Venting anxiety is so much worse than i thought

[jigsaw_falling]

'anxiety' is one of those words that gets thrown around a lot, because of course everyone is anxious sometimes. so, in the past when people have said they suffer from anxiety or social anxiety, i really didn't understand how much that could effect them.

now i have awful anxiety, mainly social anxiety, and it's literally ruining my life. school is literally unbearable, panic attacks and breakdowns in class and in the bathroom every day. it makes me isolate myself, and honestly has made my suicidal ideation become so much stronger, to the point it's the only thing i think about.

i saw a psychiatrist this week, and got prescribed escitalopram for the anxiety. i was honestly so relived, because i don't think i can continue functioning with this much stress and self hatred and panic. but, looking into the side effects of antidepressants, weight gain is a potential one. i broke down while reading about how that probably won't, but MIGHT happen.
my psych doesn't want to prescribe me the one type of antidepressant that's not linked at all with weight gain, so i feel like my way of making life more unbearable is gone.
im just too terrified of putting on a lot of weight through taking meds, i cant bring myself to try.

im not making any progress in therapy, and lying to my therapist. and now i can't even manage my levels of anxiety. this sucks, i just want to go

 

[d3c96524be95]

I'm sorry for what you are going through. I think this thread would be a better fit in the Recovery section because it seems that you're trying your best to get better in spite of your suicidal thoughts. I think that's very brave of you. Back when I was at school, I would puke almost each morning out of anxiety (social anxiety + atychiphobia). Every so often, I would cry in class and in front of all my schoolmates because I was so anxious, shameful and sad. It's probably hardly comparable to your situation right now, but I think I can at least have a rough glimpse of what you're enduring.

It seems that among all the adverse events of Escitalopram, you are mostly worried about the weight gain. It's a shame doctors are constantly minimizing the adverse events of medications. I know by experience that adverse events can be very incapacitating, to the point where they're just an additional burden to an already shitty life. Therefore, I find that your fear is very understandable and I think it should be heard and addressed.

The good news is that among all the adverse events of Escitalopram, the weight gain is certainly one of which you have the most control on. AFAIK, the weight gain is not due to a physiological change that'd make your body magically generate more fat out of thin air. It mostly comes from changes in eating habits induced by changes in serotonin levels in your brain that are known to affect appetite. If you monitor closely what you eat, eat balanced meals, avoid overeating, avoid snacks, avoid carbohydrate-rich food, avoid glucose, you should not be gaining weight (and you might even lose some weight just because you'll start paying more attention than before to what you eat). Put another way, if you eat the exact same things in the exact same quantities as before, you should *not* be gaining weight with Escitalopram.

Now, this is theory. In practice, I've found it quite difficult to stick to this when taking those medications because my body was really constantly craving for food. I felt both that I had lost the sensation of "fullness" and also that I was constantly hungry. It might depend a lot from one person to another, but dismissing the urge to eat surely requires some kind of willpower. Also, setting an objective boundary between eating normally and overeating is not as easy as it may seem, especially if you were not paying a lot of attention beforehand on your eating habits. In my case, Escitalopram definitely made me more prone to binge-eating (I'm usually borderline-anorexic), and more prone to desiring sweet food. The latter issue was the easiest to fix because I could just remove any sweet food from my shopping list (and that's an habit I kept after stopping these medications btw). The former issue was harder to mitigate however. You have to acknowledge that you cannot trust your body anymore for telling you when you're full and when you're hungry. You need to differentiate the sensation of "feeling hungry" and the sensation of actually "being hungry" (this is probably unclear, but it's really how I experienced it). After a few weeks, I felt that I got used to this and that it was not a relevant issue with Escitalopram for me anymore. I did not gain any weight under Escitalopram, and I'm pretty confident it was mostly due to the increased surveillance I sticked to. But again, it might vary from one person to another. For instance, some predispositions to compulsive eating behaviors are genetic.

Also note that although Escitalopram is indeed associated with gain weight, it is far from the worst in this respect. I had a way harder time controlling my binge-eating tendency with other molecules (such as quetiapine, luthium, amitriptyline or mirtazapine). I had other very problematic issues with Escitalopram (the most problematic one would only affect men, so probably not relevant for you), but the weight gain was definitely not a major concern once I got used to it and was properly informed of the risks and workarounds.

If you're mostly struggling with your anxiety right now, I think anti-depressants can indeed help you if adverse events are bearable. Depending on your personal situation, it might also be worse starting a CBT which sometimes offers good results against phobia and anxiety. It's definitely a long and hard process and it will surely not solve everything, but it's also possible that it can help you, even very slightly.

Hope that helps.

 

[FuneralCry]

It sounds really horrible and tiring being trapped in that situation, existing certainly can be torture, and it's understandable just wishing to be gone. But anyway, I wish you the best.

 

[jigsaw_falling]

I'm sorry for what you are going through. I think this thread would be a better fit in the Recovery section because it seems that you're trying your best to get better in spite of your suicidal thoughts. I think that's very brave of you. Back when I was at school, I would puke almost each morning out of anxiety (social anxiety + atychiphobia). Every so often, I would cry in class and in front of all my schoolmates because I was so anxious, shameful and sad. It's probably hardly comparable to your situation right now, but I think I can at least have a rough glimpse of what you're enduring.

It seems that among all the adverse events of Escitalopram, you are mostly worried about the weight gain. It's a shame doctors are constantly minimizing the adverse events of medications. I know by experience that adverse events can be very incapacitating, to the point where they're just an additional burden to an already shitty life. Therefore, I find that your fear is very understandable and I think it should be heard and addressed.

The good news is that among all the adverse events of Escitalopram, the weight gain is certainly one of which you have the most control on. AFAIK, the weight gain is not due to a physiological change that'd make your body magically generate more fat out of thin air. It mostly comes from changes in eating habits induced by changes in serotonin levels in your brain that are known to affect appetite. If you monitor closely what you eat, eat balanced meals, avoid overeating, avoid snacks, avoid carbohydrate-rich food, avoid glucose, you should not be gaining weight (and you might even lose some weight just because you'll start paying more attention than before to what you eat). Put another way, if you eat the exact same things in the exact same quantities as before, you should *not* be gaining weight with Escitalopram.

Now, this is theory. In practice, I've found it quite difficult to stick to this when taking those medications because my body was really constantly craving for food. I felt both that I had lost the sensation of "fullness" and also that I was constantly hungry. It might depend a lot from one person to another, but dismissing the urge to eat surely requires some kind of willpower. Also, setting an objective boundary between eating normally and overeating is not as easy as it may seem, especially if you were not paying a lot of attention beforehand on your eating habits. In my case, Escitalopram definitely made me more prone to binge-eating (I'm usually borderline-anorexic), and more prone to desiring sweet food. The latter issue was the easiest to fix because I could just remove any sweet food from my shopping list (and that's an habit I kept after stopping these medications btw). The former issue was harder to mitigate however. You have to acknowledge that you cannot trust your body anymore for telling you when you're full and when you're hungry. You need to differentiate the sensation of "feeling hungry" and the sensation of actually "being hungry" (this is probably unclear, but it's really how I experienced it). After a few weeks, I felt that I got used to this and that it was not a relevant issue with Escitalopram for me anymore. I did not gain any weight under Escitalopram, and I'm pretty confident it was mostly due to the increased surveillance I sticked to. But again, it might vary from one person to another. For instance, some predispositions to compulsive eating behaviors are genetic.

Also note that although Escitalopram is indeed associated with gain weight, it is far from the worst in this respect. I had a way harder time controlling my binge-eating tendency with other molecules (such as quetiapine, luthium, amitriptyline or mirtazapine). I had other very problematic issues with Escitalopram (the most problematic one would only affect men, so probably not relevant for you), but the weight gain was definitely not a major concern once I got used to it and was properly informed of the risks and workarounds.

If you're mostly struggling with your anxiety right now, I think anti-depressants can indeed help you if adverse events are bearable. Depending on your personal situation, it might also be worse starting a CBT which sometimes offers good results against phobia and anxiety. It's definitely a long and hard process and it will surely not solve everything, but it's also possible that it can help you, even very slightly.

Hope that helps.

thank you, and it is actually reassuring to know i won't magically just gain weight out of nowhere. still, i'm just honestly scared, because i struggle with both eating too little and eating too much, and i'm worried about if the meds will increase my chances of binges. but i am considering taking the meds, because as long as there's a way to manage this potential side effect, i probably shouldn't be eliminating taking meds that could make my life a lot better.
thank you a lot for the advice, sorry for the late reply:)