Meds, Mind, Body & Benefits > Mental Health & HIV

Panic Disorder

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I have been diagnosed with a Generalized Panic Disorder that seems to be getting worse and worse.  I started on Lexapro about 2 years ago but it seems to have stopped working so I have been switched to Effexor.  I have been on it for about 6 weeks and had the WORST panic attack of my life yesterday.  Luckily I had a Psych appointment and he was able to help. 

My attacks used to be somewhat mild, general worry and such.  They have now gotten to being pure hell - sweating, can't breath, chest pain, no appetite/vomiting, exhaustion but can't sleep, fear, paranoia.  He gave me Klonopin for the acute attacks and suggested I stayed with my family last night to avoid any stupid actions.

I am looking for advice from anyone who has had these panic disorders or currently have them.  What worked for you?  What to avoid to control them?  I am going through some major stress in my life (overwhelming debt, possible lay off at work, friends moving away, uncertainty of my future).

It has to get better - I can't live like this anymore. 

Thanks for reading


I hope you find a way to make the attacks less severe.  Be well.


     Panic attacks are the body's physiological response and defense to real or perceived threats (physical or psychological, broadly defined.)  It's the same mechanism triggered in our ancestors in early time when, for example, they faced a sabre-toothed tiger.

     When threatened, the body pulls blood to the muscles to metabolize them, away from extremities and capillaries (hence feeling cold or clammy.)  Pupils dilate to maximize visual information.  Respiration increases which causes hyperventilation, which, in turn, results in too much oxygen and the feeling of dizziness.  It's the classic 'fight or flight' survival mechanism.

     To counter these reactions, we need to reduce the oxygen supply.  One way to do this is to put a small paper bag over your nose and mouth, breathing normally (alters the oxygen.)  Since this can look kind of strange in public, the other method to use is called square breathing.  With no paper bag, inhale to the count of four, hold to the count of four, exhale to the count of four, hold to the count of four, and continue repeating the four steps (hence the 'square.')

     I have had what are thought to be panic attacks, about one every other year for the last ten years, and they are pronounced enough that I will lose consciousness.  The next time I sense an attack coming on, I will use square breathing.

     Sometimes knowing what is going on can make it less disconcerting.  Hope this helps.


Miss Philicia:
I've been diagnosed with GP disorder now for 7 years.  Klonopin GREATLY assisted me at the beginning half -- as a member of the benzo class it's the most effective as it has the longest half life.  SSRI's like Effexor are crap for anxiety issues, as they treat depression issues and personally I find such concerns flip sides of the same coin.

GP disorder is NOT a simple case of a few attacks each year.  They are a stready, daily event and NOT a pleasant way to live -- in fact they're quite debilitating.  However, my advice is to be very careful that you don't allow your dose to increase substantially.  Your doctor probably started you at 0.5mg/daily and while you may have to increase it depending on the severity of your attacks, try not to go over 2.0mg  and NEVER stop your daily dose all at once.  A daily dose of a benzo class drug MUST be tapered off ALWAYS.  I would imagine that your doctor cautioned you about this.

As far as treating the root problem and not just the symptoms, you should be having one-on-one therapy sessions and using a cognitive behavioral approach to zero in on causes and how best to head them off in your head.

Thanks Philly

I agree with the Klonopin suggestion.  He gave me .5 and that is fine.  I do feel anxious most days, but some days they are full on attacks like described above.

Thanks for the advice about Klonopin.  I dint take it every day, just take two when I have an attack and usually one at bed for a few days after (after an attack it takes a few days to get back to more "normal" anxiety level life he he)

I am confused with one thing you said .  My Psychiatrist told me that Effexor would help with the panic disorder.  It even says on their site it is approved for Generalized Anxiety Disorder.  Are you speaking from personal experience regarding Effexor or have you read that it doesn't work for GAD?

The counseling thing has to happen soon.  I have been avoiding it, I don't know why but I have.  I guess I am afraid of what lurks in this head of mine.



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