Thanks to all of you for your responses, it makes me feel not so alone. Today was even worse. Started off well, it was my day off so I was doing farm chores around here. I planned to drive into town in the evening to run some errands, but also to do some exposure work. I knew I had to work on Wednesday, so I wanted to have a good experience on the road before then. I took an Ativan before going, something I normally wouldn't do, but just in case. I was a little nervous, but ended up having a good time going to Kroger, Save Rite, etc. When I pulled in the driveway I congratulated myself on a job well done. I was happy. Fifteen minutes later I had an attack that lasted over 2 hours. My head spun like it never has before. Couldn't think a rational thought to save my life. Ativan didn't help at all. I cannot believe this downhill slide. Everyday it's worse and I cannot plan on doing anything because I don't know what will happen next. I also drive for a living, so it's not like I can stop doing it for a while. I have to work Wednesday and I don't trust myself at all now. What the heck has happened? In over 20 years of having this problem it has never been this bad. I thought I was on my way to recovery, but I seemed to have turned off on the road to ruin instead. I did increase the Wellbrutrin like the doc said, wonder if that could have caused this. I had only taken the increased dose for 2 days when this happened. Any thoughts? Any hope?

Hi Hopeful, Please don't feel bad! I identify with your situation completely. Since I was 20 I've had 3 bad episodes of agoraphobia, recovered, and relapsed each time. I'm in the middle of a relapse right now. It doesn't matter how well you know your CBT and your exposure therapy theory and all that - you can still experience agoraphobia. If cure was easy, I guess we'd all be cured. Let me tell you how much I identify with your problem - only 20 minutes ago I was sitting at the end of our block, waiting for panic to subside, just waiting - that's the furthest I can drive! Eight months ago, I could drive wherever I wanted. But - four months ago I couldn't even drive a couple of metres. So you see, things have improved. Sometimes, it just takes absolutely ages. Based on my experiences, here's what I think might be helpful to you, even though of course it might not be: - First of all, I think by forcing yourself to keep driving back into the place where you had a panic attack, you had the right idea, but you were 'flooding' instead of doing proper exposure. This is what I think works: Say you had a panic attack on the corner of your street. It doesn't work to force yourself to go to the corner, have a panic attack, and then quickly walk on. What you have to do is go as far as you can without having a full blown panic attack, and stay there for ages - like 20-60 minutes. You keep advancing til you can stay in the spot of your previous panic attack for 20-60 minutes without having a panic attack. Flooding and fleeing doesn't seem to work, for me anyway. - I think you are right about the effect of your medication wearing down. That's okay though - I think you could recover without any medication at all, if you are willing to practise extremely boring exposure sessions every day, as mentioned above. Also make sure that you give yourself a good chance by definitely cutting out caffeine altogether: no tea, coffee, cocoa, energy drinks, colas, caffeinated soft drinks, etc. No street drugs. No alcohol. Then if you can handle it, cut out sugar too. And get at least 20 minutes aerobic exercise each day. Then your body will be in a relaxed state.

I had an even worse attack while driving today on the way to the doc. I was going because the panic and anx has gotten much worse in the past couple weeks. Today for the first time ever, I had to stop on the way and have someone come and get me. That has never happened and it has made me very discouraged. The panic was so bad. I have been working so hard on this and now I'm much worse. My thoughts race constantly and I can't even challenge them like I could before. I have taken Wellbrutrin for over 2 years and the doc said that I've probably built up a tolerance. I was taking 150mg twice a day and now he upped it to 200mg. I was able to drive home later after I took an Ativan. This is so discouraging, I don't believe the challenges I make to the anx thoughts because I can't even trust myself to drive to town.

I can' give you any true tips but I can say that I relate. Every morning and afternoon I drive to work the same route. After a year and a half of this same route I got a panic attack out of no where by this specific on ramp. I have dealt with these panicky feelings for months at this specific spot. Some days are better than others, but for some reason the feeling doesn't go away. I have been told to count digits on car license plates and pick a color in my head and count the cars around me that are that color, but so far nothing works.

Hi well I just fell empty . I wanted to go to a double trouble meeting this evening but I don't have away there.I almost wentout yesterday and today and got a drink,but I turnd and came back home.Because the last time I tried to drink my medication stoped working after two of those vodka mixed cooler drinks,I had about four and I'm a big guy.I really didn't enjoy the way I was feeing.I've ben out work for going on three months I work two day every two weeks just to keep my benfits.I go back fulltime nov 25.I don't trust this place where I work any more I plan two culinary school when I return.

Hi, Learngrow! Yes, it was really bad when the attack came for no obvious reason after I felt I was doing so well. For 3 days after that attack, I was scared to death to drive, but I had no choice because it's my job and there was no one to cover for me. (Had to drive for 12 hours on Sunday! What a nightmare!) I was a wreck mentally and it really wears on you. I wanted so much to go back to how I felt before, when driving wasn't an issue. Yesterday I was off work, but still had to drive places. And it was like the switch flipped back off again, and I could drive pretty much fear-free. Sometimes I do feel a "switch" flipping in my head, where the fear is turned on or off. I agree with you that the scary part is you can't tell what made it flip, you said that you were in a non-stressful situtation when it happened, as was I. Since I couldn't figure out what caused it, I had the fear it could happen again at any time. I have also noticed that I seem to have my worse attacks when I have been doing very well. I don't get that. I do understand how you feel, your parents don't mean to hurt you, they just can't understand how scary a simple thing can become when panic attacks happen.

Hi. That was helpful reading about your panic setback. I feel like I am experiencing the same thing. For a few weeks I was feeling great, no panic attacks, and I was really gaining confidence driving on the highway. Then out of nowhere last week I had an unexpected panic attack in a pretty non-stressful driving situation, and ever since then I've been a mess. Over the weekend I had to drive an hour and a half, much longer than I have in a long time, and it was very tense for me the entire drive. I made it halfway to where I was going, and from there a friend took me the rest of the way. So that was a really big deal for me, but then the response from my parents was basically, "What's wrong with you?" Today my father actually said to me, "Look, you are 35 years old already and you've done all these amazing things with your life-- don't you think it's time to get over the driving thing?" I just burst into tears. I know he just doesn't have any idea what it is like, but still I feel terrible.

Certainly things that have been pushed back for a while may resurface for you to learn to deal with them in a new way. It's a gradual process of discovery. Celebrate the improvement you've had. I'm quite confident there will be more good things to come.

Thank you very much for your response! I have been actively trying to face my fears for the past week or so. I am searching for what the underlying cause might be. I even had a delivery about an hour later almost to the same 'spot'. Even though I didn't have to go past the spot, I made myself anyway. It took courage and determination, but I wanted to prove to myself that it wouldn't happen again, and it didn't. I am only a week into the Panic Program and I didn't want to plow ahead on it. But the book I'm reading talks about the intrusive thoughts in almost the same way, and I did practice that when the panic came. I wonder if all these acute attacks might mean that I'm actually getting close to figuring out my fear. That it's all bubbling up to the surface and that when it does I will understand my fear and be able to break free of it. Is that possible?

In order to do exposure work, you have to face some fear, but not too much fear at once. When you have a setback, consider it a blip on the road to improvement. Don't give up or go too fast with exposure work. Keep at it and challenge the thoughts that arise, reviewing the baby stept to get to where you have. Here's something to consider about that particular point in the road: Rather than challenge inrusive thoughts and images, it sometimes helps to simply identify them as "intrusive" or "obsessive" thoughts that don't "mean" anything at all. Intrusive thoughts are common. Most people have them. What makes an important difference is whether or not you attach any importance to them. Most people experience intrusive aggressive and sexual images. Such intrusive thoughts are normal. But most people do not attach meaning or importance to them. They are "just a thought". Its like when you have a dream that doesn't make sense. You can say, "It was just a dream and dreams don't make much sense sometimes" or you can start to worry about what it "means" about you. Sometimes our thoughts don't mean anything. So one strategy is to label intrusive thoughts and images as "intrusive" or "obsessive" thoughts and see if that takes some of their power away. You can then say, "It's just an obsessive thought". Sometimes people have trouble challenging their anxious thoughts because they haven't followed their fear far enough to find the "real deal". So a second strategy is to "follow the fear" as outlined in the panic program to see where it leads. If you are having intrusive thoughts or images, is there an underlying fear that you haven't identified yet, such as a fear that you will be responsible for something terrible happening to somebody else or some other horrible consequence? Try doing a thought record --on paper-- and really following your fear to see where it leads. Challenging thoughts on paper and really "following the fear" to discover all of your underlying fears and assumptions isn't easy but is often worth trying, even if you have been doing it on your own and in your head for a long time. Hope this helps.