I have seen a phycologist for a year but have life/death anxiety for 3 years now and still not welll

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Health/death anxiety returned in 2012, saw a phycologist in 2015, she ended treatment after 8 months as it was nhs based!!! Im in fact worse now. Have been on venlefaxine for a year now 300mg and quetapine 100mg. Phychartrist just weaned my off from amitriptyline in 4 weeks!! From 60mg to 10mg then nothing. I am now haveing sleepless nights. So am worse mentally and tired now. Help

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  • Posted

    How long were you on amitryptiline?   When did you start the quetapine?  Did you find the work with the psychologist helpful?  Was she doing CBT with you?

    I think your p-doc weaned you off the amitryptiline too fast.  How are you feeling?  Other than the sleepless nights, are you having other withdrawal symptoms?  Withdrawal from ADs can cause insomnia.  You could reinstate part of the amitryptiline to see if it helps your sleep, and then do a very slow taper once you have stabilized.  Did the health anxiety get worse after the wean off amitryptiline or was that before?

    It is very common for docs to prescribe mood stabilizers after diagnosing a patient bi-polar after going on antidepressants.  Some patients start cycling through low and high moods on ADs, so it is caused by the meds but is mis-diagnosed.  

    I would first aim to get stabilized from the rapid cessation of amitryptiline.  Have you told your doctor you are worse?  They have a few choices.  One is to switch you to another new med, which would not be good given you are destabilized by the rapid taper.  Another is to reinstate part of the A to relieve symptoms and then do a slower taper, and third up your dosage of whatever meds you are on.  You are already on a high dose of ven so upping that one would not be a good idea.  I know my sleep deterirated on ven.  A fourth option, which your doc would doubtfully recommend, is to reduce/taper you off these meds to see if your symptoms improve.  Anxiety is a side effect of a lot of ADs, paradoxically, and the worsening health anxiety could be due to the cocktail and high ven.  

    CBT is very helpful with anxiety and depression, but is difficult when hamstrung by high drug levels which actually can impair one's ability to integrate the therapy.

    What triggered your health anxiety?  Is your current anxiety over the same issues or new ones?

    • Posted

      Hi Betsy thank you so much for all the information you are so thoughtful. I lost my hearing when i was 8years old and it changed my life. But my dad was ever so loving to me which helped me to cope. I then lost my bestfriend to ovarian cancer she was only 18. I didnt get to find out that she was dying or see her much which was a huge shock. It brought on death anxiety i was a mess lived in fear of the desease with cancer. It took about 5 years to improve and got better n better by making a very good friend. In all of this ive had a very traumatic and lonely marriage as my husbands work involves travelling also he is not a physical romantic will buy stuff but not spend time with me much. I had ami for 2 years. Prefer not to start again tho. The physcologist did use cbt but i didnt think it worked the whole therapy 😩
    • Posted

      Then the anxiety came back in 2012 what triggered it was someone in the family passed away with bowel cancer in a short amount of time and his wife was who was left behind was always there for me with my first bout of anxiety. Now cant seem to shrug the life/ death meaning n get on. I do the errands, but im not myself.
    • Posted

      Unfortunately, I think the meds can sometimes make it hard for therapy to "work."  I have found, though, that mindfulness is helpful, with guided meditations that focus on self-compassion being good.  It takes work and practice to learn to "be" without thought, thoughts being the source of suffering, but it is worth the effort, and you deserve the self-care.  Meds can give you a break from the anxiety but they work by dampening feeling, and that can make one complacent about doing the work that ultimately needs to be done to deal with the anxiety once and for all. 

      As I said, our thoughts create our suffering.  If you can catch yourself beginning to have the troubling thoughts, "notice" them, don't judge them, but be with them and accept them,  the anxiety often passes.  Notice and "step out of" the thoughts; set them aside and remind yourself that these thoughtsj increase your suffering.

      You've heard of mantras.  Well, it is possible to break the wire in your brain that was laid down about the fear of death, which is now like a fat cable.  You break the wire gradually by 1) noticing the thought that triggers the anxiety when it pops up and 2) reciting a mantra that negates the thought, something that your brain is willing to accept.  It might be "At this moment I am fine."  You repeat that phrase 50 times a day, even more. You can break it down into chunks.  Recite your mantra with breakfast, 20 times or so.  Do another 20 at lunch.  When a scary thought pops up, recite the mantra as many times as it takes to start to feel calmer.  Take deep breaths.

      It takes about 3 weeks of reciting a mantra to rewire your brain.  This works, but you have to do it!  You might find another mantra that suits you better.

      I wish I could say "try this drug, try that drug, it will fix you right up," but the drugs aren't going to cure you - they are a band-aid to give you a platform to then tackle this stuff.  Hopefully they don't hinder you from being able to do the work.

      The drugs don't break the wires that were encoded with these traumatic events; they work by making you not care as much.

      Ultimately, relief will come when you decide that you have had enough and that you are willing to do the work to make the changes necessary to not have to be this way anymore.  

      So, what would you like to happen?  Anxiety is not something that is happening to you, it is something created within you via your thoughts.  I will say that withdrawal can cause chemical versions of anxiety and fear that just sort of happen, more a body feel than thought related, though thoughts can trigger it.  You can still deal with it through self-care.  Deep breathing, guided meditations, mantras, distraction through watching TV (comedies, anything NOT scary), listening to upbeat music, gardening, anything that you find calming.  But you must catch the thoughts that feed the fear, and make an active decision to not entertain them.  Following them worsens your anxiety.

      Sorry this was rambling.  This is not about "anti-drug," as that is not my purpose here.  But there are times that the drugs can start to work against you with chronic use, just a fact.  You see it all the time on these boards, people having their "disease" return even though they are on the drugs.  So, they should be used for the shorter term to where they give you relief so that you have a toe-hold to do the work that will ultimately "fix" you.

      I hope this helps!

    • Posted

      Thank you so much betsy, it was definietly not rambling as it was well said and explained. I will try the mindfullness with the mantras, and keep you posted. Xx
    • Posted

      cheesygrin

      There are lots of sources for free guided meditations on the web.  I will private message you a couple of my favorites.  Just switch the channel, as we say, when the anxiety pops up!

    • Posted

      Thanks for the links but ive notice they are to listen to? As i am profoundky deaf i can only repeat mantras x
    • Posted

      Oops, my bad!!!  I forgot you mentioned that before!  Mantras, definitely good, and you can still meditate.  

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