation, I will never go off my meds again. I’ve come to accept that I will be taking it for the rest of my life, and that’s ok. (I’m 42, by the way.) If you feel that the medication you are on is inhibiting your drive, you might think about switching. I’ve been on several different types, and am currently taking Effexor XR. I have a friend who can’t tolerate that one, so she takes Cymbalta. Work with your doctor to find the best medication and the right dose for you. I am in complete agreement with your last statement. Best of luck to you!

Well, it matters a lot what meds they are. If you are on benso’s like xanax, klonopin, adavan, or klonopon to name a few, you are going to have very bad withdrawal and should never stop cold turkey, you have to gradually reduce your dose. But, those drugs are generally not supposed to be used daily forever, they are very addictive. If you are on something more benign like Buspar, you might be able to go off (I would still reduce gradually) and not feel severe withdrawal. If you are on SSRI’s like prozac or wellbruton (there are a lot of SSRI’s) then typically it is expected you take these the rest of your life, but I don’t think it has to be that way, depends on the individual.

Have you read

http://en.wikipedia.org/wiki/Generalized_anxiety_disorder ?

@mattbrowne I’ve skimmed it before but just read in it’s entirety. Interesting read.

@limeaide – You read my history and repeated it here. I will never go off my meds. It interferes with life to much.

I do believe depression and anxiety is like diabetes to insulin for some people. Even with therapy, and learning coping techniques…it can still be a struggle in every day life.
I had been diagnosed with GAD when I was a teen, and I do think that diagnosis still holds true for me. I catch myself getting anxious easily sometimes, and I do still have phobias that I know will never change.
I have not taken any medication for depression/anxiety since October 2006, and I’ve really discovered a lot about my own coping techniques. I did plenty of therapy, pushing me to have anxiety attacks so I could physically cope with them. I also stayed in therapy med-free until Winter 2007 so I would not have a relapse. I have been doing just fine with no medication, I recognize when my feelings are extreme and when I need to sit back and think “Hey, it’s normal to get anxious but it’s not normal to let this overwhelm me. Knowing that it’s normal to be anxious or sad has made life a lot easier for me.

Many mental illnesses require people to take the meds forever. A chemical imbalance in your brain that is caused by mechanisms built into your DNA is very difficult to keep in check by thought alone. Some people have managed using only mental coping techniques, but that’s not very easy, and it often doesn’t work. Meds are a much better tool for coping.

They often do have side effects. Many of us worry if it stunts our creativity, and the psychiatrists insist this is not the case. It changes your mood, not your creativity, or so they say.

In addition, long term use may have effects we don’t know about. Certainly, folks who take Lithium for twenty years or more usually need new kidneys. I don’t know if there are other side effects that long term use of these drugs have.

I’m not 100% against medication to alter moods, but I’m not for it all too much either :/ I believe though, that our way of living now is far too nerve wrecking for many people who want to live simple and quiet lives. Personally, I wish there was still a way I can get away from the city life and into country life, where I am surrounded by calming things all the time, such as nature. Which gets to my point. I find nature to be the best way for me to cope with anxieties, but problem is, I can’t always get close to nature every time I need to wind down. But to me, Nature is my pill. Sunsets, sunrises, serene lakes, the moon on a beautiful night, the beach, etc. All these help me to cope with every day anxieties, BUT, all these things cant do it alone. I also need my loved ones. Family and my boyfriend. With out them, I would be miserable, and their ears and advice always help me to cope, but, some people don’t even have that! Which is understandable why they would need medication… Also, another means of coping is exercise. Feeling strong and energized by exercise gives me so much self esteem and confidence to do so much and hold my head up high.

I’ve been offered medications by many different doctors for depression and anxiety, and sometimes, I feel like I need it, but I still want to try to find other more natural ways of coping. I don’t know, but it just feels like it will make me a stronger person if I do. Not saying medication will make a person weak, just saying I feel like its a weak method of coping for ME, since I’m a weak enough person already and I want to learn to be strong.

Btw, if the medications affect on you worries you, maybe you can try doing some research into how the meds work. Read about what they do and find some life stories by people who use them. I don’t think it will change the way you think, but I’m sure some peoples bodies may react negatively to meds. If it hasn’t for you, then maybe there is no need to worry?

@Glow – you have a healthy attitude in that you always work towards a solution on your own.

My take is this. Much they way we situations like diabetes where the body has chemical problems that affect its proper function, so it seems logical to me that we have the same for mental and emotional problems. Electricity and chemistry are the way the body sends signals and effects reaction. It is no less believable that some people, myself included, would have a problem where their body doesn’t produce properly.

That being said, for me the best solution has always included your approach as well. Constant awareness of my environment and what I can do myself. And healthy counseling when needed.

oh, and Que Bueño brand nacho cheese.

@Glow You really touched on the main issue with mental illness in our society…people are ashamed, and feel weak when they have to take it, but the simple fact is…it’s medication like any other that is needed to save someones life. Yes, I do believe those types of medications literally save a persons life. Pulling someone out of the depths of depression, giving them the clarity they need to cope and get the therapy they require.

I, too, dislike being on medication and feel it has an ill effect on my body as a whole. I think it’s different for everyone though. I do think medication is thrown at people too much, I think other routes should be explored first…but people usually want a quick fix.

panic attacks have a tendency to lessen as you get older, or so I have read. I take xanax for my general anxciety disorder, but only when I feel the need. Not on a regular basis. Xanax is addictive, but avoiding the feeling of helplessness and fear far outweighs the worry of an addicting drug habit.

Look into Cognitive-Behavioral Therapy. Clinical studies have shown CBT alone to be more effective than medication for GAD, Panic Disorder, Social Phobia, etc. CBT has an even higher success rate when combined with medication. In studies that checked up on patients several months and several years after treatment, they found that those who were treated with medication alone remained symptom-free approximately 35% of the time, whereas the number of CBT patients who remained symptom-free was around 75%-80%.

The conclusion behind these findings is that medication alone only has a palliative effect, whereas CBT teaches patients skills in coping with their anxiety for a lifetime. Medication stops working when you stop taking it; CBT teaches skills that will continue to be used in post-treatment. In general, the best treatment course is temporary medication, to relax the patient in the short term, while teaching him cognitive-behavioral techniques for when he stops taking the medication.

Several years ago, I had steadily increasing anxiety (that I wasn’t aware of), which culminated in a couple of panic attacks. I was in terrible shape for a while and when I finally found a therapist, I was immediately advised to go on SSRI’s. I’m generally mistrustful of the pharmaceutical industry, so I asked for CBT instead. It was difficult during the first few months because I had no medication to ease my symptoms as I learned relaxation techniques, negative thought replacements and positive affirmations, but luckily I made it through. I’ve been pretty much symptom-free for 1.5 years now, and even when I occasionally feel anxious, I’ve learned not to panic over it.

I should add that in addition to seeing a therapist, I completed an audio course that teaches you CBT techniques. It was by far the most influential part in getting me through my GAD. If you want to learn more about it, send me a private message and I’d be happy to give you some more info. Knowing how difficult it was for me, I never miss an opportunity to pass it along to other people suffering through the same thing.

My brain simply doesn’t make enough Serotonin for me to feel happy or even neutral unless I take a serotonin-reuptake inhibitor. Thus, to keep from ending up in the morass of depression I will most likely continue to take something like Zoloft for the rest of my life. I still feel like me, but I no longer feel as if giving up is the only answer.

However, I also have had truly terrible bouts of anxiety to such an extent that I almost became agoraphobic and literally could not function. I took Xanax to help with that and have since been able to wean myself off it, substituting behavioral tools to deal with it when it seeks to rear its ugly head once again.

Thus, I am a believer in using both talk therapy and medication as needed to remain functional.

your problems have no solution other than what you can manage to do yourself. you have trained your brain to act in a particular way. unlearn and train your brain to act in a different, better way.

@Ria777 Untrue. Chemical imbalances are not the result of people “training their brains to act in a particular way.” Its more like being betrayed by an organ, just like with kidneys, liver, intestines, or any other organ not working at 100% or properly.

@Ria777 @avvooooooo I think both are, or can be true. You can get caught in like a feedback loop, and through therapy or reframing your thoughts you can change how the brain reacts to situations. I think of it as making new connections in the brain, but I don’t know the science really. But, at times it is out of the individuals control and there is a chemical imbalance. It’s both, they are not mutually exclusive.

@avvooooooo: and you can prove that how? unless you can prove that, then it remains an opinion. I prefer the opinion that gives us the power to change our lives.

the idea of “anxiety disorders” puts the locus of control outside ourselves. in my experience, people who think of themselves of victims of circumstances do worse for themselves than people who view themselves as having power over their lives even—or especially—if circumstances beyond their control have already hurt them. victimthink makes a bad situation worse.

@JLeslie: I agree with everything you said up until the last two sentences. I would have said those exact things, though, not, as I said, those last two sentences. “chemical imbalance” resorts to the pseudoscientific language of psychiatry. I would phrase it as “serotonin drops” or whatever. something specific and less subjective.

@Ria777 Fair enough. I guess you want a more literal accounting of what is specifically happening in the brain. I was generalizing about mental disorders, rather than sticking with depression and anxiety, so I used a very general term. Things like schizophrenia and other psychosis are not easily controlled through therapy, generally it requires medication, and seemingly the patient has less control, and the disorder has more.

@JLeslie: you misunderstood me. the nominalization “chemical imbalance” plays into the wrong notion that our mind/brains work like watches. and I don’t believe in the nominalizations “depression” or “anxiety” in the way that you used them.

http://www.skillstoolbox.com/Nominalizations.php

@Ria777 I would like to point out that scientists don’t know a whole hell of a lot about brain chemistry. They don’t know how the various neurotransmitters like seratonin, dopamine, and norepinephrine interact in any great detail. They don’t understand all kins of things that play a role in the chemistry that regulates the production and function of those neurotransmitters.

I think it is more honest to speak of brain chemistry and chemical imbalances than it is to act as if you understand the causes, effects and chemistry of “seratonin drops.” They know that Lithium is really helpful for stabilizing moods of many people with bipolar disorder. They have no clue how it works.

@Ria777 Thanks for the link.

@JLeslie: sure!

@daloon: re-read my previous post for the reason why I have such a problem with the phrase. believe me, I know, that they don’t know shit. don’t you see me constantly posting about how they don’t know shit?

however… we do know that self-defeating thought processes don’t help. we know that nocebos hurt. therefore the idea of these “disorders” hurt.

you mentioned lithium… well, that messes up your liver. so how about some ways of self-help that don’t mess up your liver? (other psych meds have other wonderful side effects as you doubtless know.)

@Ria777 I didn’t know about any effects on your liver. However, I do know that it can have severe effects on your kidneys, and many people who are long term users of the drug—twenty years or more—require kidney transplants. The recommended course of treatment for bipolar disorder includes both meds and “self-help.”

I just went back on Lithium after being off it for six months. I wanted to go off because I want to avoid the side effects. I had to go back on because everyone recommended it when I told them I was getting manic. I still am not sure it was necessary, but the fear of what might happen if I stayed manic got me to cooperate with the psychiatrist’s recommendation.

I understood your reasons for preferring a different language, and I disagreed with your reasoning and your language. However, that’s not very important. What’s important is communication. So long as I understand what you’re talking about when you say “seratonin drop,” and you understand what @JLeslie and I mean when we say “chemical imbalance,” it’s not an issue.

@Ria777 Since I’ve actually studied the subject, I’m relying on my accumulated knowledge. Chemistry is one thing and emotions are another. We don’t know everything about brain chemistry, but it has been pretty well figured out that brain chemistry affects symptoms and not the other way around. There are things we can do to influence our symptoms, but people are not teaching their brains to misbehave. The reason we use terms like “chemical imbalance” is because we don’t know everything there is to know. We know how some chemicals function, but being able to figure out one or even three dancers doesn’t give you a view of the whole square dance and the interactions that go on. Instead of blaming the few we understand, the general term is used in order to signify that in the entire complex system (with all the known and unknown interactions), something is not right.

If you don’t believe in psychiatry and psychiatric meds, fine. If you don’t believe in the definitions of depression and anxiety (which are labels that people use so that we can better understand what might be going on), fine. But to say no one should buy into these things is doing people who can be helped a great disservice. Mental health care carries enough stigma without people telling others to man up and deal with their problems that they’re causing when they really aren’t.

@JLeslie I do know the science (cybernetics and so on). Keeney was a PITA to learn, Bateson was easier. You learn to change how you deal with the symptoms so that they are not a problem or are less of a problem or are no longer seen as a problem. You are not, with getting out of the feedback loop, affecting the essential brain chemistry other than not having the things that stress adds to the mix floating around up there (like drunk square dancers running into everyone). You are affecting how you deal with issues by doing something different or thinking of something differently, but not how your brain functions.

@avvooooooo: We don’t know everything about brain chemistry, but it has been pretty well figured out that brain chemistry affects symptoms and not the other way around.

you say symptoms. I don’t say it. again, you cannot prove the “symptoms” and “disorder” model using science. you may consider it the most useful model, I defy you to tell me how you could raise this model to the status of a fact. or, for that matter, disprove it.

There are things we can do to influence our symptoms, but people are not teaching their brains to misbehave.

you have just said, in effect, that neuroplasticity does not exist.

Mental health care carries enough stigma without people telling others to man up and deal with their problems that they’re causing when they really aren’t.

like virtually everyone I have talked to, you have confused me with Dr. Phil.

I mean that the way that a lot of people have poor reading skills that a lot of people have poor life skills. they have a naturally low EQ, they come from bad families or whatever. now to say that you have an “illiteracy disorder” would not help.

it comes down to recognizing mistakes, correcting them and not repeating them. the tough guy approach has nothing to do with what I mean.

on a larger level, it has to do with correcting mistakes on a societal level. mistakes like encouraging overwork and really capitalism itself.