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Displaying items by tag: Generalized Anxiety Disorder


Selective serotonin reuptake inhibitors (SSRIs) are the first-line intervention for many psychiatric disorders including major depressive disorder (MDD) and generalized anxiety disorder (GAD). These drugs work by inhibiting the reuptake of serotonin leading to increased serotonin transmission. Enhanced serotonin transmission improves mood and personality. The Food and Drugs Administration (FDA) has approved several SSRIs for treating depression in adolescents and adults. These drugs include fluoxetine, sertraline, citalopram, and paroxetine. Some of these drugs are also approved for treating GAD.

            Patients diagnosed with MDD exhibit a persistent pattern of low mood and loss of interest in usual activities (anhedonia). The common characteristics of low mood include persistent feelings of sadness, emptiness, or worthlessness. Other common symptoms of depression include sleeping difficulties, persistent fatigue or lack of energy, poor appetite, frequent anger outbursts, and impaired thinking and concentration. On the other hand, patients with GAD exhibit a persistent pattern of excessive worrying and anxiety regarding everyday activities. A person with GAD will exhibit restlessness, difficulty concentrating, indecisiveness, and perceiving usual situations as threatening.

            Fluoxetine (Prozac) and Sertraline (Zoloft) are commonly prescribed to treat MDD and GAD, respectively. For depression, the recommended fluoxetine starting dose is 20mg taken once daily. The daily dose should not exceed 80mg. The therapeutic range for many is between 20 and 40 mg/day. The primary goal of treatment is for the patient to attain at least a 50 percent reduction of the core depressive symptoms or complete remission. For GAD, the recommended sertraline starting dose is 25 mg once daily for adults. Dose increments of between 25 and 50mg/day at weekly intervals to a maximum of 200mg/day may be necessary to achieve optimal therapeutic gains.

            Patients taking SSRIs either for depression or anxiety should expect a delay of between 2 to 4 weeks before they can experience the therapeutic benefits of the drugs. Some patients may require subsequent dose increments before they can achieve optimal therapeutic gains. Patients who have not attained any significant therapeutic gains by 6 to 8 weeks of treatment should discuss with their health care provider the need for an augmenting therapy or switching to a different psychopharmacological agent.

            The common side effects of SSRIs include insomnia, gastrointestinal disturbance characterized by nausea, diarrhea, and dry mouth, sexual dysfunction, and central nervous problems including headaches, sedation agitation, and dizziness. Although adverse side effects are rare, some patients may develop seizures and activation of mania and suicidal thoughts. Antidepressants can aggravate suicidal behavior, especially in adolescent patients. For additional information on psychopharmacology for mental health disorders, visit

Published in Treatments
Sunday, 21 September 2014 20:08

My Emotions

I sometimes feel as though I cannot breathe. I have had two anxiety attacks in the past year, the only ones I have ever had. But when I get anxiety, my heart beats fast. I begin to flush, and avoid eye contact with anyone near me. I fidget and get sweaty. But more than the physicals, I am so deeply terrified of whatever is giving me this anxiety that I can barely even act rationally. Simply biking though my neighborhood is a stressful experience. I wonder if the people outside are judging me, and whenever a car goes by, my throat closes up. I do anything to avoid crossing the street while a car is waiting. Talking on the phone is terrifying to me, as well as interacting with little children when their parents are present. 

I cannot explain any of this to you, or why it happens. But it makes me feel very alone. I've never met someone with G.A.D. before, or talked to someone with it. I have considered going to a group therapy for anxiety as well as psychotherapy but none are around me that I can find. If you suffer from generalized anxiety disorder, or any anxiety disorder at all, you can talk to me. I'd be very grateful. And that really goes for anyone struggling. I've also suffered from major depression and so I have insight and experience into that, although I'm not in any way a doctor or psychologist, I can give my advice. 

Anyway, I wish you luck in your recovery, and if you want you can talk to me. 

Published in Diary
Sunday, 24 August 2014 02:38

New college is a nightmare

Alright, so I remember about two years ago stupid me met someone from the internet. He had my number, my facebook, and my info from another site. It started out simply enough, going to meet someone you met online for a date. Then I got pressured in to kissing him, and I got caught up in the moment, though it never passed kissing, I let the date go on for far longer than I should have, and kissed more times than I should have. I then regretted it horribly the next day after having heavily mixed feelings. I rejected him....and then the cyberstalking began. Calls every day, repeated texts. I blocked him on the site I had first met him on, then he started talking to me on facebook. I blocked him there. Then the phone calls got more intense, happening more and more often. My ex who I was friends with came to my rescue and told him to back off. My stalker then began to make things seem like they had gone further than they had. I was called a slut, a dirty whore. Names I wouldn't even dream of calling anyone. He tried to ruin my reputation. At the time I was a devout, churchgoing Christian so no one believed him. He harrassed me day and night. I began crying whenever a call came up on my phone. I had told my dad, a retired police officer, who eventually picked up my phone during one of the calls and threatened him with a restraining order. He backed off... enough. I moved states and got engaged, changed my number. I felt safe knowing I was states away from the man who once stalked me. Two years later I moved back to where I had lived during the stalking. I got yet another number and broke off my engagement. I applied and got accepted to a four year university, which is unfortunately a few miles away from where I first encountered my stalker. Already having an anxiety disorder, generalized anxiety disorder, did not help as I began getting nervous for no logical reason in my new location and school. I went and changed my drivers license back to the state in which I now lived. In the process, I drove by the very place in which I first saw, and met, the man who ruthelessly cyberstalked me for what felt like years, but amounted to months. I began hypervenhilating and a panic attack hit. I struggled to regulate my breathing as I tried to drive as far away as I could get from the location. I shrugged it off once I got home and was able to calm my shaken self down. I curiously reentered the site in which I first encountered my cyberstalker a few days previously, and had expected his profile to still be blocked. I got a message from him anyway. A simple "hey" was all it took for me to frantically block his profile again, and consider my options. After the panic attack in the car, I have been seriously considering what to do. My choices have thus been: get therapy, take a self defense course, and make sure I have pepper spray at all times. I only feel safe on campus. Unfortunately, the damage he did has been done, and online dating has become impossible. I become terrified of meeting someone to the point in which I would have to take my anxiety medicine to stop the severe panic attack, which prevents me from driving. Meeting anyone of the opposite gender from online has become impossible. I wish time and time again that this had not occurred, that he would have gotten a sentence, something, anything, to make him understand what he did to me. I try to move on and make the anxiety fade on my own, as I have done many times before. Years without needing therapy has boiled down to me needing it worse than I could have ever expected he would have done to my mental state. I know what I have to do, but admitting you need help is often harder than you think.

Published in Diary
Friday, 09 August 2013 04:09

Starting High School

So I'm new to this website. I found out about it through Twitter and figured I should check it out. I'm 14, so I'm going to start my first year of high school in September. I'm nervous (more nervous than I usually am). Whenever I try to tell my parents or anyone about how scared and worried I am about starting high school, they always brush it off and say that everyone is nervous about high school and that it'll turn out fine. Well ok. I didn't realize everyone had Generalized Anxiety Disorder to deal with. I hate it so much when people try to act like their minimal stress is anything similar to what it's like spending every second of your life worrying about things that probably don't even matter. BEING STRESSED AND HAVING AN ANXIETY DISORDER ARE NOT SYNONOMOUS! But anyway, back to what I was saying. So my school didn't give us any information or any details about how things work at the school. We've already had three orientations and I still don't know what time school starts. There are common knowledge things about the school day that I don't know and that scares me a lot. In just a few short weeks, I'm going to be walking into a school I know nothing about with a bunch of people I barely know in a situation that's completely new to me. You know, in my middle school, we didn't have locks on our lockers. I'm going to go to school and look like an idiot because I don't know how to open a combination lock. Then everyone is just going to stare at me and I'll be known as the girl who couldn't open her fucking locker. They also didn't give us a list of supplies we need for our classes. What if I forget to buy something from Staples? I'll seem unprepared. The best advice I've ever gotten in life was that you only get one chance to make a first impression. What if I fuck it up? In addition to that, the first three weeks of school, my bedroom is being redone. That means I'll be getting a crappy night sleep on an air mattress in my play room for almost the entire first month of school. As if that wasn't ENOUGH stress, my parents are making me get a job being a referee for little kids soccer games. I'll already have to wake up early for school and wake up early to do volunteer work on Sundays, but now I also have to wake up at 7:30 on Saturdays. I barely get any sleep already because I'm up all night FUCKING WORRYING ABOUT STUFF LIKE THIS! And even when I do sleep, It's a challenge to actually stay asleep. I know it's only the beginning of August, but even thinking about September is making my stomach sick. As a little side note,my left arm is numb too. Does that ever happen to any of you? But on a more positive note, this is a col website. I really enjoy being able to vent like this. You can expect to see me on here a lot more :]


- Val

Published in Diary
Saturday, 16 June 2012 15:51

GAD and me.

I have Generalized Anxiety Disorder. Its kind of obnoxious at all times. I left my job a few months ago for reasons that I'm not going to get into but they were sound and in my best interest. Since then, I have let opportunities slip through my fingers because I play the "What if...?" game. Second guessing myself has become a sport for me and the anxiety it causes is the opposition. Only, I don't enjoy playing this sport. Every single time that it occurs, my entire day, and sometimes week, is shot to pieces. 

I play out these scenarios in my head to try to "think" of the best possible option. I usually spiral down to playing the blame game and letting in a panic attack. Worse still is that when I am attempting to calm myself down, I get anxious that I should be doing something important such as preparing for something or working on a project. I start to panic and then kind of just jump into it only to find that I start to panic that I may not be doing something in the project properly or I'm not studying something hard enough or thoroughly enough. It usually all ends up with me feeling panicing and wanting to go to sleep. 

Right now, even as I am writing this, I feel as though I should be running off and getting something done but I'm afraid to go and try it because I'm not sure if its the right thing, or even if I'm going to get it done properly. I also tend to think of what someone will say if I make a decision. I tend to read into body language or voice inflection when I tell someone a plan and then I panic and don't do the plan because it is how someone else would do it. This cycle keeps spinning out of control and I keep loosing out on great opportunities because I play the "What if...?" game. Something has to give.

Published in Diary

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we are a community of people struggling with mental health issues, you are not alone!


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We are a community of people struggling with mental health issues, you are not alone!