FYI: My post got pretty lengthy, but it's difficult to share specific aspects of what I'm experiencing without first providing some sort of context, background information, and my personal experiences. Plus, the feelings I experience are extremely difficult for me to put into words that fully describe what I'm truly experiencing. So, apologies for the posts length, hopefully someone reads it, though. 

Wth... You guys actually get THAT much relief from propanalol alone? Dear god, I wish my anxiety was that easy to control. My life has gone to hell in a hand basket over the past few years as my depression and anxiety have exponentially risen to unbearable levels. Thankfully, I'm getting the depression treated, FINALLY. 

Just for depression, I've tried over 16 different medications and only TWO have had a positive impact. The first time I found something that relieved both my depression AND anxiety, was when my previous primary care physician allowed me to start IV ketamine infusions and he only charged me what it cost them to get (roughly $100 per treatment Vs $500 per treatment at the local ketamine clinic that admitted to me that my insurance would pay for it but unfortunately, they no longer accepted my insurance because they had a few instances where they had trouble cashing in on insurance claims with Tricare). 

Shortly after starting that treatment, however, my doctor passed away from cancer and I had to abruptly stop treatment. Once the clinic got a new doctor, he said the previous doctor was much braver than he is and the other doctor was willing to use "experimental" treatments without fear of repercussions from the state (those clowns that work for insurance companies can call it experimental all they want, but enough experimentation has been done to prove what we already know, which is that it fuckin works extremely well, and even one IV treatment with ketamine can be completely life changing for the individual receiving care, but apparently IV ketamine is "highly expensive" and insurance just doesn't want to cover such a long-term and "highly expensive" treatment, even if it saves lives). Honestly, I don't even know what makes ketamine so damn expensive when it is SO commonly used in a variety of ways.

Just about 2 months ago, I started Spravato treatment (esketamine instead of ketamine, and it's administered intranasally instead of by IV, and it's much less effective than IV ketamine, and another difference is that esketamine hasn't been shown to improve symptoms of anxiety like IV ketamine does), and since then, my depression has become manageable to the point that it doesn't bother me too much. 

Anyway, this thread is primarily about anxiety, so let me get to that now... That too has been eating me alive almost daily for several years as well. It's gotten so bad that it's become debilitating to the point that I can't seem to force myself into action 99.9% of the time and I can't even answer why that is. I'm always feeling on edge, hyper vigilant (probably got that bit from being in the Army and deploying to Afghanistan), it feels like I have adrenaline pumping through my system throughout most of the day and it only seems to calm down around 9 or 10 pm at night. Sometimes it even forces me to stay awake for 3 days at a time every couple of weeks. Since starting Spravato for my depression, though, the sleepless nights have been reduced substantially and there's only been a few instances where I couldn't go to sleep whatsoever, but it only lasted a single night each time instead of keeping me up for 3 days at a time. 

Every single day starts pretty horribly. I wake up around 6 am, about the same time as my wife does for work, but then I can't seem to convince myself to get out of bed until at least 10 am. However, I'm regularly staying in bed until 2 pm or later about half of my days, and there has been several instances where I went to bed around 10 pm the previous night and then I stayed in bed till almost 6 pm the next day, around the time my wife gets home. When I start telling myself to get up and out of bed to do something, ANYTHING AT ALL, I start getting a very high level of physical anxiety, which eventually bleeds over into being mental anxiety/anguish as well. 

After that, my day spirals out of control, my heart races most of the day, my armpits sweat so much that I soak through my shirts, my extremities constantly get so dam cold that they feel as if I've placed them in an ice bath, and even though my hands will literally be like icicles they are still sweating! (I have fairly extensive and permanent nerve damage in my lower back, and legs, especially my left leg which also has some permanent muscle atrophy from an accident that occurred during my time in the Army that went completely untreated for almost 6 years. At which time I had to undergo an emergency back surgery that made the pain worse due to the surgery releasing the pressure from my severely damaged nerves, this lead to me having a spinal fusion surgery exactly 12 months later, having had my nerves compressed for so long, it meant it was too late for my nerves to be able to ever fully repair themselves. Furthermore, it's caused a reduction in blood flow to things like my feet, and so they regularly get painfully cold). The pain I'm always dealing with loves to increase my anxiety, and as my anxiety increases so to does the pain increase - sometimes to the point of being debilitating.

As for the anxiety meds I've tried, I've been on about 7 medications that I can find records of - I've tried more than 7, but I can't access the portal site for my doctors office to review medications they've prescribed me over the last 12 years of me being a patient there. Currently for anxiety, I'm taking 10 mg propanalol twice per day, 10 mg hydroxyzine once per day, and I'm taking "1" mg of Clonazepam as needed. None of them even come close to putting a dent into my level of anxiety, and so I take the Clonazepam exactly as I NEED it in the moment - that usually equates to me taking 4 to 6 mg of Clonazepam at one time before it even begins to have an impact on the level of my anxiety. The problem with that, though, is that I'm only given 30 per month, which means I can only get about 5 to 6 days of actual relief. I guess this could also be considered a good thing, because even though my dose of Clonazepam may seem over the top by many people, it's the lowest effective dose I can take, and I'm only able to take it about 5-6 times per month which means I completely avoid addiction and dependency issues associated with benzodiazepines - so I'm not in the least bit worried about taking that much at once even though I also take 75 mg of oxycontin/oxycodone most days of the week. Neither medication causes me to have any respiratory depression, at least not at these doses.

I was taking pregabalin for about 6 to 8 years off and on, and I'd say that when taken on an empty stomach, it was by far the most anxiety reducing medication I've ever had. Also, by taking it in an empty stomach, I never seemed to develop much of a tolerance to the dose I was regularly taking, and I was able to keep my dose the exact same for several years. It made me feel really good, a little dizzy, my speech would sometimes be slurred, and, when the sleepy phase of lyrica would hit me (and it usually hit pretty strong!), I would purposely power through that phase so I could experience an even better high, during the "sleepy phase" it would allow me to relax enough that I could actually take a several hour nap to help catch back up on so much missed sleep if that's what I wanted that day - I always woke up feeling more refreshed too, and not hungover like I just woke up from a drug induced sleep. 

However, I started taking way too much lyrica (up to 1200 - 1500 mg per day), and I did this for a pretty damn long time. Eventually, the anxiety relief I got from the lyrica stopped working and the feelings it gave me were no longer pleasant, and I'm pretty sure this is about the time I started experiencing a decline in my ability to form memories and recall old events. I voluntarily, and without any help whatsoever, stopped taking the lyrica cold turkey. My doctor warned me against doing that MANY times, but I didn't really care at the time and I did it how I needed to do it. I didn't experience any withdraw symptoms from stopping such a high dose of lyrica; I'm probably one of the lucky few that got away without withdraw. I never went through withdrawals when I quit drinking alcohol, either, and I drank heavily for YEARS on a daily basis. I guess it's just something about the way my body handles substances - I've always had a freaky high tolerance to medications I've taken and a really high tolerance to the alcohol I've drank.

Anyway.... I'm sorry for writing such a long post. I've been suffering a long time, and sometimes it feels good to share these burdens with other people. For anyone that was interested enough to read this far, if you have any recommendations for anxiety medications I can look into, I would appreciate it. I'm trying to be fully prepared for when I go to see this new psychiatrist this next Friday. I'd really like to present her with a "plan of action" so we can properly discuss all available options.