Monday, August 18, 2008

My Treatment Resume

Subtitles: No wonder more people don’t seek out help when they need it; and, What’s up with all the counselors pushing medication?

*Almost done with graduate school, having fun doing exploratory work in counseling (recommended for social workers) & I have my first panic attack driving on the highway in Colorado. Grad school counselor sends me to campus doctor to get a prescription for xanax. Doctor says to take it before driving (label says “don’t operate heavy machinery after using”) & to give up caffeine. Counseling stops with the end of school with the message, “you’ll be fine”.

*6 months later I receive a six week sample pack of Prozac. I take it for six weeks and then stop because of the side effects.

*About a year later, I try again & seek out an anxiety center in my area. The shrink is very nice, we have a great rapport, but he doesn’t really do counseling. He does a thorough social history, establishes that I have excellent memory skills in repeating number sequences and sends me on my way with one month worth of Paxil samples. He, too, offers me xanax & this time I say no thanks. As I’m leaving, he tells me that once I beat my anxiety, I should come back and talk to him about a counseling job. I take Paxil for one month and then stop because of the side effects &, really, this isn’t helping.

*A co-worker recommends her counselor. He says that I just need to relax & have a little fun, lighten up a bit. I say, “I have a great, happy life except for anxiety, which is a pain in the ass”. We try EMDR. I try to help the process along and bring my own treatment plans and info that I’ve gleaned from reading. After a few more sessions & more “relax more & just do yoga” messages, I know that this is not what’s going to help & give up on counseling for a while.

*After having my first two babies, I’m ready to try again. Anxiety doesn’t own me, but I’m not driving on the highway much. I still remember what it felt like before anxiety infringed on my territory and I want it gone. I find more resources & begin reading everything I can find on the subject of “how can I get over this”. I begin exposure work on my own & make progress “taking back the roads”. I set up an appointment with a recommended counselor & it’s not a great fit. I go three times & keep looking.

*Second try: nice lady, a little rough around the edges, but she goes out in the field with clients & I like her spunk. I tell her that I don’t want to do meds, but she says that if I go on celexa for 2 years & do behavioral work at the same time that my anxiety will be gone. I try it, but don’t like it. I switch to Zoloft & stay on it for about 6 mos. We drive a number of bridges and highway stretches together. She’s got the behavioral piece down. I say that I’d like to work on the cognitive piece, that in some places on the highway, I’m still feeling really anxious & there must be something I can be doing differently. She says, I’m not sure why the exposure isn’t working for you, keep trying & the anxiety will go away. We part ways & I keep working on my own.

*Third try: I contact a psychologist friend of mine & say, Look this time I really need to find someone who’s an EXPERT on this anxiety stuff, won’t push meds & is up on the current research. I find Dr. C. who is fantastic & I really like, but still encourages I try meds. She’s worked in anxiety for years & has trained most of the area clinicians in CBT. I go on Lexapro & do a lot of great work with her. She says that I’m a dream client, that no one works as hard as I do and that it’s part biology & that I really need to work on acceptance. “I know you don’t want anxiety, but you got it. You have to accept what is.” True, acceptance is important, but I’m still feeling like with all the work I’m doing, I’m still missing an important piece. After monthly visits for a year, I feel done for the time being.

*I go off Lexapro during my 3rd pregnancy, experience big waves of panic in my third trimester and it comes back with a vengeance at about 12 -14 weeks postpartum. I go back for 2 or 3 “booster sessions” with Dr. C. and go back on Lexapro (after getting the green light from my midwife & an international breastfeeding expert). Things get better slowly. I come out of hiding and begin telling everyone. This helps tremendously & others begin sharing their stories. I’m dying for community. I start up a workbook study group (with some very cool, fellow anxiety super heroes) that meets inconsistently for a couple of months & fizzles out.

*Currently – I’m “off the junk” & not seeing a counselor. I don’t have anxiety mastered as much as I would like, but I'm realizing that what I was missing was not just the acceptance, but inviting & provoking the symptoms and, yes, acceptance. Good practice means doing something that guarantees that I'll feel anxious. I wish I could transport Dave Carbonell, Reid Wilson or David Burns to my hometown so that I could work with an anxiety guru and kick this thing once and for all (well, at least feel stronger in my skills and ready for the expected ups & downs).

Looking back over all the steps it’s taken to get good treatment, I see why so many people can live with this disorder much of their lives and never learn to beat it. Access to good information, counseling & community (plus a big dose of tenacity) makes a huge difference. When I get to be an anxiety master, I am going to open my own clinic & help offer others a more efficient path. More about that later!


Lisa L. said...

I was so able to relate to your post. I have suffered at different times in my life. I too am very happy in my life otherwise - it is the anxiety that drags me down. Right now I've been suffering for a year and a half since I had a horrible experience with anaphylaxis that almost took my life. My anxiety centers around medical issues right now. Years ago it was around breathing. Thanks for your honest blog. It is helpful to know that I am not alone.

nikole said...

Sending you strength as you continue on. I'm cheering for you! What a wonderful resource you will be. :-)

patience said...

isn't it interesting that almost ALL the shrinks thought you would be a good shrink? I think your superpowers/resume are building for a reason even bigger than you...can't wait to hear more.

Anxiety Girl said...

Thanks for all of the kind comments - I thought twice about posting all of that information, but remembered Elizabeth Gilbert in "Eat Pray Love" said, "Tell the truth, tell the truth, tell the truth". I always felt a little embarrassed about how many counselors I had to "try out" or meds I tried before finding out what worked for me, but it feels good to put it out there. I hope others will read this and realize that they're not alone.

Anonymous said...

My name is Lisa Carter and i would like to show you my personal experience with Lexapro.

I am 39 years old. Have been on Lexapro for 2 years now. This medication had an almost immediate positive effect on my life. Within 2 to 3 days of starting Lexapro, there was a noticeable lift in my general mood. A WARNING ABOUT STOPPING OR WEANING OFF LEXAPRO: I started taking 10 mg daily a couple of years ago for about 2 months, then decided I just didn't want to take medicine every day. So I weaned myself off over a 2-wk period, first reducing the dose to 5 mg/day, then 5 mg every other day before I stopped altogether. I figured I would be able to tell if my mood was going downhill and I would just restart if it did. Well, there was no gradual decline. I was careful to monitor my mood and thoughts every day and everything went great for about 3 months, then C.R.A.S.H!!! I mean it hit me like a WALL, very very suddenly! Despite exercising 4-5x per week, healthy eating, etc., I hit an all-time low.

I have experienced some of these side effects-
Constant dull headache, jittery in the morning if taken before bed, dizziness. These negative side effects subsided within a week or two. Other side effects have continued, including sleepiness and yawning, apathy, vivid (but great) dreams. My libido died and never came back.

I hope this information will be useful to others,
Lisa Carter

Lexapro Prescription Information