Posted by Viridis on April 7, 2003, at 23:22:09
In reply to Re: Correction: my worst DEPRESSION is anxiety-driven, posted by bretbe on April 7, 2003, at 17:11:29
It sort of becomes a "chicken-and-egg" issue. My GP (who seems fairly dense) asserted that there's no such thing as an anxiety disorder -- according to him, all anxiety is the result of depression, so antidepressants will almost invariably prevent anxiety. Period. When I responded badly to the ADs he prescribed (as I have in the past), he told me that since modern ADs don't have side effects, I must have a "psychological" problem and would be better off with counseling. But, the counselors I've seen generally wind up telling me that I seem quite "centered" and clearly need medication.
My psychiatrist is much more open-minded. He quickly diagnosed me with a primary anxiety disorder, and started with benzos. This helped tremendously, and continues to. When I brought up the issue of anxiety causing depression, he said that anxiety and depression are "inextricably intertwined", and it's often hard to sort out which comes first. In my case, he thinks I have both an anxiety disorder that can induce depression, and a general vulnerability to depression.
He did try very low-dose SSRIs at first but (as before) I reacted very negatively, even with benzos on board. When I told him what was happening, he said that I should stop the SSRIs immediately, and that they're apparently not appropriate for my brain chemistry. He does find them very effective for many patients, and told me that he's used them himself quite successfully for depression, although he did experience substantial side effects.
I have the added complication of (relatively mild) ADD, so we moved to stimulants. Adderall helped a lot with focus, in conjunction with Klonopin and occasional Xanax. When I told him that in addition to helping with ADD, the Adderall had a significant antidepressant effect, he said yes, that's no surprise, stimulants can be very effective ADs. But, apparently it's risky (legally) for doctors to prescribe them primarily for this purpose. So, in a strange way, I guess I'm lucky to have ADD.
Anyway, my pdoc at least recognizes that anxiety can be a cause of depression, although the relationship between the two conditions is not well understood since the two so often co-occur. I, too, wish that more attention would be paid to the anxiety population. Since we constitute a pretty large group (= market), I predict that this will happen, especially as many of the big-gun SSRIs etc. go off-patent.
poster:Viridis
thread:215674
URL: http://www.dr-bob.org/babble/20030407/msgs/217288.html