Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Mental Health (Expert Forum)
Panic disorder with CONSTANT anxiety? PLEASE HELP!!
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
Panic disorder with CONSTANT anxiety? PLEASE HELP!!
by imcrazy2, Oct 19, 2006 12:00AM
I have panic disorder with agoraphobia. I have been prescribed Paxil, Prozac, & Ativan at different times over the past 8 years. I was in cognitive-behavior therapy for over a year, which helped my understanding, but of course, doesn't change my biology, or physical sensations associated with anxiety. Today, my doctor decided I should try effexor since the latest attempt (PaxilCR) doesn't seem to be working properly. (OK, fine, but....)
My question is this; Everything I read about panic disorder, or panic attacks, anxiety, etc says that a panic attack comes on, peaks, and wanes. If that were true for me, I think I would be able to handle it. My panic attacks last for days, or even weeks, coming in powerful waves, but when the waves recede, I am left with this CONSTANT heightened PHYSICAL (I can't stress enough, I am a very laid back person with few worries, my issues are ALL PHYSICAL/ ADRENALINE-type sensations) anxiety characterized by derealization, jitteriness, dizzy/lightheadedness, excess nervous energy, and such. Nothing I read about describes this....the closest thing is generalized anxiety, but this is always described as constant worry/stress (mental).
I have been examined by an endocrinologist, who said that although I match exactly the profile for hyperthyroidism, and have elevated blood metanepherine levels, he couldn't definitively diagnose a thyroid or adrenal condition (my TSH and T4 always come back either normal or borderline), and thus couldn't treat me.
I am desperate to know if there is some sort of hormonal (cortisol levels came back ok), or chemical (aside from the seratonin, obviously) BIOLOGICAL root that is TREATABLE. I realize that the agoraphobia means that I am still bound to be pre-disposed to working myself into a panic attack when faced with triggers, but those things I can understand, so I can deal with them. PLEASE HELP ME!!!!!
My question is this; Everything I read about panic disorder, or panic attacks, anxiety, etc says that a panic attack comes on, peaks, and wanes. If that were true for me, I think I would be able to handle it. My panic attacks last for days, or even weeks, coming in powerful waves, but when the waves recede, I am left with this CONSTANT heightened PHYSICAL (I can't stress enough, I am a very laid back person with few worries, my issues are ALL PHYSICAL/ ADRENALINE-type sensations) anxiety characterized by derealization, jitteriness, dizzy/lightheadedness, excess nervous energy, and such. Nothing I read about describes this....the closest thing is generalized anxiety, but this is always described as constant worry/stress (mental).
I have been examined by an endocrinologist, who said that although I match exactly the profile for hyperthyroidism, and have elevated blood metanepherine levels, he couldn't definitively diagnose a thyroid or adrenal condition (my TSH and T4 always come back either normal or borderline), and thus couldn't treat me.
I am desperate to know if there is some sort of hormonal (cortisol levels came back ok), or chemical (aside from the seratonin, obviously) BIOLOGICAL root that is TREATABLE. I realize that the agoraphobia means that I am still bound to be pre-disposed to working myself into a panic attack when faced with triggers, but those things I can understand, so I can deal with them. PLEASE HELP ME!!!!!
Doctor's Answer
by Roger Gould, M.D., Oct 20, 2006 12:00AM
, Oct 20, 2006 12:00AM
Ask your doctor about a strong dose of beta blockers when the attacks first start. That should prevent the secondary exhaustion you describe after the attack. There are probably people doing research on this who might be able to follow more hormone levels more accurately as they happen, so keep digging for those kind of research projects that focus on cortisol levels.
The doc decided to transition me back to paxil, citing "Prozac Poopout" which evidently just means that the meds just stop working for no apparent reason. Instead of totally weaning, however, it seemed that a combo of prozac 20/day, & paxil 20/day was working. So I was fine with that for about 9 months. Then, my doc (Psychiatrist) was unavailable for an appointment, and I saw her colleague. Well, that doc FLIPPED out about me being on both, and wanted me to stop the paxil & go back on the prozac, even though I explained that I would rather be narcoleptic on Paxil, than panic ridden on Prozac. She wouldn't listen, so I went to my GP who wanted to try me on Paxil CR since the only bad side effect I was having from the Paxil was sleepiness, and the CR is supposed to have milder side effects. whew....short story long, here I am still on CR, sleeping 16 hours + a day,(not an easy thing to accomplish with two toddlers!) and still having anxiety, so today, my GP said she'd call in Effexor. Haven't picked it up yet. The Ativan I have taken sporadically when things get really bad, but I try hard not to take it--have only had to twice this year--both times in anticipation of medical procedures (I'm a very anxious patient). I should probablyjust suck it up and take it, but I'm afraid of addiction
TAKE THE XANAX!!
If you are anxious, TAKE IT. That's what it's there for. I know I don't follow my own advice, but I also create panic attacks for myself by taking meds, since I'm afraid of having a reaction....LOL....do you ever feel like a complete nut? I sure do!
I have been examined by an endocrinologist, who said that although I match exactly the profile for hyperthyroidism, and have elevated blood metanepherine levels, he couldn't definitively diagnose a thyroid or adrenal condition (my TSH and T4 always come back either normal or borderline), and thus couldn't treat me.
imcrazy2,
Did the endo, that you seen, do any thyroid antibodies on you? The antibody tests are for auto-immune thyroid disease...
It is possible to have antibodies to both hashimotos disease causing low thyroid & graves causing high thyroid. Your symptoms can wax & wane (come & go) with this disorder.
Depending on when she checked your lab your TSH & results could be technically normal or boderline & you could still have this disease. You may need to see another Endo who will throughly investigate this for you. I'm surprised your endo has not checked your thyroid antibodies TSI (for graves disease) & TPO (for hashimotos disease).