Anxiety or depression ?

Hi Margarita. What an awful thing to happen to you and I am sure that you don't want that to happen again. 

My best thought is not to change any of your meds without talking to your doctor first. Sometimes it takes a while..some longer than others. to get out of your system. Let us know how you are doing. Diane

Margarita I can understand your apprehension but if I were you I would call the doctor that prescribed the meds asap and explain the symptoms and concerns and see what they advise. Get back to us. Diane

I thought I'd write this brief overview on how anxiety and depression (A&D) have affected me, in the hope that it helps you make some sense of this all-consuming state that left un-checked WILL take over your life. I'll attempt to explain how it came about, how it affected me, and what I had to do to cope with and eventually overcome it. This is very much a subjective piece and should be taken as such. I am not a medical or psychiatric professional - I'm simply drawing on my own experiences in the hope it'll help you overcome any feelings you currently have of hopelessness, despair and anxiety.

In the Spring of 2015 my wife and I separated. There wasn't any major falling out, fight or infidelity - it was just the result of several years of having less and less to do with each other and focusing more and more on the kids which left us both as strangers. A familiar story and one several of my friends are now also going through. Immediately after the separation was a complete whirlwind and I think with the enormity of this huge shift in your life and priorities I honestly don't think it's possible to comprehend what's going on. It's like the decision becomes bigger the more you think about it. In fact I believe if people think about it too much they would never make the choice to leave so maybe it's best to take a deep breath and just go for it...?

It may seem obvious, but the first thing to point out is that since A&D affects the brain it is with you 24/7 - from the second you wake up until the moment to drift off to sleep. If you have a physical ailment there is every chance you have to move or do something to provoke it which is not the case with A&D. There is a blissful 5 seconds when you wake before it hits you and drags you down to the point where you're not really sure if you can shut it out enough to even get out of bed, let alone move your thoughts on sufficiently to function outside of it. In fact there have been many many days where it has won and I've not had the strength to move past the apathy and distress it causes. It is just completely consuming to the point where to try and feel anything outside of sadness and despair feels completely pointless. It's my opinion that this is exacerbated in someone like me who's pro-active and a 'fixer' since a lot of energy and thought is wasted in trying to rationalise your thoughts and emotions, when in hindsight this is pointless. I spent a lot of time analysing and changing my own behaviour and, to a degree, the behaviour of those around me, thinking that that was the cause of my anxiety and that if I could just fix this one thing I would start to improve. In fact, what actually happened was that each time I avoided a situation that made me anxious (for example social events with my girlfriend where I would feel inadequate compared to other men), this would help in the short term and make me feel ok but then the next time it inevitably occurred it would hit me twice as bad as firstly I would know what feelings are coming so would be anxious about being anxious, and secondly this would be compounded by the helpless feeling of not having control since my efforts to manage the world around me to suit my condition had failed. I now realise that it's not possible to have total control over every aspect of your life and of those around you - indeed if this was the case all that would happen is your anxiety would move to the next thing and then the next thing and so on - it would never be addressed, only transferred.

With this in mind, in order to address anxiety and the resulting depression, as with most things, it's imperative to establish the cause and treat that, rather than simply the symptoms. As a brief aside, this would seem a good opportunity to talk about antidepressants and the common misconceptions surrounding them. Firstly, antidepressants are not 'happy pills', they do not alter your personality and nor are they the cure for any issues whatsoever. What they are is a 'stabiliser' - something to make the lows not as low and the highs not as high. They level you out. In my opinion they should be used alongside other techniques and therapies as they allow enough breathing space from the depths of your despair for you to allow in help and suggestions. Without them your thinking can be 'all or nothing' therefore blocking any clear rationalisation which is necessary for you to get better. There is an irony in that the use of antidepressants can in themselves create more anxiety as you become worried about whether they're working, if you're taking the right dose, whether you'll ever come off them, what side effects they are causing and berating yourself for having to turn to them in the first place. There is also the unfair stigma associated with antidepressants to deal with, which I'm sure prevents a lot of people using them. Those that are either ill-informed or have never tried them think that they're for the pill-popper who just wants a quick fix without putting in the leg work to be ok in their life, or they're worried that it will create distance from loved ones. Nothing could be further from the truth - in hindering access to these types of medication, those with your best interests at heart are actually creating an unnecessary barrier to recovery and compounding your situation. Please don't think of antidepressants as the beginning of the end as I admit I did, nor as a barometer of your depression, but just as another 'tool' to aid your recovery. DO NOT beat yourself up for being on them.

In this piece I cannot asses the cause of your A&D - only you can do that, but I can offer a little guidance to help make the days more bearable and hopefully in doing so give you the clarity to get to the root of why you feel this way. One thing that helped me was once I had acknowledged the A&D I treated every day - both the good and not so good days - as the path to my recovery. I took the good days at face value and the bad days as my head cleansing itself of the bad stuff, as a way of not to giving those days too much meaning. In the adjusted mental state it's only too easy to focus entirely on the bad days and ignore the good days so I found keeping a diary helped.

Regular exercise (particularly group exercise) is great as it not only provides a distraction from your thoughts, but also releases endorphins which can make a massive difference. The lethargy and indifference that comes with A&D makes any form of activity seem like an uphill task, but if you see it as a form of therapy as well as being of physical benefit, the feeling of awakening as well as achievement it leaves you with makes it well worth it.

Another activity that falls into the 'force yourself for your own good' category is socialising. You will no doubt feel socially inept and think that your presence offers no benefit to those around you, however bear in mind that no matter what, real friends will be glad to see you and most will probably not even notice you're not yourself since they're not seeing you through your own heightened senses. I admit I had bad days where I found it hard to get out of bed and was happy to wallow in my own self pity, but although giving in to the A&D felt easier at the time, I can honestly say the negative impact of telling yourself that it's the end of the world and that you're never getting better sets you back as you reinforce the idea that it's all worse than it really is.

To begin with I embarked on a series of sessions with a councillor which felt good in the sense that I was addressing the problem, however it quickly became apparent to me that whilst talking to someone impartial helped rule out some factors I thought may contribute, this wasn't going to be an intensive enough treatment for me to initiate a recovery. It was then that I turned to the services of a psychiatrist - a trained mental health professional - who was able to point out the coping mechanisms (both physical and mental) that I could use to give me the distance I needed from my anxiousness in order to address it. These included something as simple as deep and slow breathing to a count of 10 when feeling anxious - a process which allows more oxygen to the brain creating clearer thinking and counteracts the irrationality that comes from panicked, shallow breaths. It's amazing that something that sounds as simple as this should have such a profound effect, but it really does work. True, at the point of feeling terrible it takes a whole lot of will power to focus on breathing rather than wallowing in your own painful thoughts (anxiety causes the brain to adopt a self-destructive mode) however as with most mental activities, with practice it becomes easier and therefore more effective. My psychiatrist also pointed out that A&D promoted 'all or nothing' thinking patterns where there are no areas of grey, just good things and very bad things. So for example taking something negative that's been said about you - even in a light-hearted manner - as catastrophic rather than thinking that that person might just be having a bad day themselves. In those situations it becomes important to allow yourself a couple of minutes' pause before drawing conclusions as you'll often find your initial reaction one fuelled by anxious thinking. In conclusion, my psychiatrist was able to help me to see my thoughts and moods objectively rather than something outside of my control to which I had no choice but to react.

Meditation and mindfulness are very much in vogue at the moment and with good reason. With us all leading busy lives where we convince ourselves there is no time to concentrate on our own well-being, the idea of creating some calm in the mind is very appealing and should be welcomed. Broadly, meditation involves clearing the mind of unwanted thoughts or 'chatter' and instead attempting to focus on nothing - a void. Mindfulness is being in the here & now and being part of your everyday activities rather than just a vehicle through which they take place. For example noticing the environment around you as you drive along rather than just passing through it on auto-pilot thinking of a million other things. I began using meditation as a tool following several hypnosis sessions a few year back which made me feel clearer, more relaxed, more focussed. The technique was similar, however instead of somebody helping you into that state of mind, you need to get there yourself often using the breath as a focal point. Sounds easy right? Well again it requires much practice when for x number of years the brain has been conditioned to multitask to the point of rarely switching itself off. For example, how many times have you been sat watching a film and at the same time been thinking of work the next day or if the kids have done their homework? This is learnt behaviour of the brain acting in the same way that you act out learned behaviour regarding social situations, the workplace or in relationships. It takes time to unlearn and break down all this conditioning, but once you create this space in the mind it will reduce stress & anxiety and promote clearer thinking.

Everyone's triggers and reactions to A&D are different, however there are some established no no's when it comes to reducing the frequency and severity of negative thoughts anddepression. Firstly sleep: make sure you establish a regular sleep pattern and even if you find it hard to drop off to sleep establish a routine where you go to bed and wake up at the same time. Try and cut down (or better still cut out) alcohol. At the time it may feel like a couple of drinks helps take away the feelings of worry, however alcohol is a depressant and as it wears off will lower your mood. Not only this, but it also disrupts sleep compounding it’s ill effects on the mind. The same can be said of caffeine...as well as causing the mind to race, this also triggers adenine and puts the body and brain into a ‘fight or flight’ mode where it’s unnecessarily on high alert. The obvious effects of this are increased agitation and restlessness and therefore anxiety. In essence, just try and be good to yourself. Eat well, sleep well, exercise and drink plenty of water and you will reap the rewards and move on quicker from this hole you find yourself in.

Lastly, one thing my brother said to me at the outset has stuck with me and proved itself to be the case. In the beginning when my mind was racing at 100 miles an hour and every problem and issue was climbing on the back of the previous one increasing the drag on my brain and pressure on my consciousness, he said to me "you know what, I reckon you'll come out of this all the better for it". Now at the time it goes without saying that I thought nothing could be further from the truth - how could something I was struggling to even put into words let alone overcome, improve my understanding of myself as a person? How could being made to feel this bad and this out of control of my own life/thoughts/emotions/actions bring with it any advantages? And in case you're wondering - no I promise you that's definitely not an exaggeration of the way I was at that time. In fact, although I never was never close to it myself, I can clearly see the path a person might take where to not feel this way becomes such an attractive proposition that not having to feel anything - ever again - and escaping what you see as a cursed life becomes preferable. Anyway, as it turns out my brother was right. The very reason I'm sat here writing this for you is because by going through the whole process of being overwhelmed, seeking solutions, trying different coping techniques and ultimately establishing the cause, has allowed me a better understanding of the illness. I know that if I'd read something like this online instead of a whole bunch of reviews on the pros & cons of Sertraline and other antidepressants, it would have given me hope - from which recovery IS possible.

Margarita

I would advise that you go back and see your Doctor especially if you have been on these medications for around six months, you may be in need for a review.

Let us know how you get on

Merry Christmas

BOB