Medication Benefits

[Jamiesl1986]

I've been suffering from very severe debilitating panic attacks since I turned 20. I'm having a very difficult time trying to overcome them. The most concerning symptom to me are the very fast heart rates that come with a panic attack. I've tried different methods to dealing with them from biofeedback to exposure therapy, but have had very little progress. I am very against taking medications as I've heard about so many awful things that come with psychiatric medications. I'm not able to function normally right now, and I'm pretty sure that having Panic attacks on a daily basis can't possibly be good for your body. So I'm thinking about giving just giving it a try. Being able to function in life is a priority for me. I have to be able to overcome this eventually. My cardiologist suggested that I take a very low dose of Atenolol to help with the anxiety attacks since my main complaint is my fast heart rates. Is this a wise choice for anxiety, or is there another medication or method to help me get better?

[Jamiesl1986]

Thank you for your advice. I'm going to continue to try the psychotherapy under the direction of a new Psychologist who advocates the use of medications. I would like to continue without meds for the time being while in treatment. If don't see any benefit or if things get worse by the summer, I'll let the Psychologist recommend me a good psychiatrist and hopefully, I can recieve a medication that will at least grant me the ability to at least function somewhat normally. I'd rather have panic attacks once or twice a month instead of having them everyday.

[Jason Greenberg, Ph.D.]

Thanks for the additional info.  There are two ways you can go about this that I think will yield relief.  The first is to try a different form of psychotherapy where you not only gradually allow yourself to be exposed to the situation that causes the panic (driving) but where you explore what it is about driving that may be causing the panic.  The second is to try the psychotherapy with medication as well.  There are pros and cons to both options:

1) With the psychotherapy alone, you may have to deal with suffering for a period of time before you and the therapist are able to get the panic attacks under better control.  However, if you are able to gain a sense of mastery and control over them through your work in therapy, this will be invaluable to you going forward, and gives you a good chance at having a long-term benefit.

2) With psychotherapy and medication, you may experience a reduction in your panic attacks more quickly, which may allow you to feel more comfortable approaching the issue in therapy.  However, the drawback is as you noted, there can be side effects from the medication, and there is no way of knowing how a medication will affect you (positively or negatively).  If you do choose this option, seek a consultation with a psychiatrist if possible, as a psychiatrist is generally much more well versed on the different medication options than a primary care physician (or cardiologist for that matter).

Hope this helps you with your decision.

[Jamiesl1986]

I've been having these attacks for about two years now, but have really only been in treatment for about 6-7 months, which included bio-feedback and exposure therapy. The reason for late treatment was because I was running around thinking I have a heart condition or some severe illness that Doctors just can't figure out. I now know that they're just panic attacks, and it seems that no matter how hard I try, I cannot gain control of them. As of today, I'm having them on a daily basis at random. I always have my phone in hand ready to call 911. They seem very unpredictable. However, I have found at least one trigger. That trigger is driving. That's where exposure therapy came in. I assume I developed that fear due to having a huge attack while driving. After an attack in the car, I completely avoided driving. For the exposure therapy, I felt bullied by my Psychologist to force myself to drive by myself without a phone and far away from my home. I felt like I needed to take baby steps in order for this to be effective, but my Psychologist told me that I have to really push myself and Drive. I of course failed to comply to his demand, and gave up. I eventually was able to overcome driving somewhat, but I don't go far. I have a hard time driving by myself. Maybe exposure therapy works for some people, but I don't think it was appropriate for me. I don't know, maybe I didn't give it a chance. I'm willing to try again, but doing it in increments. Either way, it's ridiculous that I'm not driving. As for the attacks, they don't just happen while driving. Like I said before, they're random and it's only predictable while driving. As for them happening at home, it's strange. The attacks usually like to sneak up on me at inopportune times. They seem to happen a lot while I'm sleeping. Also when I detect a sudden change in my heart rate. The physical symptoms of the attacks are so ridiculous. I feel like that if I was able to breathe, and just deal with the palpitations and the fast heart rates that go alongside with the attack, I could get through them. I made a huge mistake in buying a polar heart rate monitor recently. I think that has added on to the problem. Every time I have an attack, I look at the watch and see the heart rate go up. I have seen it go up to to 190 before which more then likely wasn't accurate, but it reinforced my thinking during the attack that I might die. I'm pretty young, and know that this isn't good. I feel confident that this isn't an actually disease going on that is causing this. But when I have an attack, I lose confidence. I know that if I don't gain some control eventually, I could have some real nasty problems later in my adult life. So is medication at this point a wise choice, or is there a different method that I could try using to control this?

[Jason Greenberg, Ph.D.]

Before I respond to your question about your panic attacks, I was wondering if you could tell me a little more about your treatment history.  How long were you in biofeedback and exposure therapy?  And as far as the panic attacks are concerned: how often do you experience them?  Are you aware of any particular event or situation that precedes them?