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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by CaffeinePoet on August 1, 2012, at 8:02:13
Hey guys,
I'm a 30something woman programmer. This summer, I've been working part-time at a nondemanding job while on the search for something more.
I am having a bout of severe anxiety this summer. The anxiety is like this mental static that impairs my ability to concentrate and my ability to feel okay about myself. The insecurity and high level of threat detection is making me feel very jealous around my live-in boyfriend, and is also making me sound negative to my mother and sister (who I see daily).
In good news, it is starting to look like shortly, I will be starting a complex short-term project as a programmer at a local hospital.
I am seeing the doctor this week. In the past, we would have reached for an SSRI or Effexor for this. In particular, Citalopram (SSRI) has been shown to work great for eliminating the <a href="http://www.ncbi.nlm.nih.gov/pubmed/15549278">threat bias</a> that I am currently experiencing.
But. . . there is a price for everything. As you guys know, anti-cholinergic drugs can effect <a href="http://www.huffingtonpost.com/leo-galland-md/memory-loss-drugs-_b_822245.html">memory</a>, especially short-term working memory. Effexor, Zoloft, and Prozac have all given me motivational and memory problems in the past. I need to be on top of my game for this project.
A short bout of benzos recently brought on depressive feelings, but I think the benzos could be brought on more slowly. But they don't reduce threat bias.
Any suggestions?
Posted by CaffeinePoet on August 1, 2012, at 8:20:10
In reply to ssri treatment that allows complex mental work?, posted by CaffeinePoet on August 1, 2012, at 8:02:13
Same message without the links that make it hard for some to read:
Hey guys,
I'm a 30something woman programmer. This summer, I've been working part-time at a nondemanding job while on the search for something more.
I am having a bout of severe anxiety this summer. The anxiety is like this mental static that impairs my ability to concentrate and my ability to feel okay about myself. The insecurity and high level of threat detection is making me feel very jealous around my live-in boyfriend, and is also making me sound negative to my mother and sister (who I see daily).
In good news, it is starting to look like shortly, I will be starting a complex short-term project as a programmer at a local hospital.
I am seeing the doctor this week. In the past, we would have reached for an SSRI or Effexor for this. In particular, Citalopram (SSRI) has been shown to work great for eliminating the threat bias that I am currently experiencing.
But. . . there is a price for everything. As you guys know, anti-cholinergic drugs can effect memory, especially short-term working memory. Effexor, Zoloft, and Prozac have all given me motivational and memory problems in the past. I need to be on top of my game for this project.
A short bout of benzos recently brought on depressive feelings, but I think the benzos could be brought on more slowly. But they don't reduce threat bias.
Any suggestions?
Posted by Phillipa on August 1, 2012, at 10:09:00
In reply to Re: ssri treatment that allows complex mental work?, posted by CaffeinePoet on August 1, 2012, at 8:20:10
Do you feel that once the job is in full swing that you will be so involved that this feeling will leave. Could it be anticipatory anxiety? Phillipa
Posted by CaffeinePoet on August 1, 2012, at 10:20:45
In reply to Re: ssri treatment that allows complex mental work? » CaffeinePoet, posted by Phillipa on August 1, 2012, at 10:09:00
> Do you feel that once the job is in full swing that you will be so involved that this feeling will leave. Could it be anticipatory anxiety? Phillipa
Phillipa you always have the most thoughtful ideas.
No, it's not anticipatory anxiety so much: it's the stress of losing a good job and then the financial stresses attached, plus lifelong generalized anxiety. Low dose clonazepam worked well in good times.
Posted by brynb on August 1, 2012, at 15:10:37
In reply to Re: ssri treatment that allows complex mental work?, posted by CaffeinePoet on August 1, 2012, at 8:20:10
congrats on the new position cp!
i've found celexa to be super helpful in this department (and lexapro, which i currently take). i used to take benzos habitually (actually, a lot more than habitually!) but only do so now infrequently, if i'm having a panic attack or if i'm too wound up. that said, being off of them actually made my anxiety better, and i definitely think that lexapro deserves some credit here. though i'm not currently employed, i work as a teacher and writer, and i'm able to concentrate and get work done while on lexapro (as long as my mood is controlled, i'm fine). perhaps you could try a low dose of celexa (or whichever sri) so that you don't get the cognitive side effects, but where you do get the anxiolytic benefits.
as an aside, i'm also a 30-something woman and i too see my mom and sister daily (we all live in the same apartment building). my mom only lives here part-time (she and my stepdad have another house), but i suspect her presence plays a big role in the anxiety/threat bias!
as for taking benzos, they certainly are second to none for acute anxiety, but unfortunately, they are definitely depressants on a regular basis. i found xanax to work well as a prn, with less depressive side effects.
good luck...
-b
Posted by g_g_g_unit on August 1, 2012, at 20:06:17
In reply to Re: ssri treatment that allows complex mental work?, posted by CaffeinePoet on August 1, 2012, at 8:20:10
what doses of Prozac/Zoloft were you taking?
5-10mg of Prozac or 25mg of Zoloft could benefit you without any cognitive impairment .. though at those doses, they may be more suited to depression than anxiety, I'm not sure ..
Posted by CaffeinePoet on August 1, 2012, at 23:07:27
In reply to Re: ssri treatment that allows complex mental work? » CaffeinePoet, posted by g_g_g_unit on August 1, 2012, at 20:06:17
> what doses of Prozac/Zoloft were you taking?
>
> 5-10mg of Prozac or 25mg of Zoloft could benefit you without any cognitive impairment .. though at those doses, they may be more suited to depression than anxiety, I'm not sure ..I think I took 20mg of Prozac and 50mg of Zoloft, so I was pretty well up there. Something to think about.
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