POZ Community Forums
Meds, Mind, Body & Benefits => Mental Health & HIV => Topic started by: RobbyR on July 31, 2013, 06:33:35 pm
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I have been on Paxil (good and bad) and beta blockers, still get panic attacks though. My doc referred me to psychiatrist so maybe he can give me more expert advice for treatment ideas. I was given some benzos (Klonopin) years ago which helped a lot, more than anything else, but I also have a history of substance abuse (cocaine) but have been clean for 4 years & not remotely tempted to ever use again. So I feel like that's why they don't want to give me benzos cause they're scared I'll abuse them.
But just wondering what some of you guys & gals take for anxiety/panic issues? I suspect I have more going on than just the anxiety but will let the psych sort that out I guess. Paxil works pretty well day to day, but still getting these sudden panic attacks sometimes. I also just started taking Hydroxyzine which helps a bit for my anxiety.
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I'm sorry to hear you're still having anxiety and panic attacks. While mine have gotten much better, I still have daily anxiety. The all out panic attacks have just gotten better. I've had some really bad panic attacks, though.
I am on Prozac, Xanax, and the beta-blocker, Atenolol. While these have helped, I've not been cured. I honestly don't know what I would do without the Xanax. I've been in situations where I was having a bad panic attack, and gasping for air. Popped a Xanax, talked myself down, breathing exercises, and I'm usually better. I will still usually feel crappy, because of the flood of adrenaline and other chemicals.
Of course, benzos can be habit forming and cause all sorts of problems. I think it is like pain meds. People should try other things first. But, if your quality of life is not good, then you have to weigh the pros and cons. For me, I've not had addiction issues some 5 years later--knock wood. I let refills expire. But, many are different and will need more and more, which will lead to running out.
I wish you all the best dealing with this, because I know how awful it is. I avoid so many things, because I just fear I will have a panic attack in front of friends. That's where the therapist comes in. I see him, to try and deal with that.
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Cognitive Behaviour Therapy (CBT) can do wonders for anxiety and panic attacks and many studies have shown that it's much more effective than meds alone. CBT teaches you how to keep the anxiety at bay and stop panic attacks from happening in the first place.
CBT techniques can be applied to a wide variety of situations and practicing the techniques can lead to not needing any anxiety meds.
Rather than getting a referral to a psychiatrist, I would suggest you ask your doctor for a referral to a psychologist who is trained in teaching people CBT. Psychiatrists really only dole out drugs these days.
There are also a lot of books out there on CBT - while reading them can be a place to start and/or a way to keep it fresh in your mind, learning it first-hand in a face-to-face setting is best because a therapist can give you feedback on your progress that you cannot get from a book.
I can highly recommend CBT, so at least think about giving it a try. Good luck!
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To add to Ann's comment, I'd also include something called Mindfulness Body Stress Reduction (MBSR) . It has worked well for me to deal with both generalized and acute anxiety. Here's the catch - it really is a discipline that needs to be developed and practiced to fully work; unlike a benzo that is fast acting, works but cannot be sustained over a long period of time. I took a CBT based MBSR course and found it works when applied...Google it and check it out
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I asked my therapist about CBT. He said that's what we are doing. Well, while we have discussed what things raise my anxiety, what I'm thinking, and what I tell myself, I am not sure it is working well.
But, maybe it is. I guess I have learned to tell myself I've had these before, I'm not dying, and it will go away. But, I mean, it doesn't feel like intense therapy, like I would imagine. And, when you only see the therapist once a month, it gets hard to get into a rhythm. I suppose if I told him I need more frequent visits, he may find a way to work me in.
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Ted, until you feel comfortable regarding your level of expertise with CBT, you may want to see your therapist more than once a month. It could take once a week until you're more adept.
Sometimes it can be as simple as carrying the bottle of your Xanax with you, and the thought of knowing there's a pill at the ready, can stave off an attack.
I had horrible anxiety for years, and still do. But I've learned to talk myself through the attacks. You can too, just give yourself time.
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Ted, your therapist may also be able to suggest a book on CBT that will help you in between appointments. There are many on the market and like any other genre of books, there are ones that are excellent and ones that are crappy, so your therapist may be able to point you in the direction of an excellent one. Or you could browse through the books available on Amazon and read the reviews to find a good one.
A CBT book should be viewed as a supplement to therapy, not a replacement. Many of them have exercises that you can work through in between appointments.
And yes, also find out if you can see him more often. I've known therapists who wanted to see the client as often as twice a week in the early stages of CBT training. Once a month is more maintenance therapy.
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I've been on citalopram for most of a decade (I only got my HIV diagnosis six weeks ago). I've found it's been quite helpful for my anxiety attacks.
Coping mechanisms are really important too. I find that focussing on my breathing (counting 7 beats in, 11 beats out is quite calming) and things like carrying Rescue Remedy with me can be really helpful.
(Rescue Remedy is obviously a placebo, but the placebo effect is pretty powerful, so I'm ok with that ;) )
But learning how to talk yourself down is the important thing. Good luck :)
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I've been on citalopram for 9 years now , seems to help with
the happy feeling issues .
I take Clonazapram <sp> for anxiety . As Ann says often just having
one in my pocket is enought for me to make it through the rough spots .
I was born high strung so it is not something that will be going away
anytime soon :-X
I have tried going off both pills at times and end up a nervous wreck and
feel like death warming over , I spose that taking pills and feeling well is
good enough for me .
Weasel
P.S. Time for my Trazadone ....
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My anxiety has been a life long battle. I also have a strong element of avoidant personality disorder, which at times causes me to self-isolate. On the bright side I am going to see a psychiatrist soon at the recommendation of my pc doc, so maybe he'll give me a bit more clarity since he's trained in the area. I have tried ssri's and they don't do shit but give me lousy side effects. I will not take ssri's again. Not opposed to other classes of meds which I have yet to try.
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I had both EMDR and CBT for anxiety/panic attacks and post-traumatic stress. Have helped ease the symptoms. I also use positive affirmations (Louise L. Hay) and am currently working through a self-help book recommended by my physiatrist - Reinventing Your Life. It's hard work and a constant battle between pushing through the depression or collapsing in a heap. Today was collapsing in a heap....
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I think I made a good move, I decided (on my doctor's advice) to see an actual psychiatrist, which is good because unlike regular doctors they are trained in the area & know what to do. He diagnosed me as having panic disorder & social anxiety disorder. He put me on paxil & gave me a few Xanax (yippee) lol tho no refills so I'll have to be real careful with the xanax because it's addictive. I guess he only means for me to take it when I am feeling a panic attack coming on. I see him again in 3 months so hopefully I won't have anymore panic attacks they truly are scary & paralyzing. Anyone who has had one knows what I mean. So paxil & xanax here I come!
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That does sound good, RobbyR. Fingers crossed for you, dude.
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Great to hear. I hope this helps to control it, or at least make the panic attacks not as bad and less frequent. Besides a cure for HIV, I keep hoping medical science will discover how to just fix it. I know the causes are so complex and the brain is still very much a mystery.
All the best!
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The only thing I find odd, and I say this as someone who has had at least six prescribing psychiatrists in the past 13 years, never once has anyone of them put me on a new medication and not wanted to see me for 3 months. It's always in a month to check how I am reacting to the new medication, and then possibly come back again the next month before going for longer prescribing periods.
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I would love to find an alternative to xanax that doesn't knock me out.
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I was really worried about seeing the psych, because one of my main triggers for anxiety or a panic attack is unfamilar people & situations. At times if I get a panic attack I literally hyperventilate & have to carry a brown paper bag to breathe into because I feel like I can't breathe. Lordy lordy, I know! I hope I can ditch that damn bag soon! Come to find out my psych was gay, he didn't actually come out and tell me but a guy always knows & he was cool. he shared with me that he sees many HIV patients so that eased my mind a bit more. He had this weird "psychiatrist" vibe that I guess some just have, but he treated me good & with respect. It was more like a give and take than I thought, he conversed with me and didn't analyze me which I had feared. So it went ok. I'm reserving judgment until after future visits though, because this is a constant battle you never truly overcome anxiety/panic disorder.
Miss P, I didn't think much about the time in between visits. Since it's now September, and I will be seeing him in mid-October, actually it is closer to a month. So I misspoke on the three month thing.
He wants me to see a therapist but I'm not going to do that until after I start the meds because I just don't like the idea of talking about my issues with someone I don't know, and if the meds work, then no need for a therapist in my opinion.
I wish they could find a go-to one-pill fits all med for anxiety, as it is now there's tons of different ones and many work and many don't. If I had my way I'd take Ativan and nothing else because it worked amazing but I got tolerance for it so had to stop. And I hope I can use the Xanax he gave me and not get hooked on it. But I'm just going to try & trust the process & see what he says in October.
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I completely sympathise with the unfamiliar people and places stuff; it's one of my triggers too and is why I've not visited either of my parents' houses in over 10 years. Parts of that definitely can get easier, though.
Obviously it's your decision and no-one should tell you what to do, but I'd strongly recommend giving more thought to counselling. It can be weird at first, telling your problems to a stranger, but I've found counselling really helpful in the past.
Whatever happens, though, good luck, dude :-)
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The only thing I find odd, and I say this as someone who has had at least six prescribing psychiatrists in the past 13 years, never once has anyone of them put me on a new medication and not wanted to see me for 3 months. It's always in a month to check how I am reacting to the new medication, and then possibly come back again the next month before going for longer prescribing periods.
My psychiatrist, God bless her, still sees me about twice / month.
RobbyR, good luck with the new medications and the psychiatrist in general.
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CBT as Im not brave enough to go down the route of meds until I exhaust this route, Im not sure its working after nearly a year....so it might be time to try another avenue.
Id rather not just take the meds as Im already rattling with the amount of daily meds in me, and I think either my Liver and Kidneys need a break from another pill.
If anyone has any alternatives Id be glad to hear them tho.
Robby
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@Robby, have a look at EMDR therapy. For my anxiety and panic disorder it worked very fast.
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If it helps, the pill burden of the meds I take for anxiety is 1 or 2 a day and the side effects are near-nil, but I can completely understand your reluctance to add another drug to your treatment regime.
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Thanks guys il certainly seek an alternative :) :) :)