You’re having a hard time at work. The bills are piling up. You’re worried about your children. These are just some of the common stresses that so many of us face. Many people just keep plodding on in the hope that things will right themselves but often that mindset can wreak havoc later on causing anxiety disorders and related levels of depression. We can’t cope. It’s all too much. Eventually we found ourselves at the doctor’s surgery having admitted to ourselves that we are just ‘not right’.
Your doctor will probably ask you some obvious questions such as, how are you sleeping, how is your appetite, are you smoking /drinking more than usual, are you avoiding situations etc? You will tell him how you can’t switch off, how your heart suddenly races, you feel shaky often and perhaps have experienced a panic attack. When he diagnoses an anxiety problem his first offer will be that of SSRI medication. Selective serotonin reuptake inhibitors are the new anti depressant medications that are also known as anti anxiety drugs.
With supposedly less side effects than the old tricyclic anti depressants they are the choice drug for anxiety problems. If you are lucky the doctor will warn you that for the first couple of weeks or so your anxiety may increase somewhat as the the drugs kick in. Often patients are not warned of this. Some discontinue the drugs in that first two weeks because of this. They wanted to be cured not made to feel worse!
The word ‘cure’ will not have been mentioned in the doctor’s surgery because these medications don’t cure. The doctor may have said something like…’these should make you feel a lot better in time’. Those words sound rather attractive and patients leave the surgery with high hopes.
SSRI medications can be effective. Within a few weeks you certainly can feel less anxious and a bit brighter generally. Some people take longer to adjust to them and often the dosage has to be increased once or twice to reach the right level of effectiveness. There can be side effects such as nightmares, sweating, dry mouth, weight gain and decreased sexual libido. Your doctor may take you off one SSRI and replace it with another if the side effects become troublesome or they don’t appear to be having the desired affect. Sometimes a doctor may also put an anxious person on benzodiazepines (tranquillisers) which are drugs that can become addictive although this isn’t done as often as it used to be. A short course may help but weaning from these types of drugs can be a nightmare.
So! We’re a year or two down the line and the doctor thinks it’s now time to come off the SSRI’s. As you feel so much better that’s ok with you. Withdrawal is decidedly a bit on the dodgy side if you go through it without your doctor’s support. Coming off too quickly can result in an avalanche of symptoms that make you feel very anxious! Hopefully withdrawal is smooth if done properly. Now is the telling time. Once weaned off SSRI’s one often finds that the old symptoms come creeping back. The underlying anxiety once again rears it’s ugly head. Let’s look at why this is.
Johnny is having a bad time. His wife left him. He is heartbroken. He hasn’t got a very well paid job and suddenly he has mounting debts. He misses his children and they have moved many miles away and he can’t afford to do the trip too often. One day after sleepless nights and excessive worry he has a panic attack. He falls apart as it scares him so much. He begins to find his job difficult to do and ends up at the doctor’s surgery. He is given SSRI’s. Things improve for a year. He comes off the SSRI’s and within two months he is beginning to have panic attacks again. He is still on the same wage.
The children still live miles and miles away and he doesn’t see them often. He begins to suffer from insomnia again because he has the same worries he had before he went on SSRI’s. He realises the SSRI’s were a sticking plaster only. Of course they were because the original stressors were never addressed. He had good reason to be stressed. He didn’t know how to handle that stress and everything snowballed. When he originally visited the doctor, the doctor didn’t suggest how he could address the stressors or cope better with them. No. A general doctor seems to have little time for that kind of thing..delving into the why a person is in this state to begin with. It is much quicker and easier to give out anti anxiety pills.
Until we have general doctors who are very interested in keeping people OFF medication unless it is absolutely necessary: until these general doctors take the time to get to the bottom of ‘why’ someone presents in their surgery as very anxious the SSRI carousel will keep on spinning. Doctors and the drug industry work together. It’s in all their interests that drugs are prescribed as much as possible. Where anxiety problems are concerned there will always be a worldwide need for ‘a cure’. Anxiety poses a universal problem. The cure isn’t in a pill bottle unfortunately, it’s all about how to handle life’s stresses, bumps and shocks. Once root problems have been addressed the problem is going somewhere to being solved. After that once one learns how to address stress/anxiety/fear then one has tools for life. It can take some time depending on how long a person has suffered with anxiety problems but this IS the way forward.
Johnny would have done better to seek a therapist’s advice. Perhaps he should have looked for a job nearer to his children. Maybe he should have consulted a debt counsellor too. When a partner leaves you suddenly, the emotional turmoil can be great, so great it can seem like you are grieving as you would with the death of someone close. This too can be addressed….without medication.