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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by sciencegeek1230 on May 23, 2006, at 18:40:29
Hello
I'm a little nervous. I've been lurking around for a couple days, searching and reading, and I finally got up the courage to write something.
I have GAD and panic disorder and sometimes dysthymia (sp?) but the depression is mostly a side effect of the anxiety causing me to not be able to go out or enjoy anything I do. I'm hitting a bad patch right now and I think I need to try medications or cognitive behavior therapy again. The CBT worked before, in '03-'04 so I might just go back to that. I don't like taking medications because they make me very flat. I like to have energy and they seem to rob me of it. So, I guess I'm asking what you collectively think of CBT as therapy for GAD induced depression as opposed to medications, and what kinds of medications do you think work best for panic induced depression?Anyways, nice to meet you all.
sg
Posted by Phil on May 23, 2006, at 18:50:32
In reply to GAD and Panic, posted by sciencegeek1230 on May 23, 2006, at 18:40:29
Welcome...
If you aren't in an 'urgent bad patch' right now then CBT sounds good.
What meds have you tried in the past?Phil
Posted by bassman on May 23, 2006, at 20:00:19
In reply to Re: GAD and Panic » sciencegeek1230, posted by Phil on May 23, 2006, at 18:50:32
I agree-CBT is fine if you're basically fully functional. If the panic has taken you to Intense FearfulLand, all the rational arguments in the world aren't going to help you-and relaxation therapy isn't really useful for panic itself. Then you need meds to help you be more functional to get more out of the CBT-you might try Remedyfind.com for ratings of meds by actual users to get some ideas. Panic is a nightmare-best of luck and don't let it get too intense,
Posted by sciencegeek1230 on May 23, 2006, at 21:03:23
In reply to Re: GAD and Panic » sciencegeek1230, posted by Phil on May 23, 2006, at 18:50:32
I have tried Celexa, Paxil, Zoloft, Moclobemide, Seroquel, valproate, lithium, Buspar, nefazodone, benzodiazepines, amytriptiline (sp?)and Effexor. I may be forgetting one or two. I've had this problem for a few years but it comes and goes. The medications never lasted very long though. They make me feel very unlike myself so I don't like to take them. CBT has worked before. I am functional, basically, but going to work is getting difficult. There is lots of stress there and I am tending to go and hide somewhere while while I get my paperwork done. I go to work still but having lots of people around me asking me questions or giving me things to do brings the panic on (I am in administrative support). I think I must learn to cope with different levels of stress better.
You seem to know something about panic and anxiety so I will ask: What do you think of meditation?sg
Posted by Phillipa on May 23, 2006, at 21:19:29
In reply to Re: GAD and Panic » Phil, posted by sciencegeek1230 on May 23, 2006, at 21:03:23
If you can concentrate and stay still it works great for a lot of people. Unfortunately I can't focus and sit still that long. Love Phillipa
Posted by FredPotter on May 24, 2006, at 0:03:58
In reply to Re: GAD and Panic » Phil, posted by sciencegeek1230 on May 23, 2006, at 21:03:23
I feel for you sg! That was me and still is sometimes. I've had 42 years of it. Periodic sort of thing. The crises are at major life changes but it's only as I look back that I realise what I was and am scared of. It's panic over being lost, either abandoned or surrounded by people who expect things of me. Where's my Mum? Over the years I've persuaded myself that people are basically friendly. If I faint in a public place, there'll always be someone to help (unless you're in the Bronx perhaps).
I've found breathing low in the abdomen and letting it out through pursed lips helps when the fear is on me. Also Xanax taken in sufficient amounts, freely and when you need it. I would definitely not go down the drinking route like I did as it made me worse in the end. I've given that up now. There's also the distraction tricks like - notice three things you can see, 3 you can hear, 3 (not emotions) you can feel. Then 2 then 1.
I'm nearly 60 now and get anxious when I'm alone in the evening. The only thing that works is the one thing I can't face. Going out and being among people. Working towards a shared goal is the most therapeutic thing I can think of for either anxiety or depression. I need people like a plant needs water, just to have them near. Nothing more demanding
I was thinking of an extreme case, an atavistic example. There I am spear in hand, a-hunting sabre-toothed tigers. I get caught between 2 and can't run or attack so I freeze (not flight OR fight you notice). That's how my panic attacks are. Now a helpful hunter slips me a couple of Xanax. Not going to help much is it? Not even half a bottle of scotch will help. Nothing short of unconsciousness (maybe in the form of death) will take away the fear. Fear, being priority one is blasting through all other circuits.
And so I think ultimately the fear only really goes when what terrifies you is faced and dealt with. The problem is that we don't often know what we're afraid of. In the hunter scene above I'm lunch anyway so who cares?
Fred
Posted by sciencegeek1230 on May 24, 2006, at 8:07:00
In reply to Re: GAD and Panic » sciencegeek1230, posted by FredPotter on May 24, 2006, at 0:03:58
> I've had 42 years of it. >
Oh my. That's a long time. It comes and goes, you said? I'm glad you have breaks now and then.> I've found breathing low in the abdomen and letting it out through pursed lips helps when the fear is on me. There's also the distraction tricks like - notice three things you can see, 3 you can hear, 3 (not emotions) you can feel. Then 2 then 1.
I have used the breathing technique before but I will try your distraction method and see if it works too. Thank you for suggesting it.
I didn't really understand the tiger story but I do appreciate your reply to my questions.
sg
Posted by sciencegeek1230 on May 24, 2006, at 8:11:08
In reply to Re: GAD and Panic » sciencegeek1230, posted by Phillipa on May 23, 2006, at 21:19:29
> If you can concentrate and stay still it works great for a lot of people. Unfortunately I can't focus and sit still that long. Love Phillipa
Yes, I have the same problem. I have tried to sit or lay quiet for meditation and my mind keeps going. I was told to sit there as long as it takes for my mind to go quiet but it doesn't. I guess I am a thinker, not a doer.
I can usually focus well on something but not for very long too.
sg
Posted by Phil on May 24, 2006, at 11:57:36
In reply to Re: GAD and Panic » Phil, posted by sciencegeek1230 on May 23, 2006, at 21:03:23
See my above post for how many pills I take a year.
: )
Before I started meds 23-24 years ago, I would perspire noticeably through a suit, my hands would be soaked with sweat, and I absolutely could not keep my stomach from making a lot of noises. I could not be in any kind of meeting. Stomach just made the anxiety worse.
When I started on Amitriptyline back in those days, all those problems stopped. Of course it's a trade off w/ meds. All I know for sure is that I have to have them. Of course, I wish that wasn't the case but it beats the heck out of unbearable anxiety.
Good luck finding the answer and treat it if needed. Some illnesses cannot be toughed out.Phil
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