Talk to me about panic disorder

Miscellaneous and Personal Stuff I Must Share
1

I get a list of “topic is similar to” when I type in the thread title, but nothing in the list is newer than 2011. So I’ll start this new thread rather than revive one of the old ones.

I think I’m developing panic disorder. I had a full-blown major panic attack for the first time about three years ago, but luckily I had just been reading about them and what people did to cope with them. I was driving on the freeway during rush hour, and I pulled off, parked in a shopping center parking lot, and laid back and did deep-breathing and trying to talk myself out of it. I had no chest, arm, or jaw pain, so I knew it wasn’t a heart attack - just an overwhelming sense of imminent doom and terror. After half an hour, it faded away and I was able to drive home, still shaking and gasping.

Then nothing for three years. But a week ago, I was lying in bed reading at night, and started feeling awful and panicky, right out of nowhere. I had just had my Moderna booster that morning, and my first thought was that I was having some kind of weird delayed reaction to the shot. I jumped up and started getting dressed to go to the ER, but after a couple of minutes, the feeling faded. I then remembered that it was the same feeling that I had had three years ago, albeit way less powerful.

Since then, I’ve had a few incidences of an attack trying to start, but each time I get up and practice deep breathing and reciting a mantra (“fuck panic disorder, fuck panic disorder”), and the attack never takes hold. Most of these have happened while I was lying in bed reading a book or the laptop. I wasn’t reading anything scary or dramatic, just a comfort novel or maybe the message boards. As a side observation, I would also usually have an air bubble in my stomach, and getting up and burping seemed to help the attack go away. Last night the vague panicky feeling kept coming back time after time until I finally got so tired I went to sleep despite feeling badly.

Maybe a doctor’s visit is necessary, but I’m already doing the deep breathing, the mantra reciting, and the “this too shall pass” reminders to myself. I read the latest thread on this topic from 2011, and that seems to be the non-medicated way of approaching it.

Is there a newer, better way of treating this disorder since 2011?

2

I’m treated for general anxiety, which has, yes, manifested as panic attacks very seldom. You’re doing the right thing with your cognitive exercises, and could perhaps benefit from cognitive therapy to increase your expertise and resilience with the technique.

In my case I ended up under the care of a psychiatrist and I take brain meds which help a great deal; I had little choice but to do this as my anxiety would also manifest as insomnia and I went through periods of sleeplessness that would last days, so the meds were a godsend and I don’t know how I’d cope without them. I also have an as needed prescription for Ativan for when I can’t cope any other way, but I take those as little as possible since benzos are not to be trifled with.

I’m not saying you need to go the med route, but it may be worth exploring if things progress. My own symptoms started when I was about 40, having never had issues with anxiety or insomnia before. Your brain changes as you get older.

Do you have other family that have had anxiety / panic issues? Much could probably be learned from that.

3

I’m afraid, anxious and panicky a few times every day.
I know there are some good meds out there, now.
I’ve found the attacks are usually self limiting. I have learned to just ride it out, head down, deep breaths, etc.

No amount of talking can talk me down. It begins in the head and internal is how I deal with it.
YMMV.

Knowing what is happening to you is half the battle.

4

The main issue with panic disorder is becoming afraid of the panic attacks before they happen. If you can manage treat them as this thing that just happens, you can avoid making them any worse or more frequent.

Now, as for the panic attacks themselves: sometimes it’s just stress/life/etc. Sometimes there’s an underlying issue. I’d thus recommend going to a doctor about it, if only so they can test you for the latter.

5

You’re on the right track, that’s basically how I manage my panic attacks too. My mantra is “This is just your brain fucking with you, chill.” One thing that you might look into is beta blockers. I got prescribed one to manage my blood pressure and after a few months of taking it I realized it dampens down the physical effects of panic attacks by about 80% and doesn’t have the obnoxious side effects of most psych meds. If you don’t run low BP that might be an option for you.

6

I had some episodes of panic attacks years ago when I was in my early twenties, the first being that feeling of impending doom while boxed in on a six lane freeway. Later they would just come out of the blue with no identifiable cause. Doctor gave me some Valium but I rarely used them since the attacks wore off before the pill would work. After about three years they stopped happening and I haven’t been bothered since.

What helped for me was to somehow get ‘cold’ on my face, cold water, cold washcloth, rub an ice cube on face, stand in front of air conditioner, step outside in the cold, etc. And when the fear started repeating over and over to myself “Nothing terrible ever happens … it will go away.”

7

My heart was racing a lot, almost randomly and never in concert with my brain (like, I wouldn’t be having anxious thoughts while my heart was racing). I had all sorts of tests done and my heart itself was normal. The doctor and I decided it was a manifestation of my anxiety and put me on beta blockers, and now I only get the racing heart a couple times a year as opposed to a couple times a day.

Other than the beta blockers, something that seems to have nearly stamped out my anxiety and depression is having a sleep study and subsequently using a CPAP. If you have any indication that you may have sleep apnea, I highly highly recommend trying to get it sorted. I’m going to sound like a commercial here but using a CPAP gave me a new lease on life.

8

I had my first panic attack about 8 years ago and I’ve been taking an SSRI ever since, and probably will for the rest of my life. I wasn’t having any particular stress or emotional problems; it’s totally chemical in nature and as such, no breathing exercises or cognitive therapy will work.

Perhaps the OP’s first step should be to determine whether there is a serotonin imbalance. Either way, they have my sympathies. I would literally rather experience anything than another panic attack.

9

I’m back at work after a week off on vacation, and handled a pile of work for two hours. No problems with anxiety. I reached a good place to pause, so I opened up this thread. About two seconds into reading it, I got another panic attack and had to find an empty office to put my head on the desk, breathe, and recite my mantra. It passed.

Guess I’d better go to the doc. Godammit.

10

A GP would probably give you a stopgap prescription for Ativan/lorazepam. It’s a benzodiazpine so proceed with caution, but it just takes the edge off just enough. You put it on your tongue and it melts and you get relief in a few minutes.

You may just be going through a rough patch and that’s enough and all you’ll need and be done after a few weeks or months. Or you may progress to antidepressants, which is fine but it takes a great deal of time to find the right one since they take weeks to try out. There’s some very mild antidepressants, e.g. Buspirone that have quick-ish effect and would be worth trying out. I take Buspirone as needed for claustrophobia, e.g. before I get on a packed flight, and it’s very mild and quite helpful; you know you’re anxious but don’t care all that much, and it’s not a benzo so win win.

11

Thanks, squeegee. I’m off in about an hour to the doc. I’ll discuss all options with him.

12

Good luck, Teela :hugs:

13

For me, knowing I have access to meds to stop the attack reduces the power they have over me.

When I get panic or just general anxiety I start with a first generation anti-histamine and a beta blocker. If that doesn’t work I always have xanax if I need it.

Knowing I always have access to these things makes me feel like I have power and control over my anxiety, which in itself reduces the power it has over me.

As far as OP, another thing to look into is the mammalian dive reflex, which can help activate your parasympathetic nervous system and help control anxiety.

14

I’d agree with this. Knowing I have the Ativan/whatever in my toolbox helps me weather an anxiety incident without actually taking any. Weird, but there it is.

I’d have thought this was a weird parody, but apparently you’re serious. :confused: Is this an equivalent to the poster above who said they get panic relief by applying cold on their face/head?

15

I’m trying the cold compress to the face and head thing. In fact, I tried it just a few minutes ago when I was feeling a little weird. It seemed to help a lot; in any event, a panic attack didn’t materialize.

The doc ran an ekg on me, which showed no heart issues that he could see. He didn’t know what was wrong and suggested a psychotherapist. I’m one of those folks who doesn’t like the idea of a head doctor. To me, this isn’t a stress/depression thing that I can just talk away, it’s a majorly physical phenomenon. Since my heart seems fine, I’ll just wait a few weeks and see if this doesn’t go away on its own. Then I’ll reconsider my options.

16

The mental affects the physical. This is especially true of panic attacks, as they are always started by the mind. Your coping techniques you are already using are mental, yet they help.

The fact that reading this thread started another panic attack makes me think that you would do very well with some psychological guidance. For issues like this, it really is about retraining your brain, teaching it to stop the bad habits that it’s picked up, like causing you to panic.

17

Glad to hear it helped. Hope yours go away like mine did.

18

You 100% cannot separate the head from the body, not literally and not figuratively either. Your brain makes EVERYTHING happen, it tells you when to breathe, tells your heart to beat, tells your adrenal glands to release adrenaline, tells your stomach how to release acids. Go to the psych person, they are specialists in how to medicate the body to ease the mind and vice versa and will get the right prescriptions to target your specific symptoms rather than throwing shit at the wall to see if anything sticks. I know there’s stigma about seing a psych doc but try to put that aside and approach with an open mind–especially because they can also give you exercises to help get on top of the panic attacks and learn how to control them to the point where you might not need meds at all.

19

There are a number of psychotropics which can “take the edge off” of various mental/emotional conditions. If a low maintenance dose will help even things out, I see no reason not to avail oneself of that.

I don’t want to incur to ire of anyone, but my impression is that people’s personality and self image can play a significant role in how they perceive and respond to situations such as you are experiencing. One person might say, “I’m feeling anxious” whereas another person might describe similar symptoms as “a panic attack.” Even the use of certain words might affect your perception of the severity of what you are experiencing. I’ve often marveled at people who calmly told me, “Right now, I’m experiencing a panic attack.” Really? Other people have expressed this more effectively in terms of the “fear of” recurrences.

Some folk might view an attack such as yours as something they are able to work through themselves, whereas others might consider them debilitating. I’m not saying one approach or the other is right or wrong for all people, just observing that different people can view such things vastly differently. And my nonmusical opinion is that your approach can have an effect on the severity you perceive.

And some people (NOT all or even most) almost seem to “research” themselves into believing they have all manner of debilitating conditions - physical and mental. So be wary of your reaction to doing research on your own.

So far, you impress me (not that you should care about MY opinion) as handling this very capably and reasonably. Going to the doctor was the best initial step. I’m a little surprised the GP didn’t prescribe an anti-anxiety med. Psychotherapists cannot prescribe, and you don’t need to see a psychiatrist to receive meds.

Like you, I don’t readily gravitate towards counseling. If I were you, I’d keep a detailed journal of when you experience these, how long they last, and how effectively you are able to handle them. I would probably try to make my comments on the positive side - not deluding yourself or minimizing anything, but giving yourself credit where credit is due. As opposed to dwelling on how horrible the event is. You get to record your own version of history. I personally think most people are more resilient than many people give them credit for being.

So far, sounds like you are doing OK. But if they become more frequent or more resistant to your efforts, a psychologist/counsellor could perhaps provide you some different strategies. And whether they get worse or not, consider a low does anti-anxiety med. It would surprise me to hear that GPs are hesitant to prescribe them.

20

I think you’re mixing up a psychotherapist with a psychiatrist. A psychotherapist uses talk therapy and is not a doctor. A psychiatrist is an MD who specializes in, well, brain meds, and treats anxiety disorders, addiction and so forth. A psychiatrist does not do therapy; there’s no couch you lay on and talk about your mom. I’m treated by a psychiatrist for my anxiety/insomnia and he prescribes me my meds.

Teela, I’m surprised your doctor had so little to offer you. I can see him being conservative about prescribing benzos (a huge addiction issue in the US), but not even discussing antidepressants or referral to someone expert in those is a bit strange. That said, cognitive therapy (which you’re already doing solo) could help, but sometimes you need a bit more help than mental exercises. If things don’t get better, seek referral to a psychiatrist. You shouldn’t need to suffer needlessly.