When to seek inpatient treatment for Anxiety?

[MrDisabledVet]

I am on 10mg of paxil and 25mg of "major tranquilizer" for my anxiety. After having a panic attack and going to the ER twice in the span of three days. I just started my meds about five days ago. The problem I am having is that when the sun starts setting outside my anxiety ramps up. When I was in the ER I was given xanax 25mg to calm the attack down. I have had to use it again twice now because of the severity of my anxiety around this time of night. I have hot flashes, tremors, breathing irregularities, eye dialation, and naseua. My question is, when do you know your symptoms are severe enough that seeking inpatient help is needed? Should I ask for more xanax until my paxil builds up in my system and starts to work? Its scareing the heck out of me that every night I might have these symptoms that are borderline full blown panic attacks. I try self talking my way out of it, I use breathing techniques, but im worried im going to keep ending up in the ER now that I dont have any xanax left as a backup. Im a disabled vet with chronic pain, sleep problems, depression, and now my GAD has been really kicking my butt. I dont want to inpatient myself if this is just something thats a normal adjustment period. I just dont know if I can keep myself out of the ER right now without the xanax backing me up thru these horrible night episodes.

[MrDisabledVet]

Really hoping to find some relief.... its everyday and once the anxiety starts it lasts for hours. Doc put me on a benzo until the paxil starts working. Im going to try and get the va to outpatient me to a therapist near my home because im scared ill have a panic attack while driving and be stuck there freaking out. Its weird, it just happenee out of no where and now it wont seem to go away. Think im going to ask they check my blood and thyroid next. Its such a stupid sickness, I know Im not in immediate danger, but it doesnt seem to care. I get extremely shaky, lightheaded and have to urinate alot.I dont know what to do to get better, I just want to be normal :( I have a family to care for and its messing my life up.

[Paxiled]

Just be careful with Paxil -- it's very hard to stop taking once you've been on it awhile.  So make sure you have a good psychiatrist who understands this med.  I'm guessing, given the number of meds you've been on, that you've had this problem before of withdrawal without knowing it, and that caused some of the anxiety to get worse.  That particular surgery you had is notorious for not working to reduce pain, so people who get it often end up like you, being told to take serious painkillers for the rest of your life.  I'm sorry this happened to you, and don't have a clue how to make you whole, but in your situation, I hope you have a good therapist to talk all this out and I would suggest finding a good hypno-therapist who might help you with the pain.  And I'd look into some alternative therapies, as you haven't done well with the docs.  Sometimes a lot of this pain attributed to the spine is muscular, so maybe that's part of it and you can find someone who can help you work on that.  Best of luck.

[MrDisabledVet]

I have been on about 15 different medications for depression and anxiety at the least... Unfortunately I am hyper sensetive to these types of meds and get the weird side effects like eye dialation, light sensetivity, and the feeling like a tuning fork constantly vibrating. Paxil is suppose to be a med that has a lower chance of these types of side effects. Some of the medications I have taken left me feeling like a zombie all day, sure it helped control the anxiety, but it also ruined a good portion of my quality of life. I went thru Marine training, was doing good and then they informed me I had a genetic spinal problem. I ended up getting an Uncharacterized Erroneous Discharge, because they didnt find it in pre med screening, ended up with compression fractures in several vertabrae, disc narrowing, nerve dmg, and chronic pain for life from it. As if that wasnt tramatic enough I was sent home abruptly with no ability to work full time and was living on 123$ a month for almost a year. I developed social anxiety, a drinking problem to cope with the pain, and serious depression. Then I had my first full blown panic attack when I was denied a disability increase from the VA. I tried numerous medications for pain, nothing fixed it to the point I could function at a job. After seeing about 6 doctors I finally made it to a specialist that reccomended getting most of my mid back fused. 2 rods and 21 screws later, I still have chronic pain in the same degree as befor but it wont progressively get worse which is why I opted for the surgery. Five years of struggling, never having money for anything, eating from the food shelf, drinking whenever I could, I finally won my case for total disability. Now, I have money to pay my bills... but I have serious baggage from going thru that for so long. I quit my meds for pain, now I smoke herb once in awhile, it helps... It has put me in a catch 22 now though because my anxiety is amped up lately and I cant smoke it for the pain. Because of my sensetivity to those pills, I am researching every possible non medication treatment to help with the anxiety. I just dont like pills.

[Paxiled]

It's not actually that easy for most of us to get inpatient treatment for anxiety -- beds aren't in abundance, and the only thing they'll do for you is give you drugs anyway and try to clear your bed as soon as possible.  The exception is when you're a threat to yourself or others.  On the other hand, you've been suffering with anxiety for a long time now and you're still with us, so you know it's not going to kill you and that nothing truly terrible is going to happen -- you just think it is.  Frankly, the ER and hospitals aren't the greatest places to get the best treatment -- they drug you up and send you home.  I don't know which meds you've tried or what therapy you've tried, so I don't know why it's come to Paxil, but what you need to do is get a good psychiatrist and a good anxiety specialist psychologist, and know that it won't be quick no matter how you do it but an anxiety attack, though it stinks, won't kill you.  Peace, and hang in there.