hmmm, warbird while I understand you may have had an issue with a doctor, strong opinions on med use, and have had a hard time on meds, some of your responses, primarily to hope-girl, are a bit harsh.
Eg---Docs do tend to go straight to the prescription pad.
It isn't necessarily the docs fault either. As a society, we've come to expect a cure for everything with a pill. I think the best way, in most cases (although I've taken them for post-partum without doing this), to take SSRIs is through a psychologist(they know just as much about meds and can suggest to your GP) or psychiatrist. My take on going up from 20 to 40 is ask your doctor/pharmacist about any potential upping of the dosage. It sounds to me like, for this particular medication, that it is often the next step up in that regard. Some people do
have a hard time increasing a dosage. When I took two SSRIs a few years back, I was started on a med that had built in titrating program--IE--I had a weeks worth of one dose, and another week of a slightly higher dose and then onto the first cruising dose. This helps minimize any start up side effects. My usual suggestion, if you don't have this built in titration and it is feasible, is to break a pill in half and go up slowly--do that for a week or two. SSRIS aren't masking anxiety symptoms. I think benzoes do that, which are a different class of drugs. What SSRIs are designed to do is help correct the overthinking by changing or correcting the imbalances of the neurotransmitters. They aren't a cure, in most cases. However, they are an excellent tool.
All medications have risks/benefits. Some of the side effects that are listed may not even have to do with the medication. It just happened when the test study participant was taking the med, but it has to be put on the bank of "potential" side effects. Other "scary" ones occur only rarely. Often the problem with doing internet research on medications, especially for those of us with anxiety, is that med websites are full of other scared/freaked out people who only post horror scenarios. We anxiety folks often can't pick through the good info from the bad. Most things that happen in our lives--good, bad or indifferent--are highly influenced by our expectations. So depending on how you think and react to such websites (even reputable ones), I would be leary of doing even "basic research". I would stick to asking the doctor and the pharmacist what issues could come up.