How do you deal with panic attacks?

Miscellaneous and Personal Stuff I Must Share
21

As a psychologist, I found the antidepressants work the best. Though I don’t prescribe meds, I work with psychiatrists that do. Actually imipramine is phenomenal at preventing and controlling them. It is an old school antidepressant and it has three annoying side effects. Dry mouth, constipation and eye glare. The eye glare will resolve itself in a week, the dry mouth can be dealt with by chewing gum or hard candy and the constipation can be easily dealt with by eating fiber.

That said, Paxil is also good at arresting them. Antidepressants work differently for everyone so you may need to try several different ones out before you find one that works for you.

The usual course is to start out with the lowest dose then go up after a week. Then go up a dose after another week, till you go one week without an attack. Then you stay at that dose for a month, then you go DOWN a dosage. If the attacks return you go back up. Eventually you find the right minimum dose. You must take antidepressants regularly. Despite their name they are not uppers, but mood stabilizers.

I find Benzodiazepines such as Valium are very helpful in the initial treatment stage. And it’s important to build them up in your system. Panic builds on itself so you will need to take them at regular times to get your system used to them, even if you’re not panicky. Then wean yourself off them. I would not recommend longer than 60 days but each person is different. For some 60 days is too short, for others it is way too long.

I’ve also had a lot of long term success with behavior modification. The results are better long term than drugs, but the course of treatment can be up to five times as long. This is problematic, when the anxiety victim needs to function for work or social reasons.

Although it is frightening you have to remember anxiety is distressing but not dangerous. The worst thing likely to happen is you’ll panic and bolt out of somewhere, leaving people to wonder, “what was that guy’s hurry?” You don’t go crazy or die.

Good luck to you

22

Oh my gosh, your experience and mine are so similar. I went through a very difficult period which culminated in my husband’s death. As I’ve been throughout my life, I was everyone else’s ‘rock’. Instead of people consoling me because my husband was dying, it was me consoling them. Somewhere deep inside this was taking its toll on me, because I started having what I thought might be high blood pressure attacks - my heart would race, my head would spin, I would feel like I couldn’t catch my breath, and there was this terrible, terrible feeling of doom that is hard to express, but instantly recognizable if you have it. I finally wound up in the ER, thinking I was having a stroke. Thankfully it was a slow day and someone very kind explained what was going on, gave me some medication to try, and got me referrals to both a counselor and a neurologist.

None of the anti-depressants helped much, although they did assist with actual depression after my husband passed. And OMG, they truly are hell to get off of. I went through the strangest sensations -almost hallucinogenic in nature. I could ‘hear’ my eyes blink, for instance.

What helped most was very low dose Xanax, taken as soon as I felt the panic begin to build. In my case, the first symptoms were usually shallow breaths and dizziness. Even after I no longer needed the Xanax much, I carried that pill bottle around like a talisman. As long as I knew I had it, I was ok. If I’d forget the bottle (change handbags or something), the panic would immediately start to build. The tablets are nothing but powder now, but they are still in my purse, being my security blanket.

I also had luck with the breathing exercises. I would take deep cleansing breaths while trying to complete a simple task, such as saying the alphabet backwards. Nothing too challenging, but something that required just a bit of thinking. That is a technique that helps general stress, too, and something I still use.

My symptoms also included feeling as though I were being choked, so I would stand in front of a mirror so that I could see that nothing was choking me. Having the visual reinforcement seemed to help.

My best advice if you think you’re having panic issues is to get evaluated. There is no one best course of treatment for everyone. Be very vocal with your medical provider until you get something that works. sometimes it takes some trial and error to get there. In my case, I had to be very vocal about needed something for ANXIETY, not for DEPRESSION. Once I got that message across, we started getting somewhere.

23

I had the opposite experience. The Ativan and/or Xanax (I’ve been prescribed both) calmed me down, and then I was able to just get on with my life. I’ve never felt the need to increase a dose.

YMMV, of course.

I found benzos helpful as ***part ***of my treatment – which also included therapy and antidepressants. I use them infrequently these days, as I’ve been able to get away from a lot of my triggers. I use the benzos to help me sleep occasionally, and VERY occasionally for anxiety/panic. My last prescription of Ativan expired with three refills on it.

24

I haven’t really had one since my (now deceased) dog was very young. I had several attacks before I had her, then just one when she was a puppy and that’s it. And she did help me snap out of it - it never got to the bad point, it just bubbled.

So I think having a dog helped me. I have two new dogs now. They drive me nuts but no panic!

25

Don’t get them, but have struggled with anxiety. Benzos help me. But only them occasionally. Otherwise, exercise is what works for me.

26

I’m pretty much over the worst of the attacks now. I had been having a really hard time a few months back, and taking up to three Xanax a day. I was able to calm down enough to where I don’t need them now.

I do meditation in the mornings and slow, deep breathing exercises during the day. I’ve been better at identifying the onset of potential attacks and responding with deep breathing.

I’m on a couple of meds. The doctor and I played around until we found a combination which works for me. Each person is different, so what would work for me may not work for you.

I made a log of the various symptoms each day, just a one-word description and was much better at reporting to the doctor. He was really good at working with me until we found the right combination.

One trick a therapist suggested was looking around for tigers when you start to get an attack. As silly as that seems, it was able to get through to my mind that there was no physical danger at the moment.

27

Yes.

28

In a couple months I think most of my triggers will be history, which I hope will help the depression that hangs around like bags under my eyes. TokyoBayer, good to see you. It’s been a while.

29

I’ve been wrestling with this.

My psychiatrist prescribed gabapentin, which has really helped. I had to build up slowly. It made my sleepy if built up too quickly. But I got to the point where I realized that I was in the middle of something that would normally be causing me to have major freak outs, and I was just handling it. Didn’t even ping my radar. Which was just weird. So that’s part 1, meds to help me while I build skills and re-arrange my life to get things under better control. Because no question, I’ve got a LOT going on. There’s no question that there are legitimate reasons for the panic attacks.

My psychologist recommended a book called: “The Worry Trap”. I’m also working on CBT.

It’s a process. I think there’s a support thread around here somewhere. I’ll find it and add it to this thread. Maybe we can just rejuvenate that. Good luck.

30

This is a CBT book written by a Psychiatrist that I would rate a 9/10, at least, Feeling Good:
http://www.amazon.com/gp/product/0380810336?psc=1&redirect=true&ref_=oh_aui_detailpage_o07_s00

31

What do I do? Apply Xanax. Nothing else has worked. I suspect other things would work, but GABA-agonist sedatives are reliable and cheap. I ask for beta-blockers every time, and I get sent home with benzos. It only happens when I’m under huge amounts of stress, and I’m not particularly worried about being on them long. I am paradoxically wonderful in real emergencies, and of course I’m fine when only ordinary things are going wrong, so it very rarely comes up.

I also have joint hypermobility syndrome, which may or may not be the same thing as Ehlers-Danlos Type III (Hypermobility Type). JHS/EDS patients have been telling stories forever about weird symptoms like a predilection for migraine and anxiety disorders, and bizarre reactions to common drugs. (I’m ineligible for antidepressant treatment because when I tried it, I think I got every side effect on the package insert short of seizure and death. Research is finally starting to come out, although mainly on the way painkillers and topical anesthetics do diddly.) There seems to be something wrong with the way my autonomic nervous system deals with stress responses and shutting stress responses down properly when the sabre-tooth tiger has gone away.

Most people with panic attacks, I gather, don’t run into the problem of their brain being literally, physically bollixed up somehow, and they have better luck getting relief from things like CBT, breathing exercises, or self-soothing rituals than I do.

32

Do you drink any caffeinated beverages, such as coffee, tea, sodas, etc.? If so, this may be contributing substantially to your problem. Caffeine is a nervous system stimulant and that’s about the last thing a person needs who is susceptible to panic attacks. Speaking for myself, I have found it is best to taper off very slowly from caffeine, reducing it a little every day, but “cold turkey” may work best for other people.

33

Cool. Recently started with it myself. Could be placebo - hard to tell, so far - but while I’m still prone to distraction, I do feel somewhat less anxious and jittery when drinking coffee. Which is nice.

34

Find a good NLP or EFT practitioner or at least check out EFT on youtube and have a go. Good luck!

35

Thanks for your responses. They’ve been very interesting. I’m going to visit my Dr. soon and request a different anti-depressant as the one I am currently on (Zoloft - a.k.a. Lustral or Sertraline, depending on where you are) isn’t doing much of anything.

The problem I have is that I can’t shake the fear that there is something wrong with my heart. I’ve had a shit load of tests done over the years and the results have always been normal, but as soon the panic sets in and my heart starts pounding those results don’t seem so reassuring. This is compounded by the fact that my panic attacks tend to roll into one another, so one “episode” can last for hours. I imagine it would be easier to dispel such worries as I have if the attacks were restricted to a few minutes, but if your heart’s been hammering away for three hours it becomes much easier to believe the worst.

For this reason, I’m not sure how much mindfulness or deep breathing exercises would help me. Since my panic attacks are never caused by anything external (ie. money worries, relationship problems), and because I have such a weird preoccupation with heart disease, what inevitably ends up happening is that I’ll have a panic attack for no discernible reason and, more often than not, the symptoms will fuel a second panic attack, and another, and then another. I’ve never tried mindfulness, but it seems to me that any therapy which requires me to focus, or ‘listen to my body’ is bound to fail. My problem is that I focus too much!

I’m going to start seeing a CBT therapist asap. I’m also going to see about getting a prescription for a sedative, like Valium or Xanax to take in emergencies.

36

I looked at this. He also wrote one specifically on anxiety, which is my BIG issue at the moment. I ordered both.

37

Theanine & caffeine is a well liked nootropic combo. The theanine takes the edge off. Personally I use it for insomnia, I don’t wake up as often during the night when I take 200mg of theanine before bed.

http://jn.nutrition.org/content/138/8/1572S.long

38

Things haven’t been that well, so I was off here for a while. I’m coming back as things get a little better.

I still get a lot of anxiety attacks, which are less in degree than panic attacks. I get light headed which sometimes helps me remember to breath slower.

I had to stop doing a lot of things and really let go of a bunch of stuff. I am starting to turn around, though.

I hope you start feeling better.

39

I had debilitating anxiety attacks for years that interfered with my quality of life and prevented me from doing some common activities let alone things like public speaking. I sought treatment for it over and over and went through every fancy drug the doctors could come up with but it only made things worse.

Then, two things happened. I read an article about magnesium deficiency and its symptoms. I had all of the symptoms for a moderate to severe magnesium deficiency. I asked my doctor to test me for it and it came back as severely deficient (most people are somewhat magnesium deficient but mine was really bad). I bought some reputable magnesium citrate supplements and started taking those. They helped right away but the full benefits didn’t kick in for a few weeks but they were big ones. I still got some panic symptoms like a racing heart and really sweaty hands during any stressful situation but things were normal other than that.

I described the problem again to my doctor and he prescribed a medium dose of a common beta blocker. That has been a godsend and what I should have been prescribed all along. A beta blocker makes it almost physically impossible to react strongly to any stressful or fearful situation and that is just what I needed. I wasn’t ever scared of anything in particular. I was scared by the threat of fear itself going into an uncontrollable feedback loop and the beta blocker stops that loop from ever starting. I am not sure why doctors prefer newer and fancier drugs over older and proven drugs like beta blockers. No one solution will work for everyone because the root causes can be very different but you can push you doctor(s) to try something else when the current strategy isn’t working. The dirty little secret is that they are mostly just guessing what will work for you and you have to tell them when it isn’t.

40

Alprazolam (Xanax) has worked fairly well reducing anxiety for me. If it were added to municipal water supplies like we do fluoride, I suspect society would run much more smoothly.