Sunday, September 18, 2011

Meds or meditation - what's killing my anxiety?

At my last appointment, after signing off on another prescription for relatively high doses of the two medications I've been on for almost two years now, my psychiatrist asked me what I though was behind the improvement in my thinking and reduction anxiety in the last twelve months.

I rattled off a few factors, mainly yoga and regular exercise. He was intrigued by my response, insisting that it was the drugs taking effect. They take about 12 months for them to really kick in, he told me, explaining the apparent lack of correlation they had to my significant shift, unlike yoga, which made an impact almost immediately.

He said that the only way to really know for sure how much the medication was at play was to see how I went on a lower dosage, but the doubtful way in which this experimental notion was put forward left me hesitant. "Let's stick with what I'm on," I said, disappointed but comfortable.
He's a well respected man, and rightly so, but I personally think a little off the mark on this one. He's a psychiatrist, it's his job to fix problems with medication, so in a way I guess he would say that or see that as the major contributing factor, but it was a little disappointing that he was so dismissive of the natural and cognitive factors. I think I have a good idea as well about what's been working for me.

Then I read and related to this article in The Age, looking at the preferred methods of treatment of mental illness in Victoria.

No doubt the medication has served to take the edge of my anxiety, allowing me to address the underlying issues and - I would like to think - eventually reduce and come off the medication. That seems less likely or a prospect further away following last week's discussion unless I really push for it.

Perhaps without the drugs I could not have pulled myself up from the rut I lived much of my life in. Being drug-free for a few months in 2009 (after five years on, firstly, Zoloft and then Movox) seemed to be going well until an overseas trip triggered a nasty, lasting increase in anxiety and the current prescriptions were set in place, and did make a difference.

It was discovering yoga 12 months ago, however, that really had an impact on the way I think. I'd read about the cognitive therapies and tried to practice the techniques, but it wasn't until a few sessions of yoga that I actually learnt how to let go of thoughts. Simply because I had to. I had to bring all my attention to the mat and let those niggling, unneccessary, irrational, anxious thoughts float past.

I want to be able to write about what it does for me mentally, but I just don't have the words just yet without rambling on and sounding like a wanker. It's been amazing for me, that's all.

Some sessions felt fairly emotional, as if I'd opened feelings suppressed for 15 years. It was liberating and exhilerating. And realising I actually could let go of those junk thoughts, with a platform for how to do it too, gave me hope and a way of doing so in daily life. It's something I still need to work on but that was the single biggest revelation or progression in my battle with and understanding of this condition I live with.

Could I be where I am now without the medication? It would be possible, but much harder and I'm not sure I had the strength. Could I have progressed as far as I have without yoga (or at least something similar)? I doubt it. The drugs eased my anxiety, yoga has taught me how to manage the thoughts that cause it. Even though I knew and attempted strategies for doing so before I started yoga, such as mindfulness, it wasn't until I began practising that I was able to properly implement them.

I go a day or two without medication and I seriously feel it, most notably with nausea and disorientation. I've recently missed yoga for about 10 days and noticed and (possibly coincidental) serious decline in my ability to manage my anxiety. I dragged my sorry arse back there and after one session felt the best I had in days.

As always when talking about mental health, it's important for me to say this is just how things are working for me as I see it right now. Obviously doctors - of varying Degrees - are the best ones to give personal advice, and I am not one! I think it's an important part of the mental health discussion though - what's causing us so much stress and anxiety and are there natural lifestyle choices that can improve our mental health?

Both my GP and psychologist (the one I actually chat to about how things are going) tend to agree with me that there are a variety of factors at play, each important and interrelated.

I'd love to be off medication completely as soon as possible, but I'll take it as long as I'm advised to. Yoga I'll keep doing for as long as I'm physically able.

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