Drugs such as Effexor are SSRI medications.

SSRI's take a minimum of 4 weeks to even notice any of the good effects. More like 6 or 8 weeks, but she needs to give it 4-5 weeks to feel the good parts.

It's difficult sometimes to ride out those first 4 weeks. I know, I have done it, and it wasn't always pleasant. If she can hang in there, she will feel the good effects in about a month. Maybe encourage her and let her know that any side effects felt early on should go away in a few weeks.

Good luck.

Effexor is slightly different as the half life is considerably shorter. She could see results in as little as a couple weeks with it. The most important thing about Effexor is to take it at the same time every day and do not stop without talking to the doctor first. It’s because of the half life of the med. Stopping abruptly can cause symptoms to exacerbate quickly thus putting more stress on the patient. I took Effexor for a long time, missing one dose caused my symptoms to exacerbate and I became a little disoriented. Side effects are the hardest thing to get thru since the patient is so highly stressed to begin with. On top of that add taking a med with side effects that can mimic anxiety symptoms or cause even more anxiety by strange and unwanted body and mind sensations. Been there, know what it’s like. After thinking the Effexor wasn’t working anymore (it was), I went on Pristiq, a sister drug with the same half life to Effexor. I foolishly stopped Pristiq this past spring, cold turkey. It sent me into a tail spin of symptom exacerbation, worsening depression, and I had my first panic attack in years. Needless to say, I only could manage about a month before I admitted defeat and went back on Pristiq. Within a couple weeks I was feeling better again and have continued to improve. Antidepressants can only do so much, they don’t change the negative thoughts we generate that cause the anxiety, therein lies the problem . Our anxiety can worsen beyond what the antidepressant can control. That’s why many (including myself) think the med isn’t working anymore. It’s an illusion we create to justify our worsening symptoms. Both Effexor and Pristiq started working faster, within a couple weeks of starting them, faster than any other meds I had previously taken. And I have taken many different ones. I don’t know why they kicked in faster. Hope this helps.

Can I ask about the Effexor dosage. Also do you think wine as an adverse effect. Because a move caused her stress, she's most relaxed and comfortable out for dinner, where she customarily had 1-2 glasses of wine. I've heard this is not good but its hard to test her not to do one of the few things she seems to enjoy.

Please also give me your take on switching to Lexipro. She seems to want to do this and is skeptical about the idea of increasing the Effexor dosage from the current 75 mg to say 150, which the nurse/psych mentioned as an alternative.
My wife has severe anxiety but never had it before in 65 years, as a highly functioning pleasant, upbeat person, who now appears to have suffered a breakdown. .

I know someone taking Lexapro. Started on 10 mgs. Went up to 20 mgs a day. Helps them a lot with their depression, and some help with anxiety.

If she wants to take the Lexapro, then let her do it. I think something that she wants to try will have a better emotional "effect" (even if it's psychosomatic) for her. Because she will feel more - in control - of her situation. She won't feel forced into taking a medication she might not want to take (such as the current Effexor). Not feeling forced will help her feel more relaxed, in and of itself.

Drinking alcohol with anxiety medications can be tricky. Have to ask her psychiatrist about that one. Usually not recommended, as it increases the effects of the alcohol, but ask her psychiatrist about it and see what they think.

For what it is worth, no matter what med she takes, she will still have side effects. She is going to have to make up her mind, to stay where she is on Effexor or another drug. The bottom line is that not one of them will cure her, all they do is ease the symptoms a little. They do not make the symptoms go away. Her anxiety is the problem, not the meds, it’s what is driving her desperation. Until she decides to help herself by going to therapy and actively participating in any of a number of therapeutic treatment programs that will help her change her thinking process, she will remain in the condition she is in. It’s that simple. Recovery is possible, many have reached full recovery. As to the dosage, I believe I was on 300 mg Effexor a day. As for drinking alcohol, it is wise to consult the dr about that. She will have to make that choice herself, it puts too much liability on anyone else to answer one way or another.

Thanks MTD and Girl in Calif for good, insightful comments. What's the best approach when she wakes up and starts with comments related to anxiety, this is a problem, etc, . In terms of volume of negative comments and criticism, she's gone from much of our marriage at a 3 (assume around 5 as the average for a wife, men do things wrong and are perceived to be too) less than average, to around a 9, pretty much everything is a problem. Note, her self-criticism exceeds everything else.

While the counselors, doctors, friends and family (save 1) believe she desperately needs medication along with therapy, she's now on a kick of saying that a small dose of one drug set her off wrong and caused her problems. Interestingly, while she was an incredibly compliant person for medical care and other rules, now she frequently deviates and questions.

Her hormone levels are off big time.

And, for some people, the time of the month they change medication makes a difference.

The sad part is that medication is temporary. The anxiety is natural and changes - it does NOT stay the same. So, as mentioned above, she's going to have different side effects depending on everything together.

You can NOT change how she acts, reacts, responds. You can change how you act, do, react, and respond. Yes, it will probably result in her being more negative before she improves. Make it so your well-being comes first in a positive way.

Best wishes.

Just perused comments (not enough coffe yet) but agreed that the meds haven't been given a real fair test drive.

What doctor is changing them without a fair run? That concerns me.

I was hesitant to start my anti depressant too, but it has helped so much. I started with 10 mg of Paxil, then upped it to 20mg. It has helped with my negative thoughts considerably with little emotional side effects. It did take 6 weeks to kick in, but I continued to take it consistently and it has helped a lot. I would say that it is worth a try.
Hang in there. Hugs.

I personally have no complaint with the therapists, doctors, etc. My wife has been sometimes noncompliant, and skeptical about the drugs, reverse placebo effect as one therapist put it, attributing any issues or problems to side effects of the drugs. Add to it, she takes it at different times, has occasionally missed, her current dosage of 75mg is apparently low, and one close family member has expressed skepticism about drugs with a host of stories of side effects. Since my wife believes in Lexapro, we will probably switch in the hope that she buys in.

She said today she wants to get better and does not like the life she's living, but when I started to discuss what she could do, she immediately switched to things she should have done months ago, should have gone to therapy earlier, should have listened to tapes, an infuriating talk about the past that frustrates even a therapist. One therapist said she is a perfectionist and when she could not control her environment, fell apart. Again she was above average in functioning, handling crisis (had a high pressure job she did well), friendly, calm, for 66 years until this happened.

Interestingly she can switch on a dime, talking with friends, and can present an image of normalcy. Then she'll switch back.

Appreciate all the comments and people taking the time to help us.

You’ve never said how old this family member is, and that is kind of important. Is she old enough to be menopausal? Has she been checked for hormone levels? Has she had an eeg? Ct scan? Any diagnostic tests at all? Blood work? There are medical problems that can cause her anxiety. Has anything happened recently that could have caused her to deteriorate? A child moving out of the house? Even the most seemingly benign events can cause one to go over the edge, especially if they were already having issues. Being a perfectionist is a pretty hard trait to bear up under. Maybe you need to back off from her, stop hovering around and taking care of all her needs so that she has to fend for herself. That’s tough love by the way, sometimes necessary for the ones we love. It might be the catalyst she needs to move in the right direction. Her situation may be that she is unable to to move in the right direction because she lacks to capacity to tolerate pain, any kind of pain, physical and emotional. It sounds like she has all her hopes pinned on Lexapro being the cure. It is an illusion. If she has the capacity to control herself with friends and such, she has the capacity to help herself. She just may not be sick and tired enough to do it yet, she is waiting for a miracle to come along and make it easier. That won’t happen.

As always, appreciate your time and concern mtd and others. You've given some advice which I really appreciate. My wife had her thyroid removed so that plays a part. However, she was good for about 25 years with that. She's 65.

People use the term hormones and it is confusing what is meant. T3 associated with thyroid and some adrenal levels are mildly elevated and she is taking medication for that. Previously some indication of being hyperthyroid, but endocrinologist sees no serious problem.

We had a move that went bad in a crazy market so we left our home, probably a 7-8 in stress but not a 10. They do say that as someone who liked organization and habit, leaving both and being in a strange environment is highly stressful.

To be clear I'm not hovering. If anything, I want to get away sometimes, but she asks me not to leave the house, and is doing relatively little on her own. Anxiety took a place at the table, and its there, I can't get rid of it, when we planned to see a family member for my birthday, and made plans to leave at 1 PM for a hotel near her home, anxiety laughed and changed plans so we got there 1 in the morning after a lot of arguing.

She says, help me, help me, but when I make suggestions, she kind of indicates she is doing what she can which is not the case from my perspective. Again, in the past, she was well-organized, pleasant, easygoing, and sociable. Because of the dramatic change in behavior, some family members suggested a stroke but a neurologist reviewing her MRI found no abnormality. The doctors and therapists see it as anxiety and depression which should respond somewhat to medication.

She's gone from someone who worked in a highly stressful job for 3 decades and raised children, with few complaints, and did both very well, to someone who saw a part of the movie Odd Couple and said that movie disturbs me, turn it off.

I certainly encourage everyone needing help to go to therapy but candidly some of the things mtd has said are as insightful as what the therapist says and cost a couple of hundred dollars less.

You can lead a horse to the water, but you can’t make him drink. Maybe you should start staying away more often, practice a little tough love. Go on about your life and do things you want to do without her. Don’t argue with her, just do it. She will raise a ruckus at first, be prepared. You can state your case calmly and matter of fact. Then walk away, no arguing. Leave the home if necessary to avoid arguing, go for a walk, whatever it takes to avoid the argument. Sooner or later she will realize you mean what you say if you stay consistent and don’t give in to guilt forced on you. But don’t argue, walk away every time. This might spur her to get off her duff and do something when she sees you are going on about your life without her. You have to do it for yourself too and be willing to do what is necessary to make these changes stick with you and her.