Easing high anxiety

A friend asked to check in with me about starting medication. I figured elements of our discussion could maybe be helpful for others, so I’m posting them here. Hopefully it helps.

Starting medication definitely is a journey, and I don’t for a second assume that it’s the same for everyone. The meds have worked really well for me, and I know that there are lots of complex chemical interactions happening that mean different brains adapt differently.

It’s great to go in with zero expectations. My hope is that everything just gels for you, but it’s very understandable that maybe these meds aren’t quite right, and it could be an adjustment that takes time. I was very lucky that after the initial loading period (~ 2-5 weeks), things felt a lot better for me, and the side effects weren’t severe. Some people have intense side effects that mean years of going off and on different medications, doing the bioaccummulation thing again and again, until they find a combination of helpful effects and low side effects that works for them. For some people, it just clicks. I really really hope this is the case for you.

My experience isn’t far ranging. I went on cipralex. It’s been fantastic and I wish I did it years ago. I haven’t tried anti anxiety meds, but from what I’ve heard the experience can be similar. The big thing is to give yourself all the patience and time, and understand that this will be a process in one way or another. Take breaks when you need it, and be honest with people if they’re asking more than you have the capacity to deliver on. You’ll probably feel a little mentally foggy at first,, maybe a little nauseous. This is very normal and unfortunately a big part of the bioaccumulation.

Also this should go without saying, but a doctor will usually prescribe a ramp up period where you take low doses and incrementally increase until you’re at the desired dosage. Mine was 5mg for the first five days, then 10mg after. It took me a few days to adjust to the 5mg, then again for the 10, rather than it all hitting at once. Please follow their timeline. Please make sure you take your meds every day, and at a similar time. Most people set alarms. With anything SSRI based, you might feel a teensy bit high after you take your meds. Not everyone does, but when I was taking them in the morning, it made my commute a lot more pleasant.

I did find that after the fogginess subsided, it really helped me with focus. I know I get a lot of manic energy. Going on these meds has really given me the capacity to do projects again. Instead of freaking out over there being too many steps, I can take them one at a time. Also the big thing is that I can do multi-day projects again and not freak out that everything isn’t finished instantly. I’ve gotten back my ability to plan, which I lost for a long time. Everybody feels shitty and useless when starting this stuff out. It sucks, and feels really discouraging when the whole point is to push all that stuff aside. It takes time.

Please trust the process. It’s a hard and frustrating lesson, but it’s been helping me a lot now that I’m in a place where I can hear it.

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