Amino acids, especially L-theanine, and lots of vitamin C have also helped me. Finally, I have been taking a multivitamin by Truehope, EmpowerPlus, designed to help people taper off meds. You need at least one person — preferably a few — who will be there to remind you of why you are attempting to do this, and to be your cheerleader along the sidelines of this hellish marathon. I have three people in my life right now who are behind me percent. There is an end to this pain, and the pursuit of healing is worth the sweat. I mentioned Epsom salts baths in both my piece on panic attacks and in the one on insomnia.
Epsom salts are a mineral compound containing magnesium, sulfur, and oxygen. When used in a warm bath, they allow magnesium to be easily absorbed into the skin, which promotes a feeling of calm and relaxation.
According to a study published in in Neuropharmacology, magnesium deficiencies induce anxiety, which is why the mineral is known as the original chill pill. I find it miraculous how something as simple as slow abdominal breathing has the power to calm down my entire nervous system. One way it does this is by stimulating the vagus nerve — our BFF in the middle of a panic — because it releases a variety of anti-stress enzymes and calming hormones, such as acetylcholine, prolactin, vasopressin, and oxytocin. Emotional tears — those formed in distress or grief — actually contain more toxic byproducts than tears of irritation like onion peeling.
Crying also lowers manganese levels, which triggers anxiety, nervousness, and aggression. In that way, tears elevate mood. In the last two weeks, I have started to brush myself every evening before I go to bed with a dry skin brush. A friend of mine said it helped soothe her father when he was battling a brain tumor. Dry brushing can stimulate the lymphatic system, which is responsible for eliminating cellular waste products. In this way, it helps release toxins and decrease inflammation. It also increases blood circulation to the skin and reduces muscle tension, helping us to calm down and relieving stress.
They include maca root, almonds, dark chocolate, pumpkin seeds, seaweed, blueberries, kefir, turkey, avocados, and teas that contain chamomile, rooibos, lemon balm, passionflower, ashwagandha, valerian, peppermint, and kava. Massages can be expensive, but if you can afford it, this hands-on therapy can help you relax — priming your parasympathetic system — and can facilitate the elimination of toxins.
According to a study published in the International Journal of Neuroscience, women with breast cancer who received massage therapy three times a week reported being less depressed and angry. The next day, I couldn't do anything. My anxiety was telling me that I was in danger. I wasn't, but the panic was still there. I was dreading trying to sleep again.
My sister told me to go immediately to a psychiatrist.
I did. We need to get you calmed down. Having a doctor hand me something I could swallow immediately soothed me. I was able finally to speak enough to tell the psychiatrist that I had seen a terrifying accident, and that I had never really suffered from anxiety or panic attacks before. I begged her to please make the anxiety stop. The psychiatrist prescribed Xanax for a couple of weeks and then Cipralex, a commonly-used SSRI antidepressant that treats both depression and anxiety, to take long-term.
She also said that it was imperative that I find a therapist and explore what was going on in my mind. I guess she assumed the trigger was deeper than just seeing a gasoline truck in flames. Eventually, especially with a chance to talk about what happened, the anxiety calms down. Fortunately also, the psychiatrist had suggested that Lia speak with a talk therapist. Talking about the thoughts that were barraging her would enable Lia to digest her thoughts and feelings, both from the recent trauma and from prior events that had troubled her for some time.
Unfortunately, the psychiatrist did not offer non-pill options to calm the intense anxiety reaction. As the saying goes, to a man with a hammer, the world is a nail. In this case, the hammer was in fact effective. Xanax brought Lia immediate relief. There are, however, non-pill options that can produce the same immediate calming effect.
Both acupoint tapping and a visualization called the spinning technique would probably have done the job equally well. In addition, Lia easily could learn to do these techniques on her own at home should the anxiety return. I knew that I needed therapy. It had been a long time coming.
An unspoken trauma from the past was finding its way out, visiting me in dreams , and violating random moments in my life. I had been doing my best to silence it, shushing it desperately, hoping that it would just go away. So I started therapy. And I started the antidepressant drugs. And I was able to breathe.
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For a while. Therapy opened my mind to myself. I had closed it years before. Re-opening it was as if a door had been kicked down. The halls and rooms of my mind were inviting me to explore, to wander, and to get reacquainted with my inner-world. The SSRI seemed to be working too. I was more calm. I was more at ease.
I wasn't barking at my husband about crumbs on the counter or scrubbing toys with bleach every night. I was laughing a little more, yelling a little less, more balanced. What was from therapy, and what was from the SSRI? I was just relieved to be breathing normally. Pills and talk therapy can potentiate each other, that is, cause each other to be more effective than either treatment alone could be.
At the same time, newer therapy techniques, such as the Body Code and Emotion Code, enable a therapist to radically shorten the time and intensity of talk therapy. Within one session or several, an Emotion Code therapist can pinpoint the earlier problem and immediately release trapped negative emotions so that they cease to have impact. Marriage therapy also might well have helped Lia. My policy is when anyone who is married seeks therapy with me, I encourage them to bring their spouse. In almost all cases, underlying marital issues have been fanning the flames of negative emotions.
The spouse also can have a significant role in fostering a return to mental health. For instance, an anxious or depressed person may have an impulse to spend his evenings isolating and ruminating, saying troubling thoughts over and over to himself. Rumination exacerbates anxiety and depression.
A Journey Through Darkness
If husband and wife enjoy activities together in the evening, they are likely to be able to replace the rumination with pleasant interactions. I truly feel like that drug saved my mind. It also probably held my marriage together for several more years. But by a year later, I knew that something was off. I knew that it was the medication. The difficulties tend to come with the duration of use. The negative side effects which had begun while Lia was taking the pills became even worse when she tried to get off the pills. I would have several-minute episodes of not knowing what I was doing or how I got there.
Then the confusion would dissipate, and I would be left thinking that I was just imagining it. But it would happen again. Fleeting, but tangible. Almost leaving a taste in my mouth. I shared this with my husband, but he was worried about the anxiety returning if I messed with my medication. I waited. The difficulty is that after a year of taking antidepressants, anyone who attempts to stop taking them must end their use very slowly. Rather, antidepressants create drug dependency. The body forgets how to produce the chemicals that sustain well-being when they are being provided artificially by pills.
I had no sex drive. I stopped feeling motivated to hang out with friends. I stopped caring about how I looked or what I was wearing. I was sinking. I had been saved from anxiety, and was now slipping into depression. I made a unilateral decision to go off my meds. It wasn't a wise one. Looking back, I see that it was very much a desperate stand against the many factors in my life that I wasn't in control of — my devastation over my marriage that was quietly but quickly ending, my loss of focus on my passions and hobbies, my overweight and exhausted body, too strict in my religious life.
To simply argue that the SSRIs were ruining my life would be short-sighted and most likely wrong. The biggest single indication for new antidepressant prescriptions was depression diagnoses and symptoms , which was associated with over one-half of new prescriptions. New prescriptions associated with depression increased from 2.
New prescriptions associated with anxiety were less frequent but increased from 0. The incidence of antidepressant prescriptions associated with physical pain also increased over the study period from 0. As a group, prescriptions associated with other indications changed little from 0. Overall, the indication for which an antidepressant was prescribed could not be found for New prescriptions for which no indication could be identified showed an initial decline from 1. However, the incidence began to rise again from onwards reaching 1.
This pattern was reflective of the overall trend for SSRIs over the study period. The incidence of antidepressant prescriptions for CYP initially decreased between and then steadily increased over the study period to the highest incidence in This lends credence to suggestions that concerns in Committee of Safety of Medicines, over the safety of antidepressant use in CYP waned Wijlaars et al.
12 Ways to Soothe Antidepressant Withdrawal Symptoms
Since , the increase in recording of depressive symptoms in CYP has continued throughout the study period although the recording of a diagnosis of depression has shown a small but steady decline. Unlicensed antidepressant prescribing was associated with a range of diagnoses as well as for depression, such as anxiety and pain. The increase in prescribing of antidepressants over time is mainly seen in those aged 15—18 years rather than younger age groups. No increase in antidepressant prescribing was found in 6- to year-olds.
However, fluoxetine does appear to have increased in popularity from onwards, with its incidence at a similar level to citalopram by Although we found a downward trend we did not find significant evidence for this. The main strength of this study is the large population sample size of all children and young people in Wales and 11 years of follow-up.
There is no reason to believe the results would differ for the entire population of UK children. The results of the current study reflect trends in the recording of presentations to primary care, and the recognition and treatment by GPs. All prescriptions issued in primary care are recorded within the GPD, but we have no available method of ascertaining from the SAIL Databank if they were dispensed or taken. The incidence rates for diagnoses and symptoms presented are likely to be an underestimate of the true incidence in the community as a whole since those who do not present to their GP, or those with whom symptoms are discussed but not recorded, will be missed by the use of routinely collected data.
This is a common feature of all database studies, Rait et al. Although we explored a more extensive list of indications for which an antidepressant may be prescribed than previously reported, Murray et al. Thus the indications can only be inferred and not conclusively determined. Analyses reported relating to indication are, in essence, a measure of coding behaviour rather than true indications for prescribing.
Only those patients with relevant Read codes in their patient record were detected. The method used will give an indication of trends over time but may have resulted in an inflated number of individuals for whom no indication could be found, particularly where a historical record was only made once or where an individual was not registered with a SAIL practice at the time when a diagnosis was recorded.
This is a common limitation of all studies of this type Murray et al. It is possible that GPs consider that the prescribing of an antidepressant implies the diagnosis. The results of this analysis should not be used to make comparisons of rates of prescribing found across different study populations such as those in the THIN database Whittington et al.
This is because these studies provide a crude non-standardized estimate of the incidence of antidepressant prescribing without taking into account any differences between study populations based on age, gender and deprivation that are known to be associated with levels of childhood depression. Our findings may be influenced by a period effect as the CYP investigated age through the study period. The large proportion of individuals compared to events e. It would have been preferable to replicate previous work and examine rates of treated incident, first ever and recurrent depression in relation to issuing of NICE guidance for depression in and as done by Kendrick et al.
However, the number of cases of CYP are lower. This smaller sample size combined with the impact of only examining those with adequate follow-up data to determine treatment meant that there were not sufficient numbers to draw meaningful conclusions. Incident antidepressant prescriptions were examined as an alternative. A further limitation is the lack of information regarding whether and what interventions have been received at secondary and tertiary mental healthcare levels for children and adolescents with depression, i.
The Read codes and algorithms employed in this study have been previously examined against adult survey data John et al. Further work is required to extend this linkage of routinely collected data to survey data collected on CYP. This study adds to a growing literature demonstrating an increase in psychotropic prescribing for CYP across western cultures Olfson et al. We found the percentage of the CYP population receiving new prescriptions for antidepressants was in keeping with the THIN study from Wijlaars et al.
The results of this study support and extend previous research demonstrating an increase in recording of depressive symptoms and decrease in depression diagnoses over time Whittington et al. In keeping with previous research Kendrick et al. Similarly the non-significant increasing trend in incident antidepressant prescriptions seen following the issue of and NICE guidance is in keeping with previous research Kendrick et al.
The positive results reported in this study refer to the number of incident episodes of depression treated following the issue of the guidance. Many of these indications are unlicensed usage such as for pain. In keeping with previous research, Murray et al. It may be useful to issue further guidance and support to GPs in relation to indications for effective antidepressant prescribing and to promote the recording of a diagnosis when issuing a prescription. They are also used off-license in paediatrics, but without much published evidence. A Cochrane review Kaminski et al.
Many GPs feel poorly equipped to manage young people's emotional distress and feel there is a lack of clarity Roberts et al. These all highlight some considerations for the management of anxiety in CYP.
12 Ways to Soothe Antidepressant Withdrawal Symptoms
Psychological therapies should be the first line of treatment. Pharmacotherapy should not be routinely offered to treat social anxiety disorder in young people. Additionally, strategies to improve the implementation of current guidance on the prescribing of antidepressants for depression in CYP should be adopted. This could include adoption of programmes such as Therapeutic identification of depression in young people TIDY which trains primary-care staff to differentiate between emotional turmoil and depression and to implement appropriate management strategies Kramer et al.
A current focus should be the use of citalopram rather than fluoxetine as a first line treatment. The updated NICE guidance of recommends that citalopram should only be prescribed if fluoxetine is unsuccessful or is not tolerated because of side-effects and then only once advice is sought from a senior child and adolescent psychiatrist. These preferences in initiating antidepressant treatment also warrant further research. It may be that GPs find that citalopram is better tolerated than fluoxetine, or results may simply reflect trends seen in adult populations Kessler et al.
It is also possible that the increase in citalopram prescriptions is related to diagnoses other than depression, such as pain, prescribing for which appears to have increased during the study period. The absence of data regarding any interventions that may have been received at secondary and tertiary mental healthcare levels make it difficult to draw conclusions on whether this trend is a reflection of GP preference or of prescribing patterns initiated in secondary or tertiary care.
However, the rate of rejection of referrals from primary-care to specialist mental health services Hinrichs et al. Further research is required to fully understand the increasing trend in prescribing without an associated indication. It may be that indications go beyond those studied here or that GPs are increasingly choosing not to record depression in this population. Over one-half of new antidepressant prescribing was associated with a symptom or diagnosis of depression. New prescriptions associated with depression diagnosis and symptoms increased over the study period.
This may reflect increased access to treatment and a positive shift towards helping individuals with mental disorder at a younger age or an increased tendency to prescribe medication, particularly where psychological or other treatment options are limited or not available in primary care. This may be a particular problem in more deprived areas where the incidence is nearly double that in more affluent areas.
The increasing levels of those receiving antidepressant treatment at 15—18 years of age also highlights the importance of strengthening primary-care mental health care services and supporting the transition to adult mental health services, when required, given the persistence of adolescent mental health problems into adulthood Rait et al. A recent mixed methods study has found that general practice referrals to Child and Adolescent Mental Health Services CAMHS were three times more likely to be rejected than referrals from all other sources combined Hinrichs et al.
As a result, primary care may remain the most common source of care for CYP with mental health problems, independent of whether a GP feels an individual requires more specialist support. Concerns remain over the safety of many psychotropic medications for CYP, particularly with regards to antidepressants where there has been controversy regarding increased risk of suicidal ideation and attempt following initiation of antidepressant treatment Committee of Safety of Medicines, ; NICE, The uncertainty over whether those treated but not diagnosed are followed-up in line with QOF guidance Rait et al.
Overall, the results suggest that GPs are increasingly using non-specific symptom terms for recording depressive mental disorders for CYP. This decrease in recording of diagnoses may be partially attributable to increasingly cautious diagnostic behaviour by GPs. However this behaviour may also be in part due to the revised QOF guidance, Walters et al. Our results support the reports from GPs on the use of alternative terms and strategic labelling of depression to maintain adherence with guidelines Rait et al.
Awareness that GPs are increasingly using non-specific symptoms codes rather than formal diagnoses for both adults, Kessler et al. New research should examine the impact of a formal diagnosis on patient care e. This study contributes to a growing debate over increasing rates of psychotropic medication prescriptions in CYP. Antidepressant prescribing, associated with a broad range of indications, is increasing in CYP while the recorded diagnosis of depression shows a steady decline. Citalopram continues to be prescribed as an initial medication outside current guidelines.
Unlicensed antidepressant prescribing is associated with a range of diagnoses other than depression, such as anxiety and pain and, whilst accepted practice included in prescribing guidance and advice, it is not supported by safety and efficacy studies, and could be seen as contributing to the over medicalization of CYP. It may be useful to issue guidance and support to GPs in relation to indications for effective antidepressant prescribing and to promote the recording of a diagnosis when issuing a prescription. New strategies to implement current guidance for the management of depression in this population are required.
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The study funders had no role in the design, collection, analysis and interpretation of the data nor in writing the report or submitting it for publication. The authors would welcome collaboration. National Center for Biotechnology Information , U. Psychological Medicine. Cambridge University Press. Psychol Med. Published online Sep 9. Marchant , 1 D.
Fone , 2 J. McGregor , 1 M. Dennis , 1 J. Lloyd 1. Author information Article notes Copyright and License information Disclaimer. Email: ku. This article has been cited by other articles in PMC. Abstract Background Concerns relating to increased use of psychotropic medication contrast with those of under-treatment and under-recognition of common mental disorders in children and young people CYP across developed countries. Method This was an electronic cohort study of routinely collected primary-care data from a population of 1.
Results 3 58 registered patients aged 6—18 years between 1 January and 31 December provided a total of 19 20 person-years of follow-up. Conclusion Antidepressant prescribing is increasing in CYP while recorded depression diagnoses decline.