Panic disorder.
Apparently, that hospitalization thing earlier this year was a panic attack, and the dizzy spells, faintness, and shortness of breath that’s been taunting me on and off ever since is the fear of having another one.
Great.
Hey, it’s better than a heart attack (if you feel like looking at it that way). Panic attacks don’t require you to have surgery, exercise more, or eat better.
Did your doctor prescribe you an anti-anxiety med to help?
I did a thread on recovering from an anxiety disorder a little while ago. You can search my username for it if you’re interested (or email me; I’m a co-facilitator of a self-help group for people working on their anxiety disorders).
I started getting those almost exactly 30 years ago–I had no idea what they were and was terrified that I was dying. Once I found out what they were they became few and far between but I still get them occaisionally.
Well, I have actually been advised by a cardiologist and a GP to exercise more and cut out caffeine entirely.
Not yet. When I went to see a doctor about it last week, it was a day before I had to give a speech in class and he wanted to (1) avoid giving me something that would make me bomb my speech and (2) have me wait it out for a week or two and then talk to my regular doctor about it (regular doc. was on vacation). The diagnosis comes from my psychotherapist, who is not an MD. The doctor last week said to double my dose of the beta-blocker I was already on if I felt like I needed it, in the meantime.
I’m not at all a fan of SSRIs, so hopefully I can start on some benzodiazepines soon, since it’s getting to the point where I really feel like I need a chemical crutch to deal with the symptoms while I deal with the root causes in CBT.
I hope it helps you. Panic attacks (never had one, but have had anxiety which is bad enough) suck.
Remember that panic wants to trick you into thinking it’s interesting and meaningful. This is how it grows. The truth is, it’s boring and doesn’t mean anything. It will try to convince you that you should examine it and worry about what it all means. That’s a lie. Ignore what the panic tells you. It’s not looking out for you–it’s just trying to get bigger. You don’t have to agree to that.
Never heard it put that way before, Shoshana, but that’s sound advice. You’d never allow another human to manipulate your thoughts and actions the way we allow Panic to do. Food for thought, indeed.
Very true. It’s just scary as hell that an emotion could put me in the hospital by itself if I let it–and already has. I had friends growing up who had nervous breakdowns, panic attacks, etc., and I’d seen a panic attack before, but somehow the reality of it never really hit home until it happened to me.
Well, on the recommendation of my therapist, and after noting that my symptoms were still palpable, I went and saw my doctor about a medical supplement to therapy. I told him that I was not a fan of SSRIs, but would be open to just about anything else–thinking that “anything else” meant something like a benzodiazepine. Turns out that “anything else” includes SNRIs, too. So I got Cymbalta. I was told to come back in a week “if the symptoms get much worse”–I took that to mean “if the drugs aren’t working”, which turned out to be a little off base.
Needless to say, I was not happy when my pharmacist told me 20 minutes later that Cymbalta’s intended effects may not kick in for months, but side effects could show up immediately, and include dizziness (one of my current symptoms, pre-medication), drowsiness (not something I need in my life) and, um, depression (a major part of the problem in the first place). Further reading reveals it to be fairly similar to Strattera, which I took in high school for ADD, and which made me dizzy (current symptom pre-medication) and gave me light trails (current symptom pre-medication). Awesome.
I took one when I got home 15 minutes ago or so and I am feeling pretty damn dizzy, but I was dizzy in the doctor’s office too, so I guess I’ll give it a week.
It’s good that your doctors are continuing to prescribe stuff. Are you driving?
Do you have a good enough relationship with your doctor to just come right out and ask for benzos? My anxiety attacks are not frequent, thank goodness, but when they strike, a quarter mg. of Xanax does exactly what I need it to, without incapacitating me. Of course, if your doctor is just naturally suspicious, or if you don’t have a good relationship, coming right out and asking for Xanax or Valium could be seen as drug-seeking behavior, as benzos are often abused.
That’s why I didn’t come right out and ask for benzos. I’ve never been addicted to anything (quitting smoking was a breeze; even heroin couldn’t hook me), but I have a positive drug test in my records at the clinic, so I don’t want to take any chances. Plus I want to give my doctor the benefit of the doubt; he’s usually spot-on, and he’s willing to change direction quickly if something doesn’t work for me. So that’s why I’m giving it a few more days. I’m not so sure about the full week, anymore–I had one beer with lunch today and now I feel like I’m stoned off my gourd. Of course, I recognize that I won’t be putting 'em back on benzos either, but at least they (hopefully) won’t make my already-existing symptoms worse. I mean, really, the side effects list for this stuff reads like a list of my symptoms, and I’ve been feeling like utter shit since about half an hour after I swallowed it.
Struan, yes, I do drive. If it comes to that, though, I can take public transportation.
That’s a cool way of putting it, and something I will remember a long time. Shoshana, do you know a similar quote about depression?
Sure. This is not intended as medical advice. By all means seek more information if it seems interesting. This is a general response. Usual disclaimers.
Narrative therapy calls this way of thinking about symptoms “externalizing.” When I was first trained, we were told to try to get clients to own their symptoms and see them as a part of themselves (this is the “stop being in denial about your responsibility” route). The narrative externalizing technique says that we should try to help people put the symptoms outside themselves. When it’s outside (as a metaphor or image, for example), it’s less overwhelming and easier to be creative in dealing with it. Many of us do the imagery part of this already, seeing depression as a “black dog” or “ominous cloud,” or talking about how “there’s a wall inside me” or “I feel like my evil twin takes over.” Many people picture critical “editor”/“critic” eyes looking over their shoulder and commenting negatively on everything they do (or just on their attempts to write a dissertation). My experience of depression was like being in a grainy black-and-white French film that was playing at the same time as everyone else was in a Hollywood comedy showing on the same screen. Had I had a narrative therapist at the time, or known about this technique, I might have used this imagery to help explore and perhaps even deconstruct some of the more automatic aspects of the depression (in cognitive-behavioral parlance, catastrophizing, snowballing, not using thought stopping, etc.).
For example, if you are seeing depression as a gigantic black wave that crashes over you and drowns you, there might be some relief and satisfaction in drawing the wave, then noticing that you can fold up the paper you drew it on and make it smaller–it’s not infinite. And you might start thinking about what a person can do when they’re swimming and a big wave approaches–for example, you can spot it and see if you can outswim it. That sometimes works. Or you might know that you’d do better to take some deep breaths and try to ride it out rather than fighting it and thrashing around. You might even know that when you’re really in the water and you start feeling overwhelmed, you say your little “I must not fear” speech from Dune. Or that going with the flow, you’ll be swept to the island. It might be that you need some tools. A balsa raft, a surfboard, a lifejacket, a giant turtle? Wonder Woman lowering a rope from a helicopter? Moses parting the sea? It might be helpful to draw that, or do a series of drawings about how you don’t let the wave trick you into giving up and drowning. The images come from the client, but the counselor can be helpful (and hopeful) and ask questions. You might not draw it, but just talk about it.
In my experience, people find externalizing techniques easy to understand, sometimes funny, and often helpful because they help limit the problem, they assume that you are capable and have ideas and resources, and they’re often playful.
A narrative technique used in family contexts involves having everyone agree about the problem behavior they’re trying to stop getting into. They agree that at the first sign of the problem or the usual intro to the problem, whoever notices first runs and puts on their plastic Groucho nose-and-glasses. Everyone must stop what they’re doing, put on their nose-and-glasses, and then have a discussion about who saw the problem first, what they saw, and what the fdamily could do instead. As you can imagine, this is hilarious even when grim.
My clinical experience is that when we use imagery, often we can increase our sense of hopefulness and optimism simply by imagining what a solution would look like. Thus, if I see depression as a giant boot that stomps me, I might draw the boot, then in another drawing I might depict myself jumping up onto the boot, or quickly typing the boot’s laces together, or (if it turns out it’s a giant metal tripod foot from John Christopher’s novels), cleverly using magnet-mittens to climb up the leg. I’d then practice picturing my solution when I feel stomped. What does it mean to climb up a tripod with magnet-mittens? I have no idea. It’s not an exact analogue for a real solution to depression. But it does seem to make people feel more capable of challenging the depression (or whatever). Lots of kids see depression (or their behaviors) as a monster (so do a lot of adults). So what do you do? Maybe it’s a start to picture yourself spraying anti-monster spray around your bed at night, then following through on your commitment not to let monsters (e.g., negative self-appraisals) into the bed. Maybe you practice arguing with the monster, which, as we know, will say terrible things to you. Remember that when monsters get desperate, they get louder, so it’s important to hold your ground. Harry Potter boggarts are a perfect illustration of the narrative technique–you laugh at what scares you by making it ridiculous. Picturing your audience in their underwear is helpful to many people, if not to Homer Simpson. What kind of underwear is your depression monster wearing?
Some people write divorce decrees to their anorexia. Some people build bridges to stars. It’s really pretty cool.
I have to ask, when you say “So it has a name.” are you quoting The Tick when he had a hangover?
Back on topic, glad you got this diagnosed. I’ve had friends with similiar symptoms who refused to go see a doctor because “eh, it’s nothing”. It is not something to mess around with, to be sure.
If so, only subconsciously. I don’t remember a damn thing from that cartoon, although I used to love it when I was a kid.
Well, one of the doctors I saw today said that some new symptoms are suggesting to him that there might be something more serious going on. Apparently I’m taking some more cardio tests next week, and a brainscan may be in order as well. Fingers will be crossed.