Nursing student w/ Dx Clinical Depression and G.A.D

[cjprenurse]

Hi there,

In 2014, I suffered a mental breakdown from environmental factors. I was sent to mental heath urgent care where I was Dx for G.A.D and clinical depression. My psychiatrist put me on Lexapro 20 mg and had to test various anti anxiety meds. I was sexually assaulted in the past where I tend to get PTSD and freeze up. I suffer a lot from lack of sleep.

Fast forward to now, I am on

Lexapro 20 mg

Buspar 60mg

and Ativan .5mg PRN

I still continue to have high functioning anxiety. Now that I am in an RN, I am so deeply afraid of the drug screening because of the benzo. I am really afraid that the professors will try to discriminate or look at me differently because of it.

I am doing much better now. I still have a really hard time concentrating at times. I self-doubt myself and fidget a lot. It got to a point a few semesters back a professor had to step aside to make sure I was okay.

Should I discuss this with my professors? I was just thinking of since it will be in the Health Physical form signed by my PCP they won't ask questions. However, for the drug screening it will show up. How do I let the drug screening staff know I have been rx Ativan? I can get my prescription bottle to show once I go to the lab.

I apologize if this is all over the place. Does anyone share the same experience? I don't even know if I should I apply for the DSPS services. My anxiety flares up really bad during tests (my psychiatrist knows about this) it gets so bad where I cried from e very exam I took literally.

[VivaLasViejas, ASN, RN]

I don't think you need to worry too much about popping positive for benzos on your drug screen. This is easily explained by talking with the medical director at the testing site, who will probably call you with the results and ask you questions about your use of Ativan. All you need is a current prescription with your name and that of the medication and the doctor who prescribed it for you. You don't need to take it to the testing site; they won't want to see it because they have nothing to do with it. All they are there for is to obtain the sample and send it to the lab.

I also wouldn't worry about what your school or future employer will think. A LOT of nurses and students are on anti-anxiety meds. I hope you are getting therapy along with medication for your depression and anxiety. Be well.

[hppygr8ful, ASN, RN, EMT-I]

Like Vegas, I think you are over thinking this and will be fine. As long as you are not abusing the Ativan or that taking it responsibly and as directed does not impair your ability to function. When you go for a pre-employment screening they will ask you if you are taking any medications routinely. Don't lie and be prepared to prove you have an actual prescription for it.

What will get you in trouble is not mentioning it having it show up unexpectedly in a urine sample.

As for talking about your mental health issues - I varies. I would just spill your guts to anyone but if you have a trusted advisor or professor you can decide how much to divulge. Do you see a therapist regularly? If so you might discuss this with that person to see if it is something you want to do.

Peace and Namaste

Hppy

[hppygr8ful, ASN, RN, EMT-I]

I went to edit my previous post but could not I meant to say I would not just spill my guts with regard to mental health issues......

[TooLateToSedate]

Hey there, I had a journey similar to yours. Here's my advice.

First, you do not legally have to disclose any medical issue to your school, especially if you're not accepted and already attending a nursing program.

When my anxiety became a hindrance in the nursing program, the director did suggest I speak with disability services of the school. Since my issues were not really an issue related to school work, they couldn't do anything for me. However, it does sound like you may benefit from extended testing time. Be forewarned, they will require a direct proof of diagnoses from your psychiatrist, and likely will inform all your professors.

My main concern is that your anxiety and depression are not well-managed at this point. You said you are crying during every exam. That is rendering you barely functional. I hope that you have not accepted that as "your normal," and expect the world to bend around you. I am not saying this to be mean; I'm saying it because that's the real world. And if you want to be successful in the program and as a nurse, you MUST find a way to manage it successfully so that it doesn't have such a detriment on your work. Bursting into tears during every exam will quite simply prevent you from moving forward.

When is the last time you had your medications evaluated? I am asking this as someone who got through the program thanks to the graciousness of my professors and a horse's dose of zoloft. It was the first time in my life I had to swallow my pride due to mental health issues, and it wasn't easy. I kept getting my meds adjusted until I was functional enough to make it through. You need to keep looking for answers because the level you're at right now isn't functional.

As for the drug testing - most programs will only require one or two tests during the four semesters of courses, though of course students can be tested at any time. You should not be taking ativan daily, so my suggestion is, quit taking it a week before your drug test so you don't come up positive. The drug test is to rule out drug abusers, not find out every medication students are on. Be responsible and don't take ativan for at least 12 hours before your clinical days; if you can't sleep up to 10 mg of melatonin can be taken to help knock you out, recommended by my former psych.

Do not disclose your health status, mental or not, to anyone in the program unless it becomes enough of a problem to interfere with your success. If you are already expecting your mental health issues to be a huge issue during your schooling, then I think you're not ready yet and you need to get more stable before attending. School is stressful enough, combined with the fun stuff life throws at us, and you will see blood everywhere, people dying, open wounds, cursing, violence, etc., which are all enough to exacerbate mental health issues. You need to be on solid ground before you commit to school.

Good luck, and I hope you find the right path for you.