I Just Feel Like Jumping Out of My Skin

Reader’s Question

I am 31 years old, and I went to the doctor about 4 years ago for anxiety, frustration, and rages. I was on Wellbutrin, then Buproprion (?). Anyway, everything made me drastically gain weight, and the Wellbutrin made me more anxious. I have been on Zoloft for a year now, and I feel more easy going at those challenging times, but I still have a very hard time wondering what I should be doing next. I feel like I always have to be doing something.

I forget my work schedule every week. I make it a thing not to remember doctors’ dates, and important dates. I am forever triple checking everything…and I wear myself out to the point that when I want a day off, and when I have a day off, I cannot relax. I have this thought that everyone will think I sit around all day. Yet they give me no reason to think such things.

I feel so overwhelmed at times, especially when all my children are home and they all want my attention at once. I get frustrated and I have to walk away, almost like my mind can’t handle it. I have trouble controlling my emotions. I feel like I could be changing my emotion at any given moment, yet I don’t feel depressed. I just feel like jumping outta my skin at times. Please give me some feedback. I’m not sure what to think anymore. I feel like I am on a neverending treadmill.

Our Consulting Clinical Psychologist’s Reply

From your description, it sounds like you are experiencing a type of agitated depression. “Normal” depression involves deficiencies in the neurotransmitter Serotonin. The symptoms of inability to relax, jumping out of your skin, etc. are often associated with another neurotransmitter — Norepinephrine. Your current medication — Zoloft — targets Serotonin. For this reason, your depression feels better, but your agitation and inability to relax continue.

I would approach your physician with the idea of switching medications, if medically appropriate. We have medications that are SNRI — Serotonin and Norepinephrine Reuptake Inhibitors. These medications, such as Effexor and Lexapro (and Wellbutrin), target both neurotransmitters and might provide a more effective medication response.

Another issue may be related to your treatment. About 85% of antidepressants are prescribed by physicians who are not psychiatrists — mostly family and OB/GYN physicians. In my experience, they often use antidepressants in low or “starter” doses and keep the dosage low — and/or they only use one medication at a time, as in your case. If your prescribing physician is not a psychiatrist, you may want to consider a psychiatric consultation regarding your medications. A psychiatrist is best trained to effectively use medications, often at higher doses and/or using medications in combinations. You will also improve faster if you add a counselor/therapist to your treatment program.

I would recommend reading my articles entitled Chemical Imbalance and Understanding Depression on my website at www.drjoecarver.com. I’d also review the depression articles and depression tests available on this website.

Your situation is very treatable. When the physical signs of anxiety and depression are present — physical agitation, anxiety, panic, restlessness, etc. — then a medication change is often necessary.