Help - how can I help my sister with her panic attacks? Bit long...

[Inquisitive]

I've had my sister at my house in tears most of the weekend with a recurrence of panic attacks. She was having them fairly regularly, and was put onto ADs for general anxiety. She'd got a bit slack about remembering to take the ADs but she seemed to be doing ok. When she mentioned to her doctor that she wasn't taking the ADs very frequently, the doc pointed out that in that case they were really only acting as placebos, and I think being told that sort of stopped the placebo effect, if that makes sense, and she started getting the anxiety again - I'm actually not sure if she then started taking the ADs more regularly or if she came off them completely.

Anyway, she was referred to a therapist and had about 6 sessions of CBT, which finished a few weeks ago since the therapist thought she didn't need any more, but the first challenge she's faced (going away with work for a couple of days last week) has made her fall apart again. I think her fears at the moment are that she was supposed to be getting better and she isn't, and she thinks that she'll be like it forever/the CBT didn't work so nothing will, and she doesn't want to go back onto the ADs.

I'm so sorry for her and wish there was something I could do, but I'm also a little bit frustrated because I get the impression she wants someone to fix it for her but she doesn't seem to prepared to put in any work herself - she's got these tools from the CBT but she always has a reason why she can't use them. I've tried gently pointing out to her that I know it's hard work but she needs to do some of it herself, but she doesn't seem to have taken that on board really.

She's asked me to go to her doctor's appointment with her tomorrow - it was supposed to be an appointment to say that she's much better and doesn't need any more ADs, which is obviously not going to happen just yet. I don't know what I can do to help - should I make sure she asks for more ADs? Different ADs? More CBT? Some different therapy (and if so, what)? I'd be really grateful for any advice/ideas.

[lazymumofteenagesons]

Its the combination of the CBT and the ADs together that is really going to help. Also if the panic attacks are connected to agrophobia, going away with work for a couple of days is a huge step to take as a first challenge. She should be doing a bit at a time under the guidance of the therapist and learning to talk herself out of a full blown panic attack when the first signs appear without fleeing the situation.

It is important to realise that these feelings are just your body producing too much adrenaline when it is not needed, they won't kill you.

Until she has managed to get through the situations which have triggered panic attacks previously, she should still be having CBT and definitely stay on ADs. Then come off ADs slowly.

Keeping a diary of how she has coped between each CBT session will help. She will be surprised when reading it back what she has achieved. But, one small step at a time. The benefit is not immediate.

[Inquisitive]

Thanks lazymum - a diary sounds like a great idea.

I think part of the panic is connected to being away from her partner - she imagines awful things are going to happen to him (and unfortunately he's not massively reliable - tends to go off on a drinking binge and forgets to call her... but that's a whole other story...)

Going away for a couple of nights was always going to be difficult and I agree, I'm surprised she hasn't had the guidance of the therapist but she seems to have just been told she's ok and discharged without any real interest in whether she really is ok or not.

We'll see how this doctor's appointment goes today...

[lazymumofteenagesons]

If its not too late re. doctors appt. you should enquire about using beta blockers, they sometimes help the physical symptoms of panic attacks and then the vicious circle of the fear of the fear can subside.

[Inquisitive]

Doctor was very nice and helpful, and has referred her to a psychiatrist to see what they think would be a useful next step - possibly some sort of traditional therapy.

Beta blockers are a very good idea - she's said before that the physical symptoms sometimes start before she's even aware that she's anxious and then she can't get out of it. I'll mention it to her if she wants to go back to see the doctor again before she gets the referral.