Many people have in fact been cured of anxiety. It's comforting to thing about it as a chronic illness for those of us who failed to find that cure, but many people have been. So there's that. The NIH studies reporting the 30% rate are some of the very few actually double blinded studies attempted on CBT, as therapy is very hard to do double blind studies on. But I'm not really in disagreement with you on the fact some people will do better on a combination of medication and therapy, the problem is that they may never be able to stop taking the medication because of the profound changes to the brain these medications can have when taken for an extended period of time. There is a maxim in medicine: First, do no harm. So that's why I believe when people are first getting this problem that they try to solve it through therapy. Again, if that doesn't work, as it didn't for me, the medication will still be there -- I think people sometimes have this notion that if they don't take drugs now they won't be there later. I do think when the disorder becomes so bad that life becomes intolerable, medication is probably going to be necessary. I don't think our disagreement is profound, I'm just more cautious than you about little magic pills that alter brain chemistry -- we just don't know that much about the brain and those of us who went on these drugs are the guinea pigs. Many find them miraculous, and many find them torture. But as for your choices, they are yours and I would never question them.
Ditto Paxiled's posts completely.
You are FAR from alone. Drug induced anxiety/panic is all too common. All you have to do is browse these forums a bit and you'll find tons of threads describing similar experiences. Try not to think too much about how or WHY you have anxiety, as at this point, it's basically irrelevant. Try to focus more on the fact that you ARE experiencing anxiety and are addressing it (first step....which you're there, that's great!)
The drug itself is long gone, what is causing the anxiety at this point, like Paxiled said, is a conditioned response basically. 'Fearing the fear". You react to how horrible the panic attacks felt, and begin fearing having another. If you had one at the grocery store, then you'll worry about going to the grocery store again, and most likely end up having another PA there. It becomes a self fulfilling prophecy basically.
The very BEST way to get through this would be to try like heck to ignore the anxiety completely...dismiss it. The more thought and worry you give it, the more power you give it. Problem is, it's WAY easier said than done! WE are the ones who end up making our own anxiety more severe, and more long lasting, because we get stuck in the trap of ruminating about it, hyper focusing on it, some to the point of obsession like thinking. That fuels the anxiety beast, big time!
Medications can be a helpful part of an anxiety treatment plan, but all they do is help to control the symptoms, they don't change the way you think, which is the crux of the problem, and what needs worked on. HOW they work is pretty much a mystery. The "chemical imbalance" theory was created as a means to help market the newer antidepressants when they hit the market (ie SSRIs, SNRIs).
Also, being that you're so new to this, I would really recommend putting some serious effort into therapy before turninging to medications so much. And if you DO decide that medications are something you want to use as part of your treatment plan, then there are definitely more optimal, safer options besides benzos. If you were not taking the Xanax regularly, and only taking it "as needed" (here and there when the anxiety peaks), then that would be fine.
Taking it with any regularity not only will lead to dependency, but also it will start working against your anxiety, and causing more (kind of like a roller coaster effect). Oh, and I also wanted to mention that Klonopin is also a benzo, so a lot of the same risks still apply. It works a little differently in that it's a long acting benzo versus the short acting benzos like Xanax and Ativan, and it's recommended to be taken regularly, as it builds in the plasma, allowing for a more steady state of calm, versus the ups and downs of the much shorter acting anxiolytics.
Antidepressants are a more reasonable choice if you're looking to be on a medication for any significant amount of time. But therapy is a must either way. Finding a good therapist who will help you learn how to change your thinking and the way you react (the "what if" thinking) is imperative.
Experiencing an increase (or reemergence) of anxiety while tapering off a benzo is very normal and to be expected. Keep the lines of communication open with your psychiatrist. You may need to slow the taper down a bit to make yourself more comfortable. What antidepressant did your p-doc recommend? When are you supposed to start it, and at what dose? I would recommend not starting that until you've completely tapered off the Xanax, anf allowed yourself some time to adjust to life post-Xanax.
Remember that there's an adjustment period with antidepressants. They can easily take 4-6 (if not 8+) weeks to really become effective, and often times, it's pretty par for the course to feel a little worse before you feel better. It's a process, it won't happen overnight (unfortunately). It's best to try to remain patient and realize that trying an AD is a commitment, and for some, very much a trial and error process.
So, please make sure you're trying hard to follow through with the things your therapist is recommending. Therapy doesn't stop when you leave the office. Getting anxiety to a much more manageable point takes a lot of work and dedication.
Hang in there....please keep us updated!
Paxiled.
There are so many highly rated journals that support that CBT combined with SSRI's is the best method for treating anxiety. I'm not sure where you're getting your 30% from as that number is closer to the percentage of people who are completely cured. There is no "cure" for anxiety, but rather management. If you do a quick search through NIH's website, you'd be able to find a whole stash of journals and studies that support the combination finding. Obviously there is no magic bullet for everyone as everyone's body is different, but regardless, the combination is supported by evidence based practice.
Secondly, by playing with fire means altering chemicals to the brain when you don't need to. Antidpressants, and we'll specifically talk about SSRI's, work by blocking the reuptake of the cells. SSRIs don't raise the seretonin to make everything better, but rather improve symptoms to make treatments like CBT more effective. There is tons of evidence for that fact and to say that there isn't is being obtuse.
Not sure what you mean why play with fire. Also, research as far as I know doesn't conclude therapy combined with medication works best -- nothing works best, some things work best for a particular person, but the record of both therapy and medication and the combination isn't very good unless you consider a 30% success rate good. But I do agree that if you keep looking, hopefully you'll find the right combination, and I do encourage people to keep doing therapy while they're on medication so they can hopefully stop the drugs at some point, though there's also quite a bit of recent research that the brain really isn't very good at operating without these meds once you start them for an extended period of time. Which is why I encourage people to start with therapy and see if it works; if it doesn't, the drugs aren't going anywhere, they'll still be available. By the way, antidepressants don't bring chemicals back to a good level -- they alter the way the brain naturally works by focusing on certain neurotransmitter receptors and blocking the natural breakdown of the chemical messengers. So what they do is alter the natural chemical balance, as there is no evidence anyone with mental illness has an insufficient amount of neurotransmitters. Whatever the cause is, that doesn't appear to be it.
Hey Paxiled,
It's true, benzos and antidepressants are, but why play with fire to begin with? Our body is one big walking chemistry set. Some drugs interact one way with your body and other drugs interact the other way with your body. Point is under researched and proven methods, you can use the benefit of some drugs to help get back to where you once were. Research shows that drugs combined with a good CBT are the most effective at treating anxiety. Like what you said, benzo to temporarily stop the anxiety, antidepressants to bring the chemicals back in a good level and CBT to reformulate the thinking. Bang, boom, pow.
Not to be obvious here but antidepressants and benzos are far more dangerous drugs than marijuana -- the fact one is illegal and the others legal doesn't change the fact they're all drugs. Marijuana is notorious for bringing things out of us that have been safely suppressed inside, and in your case it was anxiety. What happened then was your brain became conditioned to thinking you were going to have another anxiety attack if you felt similarly -- this is how we get in this mess, though how it happens nobody really knows. So the first place you should have been sent is to a good therapist who specializes in anxiety treatment -- if you can stop the chain of anxious thinking the problem will go away, whereas drugs will only suppress the feelings. However, if therapy doesn't work for you, then your psychiatrist is right, antidepressants are the safer long-term choice -- benzos are addictive if used regularly, offer only temporary relief, and are hard to stop taking. While antidepressants are also hard to stop taking, when they work they work all the time, not just for a temporary piece of the day. Do your homework and good luck.
I complete agree that drugs are bad, but I'm a total skeptic when it comes to doctors... Going to school for years to get a medical license does not make you right and most importantly everyone reacts differently to medications! Do NOT just "put yourself in the hands of your psychiatrist"; do your homework, get second opinions. I've had every type of seizure, literally... Some brought on by anxiety (I've had ulcers since 1st grade, every doctor says bad nerves); also, I've had doctors put me on medications that clearly state "may cause seizures in some cases", since I'm high risk for seizures you'd think they wouldn't prescribe me that crap. I've argued with doctors over what certain medications treat; resulting in them checking WebMD before prescribing. Granted the meds I'm on now would kill most people & have, but I knew that when I hit the pharmacy & I personally opted for the quick fix, knowing the high risk. My seizures came on slow & were linked to stress... I'd have a sudden jerk (muscle spasm) & then be fine, a few years later my eyes would flutter (especially in harsh lighting); which later led to full blown grandma seizures (epileptic seizures). They all cause brain damage (mild, barely noticeable, mainly forgetful); and 1 of my 1st neurologist said the earlier muscle spasms (lasted seconds at most), may have built up to the damage causing my seizures--I didn't treat them early on! They tried putting me on Dilantin, kepra, Topamax, a few others, but Klonopin worked because it's used to treat anxiety &/or seizures. I'm now on Xanax, but I never should've traded my klonopin for Xanax, because Xanax can cause seizures & the withdrawls can kill you. I'd ask about the Clonazepam, and look in it online. It's safer.
Thanks for your reply. You are right, that's why I completely quit doing drugs.
Maybe when I feel somewhat better I'll have a beer once in a while, but that's it.
I had absolutely no idea weed could cause this, since it's a pretty common thing to do where I live and everyone seems to be okay using it.
And yes, I do trust my psychiatrist and will do what they'll advise me to do.
It would be horrible if it doesn't go away completely, but perhaps I can find some way to cope with it. There should indeed be ways to treat it, even aside of drugs. And I will do my best.
Thank you.