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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Margaret on August 30, 1999, at 13:33:04
Hi
I am writing about my husband who has had panic disorder for about 10 years now. He does not suffer from any other psychological disorder, except for recently, agoraphobia.
He has developed a dependency problem with benzodiazepines, as a result of being treated by a psychiatrist who believed that dependency issues were not real. He has tapered from a high of 2.5 mg Xanax + 6 mg Rivotril to 2.5 mg Rivotril and has suffered greatly.
He has tried antidepressants twice out of desperation. The first, Tofranil, produced a five hour panic episode. I flushed the pills down the toilet. The second trial was with Paxil, which produced either hypomania or Serotonin Syndrome along with severe shock to his nervous system, leaving him in a constant state of anxiety. (no one will tell us for sure what happened there and his new psychiatrist's only concern seems to be getting him off the benzos, as he is unwilling to address any of his concerns)
He has recently begun taking Atenolol for an elevated heart rate and blood pressure, with excellent results in that area. It also seems to help with some of his panic symptoms as well. (less intense)
So, my question is "Where do we go from here?". We live in a relatively small city with few psychiatrists. Is there anybody out there that's been through a similar situation and found relief?
Thank You in Advance
Posted by Racer on August 30, 1999, at 22:26:34
In reply to Where Do We Go From Here?, posted by Margaret on August 30, 1999, at 13:33:04
Yuck! What a rotten place to be.
OK, I don't know anything except for what I've experienced, but it might help a little.
My blood pressure is always too low, and Serzone lowered it even more. It's said to be a sedating or calming drug, but for me it made me very tense, which may have had to do with the adrenalin from my BP being something like 85/50 while I was on it. That might be something to try.
Then, Effexor was great for my anxiety, and didn't seem to effect my blood pressure, so that might be a possibility, too.
I think it's great that your husband's new doctor is getting him off the benzos, though. That sounds like a great first step. Maybe he'll work on the other issues more once that's happened. I'll hope so.
take care, and good luck to you.
Posted by bones on August 31, 1999, at 22:23:25
In reply to Where Do We Go From Here?, posted by Margaret on August 30, 1999, at 13:33:04
Hi Margaret:
I feel for you and your husband. I've been there - that feeling of desperation - what do I do now.
I have an anxiety disorder - I'll probably have it all of my life. I had panic attacks very badly when I was a teenager/young adult; but overcame them. There is no big secret with anxiety - you have to face the fear and ride the wave. Come out the other side - learn not to be afraid of the feelings. Not really ignore them, just let them ride over you. Once you experience "them" enough you recognize the similarity - understand their facade.
I don't sthink I'm explaining myself too well, I'm tired. I guess the bottom line is that this disorder can be managed. I would recommend to your husband that he try to get some counselling - with someone in town who specializes in anxiety disorders - a behavioral therapist would be the best bet. There are excellent books out: Claire Weekes is someone who helped me years ago: I can't quite remember the title - "Help for your nerves" I think it was called.
"Racer" is right - Serezone is usually recommended as a sedating anti-depressant. Your husband might want to try that. I suggest that he try at a very small dose and work up. People with anxiety disorders seem to be extra sensitive to anti-depressant side effects. Serezone comes in a pill form - can be broken in half it need be. A number of the SSRI's may be helpful, but again I would suggest he start at very low doses, and my experience has been that these drugs at first (1 - 2 weeks) may agitate, but then a kind of numb calm kicks in.
Best of luck Margaret and God bless. I know it's such a tough battle sometimes. ->
Hi
>
> I am writing about my husband who has had panic disorder for about 10 years now. He does not suffer from any other psychological disorder, except for recently, agoraphobia.
>
> He has developed a dependency problem with benzodiazepines, as a result of being treated by a psychiatrist who believed that dependency issues were not real. He has tapered from a high of 2.5 mg Xanax + 6 mg Rivotril to 2.5 mg Rivotril and has suffered greatly.
>
> He has tried antidepressants twice out of desperation. The first, Tofranil, produced a five hour panic episode. I flushed the pills down the toilet. The second trial was with Paxil, which produced either hypomania or Serotonin Syndrome along with severe shock to his nervous system, leaving him in a constant state of anxiety. (no one will tell us for sure what happened there and his new psychiatrist's only concern seems to be getting him off the benzos, as he is unwilling to address any of his concerns)
>
> He has recently begun taking Atenolol for an elevated heart rate and blood pressure, with excellent results in that area. It also seems to help with some of his panic symptoms as well. (less intense)
>
> So, my question is "Where do we go from here?". We live in a relatively small city with few psychiatrists. Is there anybody out there that's been through a similar situation and found relief?
>
> Thank You in Advance
Posted by Ian on September 1, 1999, at 15:11:57
In reply to Where Do We Go From Here?, posted by Margaret on August 30, 1999, at 13:33:04
> Agoraphobia is often a manefestation of social phobia,a phobia is an out of place anxious response. Is it inherent in some people or is it aquired? I'd like to think the second is true and theres a lot of evidence to support it. The trouble with medication is the body is very good at resetting its basal set points in order to accomodate them which also leads to a nasty rebound when they are stopped. I'd recommend reading "An introduction to psychotherapy" by Dennis Brown and Jonathon Pedder, also check out Peter Breggins book "Toxic Psychiatry..." and the ICSPP website at http://www.breggin.com
Posted by Yardena on September 1, 1999, at 19:05:41
In reply to Re: Where Do We Go From Here?, posted by Ian on September 1, 1999, at 15:11:57
I think it is usually hard and maybe artificial to try to separate innate tendencies from aquired ones, because the brain and our environments interact and affect each other. For very anxious people, there can be the awful "double" effect of being embarrased about the anxious reactions they naturally have to certain situations. So, they might develop anxiety about their anxiety. The feeling of not having control over becoming anxious (which can have those awfully embarassing physical symptoms) can be extremely nervewracking.
I recommend the book The Anxiety and Phobia Workbook by Bourne (don't remember his first name). It talks about different types of anxiety, various symptoms, and a comprehensive approach to managing anxiety. It is readable, practical, and comprehensive.
BTW,from what I understand, the benzos can make some people's anxiety worse if used long term. Let me say that I am NOT an expert, but my understanding is that they are not a long term approach to anxiety and panic disorders, even tho they are often used that way.
Posted by Dee on September 2, 1999, at 22:45:46
In reply to Re: Where Do We Go From Here?, posted by Yardena on September 1, 1999, at 19:05:41
I quite agree with Yardena. If we separate the acquired and innate, we may be dealing with one half of the problem as we should, while the other half drags us down. This is what I think about myself, and I really cannot talk to anyone else: There may well be a chemical imbalance in my brain that I need to take care of. However, that having gone untreated for thirty years has led to a burdensome set of survival tricks and coping skills, that, situation changed, become improper behavior.
This is why I think that my medical problem is equally a problem of attitudes and behavior. The medicine gives me the break that I so badly need so I can focus on changing my coping tactics so I can improve my life. I am fighting two wars, and the battle has to take place on two frontiers at the same time. I find that this is the only way it may work for me.As to Serzone, I have found just recently (after three weeks of taking it) that it is brining my anxiety and depression down. However, after I started taking it (something like days 4-8) I slipped into a severe, edgy, crushing attacks of anxiety. What helped me to get through this, was knowing that others had experienced the same thing, and it will pass. On a night like this I came to this page and just cried out for help... I received lots of support and was able to make it through the thing.
Just for me, now that I am starting to feel the beneficial effects of Serzone, I think it was paying the price.I really feel for you. It is so hard to go through the detoxification and deal with anxiety disorder at the same time. I was self-medicating with crystalmethamphetamine for years, and cutting that left me in the most painful place imaginable. But I made it, and others have, too. I think it is important at this time to have a support group, for sometimes it is the most important thing of all for us o know that we are not alone. When we feel that crushing pain, and we think that there is no other human in the world who could possibly understand what it feels like to have that 'knife hit into your neck and twisted over and over', as I once described it , we need someone to say "Yes, I remember how it felt." I wish it wasn't so, but sometimes things must get worse in order to get better.
Your husband is very lucky to have someone like you by his side, and a site like this to for pier support.
I wish you all the best and send lots of love your way
Dee
Posted by carrot on September 11, 1999, at 1:18:00
In reply to Re: Where Do We Go From Here?, posted by Dee on September 2, 1999, at 22:45:46
>I also have had panic attacks for years, which have at times left me completely disabled. It's tricky with the meds because everyone's chemistry is so different it's really impossible to tell what may make your husband better or worse. It's trial and error...and it certainly is a `trial' a lot of the time. Klonopin and buspar are excellent meds for panic disorder, and (as others have pointed out), antidepressants in the SSRI category are especially effective with depression and panic attacks.
I found the thing most helpful in my twenty years of panic attacks has been meditation. I live in an area where there are quite a few Buddhist Centers that hold meditation retreats. I basically sat, facing a wall for hours on end letting the panic come, and come, and finally realized that IT WOULD NOT KILL ME. I know it sounds so simple, but it's a profound realization, because in the height of anxiety, we do feel like we are going to die. Learning a technique in which your husband can somehow come to realize that his panic is created by thoughts manifesting themselves as (terrifying) physical symptoms. Therefore, if he learns to quiet his mind (through meditation, praying, deep breathing exercises), his physical symptoms may not be as acute.
Your husband may need meds to get to the point of being able to do any of these exercises. I think there's a lot of stigma re: taking medication to manage anxiety. Many people think that we should just be able to `pull ourselves' together. They don't understand that panic is not just fear, or normal `everyday' anxiety. It is paralyzing. While it is important to `keep an eye out for' medication abuse, sometimes it is necessary to use them in order to be able to benefit from therapy or relaxation techniques.
There are panic attack chat rooms/sites on the net, which may be helpful if you are in a small town where there may not be a lot of resources.
Good luck. I empathize with your husband.
Carrot
I quite agree with Yardena. If we separate the acquired and innate, we may be dealing with one half of the problem as we should, while the other half drags us down. This is what I think about myself, and I really cannot talk to anyone else: There may well be a chemical imbalance in my brain that I need to take care of. However, that having gone untreated for thirty years has led to a burdensome set of survival tricks and coping skills, that, situation changed, become improper behavior.
> This is why I think that my medical problem is equally a problem of attitudes and behavior. The medicine gives me the break that I so badly need so I can focus on changing my coping tactics so I can improve my life. I am fighting two wars, and the battle has to take place on two frontiers at the same time. I find that this is the only way it may work for me.
>
> As to Serzone, I have found just recently (after three weeks of taking it) that it is brining my anxiety and depression down. However, after I started taking it (something like days 4-8) I slipped into a severe, edgy, crushing attacks of anxiety. What helped me to get through this, was knowing that others had experienced the same thing, and it will pass. On a night like this I came to this page and just cried out for help... I received lots of support and was able to make it through the thing.
> Just for me, now that I am starting to feel the beneficial effects of Serzone, I think it was paying the price.
>
> I really feel for you. It is so hard to go through the detoxification and deal with anxiety disorder at the same time. I was self-medicating with crystalmethamphetamine for years, and cutting that left me in the most painful place imaginable. But I made it, and others have, too. I think it is important at this time to have a support group, for sometimes it is the most important thing of all for us o know that we are not alone. When we feel that crushing pain, and we think that there is no other human in the world who could possibly understand what it feels like to have that 'knife hit into your neck and twisted over and over', as I once described it , we need someone to say "Yes, I remember how it felt." I wish it wasn't so, but sometimes things must get worse in order to get better.
>
> Your husband is very lucky to have someone like you by his side, and a site like this to for pier support.
>
> I wish you all the best and send lots of love your way
> Dee
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