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When to seek support (meds)

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I have had a few bouts of major depression since my teen years. Each time, when I get to "that place" I know it's time to reach out and go on medication. I do, and it's always helped.

I've had a more challenging history with anxiety (or accepting that I have some kind of condition called "anxiety" in the first place, rather than simply reacting to life's challenges when there are, in fact, real consequences). In the past, I've suffered from social phobia and have had a lot of trouble interacting with people. It was always more pronounced in school settings where so much of life is centered around socializing and social expectation. Now that I'm older, I've accepted that I am a more introverted person (I know it's not the same thing, but for me the anxiety comes from not being what people expect in social situations) who simply doesn't tend to the same level of interaction as many others do. I'm not sure that I would even say that I have social anxiety, because I've accepted the level of interaction that I'm able to handle rather than trying to meet an external standard for what's considered normal.

But general anxiety remains a concern. When life is good and I'm able to do a lot to maintain my health: eat well, exercise, have regular chill days and spa time (yes, massages are part of it), and am not pressured to be out in the world too much, I don't get anxious. However...when life gets more difficult, when there are more demands on my time, when I don't have the time or money or flexibility to relax, I know I'm more at risk.

This goes double for when I get unexpected "upsets" in life. For instance...recently, my job informed us that instead of having a flexible work policy, we're going to be required to work on site at all times. While I realize that, in 2018, being able to work remotely is seen as a privilege rather than a right...I credit that flexibility almost entirely for allowing me to hold down a job while coming out of my most recent depression as well as preventing a relapse. In addition to having to be in the office all the time in the near future, my finances have gotten very tight and I will likely have to pick up at least one second job or project outside of my full-time, in the office schedule. This past week, my anxiety has shot up just thinking about it.

There's a final side to the story. I have been tracking my moods for several months now and have noticed that, when external pressures are minimal, I only suffer from periods of anxiety and depression during certain parts of my menstrual cycle (and may have some form of PMDD or my mood is being affected by hormonal changes). I may seek non-psychiatric treatment for this, but this will take time (I've been bounced back and forth between gyns and psych docs on these symptoms for years but I now have proof and records that I didn't have before).

In the meantime, I'm most concerned with keeping up with life changes in the coming months, managing my anxiety, and preventing a relapse into major depression.

So...my question is...when do you know it's time to seek support in the form of medication for anxiety? I'm hesitant to jump back on anxiety meds right now (the last thing I was prescribed specifically for anxiety was clonazepam, and that was on an as-needed basis when I was in school and had to do presentations, etc.) as I want to consult with a specialist about my cycle-related symptoms, and taking an anxiety med might impact this...nor do I want to react rashly after having really just one bad week. I just re-started therapy a few weeks ago (fortunately, as I was actually doing better in a lot of ways, then last week was sort of a crash and burn), so I still haven't given it time as an option for coping.

I don't expect anyone to give medical advice or a definitive answer...just thoughts on the kinds of factors you consider when you're in a similar spot. With depression, it's always quite clear to me when I need help, but my anxiety is so impacted by external circumstances (which can change, week to week, month to month...heck, even hour to hour sometimes)... 

Edited by cassis_creme
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I'm really not sure on the answer to this but I know that my anxiety is causing major life disruptions as in - I need to get a job, and other things.  I finally made a counseling appointment today.  Took Lexapro and it helped a lot with my anxiety before.

Hang in there and listen to your body/mind.  If you are questioning getting help then maybe you should.  You can always ask your therapist at your next appointment?

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  • 2 weeks later...

Hello again,

I'm doing OK for now...I did decide to go back on the medication that I'd been taking before while I wait and find out about the new treatment option. It worked fine for a couple of weeks, but Friday I had one of the breakdowns/crying spells that I've come to associate with the worst of my cycle-related "danger days" (there are about 5 days every month where my anxiety and nerves peak and I'm extremely sensitive to stress and high pressure situations..and I mean extremely so...I'm like a tinderbox)...it seems like the stress of suddenly having to be in the office every day on top of deadlines built up and just came pouring out. There was nothing I could do to stop it once it started, I just had to let it flow. Luckily I was able to take a lunch break and could go somewhere private rather than ending up in tears in the middle of the office. Having the flexibility to work remotely really did make a huge difference in my ability to manage my stress level and minimize or prevent such breakdowns.

But I had the crisis, pulled myself together, and pushed through the rest of that miserable workday. And felt much better after a good night's rest (finally! I'm so exhausted at the end of an all-office workweek) and a restful day yesterday. Now I'm back to dreading the start of the workweek again tomorrow. I have about 2 more "danger days" to go...

I'm praying a lot...this breakdown made it clear to me that the situation that I'm in is not sustainable long-term and hopefully a solution will come though a combination of better treatment and work options in the future. Understanding just where the danger days hit has helped a lot too, though. For years, I thought I just wasn't "cut out" for certain levels of intensity, particularly related to work. That still may be true to an extent but at least I've identified many of my worst days as the unfortunate crosshairs of hormones and stress. Therapy is also a God-send right now...it gives me that place to "exhale" about everything that weighs me down.

Edited by cassis_creme
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