Posted by yxibow on February 6, 2007, at 20:24:19
In reply to Diff between anxiety, akathesia, dysphoric mania?, posted by blueberry1 on February 6, 2007, at 19:23:38
> How do you tell the different between anxiety, akathesia, and dysphoric mania? When I read descriptions of them, I swear I have all of them, mixed in with anhedonic withdrawn depression. Can't tell one from the other. Since the only med I am taking is 5mg cymbalta (that's right, 5mg), I can't see it being akathesia unless I have become really sensitive.
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> I'm just real nervous. Can't relax. Hard to be in a conversation. Feel disconnected. Mind racing with worries, worries that I recognize as being ridiculous and silly, so I try to talk myself calm with reality but it doesn't work. Even in the face of plenty of evidence the worries are stupid and groundless they just go on.
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> No real physical symptoms except for a butterflies-in-the-stomach kind of feeling. No panic at all. I appear calm on the outside to anyone looking at me. But on the inside I am a wreck.
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> This was all there to a small extent before cymbalta, but has been massively magnified on cymbalta, even at just 5mg.
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> If I could figure out if I have anxiety, or if this anxiety is a component of my depression, or if this is a dysphoric soft bipolar mania sparked by cymbalta, or if this is some sort of soft paranoia, it would sure help in knowing what direction to go with meds. Cymbalta has helped in two ways...haven't had a crying spell in a while, though I feel close sometimes; and my afternoon sinking fatigue is gone. One bad side effect...sex drive is through the roof. Too much. Not normal. Can't get it off my mind.
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> How do you tell the difference?From all my experience with akathisia, that's not akathisia. Akathisia is a side effect, mostly of neuroleptics, rarely of SSRIs, I don't know if I've heard of it with Cymbalta but I suppose its possible. 5mg would be a placebo in most individuals, but we all vary.
Akathisia is the feeling that you have to either a) move, even if there is a brick wall in front of you, or b) lie on the floor writhing because you feel you have to move even if there is a brick wall in front of you. It is a movement side effect / disorder.
"I'm just real nervous. Can't relax. Hard to be in a conversation. Feel disconnected. Mind racing with worries, worries that I recognize as being ridiculous and silly, so I try to talk myself calm with reality but it doesn't work."
Definately sounds like some sort of OCD like anxiety. Its very hard to stop pure obsessions, or "garbage thoughts" racing through the mind. As a lifetime sufferer of OCD, I can sympathize that there are times that they flare up, and Cymbalta just isn't covering it like Luvox. On the other hand Cymbalta does more for my MDD, so I guess it was a better choice from my psychiatrist. They're not as intrusive for me as it sounds like for you.
In general those kinds of thoughts, other than attempting to block them with Luvox or Anafranil, become worse when one pays more attention to them or microanalyzes them. And I know that's difficult to do when they get roaring up. Perhaps some work with relaxation therapy with your doctor would help you to focus better. (It's not just hocus pocus).
Yes, you could have a PRN prescription for Xanax 0.5 at those moments, and I do have such a thing standing, but a) you don't really want to be operating heavy machinery and b) in the long run while I'm not saying that better living through chemistry sometimes is a necessary thing, knowing how to relax in a situation is something you will be able to recall again and again.
I hope you feel better-- Jay
poster:yxibow
thread:730582
URL: http://www.dr-bob.org/babble/20070201/msgs/730607.html