u/SmoothDependent3693

I'm 31M. Had occasional anxiety starting around 2017–2018, followed by a severe anxiety/depression/panic/harm-OCD spiral in 2020.

Started Prozac at 20mg. The initial adjustment was brutal. After 3–4 months, I was improving but not quite myself. My doctor suggested 40mg, but doubling my dose seemed excessive when I just needed a little more help.

I pushed for 25mg (alternating 20/30mg), wanting the lowest effective dose and room to increase later.

It worked! I stayed relatively stable for almost 6 years, with only minor breakthrough anxiety. Glad I advocated for myself.

Fast-forward to Sept 29, 2026: Woke up with intense anxiety, impending doom, panic, and nausea. Felt like my original spiral returning, though not quite as severe. The physical fight-or-flight has eased somewhat, but the underlying anxiety, restlessness, negative thoughts, and rumination remain.

- Oct 4: Doctor immediately recommended 40mg again. I agreed to start at 30mg.

- Oct 10: After a week on 30mg, possibly some minor improvements, but still struggling. She recommends 40mg on Oct 17.

Here's my dilemma:

I genuinely like my family doctor. She's a great GP, but mental health doesn't seem to be her strong suit. She's quick to suggest higher doses or switching medications without fully hearing how debilitating the symptoms and adjustments can be. At my last appointment, I almost felt blamed for my anxiety, like I should just think my way out of it.

Six years ago, she recommended 40mg when 25mg was enough. Maybe she's right now, but I'm worried about increasing too quickly, triggering activation, or taking more than necessary. Having room to increase later also reassures me, even if that's not exactly how antidepressants work.

She's away for three weeks. I'm seeing her covering doctor Oct 21 and considering waiting for that opinion before increasing.

She also suggested temporary Ativan, but I'm hesitant about dependence. A therapist once told me that facing anxiety rather than escaping it helps you overcome it, and that stuck with me. I've been white-knuckling through instead of using rescue medication, which I also felt somewhat blamed for.

My questions:

1. Has anyone had a severe flare-up after years on an SSRI and stabilized with a smaller increase, or did you need a bigger jump?

2. Is two weeks on 30mg enough before increasing to 40mg? Would slower titration reduce activation? If tolerable, why not give 30mg 6–8 weeks, or do the benefits of increasing sooner outweigh the risks?

3. Would a psychiatrist offer more individualized medication guidance than a GP, or just more dismissive pill-pushing?

I'm not against 40mg if I need it. I'm open to whatever helps. I just want to feel confident it's necessary and have someone hear me out, consider my history and concerns, and help me make a plan I trust.

Honestly, I'm scared of repeating what happened six years ago. I just want to feel like myself again.

Any advice or similar experiences would mean a lot.

I'm 31M. Had occasional anxiety starting around 2017–2018, followed by a severe anxiety/depression/panic/harm-OCD spiral in 2020.

Started Prozac at 20mg. The initial adjustment was brutal. After 3–4 months, I was improving but not quite myself. My doctor suggested 40mg, but doubling my dose seemed excessive when I just needed a little more help.

I pushed for 25mg (alternating 20/30mg), wanting the lowest effective dose and room to increase later.

It worked! I stayed relatively stable for almost 6 years, with only minor breakthrough anxiety. Glad I advocated for myself.

Fast-forward to Sept 29, 2026: Woke up with intense anxiety, impending doom, panic, and nausea. Felt like my original spiral returning, though not quite as severe. The physical fight-or-flight has eased somewhat, but the underlying anxiety, restlessness, negative thoughts, and rumination remain.

- Oct 4: Doctor immediately recommended 40mg again. I agreed to start at 30mg.

- Oct 10: After a week on 30mg, possibly some minor improvements, but still struggling. She recommends 40mg on Oct 17.

Here's my dilemma:

I genuinely like my family doctor. She's a great GP, but mental health doesn't seem to be her strong suit. She's quick to suggest higher doses or switching medications without fully hearing how debilitating the symptoms and adjustments can be. At my last appointment, I almost felt blamed for my anxiety, like I should just think my way out of it.

Six years ago, she recommended 40mg when 25mg was enough. Maybe she's right now, but I'm worried about increasing too quickly, triggering activation, or taking more than necessary. Having room to increase later also reassures me, even if that's not exactly how antidepressants work.

She's away for three weeks. I'm seeing her covering doctor Oct 21 and considering waiting for that opinion before increasing.

She also suggested temporary Ativan, but I'm hesitant about dependence. A therapist once told me that facing anxiety rather than escaping it helps you overcome it, and that stuck with me. I've been white-knuckling through instead of using rescue medication, which I also felt somewhat blamed for.

My questions:

1. Has anyone had a severe flare-up after years on an SSRI and stabilized with a smaller increase, or did you need a bigger jump?

2. Is two weeks on 30mg enough before increasing to 40mg? Would slower titration reduce activation? If tolerable, why not give 30mg 6–8 weeks, or do the benefits of increasing sooner outweigh the risks?

3. Would a psychiatrist offer more individualized medication guidance than a GP, or just more dismissive pill-pushing?

I'm not against 40mg if I need it. I'm open to whatever helps. I just want to feel confident it's necessary and have someone hear me out, consider my history and concerns, and help me make a plan I trust.

Honestly, I'm scared of repeating what happened six years ago. I just want to feel like myself again.

Any advice or similar experiences would mean a lot.

I'm 31M. Had occasional anxiety starting around 2017–2018, followed by a severe anxiety/depression/panic/harm-OCD spiral in 2020.

Started Prozac at 20mg. The initial adjustment was brutal. After 3–4 months, I was improving but not quite myself. My doctor suggested 40mg, but doubling my dose seemed excessive when I just needed a little more help.

I pushed for 25mg (alternating 20/30mg), wanting the lowest effective dose and room to increase later.

It worked! I stayed relatively stable for almost 6 years, with only minor breakthrough anxiety. Glad I advocated for myself.

Fast-forward to Sept 29, 2026: Woke up with intense anxiety, impending doom, panic, and nausea. Felt like my original spiral returning, though not quite as severe. The physical fight-or-flight has eased somewhat, but the underlying anxiety, restlessness, negative thoughts, and rumination remain.

- Oct 4: Doctor immediately recommended 40mg again. I agreed to start at 30mg.

- Oct 10: After a week on 30mg, possibly some minor improvements, but still struggling. She recommends 40mg on Oct 17.

Here's my dilemma:

I genuinely like my family doctor. She's a great GP, but mental health doesn't seem to be her strong suit. She's quick to suggest higher doses or switching medications without fully hearing how debilitating the symptoms and adjustments can be. At my last appointment, I almost felt blamed for my anxiety, like I should just think my way out of it.

Six years ago, she recommended 40mg when 25mg was enough. Maybe she's right now, but I'm worried about increasing too quickly, triggering activation, or taking more than necessary. Having room to increase later also reassures me, even if that's not exactly how antidepressants work.

She's away for three weeks. I'm seeing her covering doctor Oct 21 and considering waiting for that opinion before increasing.

She also suggested temporary Ativan, but I'm hesitant about dependence. A therapist once told me that facing anxiety rather than escaping it helps you overcome it, and that stuck with me. I've been white-knuckling through instead of using rescue medication, which I also felt somewhat blamed for.

My questions:

1. Has anyone had a severe flare-up after years on an SSRI and stabilized with a smaller increase, or did you need a bigger jump?

2. Is two weeks on 30mg enough before increasing to 40mg? Would slower titration reduce activation? If tolerable, why not give 30mg 6–8 weeks, or do the benefits of increasing sooner outweigh the risks?

3. Would a psychiatrist offer more individualized medication guidance than a GP, or just more dismissive pill-pushing?

I'm not against 40mg if I need it. I'm open to whatever helps. I just want to feel confident it's necessary and have someone hear me out, consider my history and concerns, and help me make a plan I trust.

Honestly, I'm scared of repeating what happened six years ago. I just want to feel like myself again.

Any advice or similar experiences would mean a lot.

One week into my worst anxiety flare in 5 years. Still wired, still struggling, and honestly getting exhausted.

A few days ago I posted here about having my worst anxiety flare in about five years after being pretty stable for a long time on fluoxetine.

Previous post:

https://www.reddit.com/r/Anxiety/s/guCINq7bOb

That post was about 48 hours into it. Tonight makes basically one full week, and unfortunately I’m still very much in it.

The main symptoms are still the same: feeling extremely wired and hyper-alert, racing thoughts, nausea and barely any appetite, feeling spaced out/foggy, lightheaded, short of breath or like I can’t get a satisfying breath, intrusive thoughts, poor sleep, and nonstop rumination.

The worst part is how constant it feels. I keep checking myself all day: Am I better yet? Is this getting worse? Is this turning into what happened five years ago?

Then I notice another symptom, worry about it, get more activated, and the whole thing feeds itself.

Minutes feel like hours right now.

I somehow managed to work through a few days of this, including commuting and being in the office while feeling awful. Today I finally took my first sick day.

I didn’t just stay in bed either. I got up, ate breakfast, showered, talked to my mom, went grocery shopping with her, watched some stuff, tried resting, etc. There have been a few little moments where I wasn’t as focused on the anxiety and almost felt sleepy, but then the wired feeling comes back.

So honestly, I still can’t tell if I’m getting better or worse. Maybe there are tiny windows, but overall I still feel pretty rough.

I saw my family doctor on Sunday.

I’ve been stable for years on what averaged out to about 25 mg of fluoxetine. She now has me taking 30 mg daily for this week, and the plan is probably to move toward 40 mg depending on how I tolerate it.

The frustrating part is that fluoxetine takes time. I want to get to a more therapeutic dose quickly because I’m miserable, but I also don’t want to increase too aggressively and make the activation worse.

So I’m basically stuck waiting for something that may take weeks to fully help.

She also gave me 10 lorazepam/Ativan tablets, no refills.

She specifically told me I don’t have to wait until I’m having a full-blown panic attack before using one, and that I shouldn’t feel guilty if I genuinely need it.

But I’ve still been mostly white-knuckling this without them because 10 tablets doesn’t feel like much of a safety net when I have no idea how long this flare is going to last.

Being this fucking severely activated all day, every day, it’s incredibly frustrating knowing the long-term medication takes weeks while the thing that can actually provide short-term relief is so limited.

At this point I think I need to talk to my doctor again about a better short-term bridge plan.. whether that means a little more rescue medication, clearer guidance on how often she’s comfortable with me using it, or some other option while the fluoxetine increase has time to work.

I also signed up for BetterHelp on October 4th because I wanted to get into therapy quickly. I got matched, but my first appointment isn’t until October 14th.

I’m not trying to crap on therapy. I genuinely want it, especially for the rumination, intrusive thoughts, fear of relapse, symptom checking, and the whole anxiety-about-anxiety loop.

But when every day currently feels about three days long, waiting more than a week to talk to someone feels brutal.

Work is also becoming a big worry.

I’m on a temporary contract right now and the plan was hopefully to become permanent in the new year. I’ve already talked to a union/workplace rep because I may need some temporary flexibility or accommodation while I get through this.

Of course my anxious brain immediately goes to: What if this makes me look unreliable? What if this affects my permanent position? What if my anxiety starts screwing with my job and financial security too?

My family pretty much knows now as well.

I told my mom and one brother, and my other brother called me today. I started explaining what was going on and just broke down crying.

I hate feeling like I’m burdening my family because everyone has their own stuff going on, but I’m getting to the point where pretending I’m fine is harder than just admitting I’m struggling.

I’ve tried the usual coping stuff too — meditation, yoga nidra, walking, getting out of the house, TV, distraction, showering, talking to family, trying to eat normally, etc.

Sometimes I get a tiny bit of relief. But honestly, when you’re this activated, even following a meditation video can feel like work.

I know this probably sounds dramatic, but sometimes it genuinely feels like I have the worst anxiety of anyone I personally know. This isn’t just “worrying a lot.” It affects my eating, sleeping, breathing, concentration, work, ability to relax, social life, and just feeling comfortable inside my own body.

I know I recovered from something like this before. I know one awful week doesn’t automatically mean I’m back where I was five years ago.

But knowing that logically and actually living through every hour of it are two very different things.

So I guess I’m looking for experiences from people who have actually been through this level of anxiety:

Did you ever have a flare this intense after being stable for years? Did it stay pretty constant for days or weeks before finally starting to loosen? Did an SSRI increase eventually help? Did your doctor use anything short-term while you waited? How did you know when to use your rescue medication instead of continuing to white-knuckle? And how did you get through the days when every hour felt like forever?

Any advice, experiences, reassurance, or just hearing from someone who gets this would mean a lot right now.

I’m still fighting through it. I just really need some help getting through the clock.

Thanks.

Let's say you've been diagnosed with and have been living with a chronic mental health condition such as anxiety, panic disorder, a mood disorder, a stress-related disorder, or OCD.

You've been managing it through treatment, with a long documented history of medication use, and have been doing well for a long time under previous working conditions. However, recent workplace changes have caused things to start slipping, and you need some additional support to prevent your condition from deteriorating, spiraling, and eventually going off the deep end.

Since employees and their healthcare providers can attempt to make recommendations, but don't get to choose the specific accommodations that are ultimately implemented, what kinds of accommodations does the OPS most commonly provide for mental health conditions?

For those who have gone through the process, what accommodations have you found genuinely helpful for managing your mental health, beyond being referred to EFAP?

How long does it usually take for a retroactive adjustment to be paid out and for the new wage rate to appear on future paychecks?

It's been about six weeks since my merit increase effective date, and I still haven't seen any changes on my pay stub. I haven't submitted a ticket yet because I know they're dealing with a backlog, and I wanted to give it some time before reaching out.

Has anyone had a similar experience recently? If so, how long did it take to be processed?

Thanks,

Sorry for beating a dead horse - but it needs to be said.

Yesterday and today, I will have spent a combined six hours commuting through this smoke-storm so I could sit in the office, attend virtual meetings, and send emails to colleagues and stakeholders in other buildings and other cities.

Thanks, Doug, Michelle, and my manager.

But seriously, isn't this exactly the kind of situation discretionary or ad hoc approvals are meant for? This smoke event has made air quality unsafe and is arguably more detrimental to health than the snowstorms that often trigger work-from-home flexibility.

Instead, employees are still expected to commute into the office to do work that can be performed perfectly fine remotely.

Anyway, I'd better get back to my emails... Good thing I'm in the office smelling like a campfire or else I wouldn't be able to send them!

My 12‑month contract is being renewed, and I’ve accumulated a significant number of unused vacation and sick days from previous OPS contracts (currently at 15:25 days respectively, potentially increasing to 30:40 over the next year if they continue to build up).

If I were to be converted to permanent in 12 months (big if), I understand that I would lose these days. I’m wondering... how I’m realistically expected to use all of them before they expire? Or what others would do in this situation.

I also feel like my manager wouldn’t be too thrilled if I suddenly tried to take 70 paid days off by this time next year lol.

Looking for advice from anyone who’s been in a similar situation.

Thanks,

Title says it all. No need for details.

How do you guys cope?