Is Medication For Anxiety The Right Choice For Me?Apr 01, 2021
Many of our clients are offered medication as an intervention option. And so many resist the idea of it right from the start. The stigma around medication still exists and doctors don’t always spend the amount of time needed to clearly explain the role and benefits (and side effects) of medications. So it can feel daunting. Is medication for anxiety the right choice for me? Let’s find out.
Different Medications For Anxiety
First things first is to realise that there are a variety of medical interventions that may or may not be useful in the treatment of anxiety. When considering pharmacotherapy it is important to understand what you are getting and why it works.
Selective Serotonine Re-uptake Inhibitors (SSRI’s) are often prescribed in the long term treatment of anxiety. You might feel confused by this as they are also known as “anti-depressants”. However, in the world of psychiatric medications, there is no “one size fits all”. You will find that a lot of medications are used to treat conditions they weren’t originally designed for. .
The same applies to anti-depressants.
The way in which the SSRI works is that it stimulates the production of Serotonine in the brain but simultaneously inhibits the brain from ‘sucking it all back up’ again. (That’s the “re-uptake inhibitor” part). The reason for this is that when the brain notices that Serotonine is not being used, it simply re-absorbs it. And then doesn’t produce much more.
It’s as if the brain thinks “well, that’s not being used, so I’m not making anymore”. And therein lies the problem.
So the SSRI’s are designed to get the brain to make more and not to re-absorb it too quickly. This gives you a fighting chance of actually using the Serotonine before it is taken away again.
SSRI’s For Anxiety?
The thing about Serotonine is that is is responsible for so many of our human functions… We are talking sleep regulations, appetite, libido, motivation, positive thinking, feelings of wellness and general happiness.
But Serotonine is also responsible for helping the brain to function as it should. It helps the nervous system cells to communicate with each other.
So it is a pretty important neuro-chemical and imperative for optimal functioning.
Too little Serotonine can result in depression. Too much can result in over activity in the nervous system. And any imbalance can result in any one of our functions (sleep, appetite, general wellness etc) running a-mock.
Anxiety conditions are often affected by Serotonine levels and nervous system functions. So adjusting these using an SSRI can be a very effective intervention strategy.
What Are The Pro’s and Cons of SSRI’s
Well, most people struggling with anxiety will notice a general calming of intrusive, obsessive thoughts. And often it is these thoughts that perpetuate the anxiety cycles. So when you interrupt those you have a great chance of becoming unstuck.
The SSRI tends to calm the nervous system down a little so that you stop feeling on edge all of the time.
Sleep becomes easier. Appetite is regulated and seeing the light at the end of the tunnel becomes a possibility.
The cons are the side effects of SSRI’s which are numerous and vary from person to person. Most common side effects include low level nausea, headaches, persistent yawning, feeling a little dazed.
Side effects should let up within 2 weeks as the body becomes used to the new medication.
The important thing to remember with SSRI’s is that they are not a “take it when you need it” type of treatment. You need to take them regularly and for at least 6 months. This allows the levels of the medication to be therapeutic. And for you to receive lasting benefit from it. View it as an anti-biotic and finish the course!
SSRI’s are not addictive
Contrary to popular belief, your body does not become dependent on the medication. Many people do, however, fear that they will not be well without the medications. This means they become psychologically dependent on taking them.
Remember that when your brain is finally doing what it needs to do with the Serotonine, you can come off the treatment and it should, theoretically, do it for itself.
This information is not intended to replace the information you receive from your medical professional. There are numerous studies showing the benefits as well as the risks involved in using SSRI’s. We neither endorse nor condemn the use of SSRI’s. There is a place for psychopharmacology in the holistic treatment of the person.
The next most common medical intervention for anxiety are benzodiazepines. These are the Xanax, Valium, Ativan’s of the medical world. These medications are extremely effective in reducing the intensity of anxiety in the moment.
They are symptom relievers. Not long term interventions.
Benzodiazepines are habit forming.
How are Benzodiazepines Useful Medications For Anxiety?
The most powerful impact that a benzodiazepine has in treating anxiety is that it has the potential to interrupt the cycle.
Remember that anxiety becomes stuck and “disordered” when we experience anxiety about anxiety. Then the edginess doesn’t seem to dissipate.
So when we can stop the cycle of anxiety about anxiety then we have chance to get in there and interrupt the process.
Many people use Benzo’s just to feel better in the moment. And the next time a panic attack or anxiety attack hits they take another Benzo. In this way they slowly fool themselves into believing that this is the only way to feel better.
When we use a Benzodiazepine intentionally (and use the momentary freedom from the cycle of anxiety to begin a new thought cycle), then we have the chance of interrupting the cycles for good.
The important thing to remember is that Benzo’s provide symptom relief. They do not treat the problem. But they do provide the space for you to start addressing the problem.
Another common medication prescribed for anxiety is Quetiapine (also known as Seroquel). This is another example of a psychiatric medication that is used off label.
Quetiapine is, in fact, an anti-psychotic. This normally freaks people out when they Google the medication they have been prescribed. So here’s the deal.
Quetiapine is used to treat psychosis in doses over 300mg. Anything less than that is usually not too effective. The amount prescribed in cases of anxiety is normally well under 200mg per day. Often only around 25-50mg per day. That is a significant difference.
Quetiapine for Anxiety
The action of Quetiapine is to block dopamine and, in effect, it also quietens racing thoughts. In some instances it has a sedating effect and can help you get that much needed rest. In other cases, it simply slows the brain down.
So this medication is particularly useful when you have racing, intrusive thoughts that keep you up into the wee hours of the morning.
An overlooked ‘pro’ of this medication is that it can be used when you need it – so not necessary to take it regularly. And it is not habit forming. So there is no chance of addiction and can be used in the longer term.
The side effects are most commonly drowsiness and a struggle to wake up in the morning. This can be overcome by taking a smaller dose, but some people just find it too sedating.
Are Medications The Right Choice For Me
This is a difficult question to answer because we can’t see inside the brain and ascertain whether there is, in fact, an imbalance of Serotonine or Dopamine. If we could, that would answer the question.
If you have a number of biological factors in your anxiety garden (please refer to this post to learn more about the anxiety garden) then medications may be very effective.
Medications provide the necessary break in the cycle so that you can do what needs to be done to alleviate the anxiety problem.
Sometimes our anxiety about anxiety gets so stuck that we just need a small break from it.
And the break is what is needed to start a new way of thinking and being with anxiety.
If you haven’t read our previous post on choosing the right interventions then head on over there now and discover how to identify the problem before choosing the solutions.
Now would be a good time to complete a self-audit for your anxiety – then now is the time: This will help you identify the potential interventions that will help you.