debilitating panic disorder

Hi, i've never asked any questions regarding my mental health on an online forum before so bear with me if i'm repetitive. I'd appreciate some advice, so i'll give a run down of my symptoms, therapy etc. I'm 28 & i've been suffering from anxiety disorder for about 4 years, the 1st couple of years it was totally manageable & i had only experienced the 1 panic attack. I've also been seeing a psychiatrist for about 3 years, Since then i was prescribed xanax .75-1mg per day & 50mg Zoloft per day. I was also prescribed Stelazine while adjusting to the zoloft as i'm very sensitive to medications as they make the anxiety worse which i find difficult to cope with. After adjusting to the zoloft & using xanax, i felt great. I'd only get a bit nervous when going to shopping centres, or in social situations where i didnt know many people. But i'd take a xanax & everything would be fine - it didnt really affect my life at all, & everything was great for a couple of years. I have one child who is 8, & i've always wanted more instead of a career & my partner & i decided that we'd like to start trying for another one soon (this was a few months ago). So i weaned myself off zoloft as i figured that would be the easiest one to start trying to get off & then i'd work on weaning myself off xanax. A month or so later i was doing great without zoloft. But out of the blue there was a huge situation in my personal life regarding my partner that destroyed me. Within 2 weeks i was living in a constant state of panic,not just anxiety. My symptoms were relentless & constant -hand tremors, depersonalisation, constant feelings of discomfort, erratic mood swings (i'd become violent at the least provocation, & break down in tears for no reason), erratic sleeping patterns, feeling like i had totally lost my sense of who i was, not being able to feel my body - primarily my legs & my mouth; this would bring on full blown panic attacks when i would go to sit down as i felt i was going to crash to the floor, & also when i would have a drink of something or run my tongue over my teeth & not be able to feel my mouth when doing so, incredibly unnerving & i would jerk away, or experience a kind of jolt. I dont know if this jerking/jolting was voluntary or not but i think it was my bodys way of trying to force sensation back upon itself. I was also seeing shadows where there werent any, i'd be awake at night and think i saw my child standing in my bedroom doorway,  then when i'd concentrate to make out his sillhouette & ask him what he was doing up, i'd realise that there wasnt anyone,or even any shadows in the doorway at all! These symptoms lasted for a week or 2 & i realised i needed serious help when it was time to leave the house and go grocery shopping. As i was getting ready, i knew i wasnt going to be able to do it. I simply could not bring myself to be in a shopping centre, i knew i'd have a full blown panic attack & this realisation that i now had a severe case of agoraphobia made me have a nervous break down. I decided to seek help immediately (at this point tho, i was only seeing my psych. every 6 weeks or so, so he wasnt aware of the turn in my mental state). My psychiatrist was unreachable that day however which threw me into a stronger sense of panic & 'freaking out', i called a telephone helpline, who then suggested i go back to see my GP who originally referred me to my psych. She referred me to the hospital as she didnt know what to do for me (this constant feeling of being fobbed off from one person to the next was making everything worse), by the time i reached the hospital i was an absolute mess! I had to go to the ER because by now it was after hours, & eventually the hospital psychiatrist came and spoke to me. They wanted to keep me in the hospital for observation, but after much deliberation decided against it. In the end, they sent me home, told me to have more xanax so i might be able to sleep & that they would call in the morning & send out a psychiatrist to see me until i could see my regular psych. The next day my psychiatrist was able to see me, so the hospital staff left it in his hands but also suggested that i see a psychologist as well. My psychiatrist prescribed me seroquel 50mgs twice a day & wanted to see me on a weekly basis. Initially, seroquel made me feel dopey & after a few days it just seemed to make my anxiety worse. I kept taking it though as i know it takes weeks for medications to fully work. But because of the constant symptoms, i thought i was going to have another break down - i started drinking to alleviate these & it was the only thing that made me feel partially normal again, i know it's not a smart move but when you feel like that 24/7 & alcohol makes you feel human again, the temptation is just too great to deny. This went on for a few weeks, & eventually my psychiatrist told me halve my seroquel & only take it at night as i WAS getting a good nights sleep from it. I dont think he realised just how much these symptoms were & still are effecting my life. My alcohol consumption went up, at its peak i was drinking 10litres of wine per week as i couldnt deal with the symptoms & like i said, alcohol made me feel half normal. I also had to stop taking the seroquel because one night, i took the 50mgs & instead of putting me to sleep, it made me wide awake & freaking out ALL night - hearing wind and voices that werent there, overall severe anxiety. I couldnt bring myself to take it anymore & at my next psyc. appointment he told me to stop taking it all together. I broke down again as i had hoped that seroquel was going to get me back on track & now i felt that there were no options for me but to just try and deal with it.(which i couldnt!) My psych. didnt want to prescribe me anything else as i dont respond well to medication,i couldnt get back on zoloft again after trying too. So he increased my xanax intake up to 2mgs a day. Since then, i have been feeling a lot better, it is the only thing that has helped - i can actually leave the house now & go shopping and pick up my child from school. Though i still cant drive (i had a panic attack while driving & am too terrified to risk it again). I have also halved my alcohol consumption(& will keep decreasing it & i wouldnt dream of driving if i've been drinking). I am also about to start seeing a psychologist too, though my psychiatrist told me that he didnt think that would help me at all. But my quandary is that xanax isnt a solution, as soon as it starts to wear off, my symptoms are right there waiting for me! It just seems to be a 'shield', & you gradually build up a tolerance to it & i'm worried that because its the only thing that helps me, i'll just have to keep upping the dose everytime i become more immune to its affects, & because its addictive i'm concerned about how i'm ever going to get off it! Obviously my dream of having more children has been postponed indefinately which is depressing. I feel i'm in a position where i cant move on with my life as i'm dependant on a drug that not only isnt a solution but its also not safe to be on while pregnant. Though i know i have to be more mentally capable anyway before having more children. I'd love some advice, my psychiatrist rarely gives me any, just asks lots of questions & isnt going to prescribe me anything else. Plus i've never felt any sense of comfort, security or insight re: my sessions with him. He has a habit of staring right through me for up to a minute sometimes, maybe he's in deep though but it makes me uncomfortable & i usually walk out of his office feeling more anxious! Any advice, insight, ideas, anything at all! would be greatly appreciated. So please, any advice minus the 'stop drinking' one(i'm working on it already). Thank you for taking the time to read this lengthy post.

[aussiegirl202]

Hi,
thanks for replying. I found your advice interesting really as my psyc. had never mentioned anything you suggested. I took it to him and thought i'd just give you some feedback on what he thought of your suggestions. He was suprised at the manic-depressive idea, he believes it's a subsequent symptom from the panic disorder (the mood swings and crashes), because its quite a bad case of panic disorder... With the seroquel, he also disagreed that the drinking caused the adverse affects - he said it was most likely related to my anxiety over medication in general - as soon as i feel 'different' from meds - it makes me anxious as i feel less 'normal/right'. Also umm i'm not sure how you and him are getting conflicting info on rivitril as he told me the half life is only a bit more than xanax and the tolerance/dependancy is just as high as xanax. His final conclusion was that because i had been on a the same low dose of xanax for so long that by the time i had a melt down and my panic disorder got WAY worse, the xanax wouldn't have been doing anything at all because of the tolerance factor....
But hey thanks a lot for taking the time to read my post and reply, it's just kind of confusing that the advice totally conflicted with my shrinks advice...

[suzi-q]

I am not a doctor...but I do know that RCA knows his stuff, objectively....I would give it  more than a passing glnce, as you did.  I would see someone else, just for a consultation, and see what he says.  I find that anxiety disorders are very much trial and error.  Give it a chance.

Suzi-q

[aussiegirl202]

Thanks again for the info! Firstly i didnt give the first advice simply a passing glance, i actually wrote it all down and took it into my psyc at my last appointment, as Ryan does seem well informed and educated on these things. And i'd have to agree that this psyc. does pretty much nothing for me, it's been a long running joke between myself and my partner that my sessions with him are useless and the only thing i get out of it is a xanax prescription! It hasnt bothered me though until recently, he just doesnt seem equipped to deal with a patient with anything more than mild generalised anxiety.
I totally agree with having to get a second opinion on all of this too, i researched rivotril myself and found out that generally across the board that my psyc seemed to be the misinformed one regarding it - kinda scary that one! The only problem with changing psycs tho is that there  very few around that offer bulk billing (i dont have to pay, not sure how it works in other countries). With the stelazine - it was prescribed only once, very early in the piece while i was adjusting to zoloft (years ago, i think i only took it a few times too), and he did insist that seroquel is commonly used to treat severe anxiety thats contributing to insomnia! It's so difficult to get to the bottom of things, so dont think i'm disregarding advice - once you start researching meds you quickly find that so many  websites and doctors themselves contradict each other! So once again thanks, and i will be looking into alternative shrinks anyway as he just keeps sending me out with more xanax (ugh)!

[aussiegirl202]

[pvcqueen]

seroquel is great for sleep, and has beneficial anti psychotic properties, plus.........it is not habit forming.  You will never get addicted to serquel, but xanax and klonopin are very addicting.

[aussiegirl202]

you seem to know a LOT about all of this... even the differences in US/UK/AU treatments. I find your advice very helpful! Out of curiosity, how DO you know all this? are you a long term sufferer? studied it professionally? etc? I will be taking a print out of this entire post to my 'second opinion'. I'm just curious as to your experience/knowledge... also could you plz give me a bit of feedback on pvc's comment there about klonopin being very addictive? I'm going to look those pdf files up right now! i cant tell you what a relief it is to have some actual 'active' info on these drugs i am/or will be taking and the disorder itself! i've always just thought, "He's the doctor here, he knows best. he's got all those 'letters' after his name on his card". thanks ryan.

[pvcqueen]

I disagree with you about seroquel........it is an excellent anti psychotic, and if aussie is hearing voices and seeing things, that would be defined as a psychosis, most likely depressive in origin, by her history.  You have your definition of extra pyramidal symptoms  completely wrong.....are you thinking of paradoxical reactions?  look up EP symtpms.........they are Parkinson like and can easily be controlled with cogentin.  I know you have done a lot of research, and are right about many things, although I don't think you are fully aware of the dangers of klonopin, while it is very much the lesser of many evils,  there are other drugs that can treat a variety of symptoms.

[yellowrose]

klonopin is a great med for panic and anxiety would not do with out it when need it . ssri are worse on me than klonopin. and ryan was a great help to me . he does know his stuff very smart and knows meds i took his advice and it got me out of my anxiety .

[pvcqueen]

so we agree...lol

[chadry]

Hi, I know from experience how hard it is toleave your home and go anywhere. I have suffered from this myself. I also have an extremely hard time taking any kind of medication. Right now I take half xanax at bedtime. I have a few suggestions for you about leaving your home and comfort zone
and returning to a somewhat normal life. Start with little trips. Do you have anyone that can go with you at first. I have left my full shopping cart so many times when I had toleave a store. This will ruin your life if you let take over. So lets start with the fact that you know what will happen when you go. Get into the store and make it short and simple. Start with 1 or 2 items. Have someone near by if you need them. Always remember what it causing you to feel this way and that it will pass. you can do it. It might take a few trys but you can do it. Keep in your head that you have gone to the store thousands of times before and you can do it again.this is easier said than done. Try your hardest not to leave until you have gotten what you went in for. Even harder. Concentrate on anything else but your body and what it is doing.I still get this way around alot of people and it is hard not to leave but there are times I force myself to stay and not give in. You would be surprised the number of people in a store feeling the same way as you. Try going to a smaller store first without alot of people and gradually worlk your way up. This is what I had to do. I had to take a bus 20 some years ago to go see my doctor. about my disorder. I had to have so much change with me to get there and back because I had to keep getting off. That was therapy in itself.I was not given any medication but I was taught relaxation techniques that I still have to use to this day. But it does get better. I still hate to drive on any major roadway so that really stinks. But where I live it is easy for me to get around on smaller roads and I am fine.I am in no saying this is easy because it is not it is very difficult to overcome but it can be done. Finding your own way of dealing with it is a trial and error kind of thing. I just do not want this to go any farther with you cause it can be so hard to break the cycle.Find some good relaxation techniques. When I started them I had them on tapes and what was the worse was I was really relaxing and then the tape would stop and I would have to flip the tapes. LOL. NOw with cds and everything else available I am sure you can find something it help you. The ones that I preferred where the ones that taught me to relax my body one part at a time. By the time you have it mastered you feel like you are floating away. In a good way. I hope you can find something to help yourself. The only reasone I am taking the xanax right now is because  workmen's comp doctor prescribed it for me because I used to get so worked up whe I had to go see them. They were not helping me and they frustrated me so bad with all the medication they wanted me to take,even thought I would tell them over and over again how I can not just put anything in my mouth like other people. They wanted me to take so really heavy duty pain pills and I just can't. It took me forever to take a muscle relaxer and I finally only did that because I had no choice. You are not alone in waht you are feeling. There are many of us out here who feel the same things. Please take care and I hope I was able to help you feel a little better. I can not help with the medication part butI can only give a few suggestions as to what helped me overcome alot of my problems.
Take care.
Chadry

[Raine9]

Hey Ryan,

If you don't mind, I want your opinion on something.  I believe I have GAD but I don't suffer from panic attacks.  My main problem is Hypochondria, the anxiety is secondary.  When I feel that my anxiety is unbearable, I'll take .5 milligrams of KIonopin in the morning and .5 at night.  Sometimes, I'll take 1 mg in the morning and nothing at night.  But I won't allow myself to take it for than say, 3 days in a row because I don't want to develop a physical dependence.  I take a break for a few days to a week and then the anxiety catches up with me again, then I'll repeat.  I know you completely disagree with this.  But I just don't want to rely on meds to cope with my anxiety unless I feel it is completely controlling my life.  Oh, yeah, I'll sometimes (not very often at all)  have a couple of glasses of wine with dinner after taking .5 mg of Klonopin in the morning.  It doesn't seem to bother me.  But will this possibly do some damage to my liver?  Anyway, if you have any thoughts or opinions...  Please don't scold me for taking K the wrong way.  (LOL)

Thanks

[pvcqueen]

How did your doctor prescribe this?  Does he/she know you are self adjusting the regime?  Forgive me if I am intruding, since this was directed at Ryan.

[Raine9]

My doc prescribed 1 mg in the morning and 1 mg at night along with Paxil.  I don't take the Paxil at all.  Well, he does know that I do not want to take the Paxil but he doesn't exactly know that I am self adjusting.  It was agreed between he and I that I would try alternative methods to relieve my anxiety, ie, excercise.  If all else fails, then meds would be the last option.  I have 2 kids so I don't have a lot of time for myself.  That's why I've been resorting to the Klonopin for relief.  However, when my prescription runs out, I'll have to see him again for a refill.  I suspect he'll have some questions for me....

[pvcqueen]

I found that hard sweaty exercise was the best for my head, but with kids, that can be hard. I remember those days.  I think the YMCA has childcare as well as some gyms..........my favorite place has always been the Y, it is cheap, and there are some inspiring people there ( get very competitive when I look around, and I know it is silly)........along with some eye candy.   Good luck.

[Raine9]

Thanks for your response.  Yeah, I don't understand why my psych prescribed 1 mg twice/day.  I would take 1 mg in the morning and felt fine the entire day and it also helped me sleep, so I didn't feel the need to take another mg at night.   I don't have a severe case of panic disorder.  Yeah, I was a bit of a mess a year ago after my health scare but things have gotten better.  I still freak out about health issues but at least I don't wake up in the mornings crying anymore.    

I noticed you didn't address the "liver damage" issue.  I tried researching this but all I found was that alcohol would intensify the effect of the drug, like drowsiness.   However, I could not find anything on possible liver damage.  I don't intend to make a habit of doing this.  I know that mixing drugs and alcohol is a "no no".  I was just wondering.  

Anyway, thanks again and I hope you are well.  

[Raine9]

Thanks again Ryan!

Just a couple of questions.... what is CNS and what does "somnolence" mean?  KIDDING! I'll look it up. (hehe)

[aussiegirl202]

hi again guys. Just an update and a request for opinions again.. Ok, my panic/anxiety has gotten a lot better (bless xanax ugh). At home it's pretty much just generalised anxiety which i can handle. BUT i cannot leave the house still! Even if i've dropped a mg of xanax and/or had a drink or two. i can only leave the house if i've had quite a few drinks. Instant panic attack, and it's ongoing until i get back to a comfort zone (car or home). So i guess i've got a bad case of agorophobia and social anxiety now? I dont know, i was considering OCD because as soon as i step out of the car i'm instantly 'god i'm going to freak out, i'm going to have a panic attack' and i just CANNOT stop myself from obsessing about it, i try the diversion techniques but in the end i just get the worst case of depersonalisation/derealisation and i have to go. This is such a life wrecker as i'm dependant on someone else to get my child to and from school, and i cant help but freak at the possibility when he cant do it anymore, i mean i'm totally incapable of taking my son to school. The repercussions of that would be disasterous. So i had my last shrink appointment, gave him the info on rivotril and he's not convinced, he said the cumulative effects because of the long half life would make it too hard for me to ever get off it, and the build up of it in my system. I think he's not treating my panic disorder as a long term condition then? (and he's aware that i do want more children down the track). And the sudden onslaught of the severe panic occurred after a traumatic event too so thats why i'm thinking he's not treating it as a long term condition. i dont know?! what he did do however was prescribe me Paroextine. Does anyone have any experience with this? Ryan, whats your call on that drug? As a side note i was thinking about hypnosis, anyone had any good experiences with that at all? Thanks all for your input and advice.

[Mark TX]

I'm not nearly the expert in all these medications as some posters, but want to add my support.  

Stop drinking!

I felt I could 'manage' my drinking for years... and managed myself very nearly into a nervous breakdown.  I finally quit and that made the worst of times go away.  It is your most important priority from what I can tell.

I did find it odd that your psychiatrist told you a psychologist wouldn't be able to help you.  It seems you can use all the support you can get at this point.  But perhaps he's got a good reason.

Good luck to you.

Mark

[aussiegirl202]

Just let me say -NOOOOOO. this is so freaking depressing. u mean these new meds are possibly going to do nothing for me and probably going to make it worse? seriously though, thanks for the advice and opinions. But that's it? i HAVE to get a new shrink? I do kind of think that i do need to  anyway, it's just so hard to find one that bulk bills. i wish he would be more open minded. I dunno i'm so un-(de)motivated these days, i dont even make phone calls that i have to. i hate to think that it's just laziness but i dunno i cant be bothered doing anything at all anymore - apart from the guilt-that gets me to makes my sons breakfast and lunch for school. What on earth is wrong with me? 2 years ago i was a normal person and all i worried about was what i was doing on the weekend! I'll get a new shrink and go through the whole shyte again and see a psychologist too. Insist on rivotril too. I'm not even drinking that much anymore, a couple of drinks every other day - to get me through 'outside' events.. but it's not even working now. i really dont think my drinking is a problem now. I've just started the paroextine (1st day) so if u seriously think it would be detrimental to my symptoms - yeah confirm. (plz). sorry if i sound a bit scattered, as i said 1st day on the new drugs and it effects me badly.

[Mark TX]

I know nothing about paroextine.  I can offer no advice.

The best advice I can offer is first, find a doctor you trust, but be prepared to ditch that doctor if you're not feeling better within a reasonable period of time.  If you're as depressed as you sound... it may take some time.  I've been there, I understand.

Second... I can't stress enough focusing on the postive things in your life.  Drugs and doctors alone will never be the answer.  If they were... you wouldn't find all these people coming online seeking advice and answers.  Develop and strengthen your family and friendships.  It can be easy to let friendships drop when you're depressed.  They give up after a point.   Make the effort of picking up that telephone and calling an old friend.  No matter how much of a hole you find yourself in, a friend's voice is always a good thing.  Even if you don't feel so at the time.  Just do it.  When I was very depressed I'd sometimes pack a bag and go spend a few days at my sister's house.  It was hectic and crazy and the kids could be annoying... but being with family gave me something positive to do.  It always helped.

The thing to remember is that this will pass.  You will get your life back eventually.  There are things you can do to make that day come sooner.  Focus on those things.

Good luck!

mark

[benita67]

[benita67]

Hello Ryan I am reading your posts and I am suprised on how much info you Know about meds.
let me tell you a little bit about my story and if you can give me some advice.
Four years ago I had a baby I was 35 years old and it was my 4th baby I was fine with my other three but with this pregnancy I felt terrible, I gained 65 pounds, I had vomits all the time etc....
When I gave birth to my baby, the day I went home from the hospital, I woked up in the middle of the night feeling i couldnt breath, so to tell you the story short, after going with 5 doctors, Cardiologist, gastro,neumologist,general dr, etc. and three months after it started , I went to a Phsyc,
he told me I had Post partum depression and panic attacks, so he prescribed me Zolof first 25Mgs then 50 Mgs. and the highest eas 75 mgs, and also he prescribes rivotril 2 mgs. daily  1 mg in the morning and 1 at night.
I was very depressed and anxious, the rivotril was OK but Zoloft made terrible side effects, but i continued taking it.
After 3 months I started to feel better ...much better... it was me again, I never had a panic attack again and I started enjoyin life.So the doctor took away rivotril and I still felt great
I was always resistant to take anti depressants because i am a very active, full of life person, I couldnt believe I needed a med. to feel fine , so like 18 months after I started Zoloft I began pressuring him to stop zoloft gradually so he did , in one month I stoped it as he told me.
For the first two months I felt fine but I started to feel strange feelings on my head, like I was going to faint. Weird sensations, so I started to be Hypocondriac and started to feel depressed again.
So I started zoloft again and now Ive been on zoloft for two more years 50 Mgs and know that the strange feelings in my head were a withdrawl (withdrawal).
I want to stop taking Zoloft, I dont want to take it eternally please let me know what can i do........

[deslang]

i have the same thing but about two years ago i found that by social contact and trying to find new things to see and do helped.
i found that i start on 50mg zoloft then they  increasing till it was 250mg
i was totally use less then i found you are not take for more then 6months at a time then they but me on sertraline at the first increase i stop the lot and started to get out. in mental health it is to easy to wright a scrip