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14 years ago 0 286 logo logo logo logo logo logo logo logo logo logo 0
Resurgence of Panic Attacks

Hello there,
 
I've dealt with panic anxiety on and off all of my life. In high school I was having difficulty going to school so my doctor put me on Paxil, which I took for eight years. Last April I felt like I was in a good place in my life and hadn't had any serious anxiety issues for some time, so I wanted to try being drug free. Little did I know what I was getting into.
 
I quit Paxil cold turkey (I realize now that is not recommended but I did check with my doctor and he okayed it) and I went through a horrible six week withdrawal with insomnia, shaking, nausea, and rebound panic. Since then it has been a constant struggle to return to normal life. I have looked into and tried many alternative ways of dealing with anxiety - changing my diet and exercise patterns, acupuncture, counseling, herbal remedies, etc. I have also occasionally used Xanax to subvert major panic attacks. I've had good stretches but had a couple of panic attacks in mid-December that has started a major flare up. All of a sudden it's not just the old feared situations that cause panic attacks, but I'm afraid to even leave the house by myself because of all the attacks I've had in the last couple of weeks. Now I experience a daily near-constant anxiety and am at a very low point.
 
 My ultimate goal was to remain drug free and manage my anxiety without it, and especially after my Paxil withdrawal I am very skeptical of drugs. However, after having to use Xanax fairly often in the last few weeks (and I know how addictive it can be), my doctor has convinced me to try a low dose of Prozac to help me return to feeling functional and being able to work on my anxiety through exposure therapy without constantly being so symptomatic.
I'm frustrated about being on another SSRI because the side effects of Paxil were significant - though I didn't realize how much of an effect it was having on me, since getting off of it my libido has increased, I've lost 25 pounds, and my sleep patterns have returned to normal. I want to manage this anxiety - right now it is so unbearable that I'm not functioning and am willing to do everything - but I don't want to return to those or other side effects either.
 
 I've done a lot of anxiety research over the years so know a lot of the logic about how panic attacks won't physically harm you, how fight or flight works, and how exposure therapy can be beneficial. But, it's hard to get logic to overcome emotions. I'm very frustrated by this recent major setback, because I am a very active, motivated person and feeling limited by my anxiety makes me very hard on myself.
 
I'm hoping the Panic Program will help guide my recovery work, and I'm hopeful that I can find help and support in these forums. I'm especially interested to hear from people who have tips on managing anxiety without drugs after having been on them for some time, and I need support as I try to justify myself going back on an SSRI for at least the short-term.
 
This got kind of lengthy, but I guess I had a lot on my mind. It helps to put it into words.

14 years ago 0 286 logo logo logo logo logo logo logo logo logo logo 0
Exposure Questions

I have read about exposure therapy before and just completed the week four lesson. It describes everything very well, but I'm still left with some of the same questions I've always had about working with anxiety through exposure. If anyone can offer any insights that would be great.
 
1. I understand how panic works and how my body is reacting during a panic attack, thus I'm not scared during a panic attack that some harm will actually come to me. Instead, I just HATE feeling that way, and the vast majority of my fear is centered around my "fear of fear", or fear of having a panic attack. When working with exposure, you're inducing anxiety in a sense, and while I understand you don't want to put yourself in a situation that will result in a fear rating of 90-100, if I go somewhere and feel really anxious (even up to a 60-80) I feel like my fears of feeling fearful are coming true, reinforcing my "fear of fear". Does that make sense? I guess you are just supposed to witness that your fear level will come down, but when my biggest fear is feeling miserable, and I go into a situation and feel miserable (even if I'm slightly less miserable at the end) I feel like my fears are reinforced. How do I get around this?
 
2. As I already mentioned, most of my fear is "fear of fear", and so I have a lot of anticipatory anxiety. How do you use exposure to deal with anticipatory anxiety? I understand that if you go through exposure and realize there is less to be afraid of, your anticipatory anxiety will eventually go down, but is there any way to address this more head on? For instance, if I develop an exposure plan for the next few weeks, my overall anxiety level will be much higher 24/7 thinking about all the challenges I'm going to be putting myself through.
 
 3. Similarly, what about when a decent number of your panic attacks occur "out of the blue" rather than in a particular situation....how do you work with exposure in this case? It's hard to nail down a particular fear that's triggering attacks in these cases, so it's impossible to come up with any exposure plan.
 
 4. Finally, I have a specific question about developing an exposure plan for my fear of going to events such as plays and sporting events. Often when I do these activities I feel fine for much of the event, and my anxiety increases as the event goes on until I find it difficult to stay there near the end. Often my anxiety isn't at its peak until towards the end of an event, so even if I get myself to stay in the situation and endure it hoping the anxiety will eventually go down a notch, the event often ends first - so I get to leave, and of course immediately feel better, so I feel like my fear is being reinforced. How do I do exposure work when my anxiety increases the longer I'm in a situation, but I don't have control over how long the event lasts?
 
 I got a little long-winded there, but it's helpful even just to put my concerns into words, so thanks for reading, and any thoughts you have will be much appreciated.
14 years ago 0 286 logo logo logo logo logo logo logo logo logo logo 0
The "gag feeling"

One of the physical sensations I get during an anxiety attack is the feeling like I'm going to gag. Sometimes this feeling gets so severe that I do actually gag several times. Anxiety can lead what I call the "gag feeling", but other things that make me feel a similar sensation in my throat (such as post nasal drip from my allergies) can also lead to anxiety. This feeling makes me the most anxious when I'm not at home, because if I gag in front of others I think people will think I'm crazy or something is seriously wrong. It does still happen at home sometimes, though, which is when I sometimes I end up gagging and spitting into the sink until the feeling passes.
 
Has anyone else ever experienced something similar?
 
When I feel this way, I always wonder if it's better to fight the feeling (I know in general you should let yourself feel the anxiety rather than resist is so you realize it won't harm you) or give in to the feeling and gag (but often when I try this route I get more and more worked up!)....any suggestions?

14 years ago 0 286 logo logo logo logo logo logo logo logo logo logo 0
The "gag feeling"

Samantha,
 
When I'm experiencing it I'm able to swallow all right, but I definitely breathe shallowly.  The doctors I've talked to never think it's anything serious, but that doesn't make it any less uncomfortable! When I do give in and gag, it does feel like I could throw up (which is one of my greatest fears!), but I never do and it doesn't have nausea as part of it.
 
I'd definitely be interested to hear if others have experienced the same feeling. I know anxiety manifests itself different for everyone but it's definitely nice to know you're not the only one who has had to deal with something!
 
14 years ago 0 286 logo logo logo logo logo logo logo logo logo logo 0
Hi All!

Chrissy,
 
I'm in the same boat in the sense that I had my anxiety under control for several years, but have recently experienced a bad flare up and am trying to get things back under control. It's always good to know you aren't alone in your particular situation, so thanks for posting!
 
Do you experience many side effects from the drugs you're on? My flare up started when I got off the SSRI I had been on long-term. I went through a bad withdrawal and had a hard time learning to cope with anxiety again. I really, really wanted to be drug free, but I recently "gave in" and started on a small dosage of a different SSRI, at least for a while. It has made some very noticeable differences in my anxiety levels, but I do experience some negative side effects. I'm always curious as to what other's thoughts are on being drug-free, taking drugs, coping with side effects, etc.

14 years ago 0 286 logo logo logo logo logo logo logo logo logo logo 0
Hey

Jimmy,
 
Hang in there! Don't be afraid to open up - you aren't crazy and a good therapist will help you realize that! I was afraid for a long time that a lot of the things I thought/felt were my own unique problems and no one would know how to help me with them, and it has been comforting to find out that that's not the case at all. Many people deal with the same issues, and more importantly, many people overcome them and feel "normal" again!

14 years ago 0 286 logo logo logo logo logo logo logo logo logo logo 0
Sense of Crazyiness

When I'm in the middle of doing a lot better, then suddenly have a rough day and a panic attack again, I always feel a little defeated and worry everything is falling apart and that I'm entering a really bad spell again. I just repeat to myself that it's normal to have a harder day every now and again, but that doesn't mean I won't continue to progress and improve.
 
I carry Xanax with me all the time when I'm away from home for emergencies, even though in the last few weeks I've rarely used it. I know exactly how comforting it is to have that "safety net" in your pocket, but I read some very good advice that I'll share: the pill in your pocket isn't helping you to relax at all. You do all the relaxing yourself - having the pill in your pocket is just a sign we read telling us everything is okay and to relax. Think of all the times you have the pills with you and don't use them. Those are all cases where you keep yourself calm without the aid of a drug. I remind myself of all those times when I find myself away from home without the Xanax.

14 years ago 0 286 logo logo logo logo logo logo logo logo logo logo 0
Just can't fix this

Zot -
 
Wow, our situations sound so similar! I was diagnosed with GAD/panic disorder as a child and spent eight years on an SSRI. I also didn't like the side effects and was in a pretty good place so got off them nine months ago. The withdrawal and rebound anxiety was horrible, and ever since then I've been searching for ways to manage my anxiety - including St. John's wort and acupuncture - and recently started trying a different drug. I really wanted to be drug free, but I'm trying to tell myself as Davit suggested that it's something I need for now and it doesn't mean I will be on it forever.
 
I was a 100% skeptic when I went in for my first acupuncture treatment but I was desperate and it had been recommended to me by several people. I have to say that while it is by no means a cure-all for anxiety, it has definitely helped bring my overall anxiety down a couple of notches. I often feel much more relaxed right after a treatment, with a noticeable drop in overall anxiety the next day. I know there are a lot of different types of acupuncturists out there, but I've gotten really lucky with mine, so if you think you're not getting much out of your current acupuncturist maybe you could try finding someone else who is a better match for you.
 
Hang in there - I've had my share of ups and downs over the last few months too....just know you're not alone! Progress of dealing with anxiety often feels like two steps forward and one step back but at least the overall trend is improvement. I'm continuing to work with the Panic Program and other CBT and relaxation methods. It's frustrating when there isn't more immediate improvements but I figure the more tools you have in place to deal with anxiety the better chance one has of making a full recovery.

13 years ago 0 286 logo logo logo logo logo logo logo logo logo logo 0
Coping with Work

It's been a while since I posted here but I thought I would check in. A year ago I went through terrible withdrawal getting off Paxil (that I had been on for eight years) and have been experiencing lots of ups and downs since then. This winter I had a terrible break down but felt like I had made a lot of progress and went back to my seasonal summer job this spring. 
 
Now that we're in the thick of summer, several things have caused me to experience another "flare-up" in my anxiety. One is the increased stress and busyness at work, and another is my allergies, since the post nasal drip I experience acts as a trigger for my anxiety and the feeling like I'm going to gag. I have cut back my hours a bit at work, but still get very worked up whenever it is time to go in for a shift, and I'm not able to relax on my days off - instead, I just worry about how I'm going to get through my next shift.
 
A lot of the work I have done with my counselor has surrounded trying to be kinder with myself and to not always push myself so hard, since my instincts over the years have led me to push through my anxiety no matter what even if it makes me totally miserable. There are other parts of this job I don't like - my employers are not very understanding of what I'm dealing with, we don't get breaks, there is limited opportunity to use the restroom, etc. I know this is not meant to be my career for life, but I've stuck with the job last summer and this summer to try and prove to myself that I can do it without anxiety. Now that I'm so miserable with anxiety and not enjoying the job that much, part of me is tempted to quit. I don't know if this is giving in to the anxiety, or taking care of myself by getting out of a situation that's not working for me. I don't know what to do, but for the last two weeks I have been in a heightened state of anxiety just worrying about getting through the next shift, and then the next.
13 years ago 0 286 logo logo logo logo logo logo logo logo logo logo 0
Coping with Work

Thanks for the responses Ashley and Davit.
 
I do understand anxiety and know that it won't hurt me, both from working through parts of the program here and from therapy and other ways of trying to deal with my anxiety over the years. As we all know, that doesn't necessarily make it any less pleasant to deal with! My anticipatory anxiety isn't about dying or having a heart attack or anything - just fear of fear, and not wanting to experience another panic attack.
 
I'm still not sure what to do about work. I've talked about leaving this job for the last two years due to other reasons and now that I'm struggling every single day with anxiety I'm so tempted to finally walk away, but haven't yet. I don't want to "give in" to my anxiety and reinforce the fear, but on the other hand I think I rushed into too much with the world load I've had this summer and it would feel like such a relief to just focus on getting better and not just surviving from shift to shift.
 
It's especially tough right now because my counselor is unavailable for a couple of weeks and my acupuncturist is on vacation - two people who I get a lot of support from. With little sympathy or understanding from my employers it's been very difficult because often during bad bouts of anxiety I feel totally abandoned and alone. Thankfully my parents and boyfriend have been very caring as they always are, but they don't have the expertise to help give me the direction I feel like I need right now!
 
Over the last two days I've had a stomach ache, and I don't know if it's a stomach bug or just another manifestation of my anxiety. I want to call in sick to work today, but I don't even want to let myself do that in case it's reinforcing the fear! This morning I went out early to meet some friends and had to come home before too long due to not feeling well, and I even get frustrated with myself for that.
 
 Thanks for letting me vent here....