Anxiety, Stress and Medication
You may be looking at this website because you prefer not to use medication to help with your stress and anxiety or OCD. For some people, overcoming anxiety and depression is achievable without the use of medicines; this is also true for milder forms of OCD. NICE (the National Institute of Clinical Excellence – the body which gives guidance on which treatments have the best results) recommends Cognitive Behavioural Therapy – CBT as the best treatment for anxiety. Hypnosis and CBT together are known to be far more effective than CBT alone. At Manchester Hypnotherapy we use the ideas of CBT whilst you are in hypnosis. The very relaxing experience of hypnosis allows you to feel calm enough to think rationally and logically, which you need to do to carry out the work which CBT entails.
Short Term Medication can be a useful helping hand in helping anxiety
However, you may have got to the stage right now where you feel that you have been on the treadmill of thoughts going round and round for so long that you cannot take it any more. This is particularly the case for those suffering with anxiety, insomnia, panic attacks and OCD. You feel awful, most days if not every day. Or your anxiety may be so severe that you feel you cannot focus on the ideas of CBT – your anxious, worried thoughts are uppermost in your mind and you can’t seem switch off from them, except when in hypnosis. In these cases short term medication, used in combination with hypnosis and CBT, can provide the relief needed to help you focus on the therapy you are undergoing and to remove the very worst of your symptoms.
Many clients tell me that they have never felt so relaxed as they do during hypnotherapy sessions – including those who take valium (also known as diazepam) or sleeping tablets. One of the aims of hypnotherapy is to teach you self hypnosis so that you can achieve this state by yourself. However, whilst you are still improving your self hypnosis skills, you may feel that you need medication in the short term to relieve the cycle of fear, worry and uncertainty. If for example you are worried about your health (a very common form of anxiety) then taking medication can help you to realize that it is the anxiety which is producing your symptoms – because the medication stops the anxiety, the physical symptoms of anxiety reduce and you feel better, so you realize that it wasn’t a serious physical illness after all. This reassures you, you worry less, and the symptoms (which were just the physical side of your anxiety) disappear – and so you have broken the cycle. But medication should only be seen as a temporary measure to help a longer term problem. If you just take the medicine without any counselling or therapy, then there is a good chance that, once you stop taking the medication, the symptoms will return. If at the same time as taking medication you also undergo therapeutic treatment, such as CBT, hypnosis and hypnotherapy, to help you understand your anxiety and to clarify those misunderstandings and assumptions which so often make you anxious, then you have dealt with the problem.
Hypnotherapy and CBT let you get rid of your anxiety permanently
If your anxiety is caused by a particular problem – a bereavement, loss of a job, a relationship break up – and you are not normally anxious, but the anxiety is currently severe, then a short term of medication may be all you need to get you past it, or to cope on those days when things just seem overwhelming. However, hypnotherapy and CBT teach you how to deal with ALL anxiety related problems, both immediately and in the longer term – once you have learnt how to switch off anxious and intrusive thoughts then you will always be able to switch them off, no matter what they’re about.
What are the different medical treatments for anxiety?
There are two main types of anti-anxiety medication, benzodiazepines and SSRIs. In addition, beta blockers are also sometimes used to control some of the physical symptoms of anxiety.
Benzodiazepines are often called sedatives or tranquilizers. You will probably be more familiar with the brand names of these tablets – the most widely prescribed are Valium (diazepam), Klonopin (clonazepam), Ativan (lorazepam), and Librium (chlordiazepoxide), which are used for the short term, very speedy relief of both the physical and psychological effects of anxiety and panic, and Restoril (temazepam) which is mainly used to treat insomnia.
All benzodiazepines work by enhancing the chemical gamma-aminobutyric acid (GABA), which is a naturally calming brain chemical. It slows down, or prevents, certain nerve signals in the brain. Benzodiazepines are active in the body for a short time – around five to ten hours, generally, but may have a “hangover” effect – some of the side effects can still be felt the following day.
Side effects are discussed further at the bottom of the page. They may include drowsiness, confusion, difficulty co-ordinating, dizziness, difficulty driving or operating machinery, and feeling “woolly headed”. These effects are worsened if benzodiazepines are taken at the same time as drinking alcohol, as both alcohol and benzodiazepines act by sedating the central nervous system. If the side effects are severe and you cannot function then the dose you are taking is probably too high and should be reduced. You should still be able to function normally and live your life, but without the feelings of anxiety – the aim is not to completely sedate you. It is possible to overdose on tranquilizers, particularly if taken with alcohol and care should be taken.
If you are someone who reads a list of possible side effects, and then tends to experience them, it can be useful to get a friend or relative to read them for you. You are much less likely to experience side effects if you aren’t expecting to feel a certain way and looking out for the symptoms!
Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are anti-depressants. Many people are unaware that they are also contain an anti-anxiety component. In fact they have a better track record of helping anxiety and obsessive thinking than they do with depression – no test has shown that they are better than a placebo at treating depression. However they have been shown to be extremely effective in treating anxiety and obsessive or compulsive behaviour. Frequently prescribed SSRIs are Fluoxetine (the most common brand is known as Prozac, and this name may be more familiar to you), Citalopram (brand name Cipramil) and Escitalopram oxalate (Cipralex). These particular SSRIs are good at helping to reduce anxiety and your GP may prescribe these even if you are not depressed, in order to help you overcome stress. There is also Venlafaxine (Effexor) and Duloxetine (Cymbalta) which combine SSRIs with adrenalin blockers.
SSRIs, unlike tranquilizers, do not have any immediate effect. You need to take them regularly for a period of time – usually 7 to 10 days – before they will begin to act. This is because they very slowly build up the necessary level of chemical in the brain and a number of doses need to be taken before the level of the drug reaches reaches the point where it is effective. Some people report that their depression feels worse before it feels better, but this is often due to an expectation of feeling better immediately – when this doesn’t happen (and it cannot happen, because the dose takes a while to build up to an effective level) they then feel that nothing will help, which increases their feelings of hopelessness. However, most people do begin to feel better after a week or so.
Any side effects of SSRIs usually wear off after the first week or so but if they do not, or if the side effects are severe, then discuss a different dose, or taking a different type of SSRI, with your GP.
Although these drugs are not addictive, many people find it helpful to discontinue their use slowly, over a period of weeks or even months, rather than suddenly stopping.
The main use of beta blockers is the treatment of high blood pressure and heart problems. They block the action of adrenaline and noradreanaline. These drugs can also be used, at a lower dose, to treat anxiety, panic and migraine. They are particularly good at helping phobia and performance anxiety. Adrenalin is responsible for the physical effects of anxiety and panic. Adrenalin increases heart rate and blood pressure, which makes you breathe faster. Because beta blockers stop the adrenaline from working, your heart rate, blood pressure and breathing remain the same. This is helpful in preventing anxiety becoming full blown panic, as without them you may add to your original worry by worrying that you are having a heart attack or are otherwise seriously ill. Amongst the most commonly prescribed beta blockers are Propanolol, Bisoprolol and Atenolol, although there are many others. If the beta blocker you are prescribed does not suit you (although side effects are rare, some individuals do experience fatigue, dry mouth and dizziness) then you should ask your GP to prescribe another.
With any medication there is a risk of side effects. However, you should be aware that many people experience no side effects at all.
With anti-depressant SSRIs (which are also used to treat anxiety), side effects are usually more noticeable at the very beginning of starting the treatment, and disappear after a week or two. The risk of side effects are even lower if you start off with a lower dose, so that if you have been prescribed, for example, 20mg per day, it may be advisable to start by taking just 10mg per day for the first week. Some GPs advise this, some don’t mention it, but many people who have taken this type of medication have found it a useful way to minimize side effects. If you are concerned about possible side effects you should discuss this with your GP. There are many different brands and versions of anti-anxiety medication, and if you find the side effects of one brand or type are affecting you, then your GP can prescribe a different one which may be more suitable for you.
Can I get addicted?
Of the thee main types of anxiety medication, only benzodiazepines (tranquilizers) are potentially addictive, which is why GPs will only prescribe a short course; SSRIs and beta blockers are not addictive. However when the time comes to stop taking any of these medications, you should reduce the dose slowly, so that the body does not have to suddenly become used to being without them.
Hypnosis in south Manchester
The therapists at Manchester Hypnotherapy have over fifteen years of experience in treating insomnia, anxiety and teaching self hypnosis. If you want to find a hypnotherapist in south Manchester to helpstress and anxiety,, emotional problems, or low self esteem, then go to any of the independent websites which list and give reviews of hypnotherapists (for example www.freeindex.co.uk – Google also displays reviews) and you will see the excellent results which Pam and her team have achieved. If you would like further information about hypnosis in Manchester, for insomnia, self esteem and confidence, depression, for help with weight loss, to break bad habits, or for any other problem, please call 07779 575 816 for a free, no obligation, confidential discussion.
Hypnosis and hypnotherapy in Didsbury, Manchester – convenient for Chorlton, Gatley, Cheadle, Stockport and all areas of south and central Manchester.