On STRONG MEDS and Making it through Med School

[MD2b20004]

I am on very strong mental meds for anxiety, panic attacks, seizures. I take 40mg lexapro (pretty much max), 6mg (Xanax) pretty much max, 400mg (seraquil) pretty much max, and 1000mg depakote. I took a leave of absence from med school a while ago, some may remember due to how extremely messed up my anxiety got and how it mad it difficult to study, concentrate, sleep, breath right, and all the other symptoms that come with anxiety, just google GAD (Generalized Anxiety Disorder) you find out. Now I been in steady treatment for 7 months, i feel like the meds are helping me, but the side effects are scary: loss of short term memory (I keep repeating same stories to friends without knowing, very very high fatigue that I feel like sleeping 24/7, and sometimes i get occasional tremors and respiratory problems from the side effects. All the drugs are pretty addictive, skip a xanax dose and i am screwed. Now any of you med students on such high levels of dosage of similiar meds and manage to get through classes with no problem or at least able to manage to keep up. I am scared to go back and lose more money on tuition thinking I am ready but I really am not. I still have anxiety symtoms with the meds, but at lower levels, like I get scared to commit to a job or make commitment to long term things because I fear my anxiety is going to play with my head and convince me to leave due to unrealistic thoughts which is another symtom of anxiety. I am scared like 7 years of med school what if it peaks again at year 3, or 4 or 5, etc... I lost all that money and achieived nothing but huge sums of loans and higher doses of meds. Anyone with similar problems, stories, know others with such problems please share them with me.

Thank you.

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[beanbean]

Glad to hear you are doing a bit better with your symptoms. It sounds like things are moving in the right direction. Only you can decide when you are ready to give school another shot. Considering the high doses of meds you are on and the side effects (fatigue, etc.) you might want to take things slow. What is the long-term med plan you have made with your physician? Are you planning to try tapering doses at some point of some of the more sedating meds?

Keep your chin up and remember the anxiety can't hurt you. Take things a step at a time and keep pushing. There are students who make it through med school with a wide variety of medical problems and obstacles. Take it slow with school and know that if things get tough again you can always take another leave. Running too many "what if" scenarios in your mind will only make the anxiety worse. I know someone who was virtually housebound due to agoraphobia and anxiety at one point in their life and is now a successful med student.

Believe me, you will make it through this.

 

[Kezaar]

Maybe practicing something like Tai Chi Chuan can help you to calm down ? You'll have to overcome those anxieties someday anyway.

 

[MD2b20004]

Thanks for the inspiration, its so difficult, i hate my life i so wish i can snap out of this, oo to add on it, my family provides no support and just think I am being lazy or dont want to do anything with my life or lost all of my ambition all of a sudden, so it makes stuff worse (cant blame them i guess, none of them are educated). But I get alot of, go WORK and pay your own bills, you look fine! It doesn't help my case at all.

 

[Rendar5]

Have you considered bringing ur family in to talk with ur doctor to explain what's going on. Might make what u're going through more legitimate to them, possibly?

 

[MD2b20004]

my family cant come or really care, i been living on my own since 16, my parents live overseas too. All i got here in the US is my brother and he is 33, not educated and thinks he knows it all and he ends up transmitting his prospectives to my parents based on his own intepretation and because he is the eldest, they just buy what his ignorant self says even though he didnt even finish high school.

 

[JakeHarley]

my family cant come or really care, i been living on my own since 16, my parents live overseas too. All i got here in the US is my brother and he is 33, not educated and thinks he knows it all and he ends up transmitting his prospectives to my parents based on his own intepretation and because he is the eldest, they just buy what his ignorant self says even though he didnt even finish high school.

I know you've probably already tried this or had someone suggest it, but have you looked into psychotherapy as an addition or alternative to your current method of treatment? I say this because it is clear that you are hitting the wall trying to medicate the problems away, and because it sounds like you may have some very heavy unresolved issues from your family life. Its very possible that not all of the depression and anxiety you feel is due simply to chemistry, there could be a huge cognitive component that is not and will not be solved through medication.

I am also from a difficult family background, and suffer from some of these same things--although to a lesser extent than what you describe. I've found therapy to be a huge benefit, while anti-depressants/anti-anxiety meds offered minimal and temporary relief with undesirable side effects.

I have a couple of resources available to locate good therapists. If you are interested, PM me. Most insurance plans will cover you for a certain number of visits per calendar year, meaning if you start to see someone now, your number of allowed visits will roll over in a few months.

Take care!

Jake

 

[MD2b20004]

CBT seems too long of a road, too expensive, too time consuming (i wont ever have time to get a job if I get to that farfetched point of being well enough to get a job, and if CBT requires alot of time commitment imagine how it would be in medical school. And to be honest, i dont believe too much in CBT, i just want my physical symtoms to go which the meds are finally starting to help but again with those extremely adverse side effects. My family's point of view, "you look healthy, we got no money to help you, go get a job..."

 

[pschmom1]

Im sure you feel helpless and just want to be "normal" but the meds are only going to mask the problem. You are on quite a mixture of meds, and some antipsychotic meds at that. I can't imagine how you can feel "good" on all of those meds. I know that therapy seem like it will take too long to see adequate results, but it really is worth it. Any doctor perscribing these meds will vouch for that (psychiatrist I hope). Also, as far as cost goes, have you looked into community programs that charge based on income? There is the right help out there for you, it just takes some research to find it. Don't get discouraged, I know it seems as if nothing can fix this problem and it will never go away, but I do know that psychotherapy is key in your recovery and future mental stability. Please dont settle for just the meds and come to this forum for friends and a shoulder cause your family is obviously not available under these circumstances. Good luck to you.

 

[samenewme]

CBT seems too long of a road, too expensive, too time consuming (i wont ever have time to get a job if I get to that farfetched point of being well enough to get a job, and if CBT requires alot of time commitment imagine how it would be in medical school. And to be honest, i dont believe too much in CBT, i just want my physical symtoms to go which the meds are finally starting to help but again with those extremely adverse side effects. My family's point of view, "you look healthy, we got no money to help you, go get a job..."

CBT did a lot for my (admittedly less severe) anxiety and depression, and I'm off two of my three meds. It's a hell of a lot cheaper than med school tuition.

 

[JakeHarley]

CBT seems too long of a road, too expensive, too time consuming (i wont ever have time to get a job if I get to that farfetched point of being well enough to get a job, and if CBT requires alot of time commitment imagine how it would be in medical school. And to be honest, i dont believe too much in CBT, i just want my physical symtoms to go which the meds are finally starting to help but again with those extremely adverse side effects. My family's point of view, "you look healthy, we got no money to help you, go get a job..."

I hear your concerns, it can certainly be daunting to face the prospect that some things are not fixable by drugs. I would urge you to reconsider your beliefs about the efficacy of psychotherapy, especially considering the dire situation it sounds like you are in. If there is a possibility that something as accessible as therapy could help, why not try it?

Secondly, the symptoms that you are describing as "physical" may not be seperable from the underlying psychological causes. Drugs will only ever mask these symptoms, apparently in your case they don't even do that--and they are leaving you basically non-functional in life.

Third, if you've got the time and money to be drugged out on all those meds, you probably have the time and money to see a good therapist. The typical period of treatment is an hour a week for a few months. Sounds like you've already lost many more hours than that with your current approach.

Fourth:

My family's point of view, "you look healthy, we got no money to help you, go get a job...

This is a very telling statement...you aren't your family, you are you, you have to do what you need to do for yourself. This is exactly the kind of thing that drugs will NEVER fix.

Lastly, as a future physician, you will probably end up having patients who deal with the same issues that you have. Will you tell them to "suck it up" and blindly prescribe these heavy psychoactive drugs while ignoring other possible causes and therapies?

I don't intend to sound as if I am badgering you, I just know first hand that these things are complicated, and that a multi-faceted approach to healing yourself is almost always best. I've also a very close friend who has been working as a therapist for several years, and he's consistently seen amazing improvement in his clients through helping them face past family traumas. Your family denying your difficulties and showing little compassion for you is a prime example of the kind of traumatic family experience that results in anxiety and depression. It destroys your sense of self and your ability to face difficulties in life.

Good luck--I wish you all the best!

EDIT: DITTO TO THE TWO POSTERS ABOVE!

 

[beanbean]

Meds may seem like the easiest solution right now but you need to develop a plan for the long term. You may always need some medication to keep the symptoms to a reasonable level, but therapy is what will help you manage your symptoms and keep the meds to a mininium. There are other types of therapy besides CBT. The fears you have right now about med school, family, etc. are exactly what you should be talking to a therapist about.

 

[bridge2006]

There is a book called "Feeling Good" that a very respectable psychologist I worked with recommends to her pts either on its own or as an adjunct to therapy. It is essentially do-it-yourself CBT. Worth a try at $10 for paperback. Good luck!

 

[pschmom1]

There is a book called "Feeling Good" that a very respectable psychologist I worked with recommends to her pts either on its own or as an adjunct to therapy. It is essentially do-it-yourself CBT. Worth a try at $10 for paperback. Good luck!

Ahh, good book from the ever respected psychologist David Burns. Great advice, and great book .

 

[Ottercreek]

I am on very strong mental meds for anxiety, panic attacks, seizures. 6mg (Xanax) pretty much max...

While xanax will mask the anxiety short term, it will be the cause of much more anxiety for you long term. It will be very difficult to function as a physician on xanax due the very problems you described - sleepiness, and especially short term memory loss.

Talk to your physician about tapering off very slowly, as xanax will cause you a tremendous amount of anxiety during withdrawl.

Pursue some of the other anti-anxiety avenues mentioned here if being a physician is your goal. Short term memory loss will cause you (and your patients) tremendous problems later on.

 

[futurecooterdoc]

You should quit if you feel like you can't handle the stress. Think of your illness as a gift and become a fighter.

-futurecooterdoc

 

[fun8stuff]

CBT seems too long of a road, too expensive, too time consuming (i wont ever have time to get a job if I get to that farfetched point of being well enough to get a job, and if CBT requires alot of time commitment imagine how it would be in medical school. And to be honest, i dont believe too much in CBT, i just want my physical symtoms to go which the meds are finally starting to help but again with those extremely adverse side effects. My family's point of view, "you look healthy, we got no money to help you, go get a job..."

you are blocking the arrows... but they are going to keep coming forever. what you need to do is to attack the archers. then, and only then, will the arrows disappear forever.

 

[Psycho Doctor]

I hear your concerns, it can certainly be daunting to face the prospect that some things are not fixable by drugs. I would urge you to reconsider your beliefs about the efficacy of psychotherapy, especially considering the dire situation it sounds like you are in. If there is a possibility that something as accessible as therapy could help, why not try it?

Secondly, the symptoms that you are describing as "physical" may not be seperable from the underlying psychological causes. Drugs will only ever mask these symptoms, apparently in your case they don't even do that--and they are leaving you basically non-functional in life.

Third, if you've got the time and money to be drugged out on all those meds, you probably have the time and money to see a good therapist. The typical period of treatment is an hour a week for a few months. Sounds like you've already lost many more hours than that with your current approach.

Fourth:


This is a very telling statement...you aren't your family, you are you, you have to do what you need to do for yourself. This is exactly the kind of thing that drugs will NEVER fix.

Lastly, as a future physician, you will probably end up having patients who deal with the same issues that you have. Will you tell them to "suck it up" and blindly prescribe these heavy psychoactive drugs while ignoring other possible causes and therapies?

I don't intend to sound as if I am badgering you, I just know first hand that these things are complicated, and that a multi-faceted approach to healing yourself is almost always best. I've also a very close friend who has been working as a therapist for several years, and he's consistently seen amazing improvement in his clients through helping them face past family traumas. Your family denying your difficulties and showing little compassion for you is a prime example of the kind of traumatic family experience that results in anxiety and depression. It destroys your sense of self and your ability to face difficulties in life.

Good luck--I wish you all the best!

EDIT: DITTO TO THE TWO POSTERS ABOVE!

this is a great post. Having worked with a psychiatrist and suffering from depression, panic attacks and post traumatic stress anxiety, i can agree that meds may alleviate some of the symptoms but for long term effects, therapy is definitlty part of the solution.

 

[Sustiva]

this is a great post. Having worked with a psychiatrist and suffering from depression, panic attacks and post traumatic stress anxiety, i can agree that meds may alleviate some of the symptoms but for long term effects, therapy is definitlty part of the solution.

I agree 100%... I have a question... what is the therapeutic goal in prescribing xanax or klonopin (.25, .5, 1.0 mg ++) tid??

 

[starwisher]

Hi,

I took time off of med school because of mental health problems too, in my case it was with social anxiety and depression. I actually overdosed on some of my meds the summer between my first and second years of med school and then still tried to take my second year. Not surprisingly I couldn't make it through the year. My depression is a much bigger problem for me than the anxiety (I've never had panic attacks or anything like that) so I'm not sure how comparable our situations would be. I didn't find medication at all helpful for me, although I did take it for over a year. I am in school again now and doing much better, although I still fear not being able to finish. I have pretty extensive therapy still and I know I couldn't be in school without it. I don't do CBT and actually don't know that much about it, although I have heard that it is the best treatment for anxiety disorders.

I tried to go back to school before I was ready and ended up needing to ask for additional time off, it actually made things a lot harder for me and now I have the additional pressure of knowing that if I don't make it through this time I have no more second chances left. I definately recommend making sure you are prepared before attempting to start school again so you don't put yourself in that same situation. This time before I returned I tested myself by getting a job in the months before returning to school to make sure I could handle making a committment to a schedule again. If you don't think you can commit to a job right now I would guess that going back to school isn't yet a possibility. Really you don't know what you are capable of until you try though, perhaps gradually committing yourself to more long-term activities can help you reduce your anxiety about not being able to follow through with things. For me there was a point where I couldn't follow through with anything except attending my therapy (and even then I still missed some appointments).

It seems like the committment and cost of therapy is what is making you dismiss it as an option. The time committment part of therapy would actually probably be a benefit for you to see if you have the ability to stick with it, especially if you are so unwell that you can't even work. What else are you doing with our time that therapy wouldn't be an option? If it doesn't work it doesn't work, but if it does it will be time well spent. My doctor understands my lack of finances and was willing to see me at reduced fee, it is quite possible you could be referred to someone who would be willing to make a similar arrangement with you. If you still live in the area where you were attending school I suggest contacting your former schools counseling or health services to ask about the possiblity of counseling through the school or for a referal to someone in the area who charges people based on a sliding scale.

Good luck!!

 

[RustNeverSleeps]

I am on very strong mental meds for anxiety, panic attacks, seizures. I take 40mg lexapro (pretty much max), 6mg (Xanax) pretty much max, 400mg (seraquil) pretty much max, and 1000mg depakote. I took a leave of absence from med school a while ago, some may remember due to how extremely messed up my anxiety got and how it mad it difficult to study, concentrate, sleep, breath right, and all the other symptoms that come with anxiety, just google GAD (Generalized Anxiety Disorder) you find out. Now I been in steady treatment for 7 months, i feel like the meds are helping me, but the side effects are scary: loss of short term memory (I keep repeating same stories to friends without knowing, very very high fatigue that I feel like sleeping 24/7, and sometimes i get occasional tremors and respiratory problems from the side effects. All the drugs are pretty addictive, skip a xanax dose and i am screwed. Now any of you med students on such high levels of dosage of similiar meds and manage to get through classes with no problem or at least able to manage to keep up. I am scared to go back and lose more money on tuition thinking I am ready but I really am not. I still have anxiety symtoms with the meds, but at lower levels, like I get scared to commit to a job or make commitment to long term things because I fear my anxiety is going to play with my head and convince me to leave due to unrealistic thoughts which is another symtom of anxiety. I am scared like 7 years of med school what if it peaks again at year 3, or 4 or 5, etc... I lost all that money and achieived nothing but huge sums of loans and higher doses of meds. Anyone with similar problems, stories, know others with such problems please share them with me.

Thank you.

Not to get too personal -- and please don't feel that you have to answer this publically, these are more issues that you might want to think about than things you have to tell the SDN community -- but do you know why you are taking all these medications? Seroquel, for instance, is an antipsychotic. However, it is also used for agitation and for difficulty sleeping. If you were given Seroquel for sleep difficulties, you may want to discuss alternatives with your doctor, since medications like Seroquel pack a real punch in terms of side effects. Depakote (a "mood stabilizer") also is associated with significant side effects; this might be another one to discuss with your doctor to see if it is actually helping you and/or if it is a medication you really need. You mentioned that you seem to have dependence problems with Xanax. Have you told this to your doctor? This is something that can be addressed, too, at the right time (for instance your doctor might want to stabilize your symptoms first before he tapers your Xanax) and setting.

I applaud you for taking you illness seriously, and for considering how it might impact an tough endeavor like medical school. I think you might feel a lot better (and hopefully improve your short-term memory) if you could get your medications in order -- maybe tailoring your doses and discontinuing medications that are causing more harm than good.

You mentioned that you are on a leave of absence from med school -- do you still have access to school services? Often schools offer free or reduced cost therapy to their students. I know you mentioned that time and money are obstacles to therapy, but if you could find a feasible situation, you might find the combination of medication and psychotherapy to be more helpful than either one alone.

I'm sorry that you've had such a tough road through med school so far. I hope you can get your health issues worked out - don't give up on yourself!

 

[MD2b20004]

Not to get too personal -- and please don't feel that you have to answer this publically, these are more issues that you might want to think about than things you have to tell the SDN community -- but do you know why you are taking all these medications? Seroquel, for instance, is an antipsychotic. However, it is also used for agitation and for difficulty sleeping. If you were given Seroquel for sleep difficulties, you may want to discuss alternatives with your doctor, since medications like Seroquel pack a real punch in terms of side effects. Depakote (a "mood stabilizer") also is associated with significant side effects; this might be another one to discuss with your doctor to see if it is actually helping you and/or if it is a medication you really need. You mentioned that you seem to have dependence problems with Xanax. Have you told this to your doctor? This is something that can be addressed, too, at the right time (for instance your doctor might want to stabilize your symptoms first before he tapers your Xanax) and setting.

I applaud you for taking you illness seriously, and for considering how it might impact an tough endeavor like medical school. I think you might feel a lot better (and hopefully improve your short-term memory) if you could get your medications in order -- maybe tailoring your doses and discontinuing medications that are causing more harm than good.

You mentioned that you are on a leave of absence from med school -- do you still have access to school services? Often schools offer free or reduced cost therapy to their students. I know you mentioned that time and money are obstacles to therapy, but if you could find a feasible situation, you might find the combination of medication and psychotherapy to be more helpful than either one alone.

I'm sorry that you've had such a tough road through med school so far. I hope you can get your health issues worked out - don't give up on yourself!

Trust me, I know all the side effects/possible side effects of the medication I am put on, but yanking them off does not help. I asked my doc to take me off Depakote, which he did. I been on Meds straight for 9 months now, to be honest it helped my panic attacks and helped my anxiety a bit(with time, SLOWLY, but hopefully will continue), last time the doc tryed to try a new drug or when i skipped a dose of xanax, I had a seizure. The problem is the doc nor I know exactly when i will be fine enough to be tappered off all the drugs, the goal is to be just left on 40mg lexapro and pull off the rest, but my question remains, ANYONE on similiar drugs and still functioning in school, anyone drop out due to these symptoms or drugs, anyone fear , like me, that its going to happen again (a relapse) and you cant continue and your left with a load full of loans?

 

[MD2b20004]

Hi,

I took time off of med school because of mental health problems too, in my case it was with social anxiety and depression. I actually overdosed on some of my meds the summer between my first and second years of med school and then still tried to take my second year. Not surprisingly I couldn't make it through the year. My depression is a much bigger problem for me than the anxiety (I've never had panic attacks or anything like that) so I'm not sure how comparable our situations would be. I didn't find medication at all helpful for me, although I did take it for over a year. I am in school again now and doing much better, although I still fear not being able to finish. I have pretty extensive therapy still and I know I couldn't be in school without it. I don't do CBT and actually don't know that much about it, although I have heard that it is the best treatment for anxiety disorders.

I tried to go back to school before I was ready and ended up needing to ask for additional time off, it actually made things a lot harder for me and now I have the additional pressure of knowing that if I don't make it through this time I have no more second chances left. I definately recommend making sure you are prepared before attempting to start school again so you don't put yourself in that same situation. This time before I returned I tested myself by getting a job in the months before returning to school to make sure I could handle making a committment to a schedule again. If you don't think you can commit to a job right now I would guess that going back to school isn't yet a possibility. Really you don't know what you are capable of until you try though, perhaps gradually committing yourself to more long-term activities can help you reduce your anxiety about not being able to follow through with things. For me there was a point where I couldn't follow through with anything except attending my therapy (and even then I still missed some appointments).

It seems like the committment and cost of therapy is what is making you dismiss it as an option. The time committment part of therapy would actually probably be a benefit for you to see if you have the ability to stick with it, especially if you are so unwell that you can't even work. What else are you doing with our time that therapy wouldn't be an option? If it doesn't work it doesn't work, but if it does it will be time well spent. My doctor understands my lack of finances and was willing to see me at reduced fee, it is quite possible you could be referred to someone who would be willing to make a similar arrangement with you. If you still live in the area where you were attending school I suggest contacting your former schools counseling or health services to ask about the possiblity of counseling through the school or for a referal to someone in the area who charges people based on a sliding scale.

Good luck!!

can you please pm me with your situation now and tell me a little more about your situation and how/when you were diagnosed and why you went back to school unsure and when do you think its time that you are sure ur ok, and let me know where you stand now, are u in school, out? are you a freshman or how does the time off work with your school?