need doctors suggestions on what to do

[JaneToxic]

ok the question is obviously what are your suggestions on what i should get like tested for or examined for

for one i am female and age 22 height 5ft2 and weight about 154pounds (my issues started when i turned 17)

i suffer from what ppl call panic disorder i recently had a bad panic attack a few days ago and recorded alot of the symptoms that happened throughout the time it took place, its still going on as we speak, its like never ending in a way.

anyways i was on klonopin for over 2 years for it and recently stopped taking it about 3 and a half months ago, this is my first attack since i been off of it, other then general anxiety everyday, but i have a few strange symptoms that may not be related, i also have a type 1 chiari malformation, i get panic randomly out of no where for no reason, so this is me trying to find what could actually be causing them

my symptoms include-

-lightheaded/dizzy/brainfog
-vertigo/room spinning/felt like i was spinning
-couldnt focus on anything but my dog at the time when it started
-i had blur or fog in part of my eye or eyes
-legs shaky when standing
-hard time breathing
-i was laying down when it first started spinning and everytime i would move just my head even it would get worse and i could not pick myself up
--i had leg pains that night as well like growing pains
-i had pain that i felt was traveling, in shoulder, back, neck, spine, head, left arm, bottom/back of skull, front of head between eyes, also once a quick sharp pain behind my left ear
-trouble thinking, yelling(at barking dogs), forming sentences or thoughts
-felt warm maybe like a hot flash
-frequent urination
-heat and light sensitivity
-head throbbing(also happened once the week before)
-insomnia
-loss of appetite
-impending doom feeling,depersonalization,derealization
-gas, stomach issues
-sudden silence in hearing followed by a ring right after
-numbness in arms, legs, hands(these happen all the time in everyday quite alot)
-my friend tried to massage my upper back/neck area and after a few seconds i looked up to foggy vision and he almost had me pass out within seconds, was a bad feeling

currently still suffering from(few days after start of attack)- (basically)

-brain fog
-hard to think and concentrate
-pain in neck/bottom part of skull and right shoulder/head
-my right hand recently went numb and my left arm hurt(yes i know those are similar to heart attk but im to young)
-loss of appetite
-frequent urination

other odd things u might want to know when evaluating this is i have a history of stomach issues in my family, i have had stomach issues since i was a child, i did get physical therapy for my neck once they did find it tensed up,it helped but didnt, it made me feel the pain in the bottom of my skull possibly even more than i had, it hurt everytime she pushed against it during therapy

now i know this might sound strange but i keep my hair up in a ponytail tight, its obviously against the back of my skull the area where pain happens, most of my life i have always worn it all day all night even when i sleep, sometimes when i remove it i feel very strange but i think of the chiari thats right there so idk, i did take it out the past few days and did a not very tight side ponytail, when i push my hand against the back bottom of the skull i sometimes feel a little relieved of a symptom or 2

my stomach issues when i was younger was always sending me to the nurse, i would feel pressure in my stomach and even when i would relieve some of the gas it still hurt like there was more(this would happen everyday), but every breakfast and lunch i would always have milk in my meals and would feel bad after eating everytime(at the time i was younger and nodded it off most of the time) but i suppose it couldve been the cause of my problems but i have no been diagnosed for lactose intolerance as of yet, i did see a tummy doctor who told me my stomach issues are anxiety and a psych therapist told me it was agoraphobia

at  some point the past few years i did slip and fall landing my spine on the edge of a stair and was in pain and paralyzed for a short while but it went away after a big bruise and such

my first panic attack at the age of 17 i had it happen right after i was taking my 6th hit of weed (yes i know this is bad and havent done it since that day)

i also only usually drink about 2-4glasses of water a day, i feel as if thats all i can drink otherwise my stomach hurts which might be abnormal idk

if you need to know other things u can ask away my email is ***@****

[JaneToxic]

a new doctor diagnosed me with Benign paroxysmal positional vertigo, these may have been causing my panic attacks, i am now on a generic of ativan and going to be put on lamotrigine, im not sure if they are going to do any further tests as of yet, i want to find an underlying cause so i can fix this problem, i fear i may suffer from it forever since there isnt a real cure for that

[JaneToxic]

thank you :)

[nursegirl6572]

Here's the link to the CM forum:

http://www.medhelp.org/forums/Chiari-Malformation/show/257

[nursegirl6572]

Yes, it can cause all kinds of symptoms, and based on where you said the PT was pressing, I can imagine that would cause some pain.  My point was just that the ponytail didn't CAUSE the chiari.  Both conditions will likely feed off each other.  Because you're anxiety prone, any symptoms you have that are related to the CM have the potential to trigger an anxious reaction.

That's why you have to work at managing BOTH conditions, staying away from triggers that will exacerbate either condition.  The better managed each condition is, the better you will feel overall.

We have a chiari community here, you should check that out as well for more information on how to manage that specifically.

[JaneToxic]

i was diagnosed by a nuerologist and mri, and couldnt it cause anxiety, panics and an imbalance like vertigo, cause i feel the pressure on the back of my skull may have been pushing on something or some part that could cause vertigo, but when i had physical therapy before she would always push on the bottom of my skull and its excruciating pain like right now, i found that to be odd

[nursegirl6572]

Have you been diagnosed with chiari?  If so, were you diagnosed with primary or secondary CM?  Chiari cannot be cause by a tight ponytail hon.  It may cause an exacerbation of symptoms, but can not actually cause the malformation.

[JaneToxic]

right now my mind has come to the conclusion that from wearing my ponytail tight in my hair for year may have caused my anxiety and chiari malformation, just think it was pressure against that spot where it is, and chiari is known to cause anxiety etc, so since that attack the back of my head where it is has been in scaulding pain along with my neck, and i had fully taken my pony tail out and the pain was so bad i couldnt rly sleep, but i feel very different now that i took it out, but years of that might take years for it to go back to normal, it said online once the pressure causing the chiari is taken away it could retract and go away on its own, so only time will tell i guess

[nursegirl6572]

(Continued.....)


Making some lifestyle changes is important too.  Really, just the obvious stuff is a good starting place...avoiding stimulants like caffeine, trying to get quality sleep, getting some exercise, even if it's just a walk every day, eating healthy, avoiding alcohol, etc.  Just the physical exercise alone will help to improve your overall feeling of well being.

So, as you can see, there are a ton of things YOU can do to help yourself.  I know for me, the more I do, the better I feel.  I sometimes have to dive in head first and address the anxiety in the ways I know will work for me.  

Therapy will help you learn coping techniques too, for those situations where you have a panic attack.  In that moment, it's really hard to concentrate on any kind of tool to decrease the panic, but there are things you will find that will work for YOU.  Everyone is different.  

For me, self talk (telling myself, "there is nothing to fear, you are like everyone else") and progressive muscle relaxation helps me a lot in the event of a panic attack.  So does sticking it out.  The times when I flee, the panic attack sticks with me more dramatically.  When I ride them out and NOT allow myself to flee, those attacks don't impact me as much.  You know what that's like...how badly you feel after an attack...the derealization, depersonalization kicks in, and you can't think about much else besides that panic attack.  It's a LOT like what a person with PTSD goes through.  Let's face it, panic attacks are awful and they ARE traumatizing.  When you endure them, even for a little longer than is comfortable for you, it will start chipping away at that anxious thought cycle we all get stuck on.

Hope this has helped you.  You're not alone.  You're among people here who understand, who live through it also.  We're all fighting the battle.  Please keep posting, and let us know how you're doing.


Take care!

(P.S....browse the site, there are a lot of tools that will be helpful in your anxiety treatment.  There are trackers, a journal feature that you can set either to private, for your eyes only, or public, where others can follow along and offer support, encouragement and ideas.  You can send private messages to other members, there are numerous resources, articles, etc.  If you have any site related questions, please ask!)

[nursegirl6572]

Hello and welcome!  Glad you found us!

Managing something like panic disorder can be rough at times.  I too suffer from PD, so I can comiserate.

Really, the best way to make progress is to change the way we THINK (the "what iffing") and the way we react to anxiety.  We get stuck in that anxious cycle of worry that just keeps going round and round.  It isn't easy, and it takes time, work and patience, but it's possible.

Having the RIGHT therapist, and the right kind of therapy (ie, CBT, which is great for anxiety sufferers) makes all the difference in the world.  If you feel you're not seeing progress with your therapist, find a new one.  Sometimes it takes some time and trying a few different therapists until you find that one who really makes a difference and starts making the light bulb go off!

Also, medication can be an important part of treatment.  Again, it's the same kind of thing, a lot of trial and error until you find the right medication.  Medication will only help to control your symptoms of panic while you work on the other stuff in therapy, it doesn't "cure" anxiety.  It's a lot like treating any other chronic condition, like hypertension, diabetes.

I would recommend that you speak with your doctor about trying a new medication.  One possibility would be to try a different antidepressant (like Zoloft, Lexapro, etc) along with a short acting anxiolytic, like Xanax or Ativan to be used "as needed" as a rescue med in the event of a panic attack.  That combination of medications is commonly prescribed, because it tends to be pretty effective.  Just something to mention to your doctor.  Make sure your meds are being managed by a psychiatrist too, not just your PCP.  That's important.  And the same thing I said above in regards to your therapist applies for your doctor as well...if you aren't seeing progress, or you feel your doc isn't listening to your concerns, find a new one.

Lastly, there are LOTS of things YOU can do on your own to help address your anxiety.  I can tell that you're very knowledgeable about your condition, which is great.  The more we know and understand, the more fear it takes away for us.  There are so many self help books out there that you could pick up. Here is a link to a list of resources I compiled:

http://www.medhelp.org/health_pages/Mental%20Health/Anxiety-and-Panic-Resources--Books--Websites--Self-Help-Programs/show/1285?cid=60


Look through it and pick a book or two.  The one that I recommend to everyone is "The Anxiety and Phobia Workbook" by Edmund Bourne.  It's a must have, it's set up much like a textbook, so it's interactive and allows you to do a lot of hands on work with your anxiety.  It's important to push yourself, set goals and try your best to accomplish them.  The more you do that, the more power it takes away from the panic.

For instance, working on avoidant behavior.  Most of us with PD have a hard time returning to places, or exposing ourselves to a situation where we've had a panic attack.  We also tend to flee when we panic, back to a "safe" place (usually home).  That's because it relieves the anxiety for us.  

The MORE you can ride it out, and avoid fleeing, the better you will get.  Same with avoiding people, places and things that we relate to anxiety.  It's all about conditioning if you think about it.  You have a panic attack at the grocery store.....even though the store itself is totally irrelevant and did not CAUSE the panic attack, you will fear it, right?  Same way if you have a panic attack at 5pm at dinner time.  You will begin to relate the time of day, even the FOOD you were eating to the panic, and begin avoiding the food, and like clockwork, becoming anxious every day at 5pm.  It's conditioning, and every time we avoid a place or situation that we fear because of a previous attack, we're sending a message to our brains that there IS indeed something to fear, whereas if you push yourself to purposely PUT yourself in those places and situations (gradually of course), it sends the opposite message, that there is NOTHING to fear.  It's called exposure therapy, and it's VERY effective for people with PD.

Those are things YOU can work on on your own, setting some small goals and working your way up.  It won't always be easy, you will have days where you will meet your goals and then some, and days when you cannot even walk out the door, and that's okay!  It's a process, you have to be kind to yourself and patient with yourself.  Celebrate every accomplishment, there are no small successes in this struggle, they're all part of the progress, like stepping stones.  So, celebrate the good days and try not to beat yourself up over the bad ones.

To give you some examples on goals you could set in reference to facing your fears and working on the avoidant behavior, let's go back to the grocery store example. You set a goal that Monday you will go to the store, sit in the parking lot in your car for 5 minutes, then return home.

Tuesday, you will return to the store and go in and walk around for a few minutes (obviously, the longer the better, but if your anxiety is high, even a minute or two will be something).  Then, get back in your car and go home.

Wednesday, you set a goal to go in the store, and buy one or two items, going through the check out line, getting in your car, and going home.  

You get the idea...gradually and slowly exposing yourself to anxiety producing situations or environments.  If you do that for a while, it WILL change the way YOU react to that stimuli (the store).  If you can find a therapist well versed with CBT and exposure therapy, they can help you with those kinds of exercises.  The more you expose yourself to something that once caused you anxiety or panic, the less you will fear it.

(Continued.....)

[JaneToxic]

i tapered off slowly and made sure when it was ok to stop it with my doctor, i was also on citalopram with the klonopin, i didnt rly notice a difference, it just gave me really bad dry mouth, i eventually stopped takin it an found no difference, and my psychiatrist done all he knows, i mean he has tried a breathing practice(doesnt seem to help) and he tried to explain alot of concepts and thoughts an things, i cant really find any good psychologists here, i just kept seeing him cause he was nice to talk to and sorta understood me i guess

[remar]

Did you do a taper when you went off of Klonopin? It's not that uncommon to have rebound anxiety after stopping these meds. Taking an anti anxiety med alone can cause depression. Have you ever been on an antidepressant? It can help not only depression but anxiety also.
You need nutrition, something you already know. I do understand not being able to drink or eat anything because I've been there done that before. Until you get your appetite back I recommend that you get something like Boost. Maybe you can get a few of those a day down with no problems.
The lack of sexual interest and not being able to have an orgasm can be because of anxiety and depression.
I'm not a Dr but I do know the symptoms of depression and you have several of them, along with anxiety. Is your psychologist doing DBT therapy? If not, ask him/her  if they know anything about it. You may want to think about seeing a psychiatrist because they can decide if you need meds or not. If you do, they can prescribe them.

[JaneToxic]

the klonopin after staying on the same dose for about 2 years i couldnt even make it to the bathroom i was just getting bad during the second year not able to function normally, and lost my feelings like right now i feel nothing, i cant love or anything, theres just nothing its not normal, and i know this is odd but i also forgot to include that i have no sexual drive anymore, and i cant orgasm at all, i am seeing a psychologist once a week usually, and at the moment i can barely get 2-3glasses of water down cause i have a hard time breathing while i am drinking it, my head hurts so much in the back, and all i had today was a small bit of dry cereal cause i have no appetite or anything

[remar]

We're not Drs here on this forum but most of here do know a great deal about anxiety.
Are you in therapy, have you ever been in therapy? I highly recommend it if you're not.
What was the reason you stopped your anxiety med? You may want to think about going back on it while you're in therapy.
Try to stop wearing your hair in a ponytail. Or, at least wear a loose one or put your hair up with a clip. A tight ponytail can cause tension in your neck.
You really should try to drink 8 glasses of water a day. Your body needs to stay hydrated.