What Side Effects Will Anti-Anxiety and/or Anti-Depressant Medication Give Me?

Question:

Hello Jacob & Emma,

I came across your website last night and have been reading as much as possible on there over the evening and morning.

After five months of anxiety, I have found depression starting to creep in over the past month. I decided therefore it was time to take some medication. I have been taking Ativan off and on for a few months (0.5mg two or three times a week) but decided to start an SNRI (Pristiq).

My doctor suggested taking it at night because she’s found it’s generally sedating. I started last night and ended up not sleeping properly at all – up most of the night. I can’t exactly blame it on the antidepressant because I have had lots of other nights like this due to anxiety. So I don’t know if it’s the meds or the anxiety. All night I was obsessing over the medication and worried about side effects.

I suppose what I should do is just take Ativan at night to help me sleep but whenever I do I get a terrible guilt and worry about THOSE side effects. It’s like I’m in this terrible thought “rut” where I can’t make a decision because every outcome is disastrous. I’m worried that the Pristiq is going to make me “stoned” and not function at work. Or keep me up and make me exhausted.

Anyway I don’t know exactly why I’m telling you all of this other than I really enjoyed your site and it gave me comfort last night and maybe you have some advice for me as I start the Pristiq?

Dennis (Vancouver B.C)

Advice;

I went (and we all do who have dealt with anxiety) worry about the side effects of medication.

The truth (from the doctors I’ve spoken with) is that the amount of Ativan you are taking WILL
NOT cause side effects that can hurt you. I took at Ativan 3 times a day for 4 months at one
time and I never became addicted. So for now, when you take your Ativan at night don’t worry
about it because you are not going to get any bad side effects with that little of medication each
24 hour period.

Next thing is anti-anxiety or anti-depressant medication. These WILL not hurt you either. The
ONLY concern with these drugs is making sure you ween yourself off them very slowly when
that time comes. You may always take a small dosage of medication each evening or morning
for the rest of your life. Many people do, and that is OK TOO! I have spoken with multiple doctors
about the long term effect of Paxil for instance, and they ALL told me that a small dosage each
day can be taken for your entire life. One doctor went as far as saying that a small (10mg) dosage
daily for the rest of my life may EXTEND my life due to the positive effects of less stress and
they are starting to see a link between properly stimulated serotonin in the human brain and
longevity here on earth.

So my Advice is to take your medication when your doctor says to, and don’t worry about.
Especially in Canada. The medical system in Canada is very strict and the doctors well educated.
The only side effect from most of these drugs is a POSSIBLE little weight gain over time, so don’t
stress it.

If this drug does not work for you, try Paxil. I have been taking 10mg of Paxil daily for 8 years now
and there has been NO side effects except my weight went up 10 pounds, which I needed anyway.

Never forget that on small dosages you won’t have any huge side effects, and never forget that your
body is a miraculous instrument that will sort out all the issues on it’s own.

If you feel little brain swooshes when your medication is taking effect over the next two weeks, don’t
worry about it…..you will be fine.

YOU are going to be fine Dennis. You are living in an extremely good country as far as medical systems
go. Talk to your doctor, and you guys will find the right medication for you, and then everything is going
to level off and you will be doing fine. YOU WILL get through all of this. THIS WILL PASS!

Go for a walk today and get some fresh air. Pay special attention the trees, and fields, the streets, the
people, and the wonderful and historical piece of Vancouver you are currently living in. Breath the air in
deep and remember…..you are still here, and you have many good years to come in your life. Your mind
is going to settle down, and your body is going to be fine.

Take your Ativan a couple times a day until you find the right anti-anxiety/anti-depressant meds for you.
Don’t worry – twice a day will not hurt you. Don’t forget that. And don’t forget that you are not alone with
these fears, worries, and imagined “problems”. You are one of many many millions on this earth who
are or have dealt with exactly the same “stinkin thinkin”.

Now watch this video

Read A New Earth by Tolle as well. I found it really helped me calm down.

Response;

Thank you for the reassuring words. I will try to lighten up regarding Ativan as sleep is very important to me.

I started the Pristiq last night and today I am absolutely EXHAUSTED. I am scared because I don’t know how I will manage to work if this exhaustion continues. I’m not sure if it’s from the Pristiq or from being up so much last night (probably a combination).

I’m not at all worried about being on drugs for a long time, or the weaning off process. I think that sometimes medication is necessary and have no problem with this. My problem is that I worry to death about the side effects and don’t know if/when they will go away. One problem with Pristiq is the starting dose is the therapeutic dose – it only comes in 50mg. So I can’t “start small” and work up. I guess this is good and bad because if I can get through the first few days hopefully it will get better and then I don’t have to do a dosage increase.

Anyway, I am going to have a nap!

Thanks again for your help, I appreciate it so much. I don’t have anybody to talk to who knows what I’m going through and I feel like I’m driving my wife crazy complaining.

Dennis

Follow-up again;

Ah yes….naps are fantastic. Slows down the heart rate.

I also watch old feel good shows before my nap every day. Like
Beverly Hillbillies, whatever is safe and funny.

Yeah, and I drive my wife crazy too!!

Love Jacob

Tired, Fatigued, and Exhausted Starting Ant-Anxiety/Anti-Depression Meds;

Jacob, do you have any idea how long the exhaustion might last? Is it maybe just the first couple of days and then gets better? My problem is I have no idea how long to “tolerate” it. Or am I just being totally overanalyzing things after only one day!!

Advice;

You’re not overanalyzing things. It’s perfectly normal to feel some concern, but when I first started taking an anti-anxiety/anti-depression medication I was exhausted for the first 4-5 days. What’s happening is your body is still trying to maintain “fight or flight” and the medication is already beginning to help.

You are going to feel very tired, and yet you may not be able to sleep, so take the Ativan 2-3 times as your doctor prescribed for the first two weeks. That will enable some sleep, and you feel better knowing the Ativan option will help you.

I know this fatique – when you walk, it’s like you are walking through think mud. SOOOO….don’t walk around much. So what if you lay around, watch T.V., read, and nap for a week and half. So what. That’s perfectly OK. I know you will have to work and all that perhaps, but take a week off from work if you can, so you can lay around the house and chill for awhile.

Explain to your spouse what you are going through and she will understand why you are relaxing allot for this week going forward. The medication will take effect in a week and half, and guess what…..you are going to feel like yourself again. Then you won’t require Ativan very often, and maybe not at all.

When the medication has kicked in fully after a month, then you will sleep normal, eat normal, and THEN IT’S TIME TO START READING GOOD BOOKS and listening to information about how to turn off your mind.

No matter what you go through in the next two weeks, remember this; DON’T TAKE ANYTHING FEAR YOUR MIND COMES UP WITH SERIOUSLY! When your mind is inventing fears, or dwelling on real concerns it is not to be trusted. When you mind starting worrying about ANYTHING, just say to yourself, “I don’t believe that fear is real, and I don’t trust my mind when it worries. My mind is not an authority, and it knows nothing of truth when it’s worried. My mind is only connected to truth when it is admiring a blue sky, a tree, a loved one, and something GOOD.”

Only the good is the truth,and the bad is just the mind trying to control your day.

Tell your mind that it can’t go get stufffed for now. It can’t be trusted right now, and the fears it wants to create and dwell on are unto itself. Turn it off by watching an old movie, going for a walk, or whatever.

Nap whenever you feel to tired – so what if you sleep allot for a week. Pretty soon you are going to feel much better.

Jacob

More;

Thank you Jacob. This is extremely comforting. What’s so difficult is that I have two young children (5 and 2), and a demanding job. They are not very understanding so I feel I have to hide my problems at work. I work at a university and am not allowed to take time off between September and April, but if worst comes the worst I guess I could phone in sick for a couple of days. If the fatigue will go away in a few days I think I can stick it out. I guess I really owe it to myself to at least give it a week. If the exhaustion is still there then I might have to try something else. I will take the ativan to help sleep. I will watch that video later when I’m home, and I will try to ignore my fears and worries but that’s a tall order when the main worry and fear is actually legitimate – being able to cope at work and get my assignments etc. finished. (I’m also in the middle of doing a course with 3 weeks left and can’t get out of that).

Anyway I know I sound like a “whiner” and negative and I hope you don’t mind me emailing you. I’m sure you get tons of emails from your website so I appreciate that you took the time to answer mine.

Dennis