OT: non-drug treatments for anxiety and depression

[ellen1159]

After years of taking antidepressants (SSRI's) for depression, I weaned myself off of them seven months ago. I wanted to see how I did without them (I also discontinued psychotherapy at the same time) and I wanted to save money. I felt pretty much okay until a few weeks ago, when I noticed some familiar and unpleasant symptoms creeping back. With the difficulties I've been having getting used to my Bipap machine and mask, plus being unemployed, my stress level is higher. This time, I notice a lot more anxiety as well as the typical depression.

I started seeing my old therapist again and asked her to put me back on the meds I had taken for years and tolerated well, Buproprion XL (generic Welbutrin extended release) and escitilopram (general Lexapro). I started them together, in the lower initial dosages, Sunday afternoon. By the evening, my blood pressure was in the 160's/90's and my heart was racing. I had also made the mistake of using an OTC nasal decongestant spray so I could better tolerate my mask, and that made things even worse. I didn't notice the warning on the spray bottle until it was too late (it's in the garbage now).

I had every nasty side effect of serotonin syndrome, a potentially fatal condition. I've got no appetite and have lost 10 lbs. since starting the meds, am restless, the insomnia is awful (can't sleep more than an hour at a time). I have a slight headache, diarrhea, and muscle tension like a band around my head.

My BP is back to normal as of Wednesday, but the meds don't wash out of your system for 8 to 14 days. I wouldn't wish the past week on my worst enemy. Most of the time I'm on the couch, pillows plumped up, trying to doze or rest as best I can. My internist said that it was probably from starting both meds at the same time, and I can't recall if I started them together years ago. She said I could restart the bupropion and see how I tolerated it. As if! I'll never touch these meds again.

Have any of you sought non-drug treatment for anxiety? How well did it work?

The doc who prescribed the meds for me said I might want to try Ativan for the anxiety I'm having, but I see that it might not be a good idea for an apnea patient because it affects breathing.

The only positive thing to happen out of this nightmare is that I'mnow almost 30 lbs. lighter than when I did my sleep study.

[jdm2857]

You might consider VIstaril (Hydroxyzine Pamoate) as an anti-anxiety agent
that does not cause respiratory depression.

[Stormynights]

I had severe depression after my daughter was killed. I fought it myself by changing my thoughts. It was very difficult at first but over time it changed my life. I would make myself think of 3 good things for every bad thought that entered my mind. It was very hard to come up with good thoughts and it started out with simple things. It was hard work but it worked. If you want to hear more send me a PM. I will be happy to pass on what I learned.

[kaiasgram]

Hi Ellen,

Some people have a good result with cognitive behavioral therapy (CBT) for anxiety and depression.* Outside the realm of psychotherapy there are many approaches that people have found helpful -- meditation, breath work, massage, yoga, tai chi and chi gong, exercise, dietary changes (e.g. avoiding foods that cause blood sugar fluctuations), acupuncture, and there are other things I'm sure I'm not thinking of at the moment. Oh, and there are supplements and herbs that are thought to help with anxiety, though that takes you back in the direction of "taking stuff" -- but some herbal teas might be an option to try.

jdm mentioned Vistaril -- I know you didn't ask for medication ideas but in case others are curious, Vistaril is an antihistamine also known by the brand name Atarax.

* What Stormy described as her way of coping is a good example of how CBT works -- she purposefully and systematically learned to identify and replace negative thoughts with positive ones. It does take commitment and lots of practice but it can be very effective.

[Janknitz]

Take a gander at Julia Ross' book called "The Mood Cure". You may benefit from some amino acid supplements.

[49er]

Hi Ellen,

I like the suggestion of CBT alot.

As one who also got off of psych meds after several years of being on them, I have found as have other people who have been on them is that your body can be very sensitive to supplements. So if you decided to go that direction, please tread very carefully. The rule on withdrawal boards is to start a lower than normal starting dose and go very slowly. And take one supplement at a time so in case you have problems, you know what you are reacting to.

Finally, you might want to look at thread on anxiety as it is one of the best one I have seen.

http://www.paxilprogress.org/forums/sho ... hp?t=49645

Basically, the idea is to accept your anxiety and not fight it with the theory that with acceptance, the bouts don't last as long. Fortunately, I have had very few anxiety attacks but when I had them, I found the thread very helpful. Hopefully, you will also.

49er

After years of taking antidepressants (SSRI's) for depression, I weaned myself off of them seven months ago. I wanted to see how I did without them (I also discontinued psychotherapy at the same time) and I wanted to save money. I felt pretty much okay until a few weeks ago, when I noticed some familiar and unpleasant symptoms creeping back. With the difficulties I've been having getting used to my Bipap machine and mask, plus being unemployed, my stress level is higher. This time, I notice a lot more anxiety as well as the typical depression.

I started seeing my old therapist again and asked her to put me back on the meds I had taken for years and tolerated well, Buproprion XL (generic Welbutrin extended release) and escitilopram (general Lexapro). I started them together, in the lower initial dosages, Sunday afternoon. By the evening, my blood pressure was in the 160's/90's and my heart was racing. I had also made the mistake of using an OTC nasal decongestant spray so I could better tolerate my mask, and that made things even worse. I didn't notice the warning on the spray bottle until it was too late (it's in the garbage now).

I had every nasty side effect of serotonin syndrome, a potentially fatal condition. I've got no appetite and have lost 10 lbs. since starting the meds, am restless, the insomnia is awful (can't sleep more than an hour at a time). I have a slight headache, diarrhea, and muscle tension like a band around my head.

My BP is back to normal as of Wednesday, but the meds don't wash out of your system for 8 to 14 days. I wouldn't wish the past week on my worst enemy. Most of the time I'm on the couch, pillows plumped up, trying to doze or rest as best I can. My internist said that it was probably from starting both meds at the same time, and I can't recall if I started them together years ago. She said I could restart the bupropion and see how I tolerated it. As if! I'll never touch these meds again.

Have any of you sought non-drug treatment for anxiety? How well did it work?

The doc who prescribed the meds for me said I might want to try Ativan for the anxiety I'm having, but I see that it might not be a good idea for an apnea patient because it affects breathing.

The only positive thing to happen out of this nightmare is that I'mnow almost 30 lbs. lighter than when I did my sleep study.

[Loreena]

Hi Ellen,

There's a number of things that sleep apnea has disrupted or seemingly "wrecked" in my life that I could freak out about, and to some people, probably should. Call it what you will, but I've chosen just not to think about those things anymore, or to "go there," know what I mean? My attitude now is to just do the best that I can every day (no matter what others think) and I won't look back or think about what might have been. It's really the only way I can survive. Hope this helps.

[BlackSpinner]

Exercise! Probably the hardest thing to do when you are depressed but the cheapest and effective.

You have to do it until your heart rate is at its most effective (depends on age and weight). The chemical changes caused by the adrenaline are what does it. Just waving a few weights for 5 minutes doesn't do it, you need to be sweating and breathing hard (but not too hard you can't talk).

Singing also helps some people as it really is a form of breathing therapy.

[oak]

the things everyone has suggested are great ideas. i especially think CBT therapy will help. do you have confidence in your therapist and are you able to access them as often as needed?
believe it or not, i think cpap is the best non-drug treatment for anxiety and depression i have had. i feel sooooo much better now that i am not so sleepy and not afraid to drive again. i can empathize with your situation with the meds. my depression was very drug resistant and at one time i was on 4 meds for anxiety and depression. i even felt anxious about going to sleep! (now I know why). now i am down to 2 meds and hope soon to be weaning off those. keep up with your cpap and i bet it will help you also. hang in there ellen!

[ellen1159]

Thank you everyone for the thoughtful responses. I went to the library yesterday and got out a book by Lucinda Bassett on self help for anxiety and panic attacks. I also got out some fun summer reading novels. This morning I went to an Al Anon meeting, a support group that I've attended in the past (my two older children are substance abusers). I found it helpful back then for building resilience and not sweating the small stuff, I just didn't commit to it the way I perhaps should have. I like my therapist and she wants to make me a guided meditation tape, I also found a local meetup group for mindful meditation that is supposed to help with the stress and anxiety I'm having over my apnea.

Physically, I feel a bit better today. I was able to sleep for a few consecutive hours last night, and this afternoon I made myself put the mask on and lay in bed for three hours. I did doze off for a little while (the insomnia is still bothering me, as well as my appetite being off). I was happy that I could even tolerate the mask for that long. I see the sleep doc on Tuesday and I'm going to fess up and tell him I lowered my pressures from 15 min 25 max to 14 min 20 max and I tolerate them just fine, it's just that the mask is uncomfortable and leaks (Quattro Mirage). maybe they'll give me another mask. Tried the mask liner but either I cut the hole too big and it's useless or not enough and I'm smothered.

I know if I could just go four hours with the mask on and sleep most of it, my mood would improve dramatically and I wouldn't feel so helpless.

[kteague]

Wow, is this OT thread ever timely! Was reading it earlier, including the link to a thread on another forum. Just a couple hours later there was a loud insistent knock at the door. It was our mailman urgently asking for a glass of water for a lady in the lobby just a few steps away. He said she thought she was having a panic attack and that a glass of water might help. Having just read this thread I was able to be calmer and not panic and call 911 thinking she was having a heart attack or something. She said she has these episodes from time to time. Said she was taking a nap and woke up in a panic and ran outside because she was afraid to be inside alone. Stayed with her and talked a while until she was calm and her pulse slowed down. Glad you all had me prepared!

[goodcheer]

Just a small tip: reduce or eliminate the amount of simple sugars that you eat in the form of candy, white flour, etc. I find that high amounts of sugar and high glycemic carbs cause mood swings. Hope this helps!

[Todzo]

In my case I found that all psychotropic medications are only effective for many months to perhaps a few years. Then my body gets so used to the drug that I experience more withdrawal symptoms during my normal day than therapeutic effects. I guess my brain adapts.

I do not use them anymore and am glad to be rid of them. I think my current balance issues which were acute while using the drugs are a long term effect of them. It is kind of scary to read up on the actual side effects and then compare that to the actual therapeutic effects that they see amongst a normal population which would use the drug.

I have found the following helpful to me as I work to reduce the negative effects of anxiety in my life:

1. I moved away from the violent city. I come from a small city in Montana. Moved to the big city in 1980. Until I was assaulted and robbed in 2005 I had no idea of the social dynamics which bring forth crime in our big cities. Now I am very aware of the extreme contempt many have for older white men. As well as the extreme contempt all have for the poor in the big city. I am much more safe and have better social interaction in my new little out of the way college town. Four times the intellectual stimulation and 1/200 the crime. I love it!

2. The new city has better sunlight hours. More sun is better for my mood I find. I am still working to build some in door lighting systems to keep my mood up with artificial sunlight in the winter time. Part of it is the effects on the eye seeing well lit scenes. Part of it is the few minutes (like 10 minutes only) I expose my skin to the sunlight. I keep the UV index under 8 when I do this. Any pink and I count what I did as over doing. The UV does harm the skin. The body responds by producing such as vitamin D and other substances to rebuild quickly. The result can be a body wide improvement in healing. But ya gotta be careful. I do not go out if the UV index is above 8 – most of the time I stay in the shade between 10a and 3p.

3. I am still pursuing an active lifestyle. I remember using a single step to try to get some exercise, as well as using gallon water bottles as weights (add a broom stick you can do more). I remember using the building stairs in the winter time to try to get my heart up to aerobic rates. In recent days (and for years now) I have been using good pedometers to keep track of my steps. The Japanese in the 60s gave us the 10,000 steps a day criteria for the “active lifestyle” threshold. In the past I really fell short in the winter time and made perhaps 65% in the summer time. This year I spent a lot of hours on the cycle (TV is a draw – use the draw!) and treadmill and my pedometer (a new replacement) shows above 80% since I bought it in April and July came in at 93%. You do use a lot of shoes but it is very good for mood and weight loss. It is also highly recommended to keep arthritis at bay. I will start up using my personal trainer in September. In the summer time it is easy to be drawn to activity, in the winter a relationship with a personal trainer and some goals, well, it works!!

4. I am still pursuing good fuel. I believe that if you make the effort to feed your body all of what it really needs you will not be drawn to feed your body what it should not have. For several years I worked with a dietitian (medicare was glad to pay for this apparently – a very healthy investment!). To that basics understanding of what is good to eat I have added eating for a healthy microbiome, staying away from GMOs, RBHts, and foods that use a lot of “cides” in their production (see: http://www.thedailygreen.com/healthy-ea ... ds#slide-1 ). Many if not most of the chemicals our brain uses to work well (e.g. serotonin) are produced in our gut. Our food supply has grown unhealthy (see: http://www.imdb.com/title/tt1286537/ and http://www.amazon.com/In-Organic-We-Trust/dp/B00B47N08W ) which may be the reason we see so much sickness and problems with depression these days. We need good fuel!!
The NCIS character Gibbs was asked how to recover from Post Traumatic Stress (PTS). He said simply “re-establish purpose and work on trust”. For me that now translates into writing classes to work toward my purposes, and looking for resources to better determine who I should trust.

May we find the best solutions!

Todzo

[49er]

This is going to sound way too simplistic but it seems that eating chocolate with 85% cacoa has greatly helped my mood. Of course, having started a paleo type diet a week ago, it could also be due to simply missing a nutrient I am not getting. So take my advice for what it is worth but obviously, you have nothing to lose my trying this.

49er

[Loreena]

This is going to sound way too simplistic but it seems that eating chocolate with 85% cacoa has greatly helped my mood. Of course, having started a paleo type diet a week ago, it could also be due to simply missing a nutrient I am not getting. So take my advice for what it is worth but obviously, you have nothing to lose my trying this.

49er

You Go, Girl! That is great news! I have never been this thin since highschool.