What do you define as “extreme anxiety”

[BeeilderedOtter]

If you’re averse to medication in all circumstances besides near death, why did you accept the prescription? Ask your prescriber why they think you need a medication that you don’t think you need.

If you can work through anxiety, function, and appear normal, you’re nowhere near “extreme” anxiety. That involves panic attacks, disassociation, getting stuck in fight/flight/freeze— and lacking the perspective to get back easily on your own. If you’re getting to the point where your coping skills don’t work because you have lost perspective, that is when medication can help, taken as needed. If you get that bad often enough that it interferes with your ability to function, it may be worth having them on hand. If you don’t, count yourself fortunate and have a frank discussion with your prescriber about why they’re giving you access to a controlled substance you don’t need.

 

[Warrior Chicken]

I did not write in my post as you’ve written here that I’m “averse to medication in all circumstances besides near death”.

I wrote:

I don’t like medications, took me quite some time to even consider their use as a method to treat ptsd. But my train of thought has adapted somewhat.

I agree with you that a conversation with any prescriber about the nature and intention of any controlled substance prescribed is important, and one that every patient would benefit from.

 

[user27357]

Same. Which is why if I would have to take them every day? I don’t take them at all. Either it works as a short sharp jerk on the leash, or it doesn’t.

Aaand today i was told to take my benzos like a good patient because we aren't giving you anything else until it stops working. Altogether. until it stops working.
So, once told to use sparingly and I did. Now taking them as prescribed which I guess is a math problem, x=total days divided by the total prescription in units, solve for x.
Screw that, I need a bigger jerk on the leash, less often, they want me to get smaller and smaller jerks more often (as needed) (needed every day these days) (why bother?)

 

[coraxxx]

Aaand today i was told to take my benzos like a good patient because we aren't giving you anything else until it stops working. Altogether. until it stops working.
So, once told to use sparingly and I did. Now taking them as prescribed which I guess is a math problem, x=total days divided by the total prescription in units, solve for x.
Screw that, I need a bigger jerk on the leash, less often, they want me to get smaller and smaller jerks more often (as needed) (needed every day these days) (why bother?)

Only you can know if it's adequate or not. I had a recent struggle from getting out of Ativan after 1 year of taking it between 2.5 and 10mg a day, which was really heavy but managed to get rid of it in a couple of months. It has been useful for the time it was used.

Depending on the type of benzo its half life and your degree of anxiety it might be worth following that line of treatment or not. For now much of the theory is that it shouldn't be prescribed as first intention and avoid long term use as much as possible but again depending on your case that might be impossible to implement. Going up to the point it "stops working" feels a bit risky to me since after benzos stop working no many things will work and you can't get off them just as that. Now I also do think it's a useful medication so it's not as if I was challenging that idea but if I were you I'd like to ask some questions on how they intend to manage the moment it's not working anymore and what they expect to do for improving your condition outside of the chemical engineering.

 

[user27357]

improving your condition outside of the chemical engineering

I agree with all you said. As far as improvement- most of the improvement would be to alter my life situations and that's not going to happen. Inpatient care has occurred to me but I am not suicidal so I probably wouldn't get a spot and besides, I am taking care of my wife when I am not working. I am living two lives on top of each other and it is nearing a place where it has to stop, somehow, but it isn't going to be through a drug prescription, that's clear. My recent foray into extreme anxiety was from worrying about a premature grandson and not being able to see him in the hospital at all and then being respectful of my son's wishes and staying clear until his lungs are a little further along. I saw him last weekend. Before that there were days when I couldn't remember his name because I had no choice but to compartmentalize the stress and even thinking about his name was a head full. grandpa isn't supposed to be wired this way, it was extreme anxiety not knowing if he was going to make it. I think I am just a little bit stuck here. He is 3 months old and it still chokes me up to think about his fight.
I have a week off in 2 weeks. And a full bottle of xanax. Good to go.

 

[Friday]

Screw that, I need a bigger jerk on the leash, less often, they want me to get smaller and smaller jerks more often (as needed) (needed every day these days) (why bother?)

Clearly, I agree.

However?

we aren't giving you anything else until it stops working.

The strikes out part is important, and will follow!

“Until it stops working” are my doc’s 30+ year opiate plan for me… to avoid total joint replacement 1) until I’m in my 50s and they can actually perform the surgeries ethically 2) for as long as possible after that to delay surgery. As joint replacement has to be redone every 10 years, or so.

“Until it stops working” is far more typically a short term addiction vector; increasing, increasing, increasing… attempting to get the same result with higher and higher doseages. Then either doing a fast & dirty tolerance lower (like with certain types of cancer, particularly childhood cancers, so that they can start over, getting the same results with lower doses)… or …the most common way people become addicted to Rx’s and then -usually- have to stay off of them the rest of their lives.

But? It can also be a long term treatment plan… by taking deliberate steps to keep tolerance levels low.

Which means that sometimes? I’ve taken more opiates in 3 days than I usually take in a month (acute injury, surgery, etc.). Ditto, that I’ve very occasionally gone months taking opiates 24/7 at reeeeeeeeally rather high dose/freq… and then taper down (not off), until I’m back at my intermittant/low dose low tolerance norm.

^^^
The most difficult thing I’ve found with any medication that has high addiction potential -aside from the addiction itself- is actually politics/pop-culture.

Like the recent All. Opiates. BAD. popCulture nonsense. Even people on freaking palliative care have been denied pain meds, much less the people like me for whom it’s a quality of life issue. And we’re talking seeeerious quality of life stuff, like the ability to work, or exercise; the ability to both earn a living, and be physically fit/healthy… just thrown out the window for “go on disability, making 10% of what you could make, actually working… and, oh yeah, become a fat/unhealthy couch potato with serious health issues due to forced sedentary life”.

FORTUNATELY a) my docs are good enough we just periodically do the 6 months no meds, whilst we jump through all the legal hoops b) I’m not so f*cked up I lose everything (job/home/relationships/health) during that time period, I’m “just” losing 6 months to a seriously proscribed life c) I’m not -usually- so f*cked up that any time off of them are “lost” hours/days/weeks as I’m curled up unable to do anything but breathe through & distract myself from the pain d) I go on med holidays all the durn time, anyway, so it’s not a new thing (and rather as seeing those holidays as a proscribed life? I see them as my baseline that I GET to step away from, and lead a full/active/amazing life.

But the politics are crazy making. I can’t even discuss the ping pong ball in a tumble dryer aspect of the court of public opinion & legislators wanting to play doctor, and how those whackadoodle entities effect real life… without us being here all day. Besides. I’m sure you’re more than aware & have lived them, your own self.

***
So it CAN be a long term plan.

Just doesn’t sound that’s what your docs have in mind. Because… WTF is up with this “no other options until” business?!? Speaking of crazy making!

 

[user27357]

@Friday I have been on the long term opiates fiasco too, happily I have had corrective surgeries and treatments that have made them unnecessary until all of my past symptoms came roaring back after a particularly stressful event a few years back, involving my wifes ordeal with her own trauma. You may remember that, you have replied on my posts in the past. I lived basically 2 years of extreme anxiety first over the sudden turn my marriage was taking and then the stress of knowing why but not being able to alter any of the reasons. When I tried giving the deluge of opiates I was on up cold turkey, I recovered quite nicely. I thought I was dieing, in fact, I was. First from prolonged extreme anxiety and then the opiates that appeased my bodies attempt to stop the effects of all that stress.
I don't like the idea of saturating and withdrawing cycles at all, but I gotta do what I can to stay somewhat sane and functional and right now thats be a good patient and take your xanax, good night nurse. six months from now I may be on another withdrawal cycle but stopping right now is not an option. It just isn't.

 

[user27357]

my god, the original question is how do you define extreme anxiety and i guess I have to change my answer. I said awhile back that extreme was where I went when the crap hit the blowers, but now I see it happening because I just can't slog another mile in this knee deep crap, nowhere near the fans and if approached one step at a time just a walk in the crap- until you just can't do that anymore and then either me or my body will start doing what we do, survive by finding a way out or over or around the worst of the crap. We are still slogging but definitely feeling anxiety in the extreme about SO MANY STEPS, SO MUCH CRAP!

 

[coraxxx]

Yeah there are days you just feel like every time you wake up you make yourself a shit sandwich and eat it will all pain and helplessness. I'm sorry you're in that situation it really sounds super harsh.

Also agree with Friday on the f*cking crazy making policies about addictive medications, it actually prevents people from looking for reasonable solutions. Because of this I was left in benzo withdrawal and doctor after doctor refused to provide treatment until I had to find a damn military psychiatrist who was like oh okay it's better you not to drop dead or explode while flying. I'm civilian. To other doctors, every one of them lectured me about how benzos shouldn't be first intention and how my psychiatrist was wrong to prescribe them long term.

As much as the side effects of haze with Ativan were, I don't think I would have been anywhere near to be able to pass through a year of batshit insane shit with no means of changing my situation in short or midterm. I didn't like the withdrawal and it could have been avoided. But finding myself at new doctors and having to explain the reasons I got so deep in it every time, it's just something extremely dire for patients and dismissive of their experiences, it's not okay. There is always this assumption that being addicted means you're weak, that it's wrong, that you shouldn't, blah blah blah. Truth is sometimes it's far from being the worst choice. Much better to be in a haze for a couple of years than to go berserk and blow your life up. If the medication, even addictive, helps you to keep function, then it's working. If it's starting to prevent you to have function, then it's time to try something else. But it's not a matter of defining whether or not a medication is good or bad in itself.

In any case what's important is the globality of the treatment. Normally you'd be trying to improve in all fronts. Medication to give you some buffer and dull the edges of the blade for a moment, CBT or talk therapy to sort things out and implement better patterns, and gradual improvement or changing of the situation that is causing the problem. And yeah as long as you're stuck in severe anxiety benzos make a lot of sense.

But it's important you can discuss the question in depth with that doctor, no matter what kind of drug or treatment it is it's the kind of "defaulting to" vibe they're giving that I don't like here.

 

[Survivor3]

I had extreme anxiety yesterday for several hours. I was literally scared shitless . Took medication early to counteract it. It feels bloody awful. Just kept saying to myself "suck it up and get through it". f*ck that

 

[Bigmess]

my god, the original question is how do you define extreme anxiety and i guess I have to change my answer. I said awhile back that extreme was where I went when the crap hit the blowers, but now I see it happening because I just can't slog another mile in this knee deep crap, nowhere near the fans and if approached one step at a time just a walk in the crap- until you just can't do that anymore and then either me or my body will start doing what we do, survive by finding a way out or over or around the worst of the crap. We are still slogging but definitely feeling anxiety in the extreme about SO MANY STEPS, SO MUCH CRAP!

Now that gross example I feel all too well, it's almost like always throws the most crap your way when you need it the least in the situation. I used to be a heavy kratom user but stopped gradually towards the end of the Summer. I've over time made a lot of advances in my personal health physically and mentally but there is always the undercurrent of PTSD. I always feel like I'm either in danger or running out of time before the next big disaster whatever it may be. This year for me personally has been an absolute roller coaster. Sometimes the only thing that keeps me fighting is knowing that there is nothing else to do but this also makes me extremely aggressive. You just can't win sometimes. But if I take it easy too much this makes me a bigger target, so often i find myself subconsciously defaulting to hyper vigilance, minimizing my presence, and working on things in my life like I'm planning to escape from behind enemy lines instead of just solving day to problems or doing a personal project Everything I'm doing seems to have that pattern of self improvement + stability, I'm rarely just doing something because I enjoy it which I think is what keeps me away from just simply enjoying a lot of things in general casually save for music which I have a million reasons for enjoying. It's so unhealthy but it feels like there is little other options when you're still not actually safe all the time and need to actively maintain safety.