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Ask Dr. A. Rene Your Own Question

Dr. A. Rene
Dr. A. Rene, Psychologist
Category: Mental Health
Satisfied Customers: 16
Experience:  10 years of clinical experience with expertise in trauma related disorders.
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Ive been on Cymbalta for about 7 years, a few years at 30mg

Customer Question

I've been on Cymbalta for about 7 years, a few years at 30mg and a few at 60mg. I weaned down to 20mg when I was pregnant with my 2nd child, but went back up to 60mg after he was born. I got off for a few months, but the withdrawal was too much for me, so I got back on 60mg and have been for 2 1/2 years and have felt GREAT. 2 weeks ago, I had a mini panic attack, and since then, I've felt anxious and down. It's gotten better since then though. I haven't taken a Xanax in a few days. Could this just be a stress related spell? Do I need to up my dosage? My dr. told me I could. My TSH went up to 2.82 as well, so not sure if it's thyroid related. I take 175 mg of Levothyroixine. I feel spacey and disconnected and just tired. I sleep good, 7 hours a night, and have started exercising and eating right again and taking my vitamins :) Any advice? Thanks. XXXXX feel good, but I can't quit thinking how I feel all day long, and it's making me spacey feeling. I did this when I had postpartum anxiety as well, and it eventually went away. It was much worse than this though. I know I can get through it, but it's set me back these past two weeks.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. A. Rene replied 1 year ago.

Dr. A. Rene :

“Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will spend its whole life believing it is stupid.” – Einstein

Dr. A. Rene :

Good morning! It sounds like you are struggling with readjusting to your medication.

Customer:

Hi. Well I've been ok on it for 2 1/2 years :)

Dr. A. Rene :

And now it sounds like your anxiety is getting amp'd up and you are worried about this becoming a new cycle?

Customer:

yes, exactly!!

Dr. A. Rene :

I believe you are on the right track in just taking it day by day. Maybe you would benefit from keeping a journal to track if there are certain things triggering your anxiety...

Dr. A. Rene :

Anxiety has a funny way of keeping itself going in the strangest ways... and one of the best things you can do is just recognize it, honor it, and give it space to work its way through.

Customer:

That's the thing...I don't really have anything triggering it other than normal everyday stress....kids, family, work, activities, bills, etc

Dr. A. Rene :

If you have a history of anxiety taking over... the mere symptoms of anxiety can be enough to get it going again...

Dr. A. Rene :

Even little things related to your kids, bills, etc. can trigger a body memory which can get it going

Customer:

oh, ok. That must be what's happening then. Should I just deal till I get over this spell or up my meds? I really don't want to or think I need to, but I was given the option. I just don't like the spacey, unreal feeling. That seems to be what's left since my little attack.

Customer:

I have felt great for so long, it's weird to feel crappy!

Dr. A. Rene :

I believe that we each know ourselves best... and you will know if/when you feel you need to up your meds... Just knowing it is an option can be enough to help you through the difficult times...

Dr. A. Rene :

Anxiety doesn't like to feel like it is backed into a corner... so keeping your options open can be a beautiful thing.

Dr. A. Rene :

It can be scary when old, uncomfortable feelings resurface after a nice spell of feeling better.

Customer:

I pretty much just have to push through it and hopefully it will go away again?

Dr. A. Rene :

You can try simple strategies like "grounding" strategies to keep you in the here and now when you get triggered... and with each time you are able to do this... it should get easier.

Dr. A. Rene :

Are you familiar with grounding strategies?

Customer:

What are "grounding strategies"? Is the spacey feeling part of the anxiety lingering?

Dr. A. Rene :

Yes - spacey feelings can be part of anxiety...

Dr. A. Rene :

Grounding strategies are mental/physical strategies to help you get out of your head/body and back into the present...

Customer:

oh ok. That's what I've been trying to do :)

Dr. A. Rene :

Some examples include focusing on things around you in the moment... naming colors, shapes, sounds... or in seeking out calming scents, soothing sensations (hands under running water), and breathing into the moment...

Dr. A. Rene :

see... you already are your own best support :)

Customer:

Thanks :) I will try these techniques and hope for the best. I need to feel better for my hubby and kids!

Dr. A. Rene :

And most importantly, you need to feel better for you! Best of luck to you and yours!

Dr. A. Rene :

Sincerely,

Customer:

thanks!

Dr. A. Rene :

Adena

Dr. A. Rene, Psychologist
Category: Mental Health
Satisfied Customers: 16
Experience: 10 years of clinical experience with expertise in trauma related disorders.
Dr. A. Rene and other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.
Hi again. Just a question...how can I make myself quit thinking about the anxiety all the time? I wake up wondering how I feel and it continues throughout the day and makes me exhausted. Is that something upping my med would help for the time being?
Expert:  Dr. A. Rene replied 1 year ago.
Miranda,
I'm not sure if the Cymbalta will help much with the anxiety... so you may want to consult with your doctor about considering something to take in the short term to get you through this difficult spell.

Other than that, you may benefit from continuing to recognize and honor your anxious feelings without judgment and practice deep breathing from your belly... breathe in to the count of 5, hold for 2 seconds, and then breathe out slowly to the count of 5. Repeat this several times using a 10 in count, hold for 5 secs, and out for 10 secs.

Do you have any hobbies or activities you enjoy and can "stay present" for such as art, puzzles, crosswords, coloring, etc..? These can also be helpful to redirect yourself when you are feeling anxious.

If you are interested, I could also recommend some good books that may also help you with managing anxiety and that general sense of uneasiness.

Sincerely,
Dr. A. Rene
Customer: replied 1 year ago.
Thanks. I do have Xanax but don't really want to take it unless its really bad. This is manageable, just annoying! I think it's just a spell from stress and I will level out soon. I do need to practice some hobbies. Everything is always about the kids....guess ill play candy crush for a while! :)
Expert:  Dr. A. Rene replied 1 year ago.
Hi Miranda,

I'm just following up with you to see how everything is going. Are you feeling any relief from your anxiety?

Sincerely,
Dr. A. Rene
Customer: replied 1 year ago.
Yes somewhat. Thanks for asking. I'm pushing it, but feel a little better. I keep thinking about it, but I'm sure it will go away soon. I haven't upped my cymbalta yet, but I still might if this lingers much longer. Upped my vitamins and exercise and trying to lower stress levels first. It's not as bad as when I had postpartum or when I tried to get off of the med, so I think my stress level was just so high that it pushed past my meds abilities.
Expert:  Dr. A. Rene replied 1 year ago.
Keep up the good work and just remember that medication can be used as a short term tool and does not mean that you will be on it forever!

Best,
Dr. A. Rene

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