Tips on starting antidepressants?

[arnelicaa_xo]

hey everyone! so I’ve been dealing with some anxiety issues for the last 3 months since moving back to my home town. I’ve never had anxiety or panic attacks but it all started the day we moved. I’ve been in and out of ER’s (about 20 times) in the last three months cause of it. Good news, nothing is medically wrong with me. bad news, something is still wrong with me. The NP I see initially prescribed me lexapro to help combat my anxiety. Well problem with that was it made it a million times worse. I only took 2 doses and it felt like my heart was going to explode out of my chest and I kept waking up in the middle of the night with panic attacks. Needless to say I stopped taking it. After that I went to go see her and she did a cheek swab test where they test my DNA to try to help determine which AD will work best for me, and the results came back with cymbalta. So after reasearching online I scared myself way too much to take it. It’s been sitting in my medicine cabinet just taunting me. After getting my thyroid levels checked my NP said I’m taking too much thyroid medication and that could be the cause of my anxiety, so she lowered my dose. For 2 and a half weeks on the lowered dose I’ve been perfectly fine. Completely normal, until last Wednesday. I had just re-enrolled in college and was so excited about all of that and that night when I got home with my 8 month old, I just started shaking out of nowhere. Complete body tremors and shakes. My heart started racing I couldn’t breathe, it was terrible. I was beyond terrified so I drove myself and my baby to the ER where they said it was just another panic attack but it was the worst one I have experience thus far. I saw my NP the next day and she said she highly reccomends I start the cymbalta. So I did. First dose was yesterday morning. I felt ok for the most part yesterday I just felt a bit jittery. Like my jaw was like shaking and making my teeth chatter. Today I woke up feeling completely out of it. I’m assuming it’s the depersonalization I’m feeling again but I’m not sure as to why? I also have dry mouth. I’m just curious as to if these are normal start up symptoms that will go away once my body gets used to it or if it’s somethinf more serious where I should stop taking the medication. I’m calling my NP’s office in the morning to let her know too. TIA!

 

[Peacelily]

First, sorry to hear you've been struggling to transition to your move back to your hometown. Your anxiety seems like a very natural response to such a big life transition as moving back to your hometown. Do you have a mommy-and-me group that you can go to, with your baby for social support?

If not, that is something you should seek out: social support to be with other moms you can talk to. That can also ease your anxiety. If you're a new mom, your hormones could still be out of whack. Only a gyno doctor can verify that. If your progesterone is low, that can cause anxiety, esp. if you have estrogen dominance. I"m not a doctor, but I read a lot of medical articles and books about women and hormones since I'm going through perimenopause (which can also cause panic attacks).

From what you wrote, your panic attacks are related to how you're adjusting to the stress of your big move and being a mom. And I also think it's due to your thyroid medication not being the right dose.

Also, no one can tell you how your body will respond to antidepressants. They can only tell you how their body responds to medications that they take.

Although you note that doctors in the ER found nothing medically wrong with you, the thing about the ER is, doctors there only treat symptoms, and don't always diagnose conditions or diseases that require long term treatment.

Several conditions can cause panic and anxiety; cardiac, endocrine, lung/respiratory, gastrointestinal, inflammation, metabolic, neurological. For example, you could be hyperthyroid, or have asthma, or GERD, or inflammation of the liver or pancreas, or a old muscle injury, diabetes, a heart murmur, etc.

Before you rely on taking an antidepressant, be sure to visit a primary care physician to rule out ANYTHING that could produce anxiety symptoms. There are medical illnesses that will present "anxiety attacks" as one of its symptoms. Too often, people rely on an antidepressant to treat what really turns out to be a medical condition that doesn't have any psychiatric connection to it at all.

Your primary care doctor told you that you accidentally made yourself "hyperthyroid" by over-dosing on your thyroid medication. I can relate to that, when my Synthroid dose is too high, I become hyperthyroid and have panic attacks. I know that my panic and anxiety doesn't have psychiatric origin, but a disease origin.

Sure, I have anxiety and depression as a side effect of being hypothyroid, but I also have it related to my past decisions in life. So it's situational anxiety. Do I take an antidepressant? I tried Celexa and it made me suicidal. I tried other antidepressants that also made me suicidal, ruined my thyroid (Lithium killed my thyroid), made me miscarry a pregnancy (Cymbalta). I will NEVER take an antidepressant again.

I would recommend that you immediately stop all psychiatric medication and focus on getting your thyroid medication back to a normal level. Lower your dosage. Get your TSH levels retested 6 weeks from the lower dose. Keep a journal every day of what time you take your thyroid medicine (an hour before any coffee or food in the morning, or take it at night before bed).

This will help you observe that if you do have anxiety attacks again, it could be related to your thyroid problem. There are a TON of books available in the public library about women and thyroid and hormones and how those can contribute to anxiety and panic attacks.

Also, read David Burns books about panic attacks. He's a cognitive behavior therapist who has written a lot of great books on anxiety. There's a lot of great books on how to self-treat panic attacks, so that you can learn how to cope when they happen. It's an ongoing learning process for me when I have them myself. I sometimes go to the ER, knowing I am having a panic attack.

Or, sometimes, I will try hard to self-treat my panic attack first, before I go to an urgent care. What I've learned, is that an urgent care or ER doctor will treat the anxiety by prescribing an anti-anxiety pill. That doesn't really address what's causing the panic attacks, since their job is to treat symptoms short-term.

I'm not a proponent of antidepressants as I stated, based on my personal experience. It may work for some people, but antidepressants didn't work for me.

Now, I do everything I can to monitor my thyroid medication, and I take vitamins and iron (low D and low iron is synonymous with thyroid disease and can also cause anxiety attacks...well, anemia can cause anxiety attacks in women). Hope my post helps.

 

[janemariesayed]

Very interesting @Peacelily I get low iron in my blood, but the panic attacks come along with my PTSD, but I bet some of it is down to low iron. Thanks for that info. I'm going to take my vitamin pills from now on which may help my attacks be less. Thanks for this info!

 

[Peacelily]

You'd be surprised what can cause panic attacks, jane! The more I read, the more angry I become at the doctors who throw a Px of an anti anxiety medication at me rather than explore other causes for my anxiety attacks. The fact that I have a brain injury, am anemic, hypothyroid, middle-aged going through perimenopause with low progesterone. All of these cause depression and anxiety. And yet...doctors intentionally overlook these as causes and just don't want to deal with their female patients. My PCP is a man but I'm trying to find a PCP who is a woman, who will be more empathetic, and who will listen and consider all the possible causes before writing out a Px for anything.