How do I know if a certain medication I am taking for anxiety is working?

Hi. It’s Jenny at AnxietyBoss.com. Our question today is from Monica in Omaha, Nebraska. How do I know if a certain medication I am taking for anxiety is working?

You should communicate with your prescribing physician or your pharmacist about what to expect. Everyone reacts to the same medications differently. It very much depends on what medications you’re taking. There are two main types of medications for anxiety. Benzodiazepines, which are tranquilizers, and SSRIs, selective serotonin reuptake inhibitors. These are antidepressant/anti-anxiety medications.

Benzodiazepines or “benzos” as their commonly called, work very quickly, typically within 20 to 30 minutes after you take them; you’ll feel very tired, relaxed and sleepy and somewhat indifferent and apathetic.

SSRIs are very different and sometimes the effects of them are very subtle. They work gradually over a period of weeks, slowly and gently. Here are some of the more subtle cues that the SSRIs are working.

When you first wake up in the morning, you find yourself stretching before getting out of bed. In order to have a good stretch and yawn, you need to be relaxed to a certain degree, not full of tension. Other people may notice small changes in you before you do. One is that your face will look smoother. When we are anxious, depressed, angry or tense, our face tends to tighten up. We grimace and frown. Little annoyances may no longer bother you or even be noticed.

Some of the not so subtle effects that will tell you that the medications are working are the initial side effects. You may feel queasy, have stomach cramps and diarrhea and feel tired and have to take naps. These side effects tend to go away in a few weeks as your body adapts to the medications. Communicate with your doctor about any concerns that you have about side effects.

Another interesting effect of SSRIs is vivid dreaming. You may have very long and realistic dreams. Dreams have a purgative function. They rid the mind of accumulated waste. You might think of a SSRI as a psycho laxative purging the waste that is making you sick and weighing you down. Another effect is sexual. SSRIs tend to delay orgasm in both men and women. It may take longer to reach orgasm through sexual activity and in men ejaculation may feel like it’s happening in slow motion. A sensation of pressure which can be disconcerting when it’s first experienced.

Again these side effects do tend to go away after the first few weeks and most people are not troubled by them enough to stop the medications. Side effects are a signal that the medications are working. It just takes a little while to get used to and you may have to feel some minor discomfort before you feel better. Regular communication with your prescriber and reassurance will help with this process.