Anxiety / Severe Depression

[Daniel2187]

Hi. I've had some major concerns lately, about my mental well-being. I am in the beginning process of seeking help for myself now. An explanation is in order:

I am a 20-year-old male, and have been a casual drug user for a few years, mainly using cocaine, marijuana, and hard liquor (casual, meaning on the weekends). Marijuana and alcohol I've been using since H.S., but only in the last 8 months I started using cocaine. About 2 months ago, I had a pretty horrible "episode" in which I mixed excessive amounts of these three substances (which I had only done once before). Even now, I'm not really sure what this "episode" was. It continued at the same intensity for about 5 hours, so I know it wasn't just a "panic attack". I hadn't experienced anything remotely like it and was very convinced that I was going to die. The symptoms were very much like a panic attack though: (heart weakness, chest pain, lightheadedness, tingling sensations, shaking, difficulty breathing, a strong sense of impending doom, etc.) and to make a long story short, I did not go to the ER and the symptoms finally wore off. Thankfully, the outrageous, petrifying fear of overdosing and dying has caused me to stop ALL drug and alcohol use indefinitely, likely for good. I can confidently say that I have no desire for them anymore.

Well, since that day, I have had "panic attacks" similar to that night, except now they only last 15-30 minutes. Prior to this first night, I had never experienced any panic attacks, anxiety, or depression before, so I am convinced that everything afterwards was a direct result of that first "episode". After meeting with my doctor, he prescribed me Xanax XR (5 days ago) which I have been using since. Although it does "work", I've recently developed a quite severe depression, for no apparent reason. I have been practically unable to eat solid food, and I often feel like committing suicide without knowing why. After much thought and consultation with my family (who are convinced I'm on the "wrong" medication) I have decided to talk with my doctor this week about antidepressants such as Zoloft, Prozac, Celexa, etc. The Xanax XR is not likely responsible for this sudden depression, but I am convinced that it is NOT helping, and my depression requires quick help. I've also consulted with my mother, who's been on Xanax XR daily for the past 6 months. She hates it, and is now "hooked" and can't function without it. My questions:

1) Should I switch from Xanax XR to another form of medication, such as an SSRI/antidepressant? If so, which one(s)?

2) What type of therapy should I seek along w/ my medication?

3) Can I experience a heart attack resulting from my past cocaine use, even though I've stopped permanently?

4) Has there likely been a permanent physical/chemical change in my body, from the drug use, which has caused these severe anxiety/depression symptoms? If so, can I eventually overcome them through proper medication and therapy?

Thanks!

[Roger Gould, M.D.]

no to the heart attack question...won't happen. no permanent physical damage.

but,

these flash backs to the trauma you did to yourself with these medications are likely to be around for a while longer, on and off, so don't be suprised or too worried about them.

Yes, xanax can deepen a depression. Even though it is short acting, it has a hang over effect, and decreases your motivation, which heightens your depression.  I would suggest talking to your doctor about any of the ssri's you mentioned...they are all roughly the same and act slightly differently from person to person so its hard to say which will be best for you.....so, start with slow dose, think about cutting out the xanax, and if you can find a good talk therapist, that is your best bet for treatment that will be lasting.  r.g.

[Kikisu]

Dear Daniel,

This is very common, to become depressed after using these strong substances which you have used.  Usually this type of depression you are experiencing has no definite cause ie. you may be sitting in the lounge, on the bed or on the tennis court and you will experience thoughts of suicide, why am I alive?etc.  

You will get through this.  The drugs which you have taken have affected some of the chemicals in your brain which affect your mood, thinking and feelings on life.  This may take a while for the effects to wear off, sometimes years.

Daniel, you are in it for the long haul, but guess what?  You will get through it.  The fact that you have stopped taking these substances shows that you want to live life and get high on it rather than drugs.

Write to me on ***@**** and we will chat more about this.

[marriedlove]

Stopping all the recreational drugs and the binge drinking cold turkey could also lead to depression, so keep that in mind as you go through this process.  You've said this brush with death or a fear of death has you off of everything, and I hope that this will prove to be true, but you might also want to keep in mind that many users stop for awhile because of something like this (a bad "trip," an arrest, a DUI charge, etc.) only to begin again once the first rush of dread has passed.  So, you have to be vigilant about your thinking, which can easily slide once more into "I can handle it--*that* won't happen again."

I am not as persuaded as the doctor is that therapy does much for depression.  I'm a much bigger fan of medication, though I know that some people fear it, worry about becoming addicted to it, and worry about not being able to stop.  A really good doc, though, will monitor your medications, will prescribe them in relatively small increments (several months, say, as opposed to a whole year) so that he or she can check in with you frequently, and will help you determine when a change is in order, and how or whether to taper off.

Cocaine is hugely addictive.  Please do keep in mind that at least some of your depression is likely in response to coming down off that high.

Best,

marriedlove

[Consider]

Hi, from my experience, I have come to believe that stress and especially severe stress can deplete vitamin B12, with the result that we feel depressed.

I think that drugs put a stress on our systems, and I don't just mean cocaine type drugs. I was put on Sarafem, which is a Prozac look alike, and it caused severe incontinence. Then I read the insert, and the insert warned that it shouldn't be used with certain kinds of blood problems, which I think pernicious anemia type problems are.

But pernicious anemia is very rare, while B12 malabsorption and
hypochlorhydria (not enough gastric acid) are quite common. Especially the not-enough-gastric-acid thing, because of how many antacids people use.

So, I think that a lot of drugs are counterindicated, only we aren't fully aware of what they do and what our underlying problems are, so we take them and they stress our systems. Maybe not enough to have severe incontinence, but enough to cause harm over a period of time.

I think we all pretty much agree that cocaine and drugs like that can be harmful, but I think it's less well recognized that "good" drugs can be stressful, too.

Bottom line: if you have any other symptoms of low B12 besides depression (I forgot to say that once I got B12 replacement, my depression went away) then I think you might be very pleased with the results from taking B12.

www.health-boundaries-bite.com/Fingernails.html
     Your fingernails reflect your health --
     Learn what warning signs to look for --
                                Karen Kline

[Consider]

Hi, from my experience, I have come to believe that stress and especially severe stress can deplete vitamin B12, with the result that we feel depressed.

I think that drugs put a stress on our systems, and I don't just mean cocaine type drugs. I was put on Sarafem, which is a Prozac look alike, and it caused severe incontinence. Then I read the insert, and the insert warned that it shouldn't be used with certain kinds of blood problems, which I think pernicious anemia type problems are.

But pernicious anemia is very rare, while B12 malabsorption and
hypochlorhydria (not enough gastric acid) are quite common. Especially the not-enough-gastric-acid thing, because of how many antacids people use.

So, I think that a lot of drugs are counterindicated, only we aren't fully aware of what they do and what our underlying problems are, so we take them and they stress our systems. Maybe not enough to have severe incontinence, but enough to cause harm over a period of time.

I think we all pretty much agree that cocaine and drugs like that can be harmful, but I think it's less well recognized that "good" drugs can be stressful, too.

Bottom line: if you have any other symptoms of low B12 besides depression (I forgot to say that once I got B12 replacement, my depression went away) then I think you might be very pleased with the results from taking B12.

www.health-boundaries-bite.com/Fingernails.html
     Your fingernails reflect your health --
     Learn what warning signs to look for --
                                Karen Kline

[Daniel2187]

Thanks to everyone here. I am feeling better, due to several factors: (1) I am now off the Xanax XR. Since I had only been taking it for a week, my doctor said it was safe to go off it cold turkey. (2) I am becoming more confident that there is not considerable permanent damage done to my body, and that my heart isn't going to randomly "explode" one day (Haha!). (3) In addition to my regular doctor, I am seeing another doctor (N.D, M.S) at the Institute of Progressive Medicine. She has me off the Xanax XR, and onto many Vitamin B related dietary supplements, specifically Mega Omega Fish Oil, Sam-E, Inositol, and B-Complex #5. So I am getting plenty of Vitamin B-12 lately and am trying to combine these vitamins with exercise, as she suggests. Next week I am also starting Detox (even though I've been off the drugs/alcohol for a few months) and will soon be set up with some counseling/therapy.

I really like my new doctor's outlook on how I should be recovering. Instead of just shoving quick fix drugs like Xanax down my throat, she prefers "lifestyle changes through proper nutrition, exercise, targeted supplementation and stress management". http://iprogressivemedicine.com/ is their website, and you can see my doctor, Julie Khan, here: http://iprogressivemedicine.com/meethedoctors.htm. Although the doctors here are pricy, I much prefer my new doc to my old one.

As for the depression and anxiety, it seems to vary day by day, but generally it seems to be getting better. I still feel panic-like symptoms from time to time and instead of popping a Xanax, I just try my best to fight it off mentally. I've had to do that a few times this week. And the depression creeps in every now and then, mostly like Kikisu said, for no reason. I could be doing anything and all the sudden I'll wonder who I am or why I'm alive. It's tougher for me to deal with than the anxiety, especially since thoughts of suicide sometimes accompany it. A couple of you pointed out the fact that a good amount of my depression is because of being completely off drugs now, especially cocaine. I think my mind is responding to that negatively, hopefully just for the short term.

Marriedlove, I think about what you said all the time. That is, drug abusers who quit for awhile and after the big wave of fear subsides, they start using again. I sincerely hope this isn't the case for me. For my part, I have distanced myself permanently from my drug using "friends", and haven't talked with them since that first "trip". That's a big part of it, but I know that also overcoming the thoughts in my mind is even bigger. Sometimes I'll wonder "What would it be like to do *that* drug again? I don't know if that falls under curiosity or desire, but either way I need to overcome those kinds of thoughts. I sincerely do want to live a life permanently free of drugs.

As always, thanks to all.

[desteny]

I have been suffering from anxiety/depression for the past 3 years. I was on paxil cr 25 mg for the past 2 years... I had my life back.. I felt great!, no more panic attacks, no more worring all the time, no more depression. Then they took it off the market recently.. Doctor put me on effexor xr 150 mg day and Klonopin 2 mg 2 times a day, which i have been on the klonopin before and it always helped too but then she put me on prozac 20 mg which needs to be taken off the market!!!!!!!!!!!... That stuff made me go crazy.... I too wanted to kill myself and have no idea why while I was on it for about a week then I stopped taking it. I felt so out of control on prozac and all the effexor xr did was make me sit and cry non stop all the time. While on the prozac i was almost canatonic. I just could not function at all... it was the worse week of my life being on that stuff. I am so angry that the FDA covers up information about theses medications and most doctors do too. They took the one mediciation "paxil cr" off the market that gave me my life back!. Then put me on 2 medications that made me almost lose my mind and possible my life! Now after how terrible the effexor xr and prozac made me feel... i'm scared to take any other antidepressents ever again. Please becareful and do as much research as you possible can before taking any anti depressant. I'm not saying all anti depressants are bad just some affect people differently and some can help and some can harm.

[Aruba417]

I'm sorry to hear about your horrible experience with Effexor and Prozac. I have not taken Prozac, but I have heard of people feeling suicidal on it. Scary! I've been on Effexor XR for about a month now. I have never noticed any bad side effects or feelings with it. In fact, I am feeling pretty good lately. I have Anxiety disorder/Panic Disorder. I tried Paxil 3 years ago and while it helped some, it made me feel really tired. I never had any energy and I yawned all the time. All I ever wanted to do was sleep! Did you ever have those side effects? I thought it was all part of the Anxiety symptoms until my doc switched me to Zoloft and Xanax. Zoloft helped tremendously. But I felt so good after a year that my doctor removed me from all meds except for Xanax as needed. I was med free for about 7 months until my Anxiety/Panic came back with a vengence. So now I'm on Effexor and Xanax. That mix seems to be helping so far. Although we all hate to jump from pill to pill, maybe you just need to keep trying different mixes until you find something that works. Good luck!

[desteny]

I suffer from social anxiety and use to have really bad panic attacks thats when 2 years ago my doctor put me on Paxil cr 25 mg "the cr is just the time released form of Paxil". Also on Klonopin 1 mg day. Never had a panic attack whole time I was on the mediation. Well then recently they took the cr off the market. So my doctor put me on effexor xr 150 mg day and prozac 20 mg which did not work at all made me worse. I also tried zoloft 100mg day but it never worked for me either. But I just went back to my doctor and she's put me on regular Paxil 20 mg day and klonopin 1 mg day and I feel so much better. Paxil may not work for everyone but its gave me my life back. Just as other medications may work for others but didn't for me. But Paxils giving me my life back and I would recommend it to anyone with any kind of Anxiety/Panic disorder.

[tacd]

i just was diagnosed with anxiety. i take zanax when i need it.  it seems to help. my concern is that i have a 6 year old at home with me and i dont want anything to happen to me when it is just me and him.  i am also getting sharp, dull chest pains.  i hate feeling so anxious all the time.  any suggestions.

[KittyMeghanLeah2]

You've asked a lot of questions that your doctor would be better at answering.  Just remember some of the medications such as those posted on the mental health forum are very addictive and hard to get off of.  This is just a "warning" before you jump in and take medication because I believe it's going to be simply switching one addiction for another.  The only difference is one is illict and the other is prescribed (not necessarily a good thing).

[Mak13]

What can I do to help my 23 year old daughter, who is depressed?
I have offered her counseling but she refuses. I know she is angry with me and feels I was not a good mother to her.
Is there a book I can study? I want to help her but I don't know where to begin.  She is constantly pushing me away, but I don't think she wants me to ignore her.  She sometimes sounds jelouse as if she wants my attention and thinks I  give more attention to her sister.  I am afraid to ignore her. I don't know what to do? I don't want her to hurt herself.  I am an amateur and I don't know how to help her.

[Dreemland]

Zoloft or paxil never worked for me. Zoloft made me worse and paxil made me really really tired.

I am on Xanax now for the past three weeks and I feel better.