The Meaning of Anxiety and Depression

It seems bizarre to me that a number of people seem to very strongly believe that anxiety and depression are always meaningful. My first therapist told me that anxiety was like a sign post directing me towards my needs. This was a terrible thing to say to me. I've also come across a number of books that say more or less the same thing. 

I'm not saying that there aren't external factors that contribute to anxiety and depression, but whatever one is feeling anxious or depressed about isn't necessarily related to those factors. Stress is a trigger for OCD, for example, but when I find myself obsessing, it's not like I obsess about what I'm stressed out about. Trying to find meaning in my obsessions is generally disastrous.

I understand where this idea that anxiety and depression are meaningful comes from. We live in a society where antidepressants are frequently prescribed and we are told that antidepressants are necessary to fix chemical imbalances in our brains. More are more people are taking drugs.

The people who believe that anxiety and depression are meaningful are responding to some of these disturbing trends in the over-medicalization of mental illness. They see finding meaning in anxiety and depression as an alternative to blindly popping pills.

But there's a third alternative I think. We can recognize that anxiety and depression arise from a number of complex factors, which include, but are not limited to:
1. Some sort of life situation or problem--that is, the anxiety and depression is meaningful
2. A structural or chemical issues with the brain
3. A lack of exercise or good food or sleep
4. An excess of caffeine or other substances that exacerbate anxiety
5. A health condition--thyroid hormone imbalances are linked to anxiety and depression, for example. 

Just because we recognize that anxiety and depression sometimes are not meaningful doesn't mean that popping pills is the only answer, either.

Various Things I've Taken for Anxiety

Taking drugs or supplements for anxiety is a tricky thing. I've come to believe that taking anything regularly to treat anxiety probably not a good idea. I'm always concerned about becoming reliant on any substance since I seem to suffer from anxiety so regularly. Chemical addiction is another issue. For example, benzodiazapenes work really well, but they affect your brain's synthesis of GABA if you take them long-term. This causes anxiety to only get worse. This may be an issue with other substances, but the consequences of long-term use may not be as well understood.

I haven't taken anything for my anxiety in a bit. But for those who are struggling and looking for something to help with anxiety, here's what I've taken and my thoughts:

Clonazepan 
Clonazepan is a benzodiazapene. I got it from my doctor for sleep issues I was having a few months ago. I was told I could take 1-2 pills at bedtime for sleep. I found that half of a pill more than did the trick. The first time I took it, I felt a bit drugged and groggy in the morning. Then again, I hadn't slept well in three or so weeks when I took it, so it could be I was just exhausted. I took it every night for a week, and then stopped without any adverse effects. I've taken a half pill from time to time when I've been feeling particularly anxious and unsure if I'd be able to sleep well. It makes me feel calm and a bit dizzy. It's not like the things that I'm anxious about magically disappear, but I'm too dumb to really think about them. If I've been having a lot of anxiety, it's nice to feel dumb for a while and then pass out. Clonazepan is super addictive though, so when my bottle runs out, I don't plan on asking for more.

SAMe 
SAMe is a supplement that is supposedly a fast acting antidepressant. It's regularly prescribed in Italy instead of SSRIs for mild to moderate depression. Like SSRIs, it's thought to increase levels of serotonin in the brain. I took it when I was feeling both anxious and depressed and having insomnia. I took it for just over two weeks and I did not have a good experience with it. I felt emotionally numb, had zero sex drive, and my insomnia got worse. It was only when I was thinking of going off of it that I did more online research and found that a lot of people find it negatively affects their sleep, which was exactly what I didn't need. SAMe may work just fine for depression, but I don't think it works for OCD.

Inositol
Inositol is a substance found in food and also sold as a supplement. Normally you get 1-2 grams a day in your diet, but therapeutic doses are in the range of 10-18 grams per day. A number of small studies indicate that it helps with panic attacks and OCD. It doesn't have an side effects, other than temporarily causing diarrhea in some. If you start taking it as a supplement it supposedly takes 3-6 weeks to work. I initially took inositol nearly two years ago when I started getting panic attacks. I worked my way up to taking about 10 grams a day, and found my panic attacks when away. I then weaned myself off of it. I took it sporadically a few times until this last spring when I started taking around 12 grams a day to help with anxiety and OCD symptoms. I weaned myself off of it again this fall. I don't really know what I think of inositol. I feel like it helps, but it's effects are subtle. Since the only studies of it are small, it's unclear whether it really works and what its long-term effects are. This is why I stopped taking it. I find that I get a lot more anxiety while going off it, which is why weaning is so important. This last time I went off it, I felt like I was getting facial twitching. This was likely just a sensory obsession though, and it passed after a week. I think I feel a little bit more like myself, and a bit more motivated since going off of it. Then again, I'd been doing a lot of work in therapy and thinking better about my life, so who knows. Since it really doesn't have side-effects and isn't addictive, I certainly wouldn't recommend against it.

Valerian, Passionflower, and Catnip
I took a mixture of these three herbs for insomnia. I think they helped me fall asleep, but I'd wake up in the middle of the night feeling anxious and physically weird. My skin felt funny while taking these herbs. I know people who have had success with these herbs, but I'm not a fan.

Other things
Pot sometimes helps with anxiety and insomnia, sometimes doesn't help at all. Unclear why it sometimes works and doesn't. It certainly helps me stay asleep, but not necessarily fall asleep. I feel very calm and happy while drunk, but I wake up feeling horrible the next morning, so I generally avoid alcohol nowadays. Caffeine seems to contribute to my anxiety and insomnia, so I avoid it all together. I even avoid tea, including green tea. Occasionally, I'll drink twig tea (about 5 mg per cup) and eat chocolate, but I avoid these things if I've had any sleeping issues.

Update

For anyone out there, who reads this and doesn't already know what's going on with me, here's an update:

A few weeks ago, I decided to quit my job. I went into therapy and told my therapist about it. He was ubber supportive and said I seemed happy about this decision. I then asked if I should keep seeing him and he said we was going to ask me the same question. I said I felt okay going it alone for a while. We chatted a bit about a few other things--skin picking, perfectionism, etc. And that was that. I left feeling certain of my decision to quit my job, so I went and quit that afternoon.

I know I've whined a lot about how my therapist suggested I take SSRIs. After our last conversation about them, though, he let the topic go. I think he realized it flustered me. It's odd now that I'm not seeing my therapist how much I notice his absence. There are so few men in my life who are consistently nice to me, my partner being the one notable exception. Also, my therapist and I had quite a few conversations about being nice to myself. At first, I think, I believed he was telling me this out of some sort of utilitarian belief that being nice to myself would serve me better. On some level I believed that he was just nice to me because I was paying him to be. I think, though, after talking to him more I kind of came to believe that he was nice to me and wanted me to be nice to me because that's actually how he fundamentally approaches people. I found this deeply encouraging.

Since quitting, I've had a rough few weeks and wondered many times if my decision to quit therapy was hasty. Having to go to work has been really difficult. I have a lot of mixed feelings and I feel like I'm ditching  my coworkers with a lot of work to do. I find myself getting angry about things I tend to get angry about it work, and then reminding myself that I need to let go. I'll be saddest not to see my coworker every day, but we live near each other and can continue to be friends if we choose to.

I've had a really good past few days. I think not being at work has helped considerably. My anxiety levels are pretty low.

I'm concerned about January when I won't be working. I need to have structure in my life and I need to be working on things that I care about and seeing people every day. This will be hard without a job, but not impossible.