Anxiety, panic attacks... how to cope?

[newbie76]

I am in a really bad period of my life and I feel like things are destined to worsen still.

For about 2 weeks now I have suffered from really intense anxiety and panic attacks.

It started because I got worrying about my sight (I am extremely short sighted and unfortunately my high myopia doesn't show any sign of settling), but then the anxiety took over and now I am constant agony.

It's much worse in the early morning. It wakes me up at about 4 and I cannot stay still in bed. I get full blown panic attacks, I go to the toilet 2 or 3 times in a row and I also get a gag reflex of throwing up, even though, as my stomach is empty, I can't really.

I have almost completely stopped eating as I have this constant "butterfly" feeling in my stomach.

The doctor prescribed me Diazepam and Citalopram, but I have read that Citalopram can take up to 6 weeks before starting to work and you may get worse before getting better!

I am supposed to go on holiday with a friend on Thursday but I really don't want to spoil the holiday for both of us...

I have tried the relaxation/breathing techniques as well as the Bach Flowers but they don't seem to help much.

Has anyone got any tip to cope with this?

Thank you.

[Moffie65]

You just might be having a drug reaction, and not know it.  If you are peeing that much, there is a possiblity that you are having some problems in the urinary tract.  I would check with another doctor, and try some counseling.  Anxt is not one of my problems, and haven't suffered with panic attacks at all.  I can't be of service to you there.

[BrotherDavid]

Sorry to hear about you're issue. I am not sure what country you live in, but there are many Anxiety medications (here in the US) which are very easy to adjust to. I have been through depression and anxiety for many years many of the medications I have tried, take forever to adjust too, and the side effects are terrible.

The quickest was I have been able to fight severe anxiety is with Alprazolam (xanax) it works almost instantly and you will feel okay. The downside is if it is taken for long periods it is habit forming.

For longer longer treatments, Clonazepam (Klonopin) in a smaller dose works well. They say it is habit forming, but I have taken .5mg per day for over 10 years and it has kept anxiety at bay.

Paxil and most recently Cymbalta have helped and each are a pretty easy drug to take if you can wait a couple of weeks to adjust to them. To avoid dealing with side effects, take these at night to start.

Valium never seemed to really work for me.

This is just my opinion on meds. It is not uncommon form many people with HIV to experience Anxiety and sometimes a medication will help drastically.

[Miss Philicia]

If you're having really bad panic/anxiety attacks then the prescription of a benzodiazepine class med is appropriate, but they really vary somewhat.  Your increased urination is a byproduct, most likely, of the metabolization of diazepam (valium) -- citalopram is actually an anti-depressant of the common SSRI class.  But the diazepam is what should really be helping quickly with your anxiety attacks.  If these attacks have not lessened than either the dose is wrong, or you might benefit more from another benzo rather than that one, as they all have different half-life issues, which is basically the length of time that it takes for the medication to fall to half of its initial dose value.  From what I can gather, diazepam is one of the longer half life benzos like Klonopin, which is what I've taken for panic attacks and found worked quite well.

How many days have you specifically been on the diazepam?  If it's like five days or so and things aren't improving I would give the prescribing doctor a phone call.

But other than this, medications in the benzo class are habit forming long term, and should be considered a band-aid in a crisis period.  You really need to be going for hour sessions with a therapist that does cognitive behavioral therapy (CBT), so you can learn to process what are basically irrational thought processes that then cause these panic attacks.  Don't expect instant results from CBT.  You'll need to give it a good year at least, and it's up to the patient to commit to a regular schedule of such sessions.

[mecch]

http://en.wikipedia.org/wiki/Lorazepam
1) Lorazepam works instantly and works well.
2) Deal with not taking anxiety medicine after you have done some therapy and just chilled out a bit.
Eventually have to educate youself out of misjudgments and certain ways of thinking
3) Also find and do some relaxation techniques - guided meditations or breathing.  Some say these are NOT beneficial for people in a crisis, however. In that case, vigorous exercise may be the key.

Don't lie in bed suffering.  Get up and do something at least to distract yourself.  Take some pills and eventually you'll calm down and get back to sleep. Eventually you'll get back to a normal schedule.

Basically Id say you havent found the right pill and you need to do that.

[kev72]

Wow guys, you're responses have all been terrific. I hope it does help the poster.

Mecch, Lorazepam (Ativan) was the first anxiety medication I ever took way back when before some of the others were out. It worked great for my generalized anxiety and panic. What a life saver it was at the time. Then when Xanax came out around 1984 it was supposed to be the "new gold standard" of Benzo's so my doctor put me on that. It worked very well, but as years of research have proven, it became very habit forming. Now I use Clonazepam (Klonopin) in a very small maintenance dose and it has worked me for many years. In my case, Valium did not seem to help totally without having to take larger doses and get all spaced out.

In my opinion, if the poster is dealing with severe anxiety, like Miss P. said, he should try and take one of these meds to alleviate it temporarily while he deals with these new issues and seeks counseling. I am sure as time goes on things will go back to normal.

Kev

[newbie76]

Thank you all for the replies.

I should have probably been a bit more specific when I said I tend to go to the toilet many times. I was referring to going for a number 2, which is due to the butterflies in my stomach.

I was told by my GP to take Diazepam only when I feel really bad, and not on a regular/daily basis, so I try to take 10mg when I feel a rather strong bout of anxiety coming on.

I have just taken my 2nd Citalopram, so I guess I will have to stick with it for longer to see results, and I have asked my GP to refer me to a psychotherapist/psychiatrist to talk things through.

I guess I just needed to vent with someone who wouldn't judge me. Thank you for listening.

[kev72]

Hey, this is a very stressful time in you're life. If you need to take more Valium, take it. You're doctor should realize that anxiety can be severe. If he gives you the BS that its habit forming blah blah blah, tell him under the circumstances you do not care. It is temporary until you get over this hump. The Valium may also help lessen the side effects of the other medication you are taking.

Good luck and hang in there.

[R10]

i just sleep

[newbie76]

i just sleep

I wish I could too 

[BT65]

If you need to take more Valium, take it.

This decision should involve the prescribing doctor and OP.

[kev72]

This decision should involve the prescribing doctor and OP.

I tried to stress this in my post "If you're doctor tells you its habit forming, under the circumstances tell him you don't care"

[BT65]

I tried to stress this in my post "If you're doctor tells you its habit forming, under the circumstances tell him you don't care"

You basically advised the OP to do whatever he wants, doctor be damned.

[kev72]

Listen, I am not here for a debate with you. I think the person posting is obviously smart enough to discuss this with his doctor as I recommended. What you read into it is you're business but don't go off track with this guys thread. He is a big boy and asked for advice and what we write does not need you're input. End of story.

[BrotherDavid]

Why is there always someone who has to create an argument based on what they interpret in their minds? None of the people who responded to the OP suggested that he overdose on Valium for god sakes, they simply suggested he may need to increase the dose (as recommended by Miss P) or If the OPs Dr feels the medication may be habit forming, tell the Dr you don't care right now" (as posted by kev72)

I do not see where anyone is telling the OP to do anything wrong. People need to chill.

[BrotherDavid]

So just to clarify and get back on topic with you're issues Newbie76, all of us who have offered advice have experienced anxiety so we can relate very easily.

No one is simply telling you to take heavy doses of medications and turn into a zombie or lay around all day and it will all go away.  We are trying to help you get over the hump. Especially while you have to go away on holiday. Anxiety and Panic can be very debilitating and unless you have lived it, many times it seems easier to deal with than it really is. Many Drs have not been in this situation and don't understand.

The Benzo's described can be a temporary quick fix and help you sleep and stop getting sick. We all agree an SSRI or Psychologist may help long term. In the mean time, talk to you're doctor about changing you're medication or adjusting the dose if it is not helping. Valium has never been one of my fav's for anxiety. But anyway many doctors will try and steer you away from Benzo's so you need to remind him that under the circumstances you need something quickly. That is all we were trying to suggest.

Good luck

[newbie76]

Thank you all once again for taking the time to help me with this.
I am well aware of the risk of dependency with Valium, that is why in the past I was getting a prescription of 14 tablets and they would last me 6 months or so! But I agree with Kev72 that extreme circumstances call for extreme measures... or however the saying goes.

Today my stomach has been in a constant knot and at 6 I just couldn't take it anymore and thought" fu*k it!" and took a Diazepam. The anxiety just dissipated almost instantly and it is now 9 and I still feel fine. I have even managed to eat something (I had hardly eaten anything all day!).

So what I am trying to say is that yes, I am sure Diazepam can and is addictive, but at the same time medicines are there fore a reason so I'd rather take the risk than feeling like I have been feeling today. Also, considering that my doc only prescribe me 14 tablets at a time, I am sure he can keep an eye on how much I am taking.

Thank you all once again. It does feel good to share.

[kev72]

Great news Newbie!!! Believe me I have lived with anxiety and my doctor has always downplayed my symptoms and prescribed as very little as possible. There are times when the anxiety is so severe that it turns to panic which affects us physically. This is not good obviously which is why I have had to tell my doctor on occasion "Hey I really don't care about long term right now, I want to get through the week"
I do not think any of us want to abuse anything, Christ we have enough to deal with.
Good luck and I truly can relate. Take care Kev

[kev72]

Hi again Newbie,

Like MsPhil mentioned the Celexa or its newer cleaner version Lexapro are more on the lines of a long term SSRI and generally used for depression. These like many SSRIs can take a while to adjust to and can actually make things worse while they are kicking in sometimes exasperating the anxiety symptoms. Just some thought since you are just starting the med.

[tednlou2]

I've had really bad panic attacks.  Xanax does work very well.  I've had issues with the HIV pharmacist at the clinic I go to.  She doesn't actually fill prescriptions--she just counsels HIVers on meds.  When I told her I usually take 1, 1mg Xanax a day, she acted like I was some druggie.  I'll sometimes take 2.  I explained to her that the script is written for 4 a day.  I've taken this for a couple years now and don't feel addicted.  I don't crave the drug.  If I did, I would be taking the 4 a day and more.  I usually waste most of the refills as they expire.  I probably should be taking more, but I didn't want to get dependent on them like she was accusing me.  Then she said, "Well, when you start HIV meds, you can't be taking 1 a day because it will react with the HIV meds."  What a bitch! 

Anyway, I've found the beta-blocker, Atenolol has helped a lot, too, in controlling the panic attacks.  It has a good side effect in that I almost always have solid bowel movements.  However, lately, I've have a decent amount of blood on the toilet paper due to my stools being so solid.  There is actually no poo on the toilet paper because it is so solid--just bright red blood.  So, I'm not sure if that is something to be concerned about.

Panic attacks suck.  I hope you can get them under control. 

[PeteNYNJ]

Newbie

As the gang has mentioned, mental health problems usually take a while to resolve.  The drugs are hit or miss, but you should also be in cognitive therapy to learn the root causes.

Breathing exercises and pressure points work for me.  One trick, with your right pointer finger and thumb, squeeze the area on your left hand between the pointer and thumb.  the "webbish' part.  Do this when you start to feel anxiety and do it pretty hard (not hard enough to draw blood but you want a pain reaction).  This site in acupuncture causes relaxations sensations due to the brain chemistry released (I can never remember, is it cerebellum?)

Also, the benzos are VERY addictive and withdrawal is horrible so alert your doc if you are taking more.  You don't want to become an accidental junkie

Pete

[BT65]

Kev, did you not post:

If you need to take more Valium, take it. You're doctor should realize that anxiety can be severe. If he gives you the BS that its habit forming blah blah blah, tell him under the circumstances you do not care.

It bothers me when someone advises a person to disregard what a physician says if it suits the purpose.   But, obviously, you're the expert in all things mental health, so I shall argue the point with you no further.  You're also a raspy chap, and makes me wonder what your hidden agenda is.

[kev72]

I've had really bad panic attacks.  Xanax does work very well.  I've had issues with the HIV pharmacist at the clinic I go to.  She doesn't actually fill prescriptions--she just counsels HIVers on meds.  When I told her I usually take 1, 1mg Xanax a day, she acted like I was some druggie.  I'll sometimes take 2.  I explained to her that the script is written for 4 a day.  I've taken this for a couple years now and don't feel addicted.  I don't crave the drug.  If I did, I would be taking the 4 a day and more.  I usually waste most of the refills as they expire.  I probably should be taking more, but I didn't want to get dependent on them like she was accusing me.  Then she said, "Well, when you start HIV meds, you can't be taking 1 a day because it will react with the HIV meds."  What a bitch! 

This is the point I was trying to make in my post above. Many of these doctors have never experienced severe anxiety or panic, and have no idea how badly one can feel having to live with them. I have had doctors balk at the fact of giving me a script for Xanax, yet they will push some crazy drug like Lamictal or Zyprexa etc. which I think are far more toxic then benzo's. It makes no sense to me.

I am all for the different therapies and learning techniques to minimize overall anxiety, but when I am having panic attacks, the last thing I need is a doctor lecturing me about the long term effects of Xanax for gods sake. I am not an abuser of drugs and it bothers me to have to feel guilty asking for a medication that helps me when I need it. Unless you have experienced the hell one goes through, no one has a right to judge or make assumptions. I just don't get it...

[kev72]

Kev, did you not post:

It bothers me when someone advises a person to disregard what a physician says if it suits the purpose.   But, obviously, you're the expert in all things mental health, so I shall argue the point with you no further.  You're also a raspy chap, and makes me wonder what your hidden agenda is.

I told you once to but out!! Unless you have something to add, keep you're comments to yourself.  I am a raspy chap? You are a nasty bitch based on the comments you seem to post in many peoples threads. Get a life lady. My Hidden agenda? My agenda is to not let miserable people like you bother me. Go argue with someone else. I guess all of us who made suggestions above have an agenda. Freak!

[Andy Velez]

WHOA! Matters are turning snarky here and before they degenerate any further I'm going to say y'all need to chill.

Stick to the subject of the thread and NOT to sniping at each other.

Specifically, BT and Kev, no more of the back and forth stuff, please. Just leave each other alone and turn on your IGNORE button if you need to.  

[Hellraiser]

Ted, this is the third or fourth time you've said something about this pharmacist.  Can you go somewhere else?  She doesn't seem to even know what the hell she's talking about.  Xanax may react with some HIV medications but I'm sure not all of them.

[Miss Philicia]

Ted, this is the third or fourth time you've said something about this pharmacist.  Can you go somewhere else?  She doesn't seem to even know what the hell she's talking about.  Xanax may react with some HIV medications but I'm sure not all of them.

I'm not sure about xanax, but it's the same class as klonopin and I've been on at least five different HIV regimens (I guess spanning something like 10 different HIV meds) while taking this and the only think they look for is any liver issues, as that is where benzo class meds are metabolized.  It's very rare that this would happen however, but it's primarily why if one is prescribed a benzo by their psychiatrist that they communicate this fact to their HIV specialist -- and I should be clear that nobody is going to do this for you, it's the patient's responsibility though the psychiatrist should be clear in instructing the patient to do this, but frankly if they're not treating that many HIV patients they may be cavalier with it.

Otherwise, my personal experience and what I've been told by prescribing psychiatrists is that xanax, due to its short half life, isn't the best option for long term, chronic anxiety issues.  It is, however, good for short term issues, which is why it's often prescribed for something like what you would take before getting anal lesions zapped with laser surgery.  That's the best way for me to explain it.  If you've not had chronic anxiety issues than you probably don't really get the difference.

[buca45]

I have been taking Xanax for 10 years now and it has been a miracle for me on so many levels. It has 'cured' (and I hate using that word, but in this case it applies) my anxiety and panic attacks completely. Not only have those ugly episodes ceased to exist, but it allows me to get sleep at night.
I started with .5 mg twice a day and have worked my way up to 1 mg 4 X a day. I take one upon waking, one half way through the day and two a half hour before I want to sleep.
I have spoken with my Doctor about this and other drugs I requested and their habit forming properties, but his (and my) views about them are 'if it works and gives me the relief I need, fuck the thought of becoming dependent on them'.
After reading the horror stories on this forum many of you have had with doctors, I consider myself SO fortunate to have such a caring and compassionate doctor. I know he doesn't treat all of his patients as he does me and would not do the same thing in their situation. His clinic's belief is if you, as a patient, do all your homework and are very proactive in your own treatment plans and do what is in your best interest while constantly striving to achieve a life that is as near to normal as possible, then he is willing to do what needs to be done for you to get to that state. Just from the conversations and actions I observe while in the waiting room, I know most do not act as I do and do my part of the job of making me a well person.
So my advice to the OP is to become proactive in your own treatment plan and do as much research on drugs and other means needed to get you to lead as normal a life as possible. The more you know as a patient, the better the care you receive will be.
I think most doctors, when they realize that you are pulling your share of the burden HIV has put on your shoulders, will be willing to do what needs to be done in your own best interest.
Good luck and I hope you will find the solution to this problem.

[buca45]

After reading Philicias post I should add that I too have been on most every cocktail over the past 20+ years in addition to a wide range of other drugs that makes my life and pain level bearable. I do have my liver enzyme levels tested every other visit and if anything seems to be of concern, we discuss the issues immediately.
Imagine that,  a Doctor and his staff who are so concerned about the wellness of their patients that they actually CALL you if there are any warning signs that something might be amiss!! It does happen!!

[Jeff G]

Just like Richard Pryor once said ... I have been doing coke everyday for 10 years and I ain't addicted yet .

And no I'm not attacking anyones choice about how they choose to cope .

[buca45]

Just like Richard Pryor once said ... I have been doing coke everyday for 10 years and I ain't addicted yet .

And no I'm not attacking anyones choice about how they choose to cope .

LOL @ Pryor.....I actually think about that line whenever this subject is brought up.
Well we all have to die somehow, I just chose to die with my body loaded down with all sorts of habit forming drugs that make my life bearable.

[BrotherDavid]

I personally like Xanax and it works best for my Panic attacks, however when I was taking it on a daily basis, I found I needed more and more over time to stay anxiety free  .

My doctor had me try .5 mg Clonazipam for daily use and it has worked great keeping anxiety at bay. I do keep the Xanax for when I really have a bad day. The regimen has worked great for me for many years.

[tednlou2]

Ted, this is the third or fourth time you've said something about this pharmacist.  Can you go somewhere else?  She doesn't seem to even know what the hell she's talking about.  Xanax may react with some HIV medications but I'm sure not all of them.

You're right.  She just has one of those difficult personalities.  I'm glad I've only had to see her a few times so far.  When I start HIV meds, I'm sure I'll have to see her more.  Maybe she'll be gone by then. 

I've always felt if anxiety meds and pain meds work for people and provide relief, then I don't see them differently than other meds.  It is when people start taking more than prescribed, running out, and trying to get more is when problems occur.  I think most people can manage the meds and not have problems.  I think most of the problems with these meds are people just using them for recreation.  We see this with young people now--prescription meds are becoming the drugs of choice.   

I do the breathing exercises and see a therapist--not just relying on meds.     

[newbie76]

Thank you all again for taking the time to reply.
I have taken the morning off and after a rough night (woke up at 4 and had to take 2 sleeping pills to get me to 7am), I am going back to my doctor.
I want to ask him to refer me to a psychiatrist and I would also ask him to try Xanax, as the Diazepam (Valium) did help when I was having mild anxiety, but now it doesn't really work for me anymore.
Will see what he says and I'll update you guys later.
Yesterday was a particularly bad day, but I did force myself to go to the park and to the movies. It wasn't easy though.
The other issue I am having is that I am not eating. I just can't. Last night I have found out I have lost 3kg in 5 days!!

[Miss Philicia]

The other issue I am having is that I am not eating. I just can't. Last night I have found out I have lost 3kg in 5 days!!

At least go buy some protein/whey powder stuff and drink it.

[Scotian]

Hi Newbie
I totally relate to your experience with anxiety. I promised myself, if I ever heard of anyone considering taking Ativan, I would tell them to run as fast as they could the other way. If anyone is offended, all I can say is, this is my story. My experience. Take what you like and leave the rest.
Extreme anxiety was the greatest challenge for me in the early days after diagnosis. It was 2 years ago this week, I sat in my doctor’s office and he told me I was HIV+. My reaction was immediate. To say the least I was a “mess in a dress”. Right then, he wrote a prescription for Ativan (I had never heard of it) – 2 minutes later I was at the drug store ---10 minutes later I was popping my first pills, while waiting for my friend to pick me up and tell him the news.  In retrospect, I wish my doc had prescribed anything, but Ativan. There must have been an alternative? A few weeks later, with my anxiety building, he added the anti-depressant/anxiety drug Cipralex (which I was on for about 15 months). My experience with Ativan was pure hell for the next several months. It was horrible coming off it ( google  ativan+detox+side effects). I’m a recovering alcoholic (22 years). I’ll take anything that I think might relieve the emotional pain. My doc knew this. The prescription said “take when required”. Which I took as permission to pop them every 2-3 hours from the start. The ‘psychological’ if not physical addiction was almost immediate for me. Fortunately, I had access to a psychologist who was instrumental in my ‘mental recovery’.  At our first meeting I remember telling her I ‘felt I would die from the panic/anxiety attacks’. She assured me, I would not. I lost about about 20 pounds in a cpl months. Like you, going to the bathroom just to try and relieve the “butterflies”. Again, fortunately, with our healthcare system in Canada I had free access to a nutritionist who helped me get the weight back on. For several weeks, Ensure (liquid meal replacement) was all I could get down. I would wake up, already feeling anxious/nervous/weepy. I cried intermittently, daily for weeks. I had to stay with friends for the first two months. I couldn’t stay alone. I was afraid to answer the phone. check email. I had to close my business for about 9 months. Again, none of this had anything to do with the actual HIV impacting my physical health—but my reaction to the diagnosis.
I also remember meeting with a ‘buddy’ from the local ASO (he was over 20 years HIV) about two weeks after diagnosis. I explained my extreme anxiety. He said I should work to get off the Ativan. I intuitively knew he was right and that that particular med was adding to my anxiety—not alleviating it. It was just a temporary fix.
My doctor went away for 2 months holidays.  After a messy experience of trying to go ‘cold turkey’ on my own, I explained to the replacement doc, that I wanted to get off it. Gradually over 2 months, reducing the dose amount each week, I was free of the Ativan.
Here are a few of the things I did to cope with the anxiety.
-weekly meetings with the psychologist for about 6 months...she said to ask myself “What is the worst that could happen? How likely is it? Could I live with it if it happened? Also, an extremely valuable exercise she taught me was to ‘interrupt’ the anxiety loop. To ‘capture’ the thought and delete it. I would visualize my ‘anxiety loop’ as a computer and every time (for the first weeks it was dozens of times a day) …I would capture the anxiety thought...then picture myself ‘deleting’it or putting it in a ‘draft’ file to worry about later.
-regular meetings with the nutritionist. A vicious cycle, because I was freaking out over losing so much weight (what will people think?) and not being able to eat because of the anxiety.

--I also took advantage of a counselor at the ASO office...she was amazing at calming me down and even came to the ID clinic when the decision was made that I needed to go on meds
- my brother gave me one of those ‘relaxation tapes’..about a 30 minute session…I would play 2-3 times a day.
--just get inside a blanket and hug myself..it was weirdly comforting
--deep breathing/walking/exercise/massage/acupuncture
--cry—it’s Ok
--talking to a few close friends who knew about my diagnosis
So, here I am 2 years later. No anxiety meds. I still use the breathing and ‘capturing & interrupting ‘the anxiety loop…but maybe a few times a month.  I want to stress this is/was my experience. I do not want to diminish the need for others who are on anti-anxiety meds. Whatever works for you.
Sorry for running on, but for me the ‘anxiety’ was a bigger health issue at the time, than the HIV itself. After 20 months on meds my CD4 is good and VL undetectable with few if any side effects. I wish you the best.

[sanitex]

 hello Newbie76 ,your anxiety issue have remind me what i suffered before for almost 9yrs and uptill
now i'm still taken my anxiety meds.in your post you mentioned about going to toilet so often let me
elucidate you on that it's a common side effects of anxiety, however your hiv meds also contributed for
your anxiety issue (sustiva)but what i'd like you to do is get yourself to exercise mostly running and don't
lift irons like weights becuase it'll intense your musles and feel moere anxiety.i was in this your situation, even now
but i took my antideppressant medication always (leaxpro,tranxene,)but please what you have to ido s stop anything
that contian caffeine that is worst thing you can eat or drink.caffeine intake  worsting your situation but you won't
know untill someone like us who suffer the same  will explain those symptoms ,you can download this web www.
anxietycentre.com then read the articles there and find the related  one that mostly disturb you.but with all this try
exercise it helps alot for anxiety and remenber to start with joging and Discretion is the better part of valour.
do not mind my english thanks san
                           

[newbie76]

Scotian and Sanitex, thank you so much for taking the time to share your experience with me.
I am aware of how addictive benzos can be. I have been prescribed Diazepam 5mg and I try to take one in the morning only when things gets really bad... I'd say that on average I have been taking it 2 out of 3 days.

The Citalopram still hasn't kicked in unfortunately (I am on Day 5) so things are still very much difficult in the morning.

Thankfully after 2-3pm my anxiety give me a break so I usually take a bath and then go to the park to walk, read or listen to a relaxation mp3 in the sun. This seem to help a lot, so much that I manage to eat properly in the evening.

I have an appointment with a psychiatrist tomorrow morning, so I will see what he thinks of all this.

[newbie76]

At least go buy some protein/whey powder stuff and drink it.

Miss Philicia: I have followed your advice and bought a tin of protein shake! Thank you.