I've had anxiety since my mid 20s. I've lived with the constant fear of a panic attack, an invisible line of tension across my neck and shoulders. I couldn't relax, and I had a recurring terror that I was going to go mad.
I'm 40 now, so that's 15 years of living with an irrational fear that I just couldn't kick.
The recurring nature of anxiety means I've gone through periods where it has been a dull hum, and others where it is like a swarm of bees hovering around my head.
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I know all about my condition, I've had 15 years of counselling, online programs and reading books. I know why it gets triggered, how to manage it, that when it comes it won't last. I've tried everything from cognitive behavioural therapy, reading books, practicing meditation and yoga, exercise and natural herbs like St John's Wort.
But it's still terrifying, no matter how many times I've felt it before. And when my management slips or life just gets full on, all it takes is one panic attack to make you feel like it's all falling down around your ears.
Regardless, there was one thing I always refused to try, and that's medication.
For many years I've had a fabulous GP, Dr Anne Murray, who on numerous occasions suggested I try it. She'd do it gently, and every time I refused, she'd let it go.
GPs manage a lot of community anxiety and depression. Dr Murray had seen me use all the different approaches over the years, to no avail. Her professional opinion was that medication would help.
But I was scared. I thought it would make me dependent and emotionally distant. And if I'm honest, I also thought it was cheating, that if I couldn't overcome this on my own I had failed, I was weak, and I would never get better. I didn't trust "big pharma," and I didn't want to take the easy way out, by popping "happy pills".
It turns out that I'm not alone. For Dr Murray, most patients push back when it comes to using drugs to treat their anxiety disorder.
"I find this is due to belief systems," Dr Murray says, "for example 'I am responsible for my feelings and can fix them myself somehow', 'I don't like taking tablets', 'I want to use natural remedies'. I gently challenge all these belief systems, something I can only do within a trusting professional relationship which takes some time to establish."
Dr Murray says medication isn't as effective for mild cases of anxiety, but when it's recurring (like it was for me) or when it's co existing with other types of anxiety (like health anxiety with social phobia, or obsessive compulsive disorder or panic disorder) it can really help. According to Dr Murray it can be 60-80 per cent effective.
At the same time as pushing back against medication I was also a class A hypocrite. I would decry the stigmatisation of mental illness, and if friends really needed medication I would encourage them to use it. Somehow I didn't see myself as having an illness.
Luckily for me, a couple things happened at the same time to change my way of thinking. First, a very good friend decided to use medication to treat her own anxiety. Then, I had a panic attack at work. I went back to see my GP to ask about natural remedies and again she suggested medication. She thought it would be "life changing" for me.
I was so tired from the constant anxiety. So very, very tired. I had been waiting for the penny to drop, for my brain to snap out of it. And it suddenly occurred to me how ridiculous it was to not even try medication.
Dr Murray prescribed an SSRI (selective serotonin re-uptake inhibitor). It's not addictive, and doesn't change your personality. But even though I had decided to do this, I was still nervous. My friend who had started taking medication almost a year before was blunt about her experience of the first couple of weeks.
"I would seesaw wildly between feeling like my old self, to sinking lower than I ever thought I would go. My sense of self-worth was zero, I found it very hard to see the positive in anything and I cried a lot. I didn't want to be left alone - and certainly didn't feel fit to be left alone with my children."
Dr David Hughes is a psychiatrist with Wesley Mission. He says that patients feel side effects in the first few weeks as the chemicals in their brains adjust.
"When you first take SSRIs it increases serotonin levels where brain cells communicate with one another (at the synapse); this causes the initial side effects. In the first weeks as you take medication these chemical systems (serotonin, noradrenaline and dopamine) are coming into alignment, ultimately leading to an improvement in symptoms, but while this adjustment is taking place you can experience side effects like headaches, nausea and jitteriness for the first few weeks as your brain gets used to the new normal".
And boy, did I want to be normal. I wanted it enough to push through whatever those few weeks would be. My GP knew me well enough to know I'd need support through this time. She eased me into it with small doses, she gave me her mobile, and we scheduled appointments so that every fortnight I was tag teaming between her and my counsellor.
I also told my family, my parents and my husband. It was important that those closest to me knew what was going on.
In those first few weeks I was hyper-vigilant, trying to see if it was working. Wondering if the anxiety I was feeling was the usual anxiety, or medication-based. I was convinced that I would be the only person it wouldn't work for, one of the few statistics where it all went horribly wrong.
Between my family, my GP and my counsellor I made it through to the other side.
Before I started medication, anxiety was my normal state of being. As the medication started to work, I would catch myself thinking "I haven't felt anxious for a while now, something's wrong."
It takes time to accept that you don't have to live with a constant feeling of irrational fear.
To say it was a big decision for me to try medication is an understatement. After all, it took me 15 years before I was so exhausted I tried it.
I don't think I'm alone.
The trolls and critics will say we're a pill-popping nation, but I disagree. It's a brave decision, and one you do for your own well-being. It's a personal choice and it has nothing to do with anyone else.
But it's also not a silver bullet. The first two weeks take real commitment to get through. And after that, recovery is more than just swallowing a pill every morning. It means committing to good emotional health, exercising, being mindful and paying attention to the signs when life is getting too intense.
Taking "happy pills" is not a miracle cure, but it's definitely improved my life. I wish I'd had the courage to try them sooner.
If you or someone you know is experiencing anxiety, see your GP for further help. Or contact Beyond Blue on 1300 22 4636 https://www.beyondblue.org.au/the-facts/anxiety
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