Not this, not now, yes now

[vaneramos]

A bout of intense anxiety has hit. I felt some flashes last week, but during the past three days it has come in successive, overwhelming waves. It erupts especially whenever I try to plan a few hours into the future. It feels like a brain cramp: the harder I try to relax, the more it clenches. I begin to lose some basic perspective.

This afternoon I went to see the doctor. I got lost on the way, couldn't remember where I was going. It was the second time in two days I felt unsafe driving, my concentration was so poor. Anyway, I found my way to the clinic. Consulting with the doctor, I decided to take a few days off work to rest, and work on getting better.

The underlying stress goes back a few months. I can't afford to take time off for me. Therein lies one of the roots of this anxiety. I had not intended to withdraw from my emergency fund for this purpose, not now, but I have to.

The doctor is referring me to a specialist. He said, "Remeron seems like a strange choice for you." I asked why. Because Remeron is an anti-psychotic, he said. It is sedating. It does not affect the balance of neurotransmitters that relates directly to depression and anxiety.

This is not my usual doctor; he has taken on her patients while she is on maternity leave. He is the first person who has ever explained this to me. No question, the Remeron/mirtazapine has helped, but why am I taking an anti-psychotic? I have never experienced psychosis. I need more information.

Comments

[e-musings.livejournal.com]

Sometimes meds like that are prescribed because they work, even if the patient doesn't have psychosis. I think it's called off label use.

[vaneramos.livejournal.com]

That makes sense. What disturbs me is that nobody explained this to me. I have seen several psychiatrists since the one who prescribed this in 2005. During that time I have also changed my g.p. and seen several counselors/therapists who were aware of the drug. I did not like the psychiatrist who initially prescribed the drug; my last session with him he was marginally abusive, so I never went back. The drug worked, so I never questioned the prescription. Still, I feel like I've been kept in the dark. I've tried doing research about the drug online, but never found anything that concerned me or particularly cleared up my confusion. Wikipedia refers to Remeron as a "tetracyclic antidepressant". It doesn't say anything about its use as an anti-psychotic. So maybe this doctor is just wrong. However I have often heard Remeron referred to as a "last resort" for patients who responded poorly to other antidepressants. I wish I knew what all this meant.

[artricia.livejournal.com]

You can ask your pharmacist for more information. Often they know more about the drugs than the doctors know. FWIW, I was on a tricyclic antidepressant years ago, for migraines that got diagnosed as tension headaches. It sure helped me feel more stable. (I was going through a lot at the time, and had recently moved out of my parents' house because living there literally made me want to kill myself.) In any case, tricyclic antidepressants are rarely used anymore because the newer drugs -- the SSRIs and related drugs -- usually work better and with fewer side effects. I suspect that Remeron is probably a last resort for similar reasons.

[threestarblue.livejournal.com]

have you made any changes in your diet recently? maybe too much processed food? not enough walking? feel better soon.

[vaneramos.livejournal.com]

I haven't changed my diet or exercise habits recently. The only thing that has changed: I started going to bed earlier and getting a little more sleep, more like 6 or 6-1/2 hours instead of 5-1/2. It should make me feel better, but actually I think my brain is having trouble adjusting to the change in energy.

My spirits were a bit low last week, so Monday and Tuesday morning I tried using the light box to fend of SAD. Unfortunately I think that contributed to my agitation. I've stopped using it.

But most of all I think this just has to do with stress I have avoided dealing with for a few months. I need to focus on that.

[artricia.livejournal.com]

FWIW, I find that when I'm not dealing with something, I either can't sleep well or sleep too much. The two may be linked.

[vaysha.livejournal.com]

it will be great for you to get some answers and explore other options for medication.
I think it's useful to do a med review every couple of years anyway.

I send love Van. Anxiety and I are familiar with one another and it sucks.

[vaneramos.livejournal.com]

Yes, it's about time I had a review. This particular drug was originally prescribed by a psychiatrist I grew to dislike and mistrust, but the Remeron seemed to work so I stuck with it. Looking it up on Wikipedia today, I find it referred to as a tetracyclic antidepressant, not an anti-psychotic, so I'm still confused. I could use some straight answers.

Thanks for you love and empathy. It is a comfort.

Hugs,
V