Some Advice I've Given

Here are examples of replies that I've sent to people regarding their questions...at the top of each new reply, you will find a short description of what the person was inquiring about. I hope this is helpful to you!

Woman writing regarding her boyfriend's first panic attack during a movie while on vacation, she was looking for advice.

Hi...

Thanks for writing (you visited my page at www.geocities.com/spiroll2 ) I'm sorry to hear that your boyfriend has started having panic attacks. The Internet has a wealth of very solid information on every aspect of anxiety attacks, and some of the best sites are written from personal experience, as opposed to professional research findings.

First, of course, your boyfriend should see his regular physician to get his 26,000 mile checkup, so to speak, and get an "anxiety" diagnosis. From there you have several options. Medication certainly works wonders, an anti-anxiety medicine will get him through the panic attacks until a longer acting medicine (antidepressent of type SSRI most likely) is stocked up in his body. That aspect of it usually takes about 6 to 8 weeks for the full effect, which is why, normally, an anti-anxiety medication is given in the beginning, as well.

Of the anti-anxiety medications, Buspar is what is usually prescribed first because it is non-addictive, but it also takes a longer time to work, up to two weeks, and to that end, I have never met a person with panic attacks who has found it to be an effective treatment option. Xanax, Klonopin, ... there are a few others but I can't think of them just now - those are commonly prescribed anti-anxiety meds. And they work. I take xanax whenever I get a panic attack and it takes away all symptoms within 40 minutes, with relief starting in 20 minutes. I never get "wasted" from using it, and after ten years of taking it, I am not addicted to it. I often go weeks without taking it.

What triggered a healthy 26 year old male to have a panic attack on vacation? Well, to be honest, that is a question that will most likely plague him for the rest of his life. There never really is a concrete answer, but I'll offer some ideas.

That his first panic attack was during a movie while on vacation is not a suprise at all. If you think about it from a different angle, it all makes very good sense. When you are working, living out your daily existence, running from one thing to the next, your mind is constantly occupied. You don't have time to fully relax, even when you go to bed at night your thoughts are on the next day's events, or what your forgot to do that day, etc. This is a fast paced world, and for people who are prone to anxiety it's a world where thoughts never stop bombarding us. We are constant thinkers. Time goes by, perhaps a year or six months of mid-level stress, perhaps a few major crisis', and we deal with it all in an exemplary fashion. We are incredible at keeping up a fast pace, keeping everything in a straight line, and balancing every aspect of our lives. With this type of mind-set, a year or two can go by and we are always so close to some unidentifiable edge; always worried, a bit anxious, fast paced, we tend to talk fast, we tend to hold our breath alot, we have alot of muscle tension - but one thing that never stops is our minds. That keeps us panic free for a while.

Fast forward to your vacation, your night at the movies, and suddenly you're relaxing, your thoughts are slowing down, you are letting go of some control. Suddenly your body starts freaking out because you don't feel "normal", i.e. as you usually do. Relaxation and slowed thought is foreign to your mind and body and your brain senses that something is most definitely wrong. Little things start to happen, like holding your breath, or breathing too fast, your face or hands start to tingle, a rush of heat goes up your back and suddenly you're sick to your stomach, scared to death, and needing to run far and fast and you have no idea where you're headed...just as long as it's NOT where you were.

That's why that first panic attack is always described as "out of the blue". It's not really. Your boyfriend most likely had a genetic predisposition, any stressors good or bad can trigger that first "big one". No point in trying to figure out why the first one happened though, now is the time to focus on what to do to get him through this. It might not be an anxiety disorder, it might just be a short period of anxiety attacks, and with the right treatment - perhaps some cognitive-behavioural therapy alone, or combined with medicine, it may just subside.

Your support is incredibly important, but remember that the more time you spend talking about it, fixating on it, the more you are helping that panic attack to get lodged in his psyche. Once there, it's nearly chiseled in stone and hard, if not impossible, to take back. Try and get back to your normal life, with some behavioural modifications to lessen those stresses, without keeping the words 'panic' and 'anxiety' in the limelight. During a panic attack, help your boyfriend to refocus his thoughts - that's a very important key. I recommend anything tedious - breathing normally while trying to recite the alphabet backwards or something similarly difficult that requires serious mental focus.

I wish you both the best of luck, and I thank you, for your boyfriend and millions of people with panic attacks in the world who don't have anybody there for them, for supporting him through this.

Feel free to write anytime, I hope I can help.

Lisa

Woman writing after she'd been through a horrible panic attack that evening

Hi, thanks for writing. I'm glad my site was helpful to you and I'm very sorry to hear that you had a panic attack tonight, that's awful, I know. It takes me hours to come down off of one, too. Usually it totally wipes me out. I take xanax when one starts and then it's totally gone in 1/2 hour, so I don't usually have those intense several hour attacks anymore.

Your mother breathing into a paper bag when you were a child is really interesting. People do that when they're hyperventilating, but really, it's just a refocusing tool, it doesn't actually do anything other than change your focus so that mentally you stop thinking about hyperventilating, which calms you down. Weird, huh? If your mother spent time breathing into a paper bag, I'd be willing to bet that you're right, that you inherited this from her - it very much does run in families. (Panic attacks)

If the panic seems to be making your asthma worse, here is just a thought: It could be that you "THINK" it's making it worse, therefore it is. This is very common to people with panic disorder - it's an obsessive way of thinking that is comprised of "what if's". The elevated or sky high anxiety symptoms between full out panic attacks is called General Anxiety Disorder (GAD) and again, is very common, and remember that 'shortness of breath' is one of the top five symptoms of a panic attack.

I can very much relate to hating to feel out of control of anything when you're a mother. You didn't ask for panic attacks though, sure - you may have been genetically predisposed to getting them, but it's not your fault that you got them, it doesn't mean you're weak or sick or lazy or stupid (quite the opposite in fact!) or not "in control" enough.

I had a real problem with taking medicine for panic attacks in the beginning of mine - I wondered what people would think of me. Well, at first they thought poorly of me, especially my mother (who's not ever had a panic attack) and so I learned not to tell her that I was taking medication for it. I wasn't lying, i was protecting myself from her harsh criticisms, which just did me so much harm. I felt a special kind of pleasure in hearing her say that she was glad I was off those medicines and back to my normal self - WHILE I was taking Paxil. I've learned that it's more important for me to be taking a medicine that minimizes my anxiety and panic attacks - lets me lead a normal, clear-headed life - and let's me feel "normal again, than it is to be brutally honest with everyone about what medicine I'm taking. Maybe that's wrong - but the general population isn't too sympathetic for people with panic attacks, they think you can just "get over it" or get a hobby, or work harder, or some ridiculous thing like that, but that's not at all true, and if they only knew how hard we try to "get over it" in our minds, constantly, they'd be blown away by the amount of energy we put into it.

Well, I didn't mean to lecture, I just get a bit upset with people who think we're not "trying hard enough."

Take care and thank you so much for writing, I hope that your panic is gone for a while...write anytime...

Lisa

Woman writing to inquire about medicines, worry about employers not wanting her because it was hard to stay at one place for so long, etc.

Hi...you sound about at the end of your rope...God, I know what that feeling is like. But hang in there, why don't we talk about what's going on and we'll figure something out that will get you through this rough time. I am SO much like you in the tension and how you hold it in your chest and shoulders and for me, my neck sometimes feels like it has iron cords running up the sides of it and I clamp my teeth together all the time, I catch myself doing it and don't even realize I'd been doing it! No wonder we get headaches, huh?

Paxil has been a HUGE help. At least in the area of staying with things for longer and not giving in because of my panic attacks. You are NOT going to become undesirable to employers, you're going to get through this.

We face incredible challenges, just getting through each day - and paxil has made alot of them easier for me, socially I'm more at ease, I'm not agoraphobic anymore and I still have panic attacks but they aren't as big a deal for me emotionally, the paxil has alot to do with that. Sort of like if you got a big mosquito bite, you knew it was there and could see it, but it didn't itch. If that analogy makes any sense. I had to really work to find the right dosage of it though, plus I take xanax which is an AMAZING help especially during the roughest of times.

It isn't fair that other people seem to go through life so freely, but as I've gotten older I realize that everybody has their own problems, most people have problems that they hide so that everything appears normal on the outside. Nobody is perfect, and it's not our fault that we panic or are so fearful for no rational reason, it's our brain chemistry, not our personalities. We are good kind caring intelligent people - that's alot more than most people can say, even those ones who seem to just go through life so freely.

I know it's so frustrating...but don't let it get the best of you. You can talk to me anytime about what's going on.

Try to relax those muscles, if you lay in bed and make your body feel heavy, that heavy feeling means that you are relaxing, and even if it is scary the first couple of times, you get used to the heavy feeling and it's good to feel your muscles relaxing. There are times that I do this now, lay in bed and make myself relax my neck and shoulders and they are actually so tense that getting them to relax for a few minutes causes them to twitch from not being used to being relaxed.

Are you taking enough ativan? Have you tried xanax? That's what works for me. Do you work with a family doctor or a psychiatrist? I know it's expensive if you don't have insurance, but a good psychiatrist is the way to go since they KNOW medicine very well, unlike a general family doctor.

Well, write back...I don't know where you're writing from but I imagine you're up late, so that must mean your anxious? I hope not, and if you are, I hope you're feeling better.

Take care...I understand what you're going through and I KNOW you will get through it. You will!

Please write back...I'd love to talk more. I'm going to bed now (it's almost 1am here...I'm in Seattle.) but I'll write more tomorrow if you write back.

Remember to breathe! :)

-Lisa

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