Without going into a great deal of detail, I’ve been having a big problem with dysautonomia in recent months. It’s been a battle of one kind or another pretty much as far back as I can remember — way before I even had a name for what was plaguing me — but the past few years have been especially rough, and the last months have been the worst.
In addition to symptoms like chest pains, acid reflux, migraines, digestive issues, intolerance to heat/cold, low threshold for physical exertion, shortness of breath, an exaggerated startle reflex, tinnitus, and fatigue, new symptoms anxiety and panic came out to play as well.
Anxiety and panic attacks are two of the most common symptoms of dysautonomia but while I certainly was more prone to anxiety than the average person, the experience of a full-blown panic attack was new to me. And suddenly I was having them on a weekly basis, with the rest of the time filled with heightened dysautonomia symptoms and increased anxiety over another pending panic attack.
Yeah, it was awesome.
Last Monday, I went in to talk with my doctor about options. I’d been doing some biofeedback work on my own, as well as taking stabs at aromatherapy and meditation (a tough exercise when you’re in the midst of panic), but I knew I needed more help than that. I’d never been on any kind of anti-depressant or similar medication before — and was tense and anxious just considering it. I’m also prone to unpleasant side effects with pretty much any medication — e.g., multi-vitamins tend to give me really bad heartburn, and even a hint of aspartame sends me into symptoms of toxicity.
My doctor prescribed citalopram, the generic of Celexa. Unfortunately, at only 10 mg/day — a very low dose that’s generally prescribed initially in order to ramp up to a higher, more beneficial dosage (usually 20-40 mg daily) — I had a rather extreme experience of side effects.
Headaches, extreme fatigue, confusion, feeling like I was in a fog or viewing the world from behind a veil, diarrhea, constipation, stomach cramps, nausea, dizziness, problems balancing on my feet, complete lack of appetite, memory difficulty, restlessness (which is really interesting in simultaneous combination with fatigue), visual disturbances, partial loss of my voice, and generally feeling like I was drunk all the time.
Obviously, I had to stop driving. I did run some errands on Tuesday morning — just over 24 hours after starting the medication — and the results were troubling. I didn’t have any near misses or anything like that, but there were two instances in which I discovered myself farther along the road than I’d remembered driving. I was driving carefully (like always), but I guess I just wasn’t forming memory during those gaps. Erring on the side of caution, I hung up my keys.
Thursday, a good friend came to collect me from the house to go out for lunch. I still didn’t have an appetite, but I hoped to tempt myself with some fried rice. We’d gotten only a half-block from the house when I had to bite my tongue to keep myself from begging her to take me back. I was feeling very “foggy” and having difficulty following conversation or focusing my eyes. But we did make it to the restaurant, and I did eat something. Not long into our outing, however, I told her I just really needed to go home. She agreed that I was looking and acting quite woozy, and promptly took me back.
Keep in mind that I was experiencing all of these medication side effects on top of the anxiety, panic and other dysautonomia symptoms I’d already been having. (The benefits of the medication aren’t expected to kick in for about 30 days.)
Mike even half-jokingly asked, “How is it possible that your life could suck so bad?”
Friday morning rolled around, and there was still no improvement. On the contrary, it seemed that each day brought another side effect or two to the party, and as the drug started to build up in my system I was feeling worse every day. I called my doctor to ask for help. I didn’t want to give up on a possible solution so quickly, but I’d actually been much more functional the previous week when I was simply paralyzed by anxiety. Instead of stopping the medication altogether, I agreed to try a half-dose for a week or two in hopes of lessening the side effects. My doctor will want me to ramp back up again later, which I’m not too sure about, but we’ll see how I’m doing in another week.
Today is the third day on the half-dose of 5 mg. Sunday, I was conscious for a full 12 hours straight — a huge advance over previous days, when I’d lasted just a few hours at a time (and was pretty woozy while I was up). I’m still dizzy. I’m still struggling with a bit of “cloudy brain,” confusion, headaches and gastrointestinal upset, but it is better than it was. I’m back to writing and editing today, in short sprints. So far, so good.
There’s more to share, but this is my report for now. You can’t say it’s not an adventure!
Hi Jennifer,
Did your dr speak to you about Buspar? It’s great for anxiety – not depression, and it has veryvery few side effects and no drug contraindications. Also you can go off it without weaning off – unlike the SSRIs and SNRIs. Like you, I have a lot of general anxiety – mostly somatic symptoms and not panic attacks. Buspar worked really well for over 15 years. I recently had to change meds – perimenopause and hormone stuff moved me more into depression territory. My mom (psychiatrist) always says that if you have catastrophic thoughts while driving you are a good candidate for Buspar. Haha! Anyway, just a suggestion. Also I am VERY sensitive to differences between brand and generics(and I bet you are too). I had really good luck w generics on it in the last few years. Earlier the generics weren’t nearly as consistent, but now they seem to be.
Thanks, Laura! No, Buspar didn’t come up in my conversations with my doctor, though I may ask about this next time. I’ve also wondered how much of the recent rise in dysautonomia symptoms may be due to possible perimenopause, and I need to remember to ask about this as well — even though recent blood work all came back normal.