Anxiety 2 Calm

There is lots of medication for anxiety available on the market. Almost all of it is only available on prescription from a doctor.

Normally, Patients presenting with anxiety are offered Selective Serotonin Re-uptake Inhibitors (SSRI for short). This family of medication is considered suitable if the anxiety disorder is ongoing, as SSRI’s are not suitable for short term use. They tend to take at least four weeks to start working (although some people claim to feel better in as little as two days) and aren’t thought to be fully effective until they have been taken for 6 weeks to two months. The common SSRI’s are:

• citalopram (Celexa, Cipramil, Celepram, Emocal, Sepram, Seropram)
• escitalopram (Lexapro, Cipralex, Esertia, Esipram)
• fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem, Fluctin [EUR])
• paroxetine (Paxil, Seroxat, Aropax, Deroxat, Paroxat)
• sertraline (Zoloft, Lustral, Serlain)
• venlafaxine (Effexor) (SNRI)
• duloxetine (Cymbalta)
• dapoxetine (Priligy)
• fluvoxamine (Luvox, Faverin, Favoxil)

Other drugs which might also be prescribed and are similar to SSRI’s are SNRI’s or Serotonin-norepinephrine Reuptake Inhibitors. The most commonly prescribed SNRI is Venlafaxine (Effexor). SNRI’s are newer than SSRI’s and tend to be slightly better tolerated with fewer side effects. They were designed to treat depression but are also a medication for anxiety. Likewise they are prescribed for long term use, normally six months or more and sometimes years.

If a medication for anxiety which is short term is needed then there are various other options. In times of extreme grief or pain, or when panic attacks are severe, a short acting anxiolytic might be used. The normal choice would be one of the Benzodiazepine family:

• Xanax, alprazolam:
• Lexotan, bromazepam:
• Librium, chlordiazepoxide:
• Klonopin, clonazepam:
• Tranxene, clorazepate:
• Valium, diazepam:
• Rohypnol, flunitrazepam:
• ProSom, estazolam:
• Dalmane, flurazepam:
• Paxipam, halazepam:
• Dormonoct, loprazolam:
• Ativan, lorazepam:
• Versed (Hypnovel, Dormicum), midazolam:
• Mogadon, nitrazepam:
• Serax, oxazepam:
• Doral, quazepam:
• Restoril, temazepam:
• Halcion, triazolam:

Benzodiazepines are good because they work quickly (less than an hour even) and are very good at what they do – stopping anxiety and panic. In a way they are the ultimate medication for anxiety. The problem is that if they are taken for too long they become less effective and can become addictive. Constant use for more then three weeks is rarely advised.

Another drug that is not a Benzodiazepine is Buspirone, which is said to be as good as a Benzodiazipine for reducing anxiety but non-addictive and non-sedating. It has a better side-effect profile but can not be taken on an as needed basis. It has to be taken daily and takes two or three weeks to take effect. As it is non-addictive it is much better suited to long-term use Benzodiazepines.

Choosing the best treatment for anxiety is a potential minefield. There are two many treatments out there to name ranging from the clinically proven to the wacky and bizarre.

My first piece of advice is to do some Cognitive Behavior Therapy. I am not saying that CBT cures anxiety or that it is the best treatment for anxiety. What I am saying though is that the cognitive skills learned in CBT form the back bone of positive thinking and changing thought patterns.

It the bad old days CBT was expensive and your insurance or health service would only let you have a few miserable sessions. Now CBT is much more in your control. You can read some great books on CBT which have practical exercises and seeing an expert might not be necessary at all. There is another option that has become increasingly popular and that is computerized CBT. You can use this online and it takes you through various exercises. There are many websites offering this service for free or a nominal price. Moodgym is one such.

You can also try something like the Panic Away program that has successfully helped thousands of people overcome panic attacks and anxiety.

In an article about treatments for anxiety it would be normal to talk about drugs, medication and herbs. i won’t talk about any of those because they don’t treat anxiety, they mask the symptoms.

I will however talk about nutrition. Anxiety can be causes or exacerbated by a lack of Omega 3 fats and some vitamin and mineral deficiencies. You should consider supplementing with a good quality fish oil that has a high EPA content. Also, make sure you are getting enough B vitamins.

If you have IBS your stomach may not absorb vitamins and minerals well enough. This could lead to deficiencies so a modified diet which avoids food which you can’t tolerate may help in the long term. There is certainly a link between IBS and Anxiety.

Lastly you need to learn how to relax. A CBT therapist will teach you breathing and relaxation exercises but in my opinion there is nothing better for anxiety than mindfulness meditation. The simple act of becoming aware of what is around you, living in the present moment, observing thoughts without letting them become you or take you over, is the most calming thing. Like all good things it comes to those who wait, or to be more precise those who are patient and can practice mindfulness regularly.

Social Anxiety can be described as a feeling of fear or dread that arises because of a social situation, intense shyness, guilt and shame. Social Anxiety may be felt before a situation in anticipation of it, during a social interaction or afterwards, as the sufferer over-analyses the interaction and feels ashamed or guilty about what happened.   Some people decide to completely avoid all social interaction, this is called Social Phobia.

Social Anxiety Disorder symptoms are just like any those for any other aspect of generalized anxiety disorder in many ways. The physical symptoms are often the same: palpitations, hyperventilation, muscle tension, nausea and vertigo. In some cases however a social anxiety sufferer may blush or stammer uncontrollably. In some cases they may even freeze, and be unable to speak.

Treatment for Social Anxiety

As Social Anxiety is caused by faulty thinking and physical symptoms that lead back into those faulty thinking patterns in a vicious circle the first line psychological treatment is often Cognitive behavior Therapy. With CBT a therapists will help you identify faulty thinking patterns or individual beliefs and then correct them or rationalize them.

The therapist will also teach some relaxation techniques to break the flight or fight cycle. CBT can be very effective and is often easily available although it can be expensive if you are not insured. There are many good books on the subject which can be as worthwhile as seeing a professional and much cheaper.

Doctors will often also prescribe drugs. Medication for Social Anxiety often takes the form of SSRI’s such as Citalopram (Celexa). These work by increasing Serotonin levels in the brain and improving mood and confidence.

Another type of drug that can be prescribed for social anxiety is a beta-blocker like Inderal. It doesn’t cross the blood-brain barrier sand therefore doesn’t effect mood but can be good for Social Anxiety because it blocks some of the adrenaline and therefore lessens the physical symptoms. This allows the sufferer to build confidence.

One vitamin, niacinamide, which is a form of vitamin B3, has been found in high doses to be beneficial for social anxiety. Scientists are divided over how it works and indeed if it works. On the consumer health rating site Revolution Health, readers have praised it’s effectiveness so it might be worth investigation and talking over with a doctor. There are safety concerns over taking high doses of Niacinamide.

Generally there is a good chance of a positive outlook for people with social anxiety. The numerous treatments available have a good chance of success and your doctor should be your first line of attack.

See Also

Do I have Social Phobia

Lots of people have had weight gain problems with  Celexa (citalopram) and Cipralex/Lexapro (escitalopram). Indeed most psychotropic drugs can potentially cause weight gain.

Advice for  avoiding weight gain.

Firstly let’s cover the basics: try to eat well, make sure you eat whole foods, complex carbohydrates and keep refined sugars and processed fats to a minimum. Also, take plenty of exercise. Whether you are taking an SSRI for depression, panic attacks or anxiety you are almost guaranteed to feel better to some extent just by exercising. It also of course keeps weight off.

Now the clever part: One hour or so before meals it a high carbohydrate snack. This could be some fruit, some oatcakes, even high cocoa content chocolate. Don’t eat too much, say a couple of hundred calories, and try to eat something that isn’t too refined, so your body burns it slowly.

You should then find that this carbohydrate snack has boosted the Serotonin levels in your brain and that this will limit your food cravings. (click here to understand why carbohydrates boost Serotonin levels.) Your appetite will return to more reasonable levels and you should keep/gain control of your weight. Worth a try anyway!

Also read:

• Citalopram / Celexa SSRI
• Coming off SSRI’s
• Best Anxiety Medication

Cipralex Weight Gain issues are part of one of the common topics I find in my inbox: the whole issue of whether SSRI’s make you put on weight and if so how can this be avoided. Many people have had issues with Celexa (citalopram) and weight gain, but as this personal experience shows, other SSRI’s such as Cipralex (escitalopram) can have weight gain issues.

I had a nervous breakdown 9 weeks ago, never felt that bad in my entire life…. Terrible anxiety, depression, tachycardia. I really did not want to take anti depressants as the side effects would have pushed me over the edge… I started getting a little better by myself but after 7 weeks I decided to start. My doc gave me cipralex and after only 2 days on that I felt much better, than noticed my weight had gone up by THREE kilos after 5 days on it!! Anxiety back of course. have been really watching what I eat, but the weight has not come off. I am hepatitis c positive and am scared to try duloxetine although that is the only SSRI that is good for severe anxiety/depression and has no weight gain associated with it. Duloxetine has been known to cause liver damage apparently. I am between a rock and a hard place as I need to up dosage from 5mg to 10 mg.

Sometime later this emailer followed up with:

I have been on Cipralex for 10 weeks now, and the weight gain is not such a major issue anymore, just have to watch what I eat. It has helped me a lot, I am on 20 mg now, and feeling almost back to myself. It took a while, but than I was not on the right dose. I was very ill, I’d had a mental breakdown and suffered from terrible anxiety and depression. It is worth sticking with it, at first you go up, almost as soon as starting the medication, than you seem to go down again, but you come up again as the drug accumulates in the system. Not quite like other anti depressants I have taken, but so far very helpful.

Firstly let me say how grateful I am to this person for sending me their personal experiences and allowing me to share them on this blog. It’s great that taking Cipralex has been positive and beneficial here, and I wish them all the best as they continue to recover! I think that it’s particularly interesting that weight gain hasn’t been such an issue in this case. It has long been known the SSRI’s have a tendency to cause weight gain, but not everyone suffers (indeed many SSRI’s list both weight gain and weight loss as possible side effects!).

No has a definitive answer to the question “why do SSRI’s cause weight gain?” but I have heard a theory which may have some credence. It is said that the action of SSRI’s like Cipralex on Serotonin receptors in some way causes the body to crave even more Serotonin, which it normally gets in the following way: the amino acid tryptophan enters the blood stream through consumption of foods containing the right kind of protein such as cheese, milk, fish, and meat. Tryptophan has a better chance of crossing the blood brain barrier and turning into Serotonin when it doesn’t have to vie for space with other amino acids. When you eat carbohydrate, insulin floods into your system and takes away amongst other things many of the amino acids that compete with Tryptophan for space. Tryptophan can then cross the blood-brain barrier and become Serotonin. Thus the best way to get a Serotonin hit is to eat carbohydrates (hence ice-cream can temporarily make you feel better). People on SSRI’s crave more Serotonin and therefore more carbohydrates and therefore put on more weight.

Is there something you can do about it? Probably yes, check out this post on how to avoid gaining weight on SSRI’s like Celexa, Lexapro and Prozac.

The use of Omega 3/6/9 oils to combat mental health problems such as anxiety and depression have been well documented of late. But unfortunately there is still some confusion with many people not getting the benefits they are hoping for. It is thought that depression, anxiety and panic could all be lessened by the use of omega oils.

In order to get relief from anxiety through taking omega oils several factors are needed.

Firstly, the right dose is important. Secondly the ratio of the oils is important, and thirdly the length of treatment.

Click Here for other important Anxiety information!

It is a minefield trying to work out how much omega oils to take. There are numerous studies which discuss this and the results can be confusing, but basically it seems that omega 3 is normally the oil which is lacking from the diet and that this can be addressed through dietary changes and supplementation. The two key ingredients of omega 3 are EPA and DHA. EPA seems to be the more important and about 1 gram per day of EPA is considered to be the right amount. It is also clear that more isn’t necessarily better.one study found that those on 1 gram did better than those on 4 grams (in an experiment tackling depression), so there is no point or benefit in overdosing. Labels on omega 3 containing supplements are highly misleading, with manufacturers often proclaiming their products to be “high strength”. This is often rubbish. It is important to seek out the few products on the market that offer reasonable doses of EPA and take enough to get 1 gram a day. This is almost impossible when a supermarket brand might contain say only 35mg of EPA (you would need to take almost thirty doses at once!). So check the label before you buy! I would also take the oil twice a day with meals.it is apparently better absorbed over two doses.

The ration of Omega 3 to 6 in your diet is important. Again, there is not an agreed figure but a ration of 2:1 omega 6 to omega 3 is probably fine. A omega 6:3 ration of 20:1 is not uncommon but totally unhealthy (omega 6 is far too available in modern diets compared to omega 3). You can buy supplements which have this ratio built in, and this makes life easier.

Length of treatment is hard to define, but if anxiety or depression have been major factors in your life then you can well expect three to six months to pass before you feel results, which will creep up on you slowly. Some people claim to have seen results in just a few weeks, everyone is different after all. The brain is using these oils to rebuild and replenish, which is a slow task! However much research seems very promising!

ALSO CHECK OUT:

EPA Oil

Hi! Just a quick note for readers in the UK. Anxiety UK, previously known as The National Phobics Society, has had funding withdrawn by the UK government. This will have a major effect on the services that the organisation is able to offer people in very real need. During the current economic difficulties the number of people seeking help has increased and the services of Anxiety UK are much needed.

You can do something to help.

Why not visit the site and do all you can to help save it! It also has lots of great info!

There have been a few interesting stories this week that although not directly related, have implications of the treatment of anxiety . Firstly the BBC reported on an interesting study on the benefits of acupuncture. The study was not aimed at acupuncture used to treat anxiety but more at preventing headaches and migraines. There is something of a link here as many people believe migraines are stress related. The study was basically a meta-analysis of thirty-three other studies and found interestingly that acupuncture worked. More interestingly still they found that so-called sham acupuncture worked just as well, that is to say that it doesn’t seem to matter whether you stick the needles in the centuries old Chinese positions, or just do it randomly. This suggests one of two things. Either the whole phenomenon is just the placebo effect and there is really no therapeutic benefit, or there is something about stimulating parts of the body which does actually promote health.

Ebooks on Holistic Health and Acupuncture

There have been some studies, albeit not enough to draw firm conclusions, that say that meridian tapping therapies such as EFT and TFT work for the treatment of anxiety, phobias and depression. It seems to me that the principle behind this success (if indeed it is real) is likely to be similar to the acupuncture. Indeed it has been said in at least one study that tapping the body randomly works as well as tapping the points listed in the algorithms specified by the therapy founders.

Whether this is a case of the placebo effect or not doesn’t really matter. What matters is there being sufficient efficacy in the treatment for people to have some kind of faith in it, for the treatment to be safe, and for it to produce long lasting results. Many acupuncturists advertise the treatment of anxiety and stress but I am skeptical given the lack of specific evidence. That said, most of us have met someone who swears by acupuncture. There is nothing wrong of course with the placebo effect! If it works for you then great!