Anxiety

I am one of the people who are doom and gloom.

I found this statement to be especially concerning in relation to your anxiety issue, in addition to the fact that you state that you are a workaholic. A little bit of anxiety is good in life to arouse your nervous system and act as a protective mechanism, but when it gets to the point where it is interfering with your quality of life, something has to change. The fact that you are pre-disposed to pessimistic thinking is likely a huge contributing factor to your anxiety.

I saw a physician a year ago concerning general anxiety and mild depression that caused me to develop costochondritis. She simply handed me a low-dose SSRI and sent me on my way. Everyone reacts differently, but, in my experience, the drug caused me to have terrible hand tremors to the point where I could barely work with my hands. When I called her back and asked about it, she told me to just "wait it out." I ended up stopping treatment about 3 months later when they didn't stop.

Did it help with my anxiety? Sure, a little, but more importantly, it made me realize that my worrying was a choice I was making. I learned to globalize instead of internalize--the things I was worrying about were out of my control. It wasn't always my fault. If I bombed an exam, but knew I had put every bit of effort and time into it that I possibly could have, I accepted it. I told myself, "Next time, I'll do better. I can make up for this." When I signed up for the physiology 2 course taught by the department head at my university who was notoriously difficult, I told myself, "It's going to be hard, but I'm going to rock this." Just like taking a shower or going to work, worrying about things is just another choice you make.

I will admit that I'm biased in this regard, but I don't recommend being put on a pill for your anxiety, unless you feel that you have a severe case of accompanied depression. First, I would try altering the maladaptive, negative, pessimistic thoughts you're having. Instead of thinking, "Man, I'm such an idiot, I totally flunked that exam," look at it differently: "Wow, that exam was pretty challenging! I did the best that I could, but next time, I'll do better because now I know what to expect." Also, try to loosen up a little--all work and no play is not good for your physical or mental health. Try picking up a hobby to help relieve some of that stress. I like to lift weights, but a lot of my fellow nursing school friends get together and do 1500-piece puzzles to help distract their minds from all things medical.

You can overcome this, and, it's important to note that anxiety isn't a weakness or a flaw by any means. It's very common and an essential part of life. :) There is no telling what will happen in the future (your preceptorship or NCLEX), so why worry about it now? All this schooling you've been doing is in preparation for the NCLEX! Go in with your head held high ready to ace it. If you don't, that's okay--there's always next time, when you'll be even better prepared than you were the first time! Also, you already admitted that you always prep for failing a class, but never do!

If you do decide to seek medication for depression or anxiety, my suggestion is to be patient. It takes a couple weeks to build up in your system before you'll start seeing any changes, if any at all. Additionally, it isn't really a "miracle" pill, in my experience (with myself and with many others). A lot of people expect to be stress, anxiety, and depression-free after going onto the medication, but the truth is, you'll probably still experience it, but manage it better. For me, the difference while on the pill was that I found that I didn't dwell so much on the things that were bothering me. My experience was with Celexa. Many friends and family did not do well on Celexa, and instead switched to Lexapro and have had stellar experiences ever since.