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Discussion

Severe anxiety

I've been working as a RN for almost 5 years. I've always been plagued with anxiety and depression but it has multiplied with this profession. Last year I tested positive for THC and lost my job. I've been put on a one year probation which makes it hard to find jobs and restricted from hospice and home health. I ended up getting another job in LTC on night shift. The job isn't bad or nearly as stressful as others I've had, especially on days. However, my anxiety is still awful. I'm on two antidepressants and take Ativan and it doesn't seem to help. I am constantly anxious in my days off worrying and dreading about going back to work. One night at work my heart rate went up to 146 and felt light headed. After an Ativan I got my heart rate down to 105. I am the sole provider for my family. If not I swear I would just get an easy minimum wage job. I feel close to tears at all times anymore. My only anxiety is mostly due to work. I pray beg and plead with god before I go in for a shift. If there's an admission I panic. My dementia and behavioral patients cause my anxiety to

sky rocket. My new insurance hasn't kicked in yet but when it does I'm going to schedule something with a therapist. Does anyone else deal with this? How do you manage and continue on? Will it ever get better? I was diagnosed with bipolar and GAD.

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    • Featured Replies

    Don't wait for the insurance. Schedule that visit stat. This is an emergency. If you can't, see the nearest ER that provides stat psych referrals.

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    OP, I second what AliNajaCat said.

    I also have bipolar disorder. You can NOT wait to see a therapist. What you're feeling, it's too much for anyone to feel. It could be something as "simple" as being on the wrong meds (if you are only on antidepressants, without a mood stabilizer of some sort -- this is not advisable for people with bipolar disorder). Regardless ... you need help NOW.

    ... And that's ok.

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    • Expert

    I've moved this to the Stress and Health Management forum.

    I echo what others have said - please contact someone today!

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    Yes, as others have said, you cannot wait to see a mental healthcare professional---preferably a psychiatrist. Have you ever been to one? They are better at managing meds than the average GP, who usually has no specialty training in psych. I am concerned that you are on two anti-depressants and no mood stabilizer; for most people with bipolar, that's a recipe for disaster. Oddly enough, it could be part of your anxiety issues. I have bipolar 1 and was put on Wellbutrin by my PCP; neither of us knew at the time that I had BP, and I went manic which included horrendous anxiety as well. I wound up with a psych referral and was diagnosed properly.

    Now I'm on a small dose of Celexa, but I'm also on a benzo, a mood stabilizer, and two anti-psychotics. You may not need that many drugs. But I think you'd be better off if you saw a psychiatrist, and a therapist to help you work on the root causes of your anxiety. I feel for you---life is too short to be that unhappy at work. Best of luck to you.

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    • Author

    I'm currently taking lamictal, lexapro and Ativan. Was taking latuda as well but had to stop when insurance did and actually feel a little better off of it. I do have a psychiatrist and he's great. I'm just tired of living with this anxiety and feelings of impending doom. I'm almost normal when not working. Work consumes my thoughts when I'm there or not. I'm sick of this anxiety and work dread. I just want to be 'normal'.

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    • Author
    OP, I second what AliNajaCat said.

    I also have bipolar disorder. You can NOT wait to see a therapist. What you're feeling, it's too much for anyone to feel. It could be something as "simple" as being on the wrong meds (if you are only on antidepressants, without a mood stabilizer of some sort -- this is not advisable for people with bipolar disorder). Regardless ... you need help NOW.

    ... And that's ok.

    I agree that I do need help but I can't afford a therapist without insurance. My 90 days will be 2/21 and then my insurance will kick in. So not too much longer. My mom is my life saver and I can talk to her about all of this and she supports and encourages me. I just feel so overwhelmed with everything and I honestly hate working. I support my family of 4 since my SO has many health problems. I feel so stressed and anxious I just want to hide in my bed. Once I get to work I'm usually okay after a few hours.

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    I'm currently taking lamictal, lexapro and Ativan. Was taking latuda as well but had to stop when insurance did and actually feel a little better off of it. I do have a psychiatrist and he's great. I'm just tired of living with this anxiety and feelings of impending doom. I'm almost normal when not working. Work consumes my thoughts when I'm there or not. I'm sick of this anxiety and work dread. I just want to be 'normal'.

    Ah. So you are taking a mood stabilizer (lamictal).

    OP -- your comment of "feelings of impending doom" is what concerns me, along with a significantly elevated heart rate and work consuming your thoughts "when (you're) there or not" (which tends to contradict your comment about being almost normal when you're not at work, no?).

    Please please please call your psychiatrist. Again, it could be something as simple as your meds needing to be adjusted, but you need your psychiatrist-- that's what he is there for.

    (Don't blame you on latuda -- that one made me nauseous for months)

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    I agree that I do need help but I can't afford a therapist without insurance. My 90 days will be 2/21 and then my insurance will kick in. So not too much longer. My mom is my life saver and I can talk to her about all of this and she supports and encourages me. I just feel so overwhelmed with everything and I honestly hate working. I support my family of 4 since my SO has many health problems. I feel so stressed and anxious I just want to hide in my bed. Once I get to work I'm usually okay after a few hours.

    Posted at the same time ...

    I'm saying this from a place that I've personally been. I know that anxiety. I know that feeling of impending doom.

    So, I'm trying to say this gently, only using my own personal experience ... but is 2/21 really, truly, a short amount of time? I'm asking that honestly.

    OP, this is your health. Your mental health is just as precious as your physical health. Would you wait 4 weeks until you saw your physician if you had DKA or a forming pressure ulcer?

    I think this is time to consider an emergency room visit. You need to stabilize. I don't know you from Eve, but this is not ordinary anxiety. You appear to be justifying it now, and I'm sure things sound better than they did two days ago ... but what about a few days from now? A week?

    You have a lot on your plate. Children, a SO who depends on you, and nursing can be no joke. Having a mental illness on top of it -- you're a super hero. But super heroes know when they need to ask for help. Your mom is a great resource; but you need someone who is trained to look at the medical issue for what it is: a medical issue.

    I'm rooting for you, whatever you decide.

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    Many employers offer a service for this sort of thing...does yours? As previous posters have noted...you need to address this NOW...not wait until "insurance kicks in". With today's deductibles, you will most likely still be paying for the visit anyway. If this is not an option, contact your local mental health center. Nursing is inherently stressful, you need help to figure out why you are feeling this way. Biofeedback may be something to look into as well...especially since you are having physical reactions to your anxiety. Good luck and our prayers are with you.

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    Propanlol works wonders for me :)

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    Agree with others that you should see someone STAT to stabilize your s/s. That being said, I know many nurses who are either suffering from Anxiety or PTSD. Some nursing positions are just too much! After you see someone, and hopefully that helps, you might also consider a change in jobs. I know that this is hard but it might help in the long run. Also, you note praying, so I would also recommend that you get in touch with your Church Pastor for support/guidance, and maybe even a support group if possible. I wish you well and hope you feel better very soon!

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    • Expert

    I would not wait for your insurance to kick in. See if you can see someone at the community/county mental health clinic to get stabilized. Or see if you can find a provider (psychiatrist or therapist) who works on a sliding fee scale. You could also call your employee assistance program if they have it.

    You can go to the ED, but--speaking as someone who does ED psych consults--what will happen is that you'll be waiting in the ED for hours. If you don't meet criteria for admission, you're going to get referrals to those community/county mental health services I mentioned. That's it.

    The ED won't set you up with a psychiatrist or therapist. They won't make the appointments for you, they'll just provide the addresses of where to go. Nor will they do medication adjustments unless the plan is to admit you medically or psychiatrically, and even then, they won't do that until after you are admitted. All the ED will do is stabilize you and ensure you are safe to discharge, or if you're not safe to leave, hold you until a psych bed or other placement can be found.

    Nor will the ED necessarily provide you with a script for enough medications--especially benzodiazepines--to last until you your insurance kicks in. The trend I see is to NOT send patients home with scripts, or if they do, to send them home with a few days' worth. And many providers are very stingy about the benzos...if you do get the meds, you're likely to only receive a week's worth of your two antidepressants and no Ativan.

    And if you haven't already, give up the self-medicating with THC, even if it's legal in your state. As you found the hard way, it did you more harm than good.

    Best of luck.

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