Anxiety and depression seriously affecting productivity

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So my anxiety and depression seems to be flaring up again, mostly due to external stresses. My personal life and my uni life has gotten me to a stage where I am either constantly vigilant and anxious or constantly apathetic and sluggish. Few times do I actually have the energy or the motivation to do normal things and it is seriously affecting my productivity.

I know I need to talk to a doctor and I am arranging that appointment, but in the mean time I want to ask you guys how you get out of a slump like this. I'd be lying if I said I wasn't desperate right now. I'm just barely getting by and it's still not good enough.

Your first task is to try to reduce external stress. Look at your personal life and ask what areas there are that you have control over and could improve. Maybe you're in a difficult relationship - take a time out. Take more "me time", and sit about or lie about staring into space. This reduces overall sensory input and allows the organism time to process.
University stress: consider approaching your personal tutor. Tell them how desperate you are and negotiate a period of skipping classes, consider trying for an extension of work deadlines.
Prepare for your doctor's appt. Write down your depression and anxiety issues and explain the symptoms and how these affect your day to day life. Give this to the doc, it saves a lot of time and avoids you clamming up cos of "white coat syndrome".
What meds might you want? Anti depressants and/or anti anxiety meds? Do a bit of research. The only recommendation I can make as to ADs is to avoid Effexor and Seroxat cos of how incredibly addictive both are. Anti anxiety? Consider beta blockers and/or a mild antipsychotic. Consider asking for a psych referral.

Medication, exercise, and lifestyle changes if possible are the big three for me. SSRI really helped my productivity and energy, but anxiety is still a struggle right now despite it's rep.

Thanks for your input. I'm actually already on anti-depressants and beta blockers. Despite the fact that they recently increased my dose, I'm still feeling these symptoms anyway. I don't think there's a lot of stuff I can change about my circumstances, but I am getting support from the university which is helpful.

I think I'm going to request a referral with the mental health nurse at my university, so I'll ask my GP about that. I'm currently not in any therapy because, well the NHS is not as good with mental illness, as much as they try. I've been on waiting lists for years and the only way I ever see myself getting some kind of therapy would be if my depression gets so bad that I cannot function whatsoever.

The only thing I know I can do is use every ounce of energy I can muster to get through all this s**t, hating every single moment of it. I don't think I can afford the luxury of waiting to feel better again.

Thank you for your advice. I will try to implement it as much as possible.

I'm on 180mg of propanol which helps a lot. But not enough. So i'm now on a low dose of an anti psychotic - Risperidone - which, added to the mix, is helping enormously.

What AD are you on? Is it working?


I'd be astonished if you got "therapy" on the NHS - I have pushed hard for it and got nowhere; just run of the mill CBT monkeys.
Last time I got a GP counsellor referral, she refused to work with me cos I was too far gone and she couldn't "hold me". she passed me onto CMHT and at least I got an empathetic shrink. But no therapy.[/quote]

I'm currently on citalopram. I went to the doctor tpday and she increased it by a further 10mg, so now I'm on 40mg a day (but to ease me into it, I've only to increase my normal 30mg dose to 40mg every other day). I've not seen a difference yet, but hopefully this will do the trick. I was only on propranolol temporarily over the past few weeks. It helped a wee bit and the worst of my anxiety seems to be over but chances are I'll be back on it again. Thankfully, I'm not on any anti-psychotic medication (that stuff scares the s**t out of me). No offense, I'm sure it helps you a lot, but I'm terrified of its affects on my brain if I ever did take them.

I also got a referral to see the psychiatric nurse at my university, whom I don't have to wait as long to see as someone outside of my uni.



When I was a child, it was a little bit easier to get therapy. I had a few weeks of what I assume was a form of CBT for panic attacks and then was sent away with a cassette tape of soothing sounds and a booklet with relaxation techniques. I did see a difference in physical symptoms, but it took many years afterwards to finally overcome the panic attacks. As I got older, I started suffering from depression and it was much harder to get any support because by the time I would have gotten any help, I would have already turned 18 and therefore non-eligible for the mental health services I was being sent for. It took me so long to even get counselling through school, let alone through the NHS. When I finally got help, it was with this gaslighting CPN who had an uncanny talent for dismissing your problems while also being a generally agreeable person. Our conversations would go something like this:

Me: My GP thinks I have depression
Her: I don't think you're depressed. You're just in a bit of a tizz because of your apsergers.
Me: My life is a constant cycle of failure
Her: You need to be thankful for what you have
Me: My family and tutors have put up with so much from me and I try so hard to change, but always find myself where I started. I'm scared that they will finally lose patience with me.
Her: That won't happen.
Me: I feel so hollow inside and I hate my very existence
Her: Have you tried telling your family about this?
Me: I'm constantly thinking about death
Her: Well don't think those things
Me: I can't deal with these emotions and I just want to die
Her: Don't be silly
Me: I cut myself yesterday
Her: Well don't do that
Me; I make myself sick because I want to destroy the hurt feelings from the inside
Her: Don't do that
Me: Maybe I will always feel this way. Maybe this is my natural state of being and I should just learn to live with it.
Her: That's the right attitude

After a while I just felt guilty for even going. I felt like I was wasting her time, when in actual fact she was wasting my time. What I do now is talk to the support staff at uni. They're not therapists, but I figure that this is my personality now. I can't change that. What they can do is at least advocate for me when I'm particularly vulnerable.

I've encountered numpties like your CPN - like you say: they are a waste of time.

Risperidone has settled me enormously - I can't speak for effect on brain function tho, cos my brain function is impaired anyway in areas such as concentration and focussing - both moderately useful for a student.

I wonder about citalopram - my experience of ssri's is that if a standard dose ain't working then neither will upping it; it might be worth your while researching a few other classes of AD - you'd be looking for stuff that might help with "treatment resistant depression".

You're doing all the right things to try to nurture yourself and get help. The NHS is useless with mental health but it's worth continuing to plug away hoping to get someone who is worth working with.

good luck.

good luck to you all- i hope you find some happiness in the wasteland