HELP/need advice-panic attacks

My mom and adult daughter get panic attacks. What has helped them when they are really bad is xanax. My daughter doesn’t take the xanax much anymore but she is now able to talk to herself which is basically a pep-talk more or less when she gets stressed and believe it or not, she is now able to calm herself down.

Sounds like the SSRI medication needs to be adjusted or changed. A panic attack falls in the anxiety disorder area and SSRI’s are used for both. When was the last time the medication was adjusted? Some seem to lose effectiveness after awhile. That happened to my son. He should not be having a panic attack if his meds are being monitored appropriately.

Janis

Thanks for your responses. This has been such an upsetting week.

The panic has become so bad for my son that the new doctor wants me to try a low dose of Klonipin again. I tried it a few days last week, but it didn’t help. We’ll see.

His SSRI does need to be adjusted again, if not changed. He’s been on it for several years. I started seeing signs of it not working last spring with sleep problems. Unfortunately I was seeing a doctor who believed that the SSRI’s are sister drugs and they are all the same. He wanted me to add all these inappropriate medications. I can’t believe he was board certified.

My new doctor suggested the homebound program for a while. I am going to try this until he gets better. I also think a smaller private school might help him feel a little more comfortable. The homebound program may give me time to look for a school.

Wondering what things worked for your son with the anxiety. Did you try therapy, and if so, what kind of therapy?

Oh, goodness. I hate to say this, but it has been an uphill climb all the way. He is now 20 and taking a semester off from college because his medication was just not right when he needed to leave. He has social anxiety disorder and that complicates things. When we first tried medication in high school (Zoloft), it worked great for several months. Then it started to lose effectiveness. At that point, I think the Dr. should have tried increasing the dosage. Instead, he changed him to Paxil. Well, that was a disaster. Changing meds made him feel worse than he did before! So he quit meds for a couple of years. He was not doing well this spring and agreed to go to a new Dr. He is now trying Luvox. I can’t tell anything yet. We did try some counseling for social anxiety this summer, but that has not been very helpful either. But it just may be my son and his situation. I’m sure counseling/therapy must help some people. Maybe the counseling would have been more beneficial if he had had the medication working at the time.

Without going into a lot of personal detail, I will just warn you to try to get the medication under control. These kids suffer so much silently that they are very prime candidates for self-medication with illegal drugs when they are teens.

I hope you have success soon with getting the medication regulated. I know it is heartbreaking to see your child suffer.

Janis

Have you looked into cognitive behavior therapy? This is not counselling (which IMO is probably not helpful here). CBT is very specifically directed at eliminating an undesired behavior (in your child’s case, anxiety) and does not spend anytime trying to figure out the root cause behind it. (I think the underlying assumption is that it is some sort of chemical glitch in the brain so there is no point delving into past history.) The method is sometimes referred to as exposure and response prevention—the child is exposed to the specific things that trigger the undesired behavior,then rewarded for preventing the response. (At the beginning, the best that usually can be done is not total prevention but delay in response.) This is a very practical and results-oriented therapy that is the standard for treating obsessive compulsive disorder—which is somewhat related to panic attacks.

I agree. I read about CBT but our counselor did not have that training apparently. That’s basically why we quit going to him. I still think some people need meds, too, though.

Janis

Janis—I did forget to add that the usual standard of care is to combine medication with CBT, at least inititally. The early stages of confronting and sometimes “flooding” someone with the source of their undesired behvior can be incredibly disturbing. Meds can help people handle these initial encounters and make it more bearable. One would hope that over time the meds could be tapered off.

I teach a health research class and one of my students turned in an article discussing how both this kind of therapy and meds changed the brain. I thought it was fascinating that this sort of therapy actually changes the way the brain operates.

Beth

i can really relate to these issues. I have found that CBT, facing your fears step by step can work under these circumstances.
1. you have a coach or someone who you really trust be with you.
2. you be on meds such as klonopan/zanac/whatever that will cover your panic for that day. then you can tell yourself…yes, i’m scared, but i won’t go over the hill into one of those terrifying panic attacks.
3. you repeat that day as often an you can until its easy.
4. you need to repeat often, esp if this isn’t an everyday issue.

i did this with driving through the tunnel and over the bridge of our city. I was with my husband, who could take over if necessary. I drove round and round on the highways until my heart wasn’t racing. here’s the problem. The bridge and tunnel aren’t part of my everyday driving. i still can’t do them, but i do know that they will be easier to tackle next time i try (with meds)

the klonopan makes you so tired, but it does provide the short term coverage needed.
best wishes
mary

I can’t help but feel that the idea of the meds being tapered off implies a judgment. Many of these problems with brain chemistry are like any other illness. If you need medicine, you need medicine…Perhaps it is better to be grateful that the pharmacology is getting better, instead of thinking that, if we just get stronger, we won’t need it.

Meds stimulate the brain. That is why they are called stimulants.

There are other ways to stimulate the brain.

There usually is more than one way to do something. I don’t think this is a knock on meds. Some kids need meds but for some kids therapy can do the trick. I believe many could benefit from both.

I’ve suffered with panic attacks since I was a young girl of 5 y/o. I am dx’d with panic disorder and generalized anxiety disorder. I use the drug Buspar (after several different medications of which I wasn’t rx’d until age 35). I’m now 46. What I like most about Buspar is it doesn’t make me feel like I’ve taken any medication at all. In fact, I feel totally drug-free. My mind is clear, I’m energetic and I have genuine feelings (unlike Paxil). It doesn’t cause weight gain like the others. It doesn’t diminish your sex drive like some (for me Paxil). I don’t have to take it when I don’t need it, like the others. It is not addictive, like some. As a sufferer who could easily never step foot outside the door or ride/drive in a car, it is imperative you treat panic disorder through behavior modification and/or medication. Otherwise a panic attack sufferer must self-medicate. I used to drink alcohol, which was unfortunately encouraged by my many different psychologists, who failed to tell me they couldn’t rx medication. It wasn’t until at age 35, dh and I went to marriage counseling that the counselor scheduled an app’t for me with a psychiatrist who made the formal dx and rx’d Xanax. Several days after I got my first rx I no longer cared to drink or smoke. We must continue to live our lives to the fullest in spite of our attacks. It’s too easy to give in to fear and anxiety and stay at home, yet still have attacks and possibly night terrors. Wanda

Nice to hear your story, Wanda.
I had a landlady for a while who could not leave her apartment. As she didn’t move, she got heavier and heavier, and the excess weight made it more and more difficult both physically and mentally for her to go out. She had developed a life for herself, with people coming to her to visit, and some work consulting by telephone, so at least she wasn’t alone, but it was still very sad.
It’s a good thing to know that there is now a treatment that can help this. Good for you keeping looking.