next »

[etheldred]

I've posted here before, but this is a sock. I'm a grad student. This isn't my first grad degree. I've always had the occasional slump, but it never seemed like a big deal or reached the point where I sought help. I functioned fine. I did my work. I did well. I could complete long projects to deadline. I taught, and got good evaluations. I interacted normally with the world.

In August, again in November, again in December, and again now, I've fallen into this state of anxiety and complete paralysis and sort of flat misery. I'm not functioning. Like, really, self-destruct levels not functioning. The new semester is starting and I have papers undone from last semester and I can't even bring myself to open my e-mail and look at how I'm flunking out. I'm not leaving the apartment and living on carrot sticks dipped in peanut butter. Stopped my hobbies, stopped going to church, stopped meeting friends or returning e-mails or answering the phone. I just got dressed and put on my coat to go to class and then burst into tears and almost threw up and couldn't get out the door.

The weird thing is that I think I seem completely normal when I just fall into functioning by accident or am forced to -- if I run into someone at the store, if I do make it to class, I talk and I seem fine. But it's like it's just one layer working and the rest is stuck. I've always been a fluent writer, I've written a 350 page dissertation, now I stare at the file for a ten-page paper and I. Just. Can't.

I finally, after a two-month waiting period, have an appointment with the counseling services Monday, but it's not like they can magically fix me. I can't take a leave if I can't manage school -- I don't have money to live on without my funding, or health insurance without my student status. I'm terrified. This has never happened before, not remotely like this. There's mental health history in my family, but I mostly seemed fine (I'm in my thirties).

Sorry to vent.

Am I going to make it through this? Anyone else had the onset of this kind of condition at the almost middle-aged point? What if my life falls irreparably to pieces?

[prof_smartypants]

Go see a doctor. One who can prescribe meds. I just got on anti-anxiety meds about a year ago, and wish I'd done so in grad school (hell, college). I found the school counselor to be completely useless. I didn't need someone to talk to - I needed something to make my brain stop running on overdrive 24 hours a day.

My GP listened to me for about 5 minutes before he knew what was going on, and prescribed anxiety meds. I'm no doctor, so I can only share my experience. I suggest you go see a real one. Pronto.

[chaosbydesign]

I agree with Smarty, definitely go see a doctor. I wouldn't rule out seeing a therapist, either.

I started taking meds and seeing a psychotherapist last year and although it hasn't been easy at times, it's the best thing I could have done.

[etheldred]

Thanks for the replies. The counseling services is the psychiatric and therapy wing of the medical services -- wouldn't it get confusing if I went to the regular medical services and had a doctor there prescribing and was dealing with a psychiatrist in the counseling services as well? Or is that how these things normally work? I don't have a regular, trusted GP who knows me here -- I haven't been here long and haven't been sick before now.

[prof_smartypants]

Thanks for the replies. The counseling services is the psychiatric and therapy wing of the medical services -- wouldn't it get confusing if I went to the regular medical services and had a doctor there prescribing and was dealing with a psychiatrist in the counseling services as well? Or is that how these things normally work? I don't have a regular, trusted GP who knows me here -- I haven't been here long and haven't been sick before now.

I went to see a new doc (I had just moved to my new job in Mountain Town). Go see the counselor and see what he/she says. Even if you just go to the university hospital, you should be able to see any doctor and discuss your symptoms.

Oh, and I didn't mean to make it sound like I was dismissing counseling or therapy - It was just not helpful for ME.

[chaosbydesign]

It shouldn't matter which GP you go to. I don't know what the procedures are where you are, but I went to a GP who then referred me to the hospital psychiatry department.

[dizietsma]

Empathetic vibes from me to you. I'm a bit the same; swings and roundabouts until I'm just stuck in a ditch.
Chime on the prescription, and the therapy.

I just wanted to mention St John's Wort. My doctor suggested/prescribed it for me. There's good data on its effectiveness for mild to moderate depression, and it worked for me. There are very few side effects, the only one I notice is that it makes hormonal contraception ineffective. It really works for me.

But I would say you should talk about your state of mind with a prescribing professional first- you might need something stronger to treat you first. Another maintenance/prevention/mild adjustment strategy is sunlight, exercise, vitamins and fish oil. This I read in the Times (London or NY, can't remember).

Best of luck.

[voxprincipalis]

Thanks for the replies. The counseling services is the psychiatric and therapy wing of the medical services -- wouldn't it get confusing if I went to the regular medical services and had a doctor there prescribing and was dealing with a psychiatrist in the counseling services as well? Or is that how these things normally work? I don't have a regular, trusted GP who knows me here -- I haven't been here long and haven't been sick before now.

Are you in the US? Psychiatrists can prescribe meds (and some also do talk therapy). You can also get a therapist or counselor if you want more talk therapy. It usually works out fine. In my non-medical opinion (but as someone who has struggled with depression and anxiety for some time), meds definitely seem indicated to triage your current condition. The first thing to do is to stop the wonky brain chemistry. Then you can sort out the rest. Talk therapy is helpful for a lot of people, but alternative methods work better for others. (We have a thread on that around here somewhere.)

The first thing to do is stop the bleeding, though. Get an appointment with a psych forthwith.

VP

[bibliologos]

Oh, hell, yeah.  This is my world too.

Evidence-based studies, which I've seen cited, but which I'm too lazy to look up now, say that a combination of meds and talk therapy is most effective.  I went with meds first, but they only do so much; then I also needed therapy.  Still do.

Oh, and what kicked me out of my dissertation depression was getting pregnant.  A whole new batch of hormones that allowed me to get the diss done.  That is now not an option (well, technically I guess it is, but practically it isn't a great solution).  So meds and therapy it is.  Two and a half years on meds, a year and a half with therapy.  So far.

[readandwept]

I'm so sorry that you're experiencing this. It's a really good thing that you're seeking help, and I imagine that wasn't easy to do, so I think you should feel proud of yourself for mobilizing the energy and courage to do it.

And, I hope I won't be adding to your anxiety with a dissenting voice, but since the advice to get onto meds ASAP has been so unanimous I do want to offer a different perspective -- at least about benzodiazepines, the class of anti-anxiety drugs that I think you are likely to be prescribed unless you discuss with your doctor wanting something different. A close relative of mine was prescribed benzodiazepines (Klonopin, mostly) for panic attacks and has had an absolutely horrific experience. I don't want to give a full accounting of it here but I will say that the drugs are officially recommended only for short-term use, but are very widely prescribed for long periods of time; they are highly addictive in a large subset of patients, which causes its own set of problems; and they may cause brain damage. Some people's experience with these drugs is very positive for their lives, but some is really horrible and long-lasting. Given my family's experiences, I can't be so sanguine about what the consequences of going on benzodiazepines might be. I would seek out other, less addictive drugs. I would not necessarily take a doctor's first drug suggestion without a lot of questions.

Is there anyone close to you who can help you to navigate this process?

[voxprincipalis]

And, I hope I won't be adding to your anxiety with a dissenting voice, but since the advice to get onto meds ASAP has been so unanimous I do want to offer a different perspective -- at least about benzodiazepines, the class of anti-anxiety drugs that I think you are likely to be prescribed

Not to detract from readandwept's well-taken advice about care with benzos, but I'd be surprised if the first meds recommended weren't some kind of SSRI, given that symptoms of both anxiety and depression (which are related) are present.

Which is just to say, OP, that you will probably have several medication options and you should definitely discuss with your doctor the potential benefits and risks of each, as readandwept wisely suggests.

VP

[merinoblue]

Thanks for the replies. The counseling services is the psychiatric and therapy wing of the medical services -- wouldn't it get confusing if I went to the regular medical services and had a doctor there prescribing and was dealing with a psychiatrist in the counseling services as well? Or is that how these things normally work? I don't have a regular, trusted GP who knows me here -- I haven't been here long and haven't been sick before now.

Go to both. Take advantage of all the services that are available to you. Tell the GP about the psychiatrist in counselling services, and the psychiatrist about the GP, so they can coordinate and they can be informed about what treatment each is offering.  It is also very handy to see both simply because everyone assesses and treats differently. You may find you prefer the treatment one offers you over the other. It's good to have options.

I experienced a trauma during my PhD that set off a mid-life crisis and turned my life upside down. I needed every mental health resource I could get my hands on to cope and finish the degree, but I did it. You will get through this. Please PM me if you'd like someone to talk to.

[navelgazer]

I did talk therapy for a year, then went to a psychiatrist, and now continue to do both. Most psychiatrists that I know of (who take insurance at least) do a one hour intake interview with you and then check in for 15 minutes every month to three months. I talked to GPs several times, and it was my experience that they couldn't recognize or care about the kind of pervasive anxiety I have. If you're having panic attacks, that would be different, but they might just give you a klonopin and say "see you later hun."

In my one hour intake interview she asked TOTALLY different questions than my talk therapist ever had. They were more about the past and less about the present. So, yeah, I've suffered from pretty pervasive anxiety from at least when I hit puberty and structured my entire life around not having to deal with it.

I doubt you'll get benzos unless you're having just panic attacks. You might get some in addition to an SSRI. I was expecting to get an SSRI, but I was given Lamotrigine instead (which hey, now has a new warning about meningitis AWESOME http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000957). It works really well. By August I felt like a new me.

[merce]

I think it depends on your institution what kind of medical professionals you will have on campus so perhaps that is why some suggest a GP for meds rather than a counselor.

If you are going to your mental health side of your medical facility in the way you described in your later post I think they will talk to you and figure out that (not if actually) meds will be something you should consider.

You could read up on the different types (like SSRIs that were mentioned here) before going in.

Even if I didn't feel the effects of meds when just going in to see someone for the first time, I did feel better just for having been proactive, having gotten out of bed, having sought a solution.  I just know you'll feel the same. I do both therapy and drugs.  In general my GPs have been thoughtful to not-so-thoughtful but have always said they don't feel comfortable going into the psychiatrist's terrain as they are the one's who prescribe drugs for mental health with the most knowledge.

[navelgazer]

Anxiety spike beginning Saturday. Happy fun times.