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Mental Health  (Expert Forum)
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posssible panic disorder, but need to confirm
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.

posssible panic disorder, but need to confirm

by tuzik2001, Jul 26, 2003 12:00AM
I had two panic attacks, once when I was 18 and once when I was 22 (I am currently twenty five)- both times when I smoked pot. Outside of these two panic attacks, I never had other major mental problems, except for maybe a minor depression. When I was 23, my physician advised me to start taking paxil to improve my mood. For the next year, I took 20mg per day, but after noticing sexual side effects I drooped to 10 mg per day about a year ago.
Everything was fine untill untill this spring. Early in the yar, i occasionally began feeling a little bit drugged/"high" and lightheaded - for no apparent reason. The, all of a sudden one day in May, these feelings increased exponentially. I began feeling REALLY drugged, out of touch with reality and fearful of losing my mind. I have never been the same ever since that day. Basically, the feelings I have described are present for most of the day. Sometimes I am much better, sometimes I am much worse, - but at no point in the day do I actually feel completely normal. Thus, it is not quite your regular panic attack, which last 30 minutes and then gets better. Around end of May, I also attempted to get of Paxil, possibly fearing that these deprovements in my mental health had something to do with my mind becoming excessively addicting to that medication and now craving more than 10 mg. However, given my already present mental problems, I have only been able to come down to 7 mg per day, since every time i tried to lower the dosage i felt even worse and more fearful for the next few weeks. I have seen three doctors about these. The two of them told me that I am suffering from depression and I should simply increase the paxil dosage. However, that did not make sense to me, given that i do not feel depressed, as much as drugged and fearful of going insane. When the latter feelings occasionaly subside - i do not feel depressed. The third doctor told me I have a panic disorder, which got triggered by me having panic attacks many years ago. He also said that I can no longer go back to the normal way i was before this spring, but some treatment (that does not involve any medications) can make me cope better with the feelings i have already described. He also told me that my whole problem has very little to do with paxil and i should gradually further taper off the dosage. However, I am not sure why my "disorder" would only come about many years later after the panic attacks, seemmingly out of nowhere. Also, panic attacks are supposed to be brief - not lasting all day long. Thus, as we speak right now I am very scared about what is going on with me and would like someone to confirm one of the theories mentioned above so at least I would know how to proceed.

Thank You

by Roger Gould, M.D., Aug 06, 2003 12:00AM
Its not proper to make a diagnosis without further contact, but if I were you I would think of what you described as more of a generalized anxiety reaction, than either panic or depression.  As such, you should ask your doctor about klonopin or Buspar if you want medications, or seek a counselor to help you deal with the issues underlying your anxiety.  You can start that process online at www.masteringstress.com.  There you can explore what is troubling you, and get professional help only if you can't do it yourself with the tools that are available there.
Member Comments (13)

by kennyd, Jul 28, 2003 12:00AM
Hi there...I just wanted you to know that you aren't alone.  I have been battling panic attacks and anxiety as well, for me I have been avoiding medication.  When I first started having panic attacks, the "aftermath" would last all day, for days, in between the more intense attacks.  I would feel like I had "pot paranoia", even though I had not smoked anything and actually quit smoking pot for that very reason years ago.  I have been going to therapy and it has been extremely helpful.  I still feel "not normal" alot, but it seems to be happening less.  At first I would dwell on it all day, from the minute I woke up ("Am I still feeling this way?") to the minute I went to bed ("I hope I feel better tomorrow.").  It's a tough cycle, and you should get some help to break it.  The meds might still be a good idea, but you should take them concurrently with therapy to try to get to the root of it.  Panic is a subconscious thought that allows a response to manifest itself before the conscious mind registers and dismisses it.  Therapy can help with this.  You can be normal again!

Good luck!

by tuzik2001, Jul 28, 2003 12:00AM
Kenny D - thanks - i feel better knowing that I am not the only one with these type of problems. Can you reccomend any specific type of therapy (is there like a special program for our type of problems?) - as I have said, I have seen few doctors and they have been rather unhelpful.

Thanks

by kennyd, Jul 29, 2003 12:00AM
To: tuzik2001
I am seeing a clinical psychologist, who was recommended to me by my family doctor.  Most are quite familiar with anxiety and panic, but depending where you live you may be able to find a specialist.  Many times the specialists are psychiatrists, which would be OK too.  One of the most effective techniques therapists use is "Cognitive Behavioural Therapy", or CBT.  I am far more aware of how I am feeling and when anxiety/panic may exist, and thus better equipped to deal with it.  Once you know it's there, often it is the pattern of thinking that results in bad anxiety or a panic attack.  Therapy takes time and is not always easy...but I have been seeing my therapist once per week for 3 months and have had significant improvement.  I used to hate going into the grocery store because the busy array of products on the shelves would make me dizzy and disocciated.  I get chest and arm pain that I used to think was a heart attack coming on.  All this stuff seems to be subsiding now, but I still get "fuzzy" several times per week.  The difference is that I am not afraid of it anymore...but I hate it.

Anyway, family doctors are great for certain things and can prescribe medications for minor conditions, but when it comes to something like this I think it is important to seek therapy.

What your one doctor said is true -- you cannot go back to the "normal" you were before this came on (that "normal" was probably part of the reason it is happening), but you can have a NEW normal, a better way of living and thinking.  Your body is trying to tell you something...you just have to find out what it is.

Take care,
Ken

by winebev, Jul 30, 2003 12:00AM
Let me please respond.  I have had anxiety/panic disorder for over a dozen years.  I am a 26 yr old female.  I am extremely educated on anxiety!  The feeling of being out of control and out of touch w/ reality and "detached from yourself" are true signs of anxiety.  There is not a set time to how long these feelings can/will last.  A full blown panic attack normally lasts for a few minutes BUT anxiety in general can linger all day long.  These strange feelings can come on without any warning or signs.  I do know that anxiety can be caused from smoking pot.  I had a full blown panic attack from that one time and never tried it again.  Most anxiety is caused by stress of course, but the main factor is the way you THINK.  Your thinking will fuel the anxiety if you are a negative or "what if" thinker.  However, you can completely control your anxiety with the proper coping techniques.  To better understand what you are going through I suggest seeing someone who specializes in anxiety, talk about possible meds, and read some good books on anxiety/panic.  As scary as these feelings may seem, they are not dangerous.  You are not losing your mind and will not have a heart attack or pass out.  I understand what you are experiencing and hope that you will at least think about talking to a professional.  There is help.  You don't have to feel this way.

by NoOneByDay, Aug 10, 2003 12:00AM
Tuzik,I feel so releaved to have read your post.You described me and my experience to a "T". Only, Effexor is the med I came off of, not Paxil. I too used to be a potsmoker until it started becoming more and more common that I would have increased anxiety/panic while I was "high". So I gave up pot.

I have been off of Effexor for a month and am still having withdrawal effects. Brain zaps, diziness, headache and flulike symptoms. My panic attacks and anxiety have reached a boiling point and I consider them pretty severe at this point. I dont know if this is related to coming off the drug. I can remember having anxiety and panic like feelings while on the Effexor but not nearly as often and severe. I feel like I cant do anything and enjoy life due to this.

I am not sure what the original intent of my post was (effexor withdrawal.....yeah =[ ) other than to let you know that you are def. not alone. You and I are going through the exact same thing it sounds like.

if you wanna contact me  here is my email address

***@****

by bob18, Aug 10, 2003 12:00AM
I used to smoke pot too and i would often feel very anxious and uncomfortable while i was on it. About 4 weeks ago i had my first panic attack and it was very scary as i was convinced i went crazy and got my dad to drive me to the hospital where i stayed overnight. Our family friend is a psychotherapist and he quickly recognised my symptoms and told me i had a panic attack. 2 weeks passed after that and i was starting to feel much better and "normal" again and than out of the blue it came again shattering all the confidence i built up in those 2 weeks. The panic attacks last for probably about 20 minutes or less but the "aftermath" goes on for hours. I had one this morning and i felt as if id rather be dead than put up with the horrible feeling. I feel lot better now and most of the aftermath is finished i guess. My familly has been really helpfull and done all they can to make me feel comfortable. After my panic attack today it took all my courage just to go to my friends house but i feel better for it. Also during a panic attack or the aftermath i got no appetite and its really hard just to eat something without going to the toilet 10 minutes later. Also i would be glad to hear form your experiances with medications and on what works and what dosent and waht side effects come with it.

thanks lots, hope you all get better soon

by tuzik2001, Aug 11, 2003 12:00AM
Thanks for the posts - reading them already made me feel better... at least I am not the only one. Does anyone know any good books on anxiety/panic?

by kennyd, Aug 13, 2003 12:00AM
To: bob18
Bob18, same thing happened to me (and just as severe) but it happened 4 months ago.  I strongly encourage you to see a therapist to talk about your anxiety/panic and possibly get recommendations on medication.  

The panic attacks will continue to happen unexpectedly until you get to the root of your anxiety/panic.  Like you, if I made it a week without any attacks I would start to think that this "illness" had left and I was fine.  But it doesn't just go away, you need to tackle it.

On a side note, one thing I was told is that smoking pot gives us access to things in our mind that we don't normally allow ourselves to have access to.  I too started getting high anxiety after smoking weed.  What it means is that the anxiety was always there, even when I wasn't high, but I was suppressing it.  Eventually it made itself known with a full blown panic attack.

by winebev, Aug 14, 2003 12:00AM
I feel your pain, everyone.  Panic attacks are terrifying but you can all absolutey be cured of this demon.  You can control them, trust me.  Smoking pot, will in fact, induce anxiety/panic attacks, so I would stay away from marijuana.  There are many books to get you off to a good start so that you can better understand why you are feeling this way, and most importantly the books reinforce that there is help and you are not alone.  I suggest reading "The Anxiety and Phobia Workbook" which you can purchase at Barnes N Noble.  This book covers the symptoms of panic, but more importantly it is a step by step workbook to help you recover.  Secondly, I recommend reading "From Panic to Power" by Lucinda Bassett, she is a recovering agoraphobic with panic.  I know how devestating the panic attacks are, I have lived with them myself.  You are not going crazy, you are not going to have a heart attack or pass out.  Once you learn the true coping techniques you can live a normal life w/out fear of  panic attacks.  Also, check out this website: www.adaa.org.  I hope you all take advice from someone who has been where you are!  Good luck, you're in my prayers!

by 3rdMajor, Sep 27, 2003 12:00AM
Tuzik,
    Cannabis is much more powerful to some of us, than is generally known.  It can cause chronic depersonalisation and derealisation.  It can trigger panic syndrome and other chronic anxiety conditions.  I speak from experience.  My anxiety was triggered by cannabis, and I suffered panic syndrome for 20 years, before the condition became widely understood.  At that time, I was placed on the new SSRI, paxil at 20mg, which is a low theraputic dose.  Paxil effectively stopped the panic attacks.  Current treatment usually consists of a short term benzo such as klonopin or xanax, and long term treatment with an SSRI such as paxil, zoloft, effexor, celexa or lexapro.  
Medical treatments seem to only mask the symptoms, however, and SSRIs have been known to lose effectiveness over time.  Best to hedge your treatment "bets" with cognitive behavioral therapy or other therapy.
Good luck

by wannaBstressFree, Oct 01, 2003 12:00AM
Gosh this is sad and such a relief to know that people have this problem. I'm 20 years old. I started having panic attacks 5 years ago, and I can't even tell you why. Which I believe is part of my problem, I can't get to the bottom of this cause I have absolutely no clue where to start. I honestly thought my life was just great. I was only 15. But I was wrong obviously. I hear how these attacks are only supposed to last a few minutes, sometimes 10, and rarely hours... That's actually what I was on the net searching for today was how come I was having this feeling all day long sometimes, not the panic attack itself, but just the feeling of going "crazy" at anytime or feeling light headed, tired, fatigue, etc.... But I noticed it's just part of it, I have seen you people are having the same problem, so now my feelings of having something else seriously wrong with me have gone away:). Thanks. I will feel this way for days sometimes weeks at a time, not being able to go to town alone, constantly wanting someone to ride with me, because the fear of having a terrible attack while driving is always on my mind. I just recently started seeing a counselor (once). I really think and hope that it's going to help me.. It feels great to hear someone talk to you that really knows what you're going through. I wish all you the best...

by Bubbles0723, Mar 16, 2004 12:00AM
I also am taking paxil, a few years ago when i was 17 out of nowheer i had a severe panic atttack wehich lasted about a week straight, i started taking the paxil and in time i was better, i was all the way up tp taking 60mg when i decided to get myself off it which wasnt a good idea i had a week long severe anxiety episode once again, i now take 25 mg of paxil cr and i am egtting much better, its really scary to go thru this because im nly nineteen, and its just not normal to have to worry so much about anxiety when i should be out enoying life...
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