Why Do SSRIs Cause Anxiety At First?

Although they're often used to treat anxiety, antidepressants can potentially cause anxiety, especially when people begin taking them for depression. Using various strategies, it is possible to get a better handle on these anxiety symptoms.

Some strategies you can use yourself; others may require working with your healthcare provider. There are also strategies that are helpful to family and friends wanting to support a loved one who is coping with antidepressant-related anxiety.

Why Do SSRIs Cause Anxiety At First?

The reason for heightened anxiety symptoms may be related to the levels of the neurotransmitter serotonin. Low serotonin in the brain is thought to play an important role in causing both depression and anxiety. It is also believed that fluctuating serotonin levels during the early days of treatment might be the reason that some people feel anxiety as an antidepressant side effect.

A 2014 study revealed that, after taking antidepressants for one month, approximately 7% of the participants developed antidepressant-induced jitteriness/anxiety syndrome. Individuals experiencing this response, which is sometimes referred to as jitteriness syndrome or activation syndrome, may notice not only an increase in anxiety, but also an increase in:

• Agitation or irritability
• Elevated mood state or energy levels
• Hostility or aggression
• Impulsiveness
• Insomnia
• Panic attacks
• Trouble staying still

Emotional

It is important to recognize that these emotional changes don't mean that you've developed a new mental health condition. It simply means that your body has either not yet adjusted to the new antidepressant or that the medication may need to be tweaked to reduce the anxiety response.

Talking with your doctor is the first step to deciding whether any changes need to be made to your antidepressant or if feelings of anxiety will get better over time. If the doctor determines that a change needs to be made, the following approaches are a few potential options:

• Lowering your dose, then gradually increasing it to the needed amount
• Switching to another antidepressant
• Temporarily using an anti-anxiety medication like a benzodiazepine (such as Ativan or Klonopin)

Your doctor can best advise you on what to do in order to avoid this problem.

Physical

There are several proactive ways to cope with increased anxiety:

• Physical activity such as jogging, biking, or aerobics can positively impact how you feel. How much physical activity should you get?
• Modify your diet. Research reveals that eating high-fat and high-sugar foods could increase feelings of anxiety, as can eating at irregular times. Choosing lower-fat, lower-sugar foods and having regularly timed meals may help reduce your symptoms. Other dietary triggers for anxiety include caffeine, alcohol, and some food additives such as monosodium glutamine (MSG). You might find that reducing these substances or eliminating them completely can help relieve your feelings of anxiousness.
• Mindfulness exercises. Incorporating deep breathing exercises and muscle relaxation can help when your anxiety flares up, too. The nice thing about these is that you can do them anywhere.

Social

Sometimes antidepressant-induced anxiety can be relieved simply by realizing that you are not alone. Connecting with others who are dealing with the same effect can make it feel less daunting or concerning. You may even learn a few tips or tricks that they find helpful for reducing anxiety caused by antidepressant medications.

Search your local area to find any anxiety support groups that are close to you. There are also a variety of online anxiety support groups available. Check a few out to see what you think. The important thing is to find one that is accessible when you need it and makes you feel comfortable and welcome.

If you find that your anxiety is not getting better, or is getting worse—especially if you are experiencing certain other symptoms like mania, worsening depression, or suicidal thoughts—do not hesitate to contact your physician or seek emergency help.

Caregiving & Helping Others

Watching someone you love deal with feelings of anxiety can be difficult. Johns Hopkins shares that there are a few things you can do to help. One of the first steps is to recognize the signs of anxiety. Physical symptoms may include:

• Feeling lightheaded, nauseous, or short of breath
• Persistent worry and second-guessing
• Showing irritability or frustration

Once you recognize their anxiety, ask them how to best support them with this feeling. Let them tell you what they need to feel less anxious. At the same time, validate their anxiety and express your concern in a positive way.

It can also be helpful to acknowledge what you don't understand about anxiety and encourage them to seek treatment. Be there for them while they work through their anxiety.

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