To ask for these meds for severe anxiety and panic disorder?

[PinkLemonadee]

I've been struggling with anxiety for a couple of years now but over the last several months it's reached a point where I cannot function. I can't take part in family life. I struggle to go shopping or even to drive anywhere, to the point where I've had panic attacks picking my kids up from school. I've pretty much given up driving after having a panic attack at a set of traffic lights. It's absolutely unbearable.

My mum passed on Friday after a short illness and there's a house to clean out and the other arrangements to make and I can't do anything because of the stupid anxiety which is ruling my life. I am utterly terrified of the funeral because I know I'm going to have the physical anxiety and I can't cope with the feeling for much longer.

I currently take propranolol which is doing absolutely nothing to help. I'm part of a group online for anxiety support and saw clonazepam recommend for acute attacks and Hydroxyzine for daily management. I understand that both of these can't be used long term but I'm hoping if I can break the cycle of anxiety I might be able to cope better.

I have been refused anything other than antidepressants (sertraline) which did nothing but make me feel unwell for the three months I took it.

I have a review with the mental health team on Monday so will ask then. I feel like I can't even grieve properly because of the anxiety - it's absolutely crippling.

Do you have the number Mind give out where you can phone and be talked through breathing?

How old are you? Just wondering as my anxiety came back recently, panic attacks, loss of driving confidence etc and it turned out I needed HRT

Yes, and the panic attacks only started after I'd completed it.

And what does that leave you thinking?

Do you do much exercise? I used to really suffer with facial flushing / social type anxiety and occasional panic but since I started exercising regularly (specifically weights) it’s disappeared. I see anxiety as excess energy in my body that needs to be released, and once I exercise it’s gone. Drugs won’t change anything long term.

Please can you stop? I don't have it in me to play riddles right now

You need to ask about safety to drive if you are prescribed something in the sane family as clonazepam.
https://www.mind.org.uk/information-support/legal-rights/fitness-to-drive/medication-and-driving/

So you can’t pop a pill to prevent a panic attack at the traffic lights and then get in the car to drive the kids….

If these panic attacks seem random with no trigger, I’d ask for a 24hr ECG

I have just found out that my “panic attacks” (heart pounding, dizziness, brain fog) that started during cancer treatment were really a heart arrhythmia called prolonged QT caused by the cancer treatment and not anxiety over death, health, work, stress.

Although I did develop anxiety because of these physical symptoms, it was not the cause of them.

The symptoms are remarkably similar to a panic attack when they are subtle.

41

I'm sorry you're feeling this way @PinkLemonadee I've also lived with severe crippling anxiety and constant panic attacks, and I've recovered.

What I can tell you is that it isn't just a case of propranolol versus the drugs you're seeking. You clearly need much more support.

Go back to your gp and don't leave their office until they see you're drowning.

What dose of propranolol do you take? They tend to start you on a lower dose, it wouldn't hurt you for them to look at increasing it. Also when do you take it? As and when? You may need to take it regularly.

These are small steps, they won't fix the whole problem, but they'll help you cope.

There are also anti depressants which are particularly good for severe anxiety. I've recently posted elsewhere about how much duloxetine transformed things for me and it is an anti depressant noted for helping anxiety.

Tell me too about your diet and sleep?
I know how desperately you need a radical change, but the smaller things are important too and it's only when I could no longer function I realised the immediate affects of how I slept and what I ate on my panic attacks.

It can and will get better x

My partner was prescribed benzos by the mental health team for similar to what you are experiencing. The dose kept having to be increased to do anything due to tolerance which develops incredibly quickly and then she was put onto a stronger Benzo. We lost a year of our lives trying to wean her off. Absolutely horrific. You become dependent incredibly quickly as in a couple of weeks and then, if you think you have anxiety now, it will seem a walk in the park in comparison to the anxiety you will have.

Pregabalin has been amazing for my panic disorder. I combine it with Escitalopram which is a really effective SSRI for panic disorder.

I have citalopram for this exact reason, it’s an antidepressant but it’s also used for panic disorder and anxiety

same age
I had a 24hr ECG as I kept having near faints but it felt different to my previous anxiety and panic
I would be in bed and suddenly couldn’t breathe and had to go outside or put a fan on my face

I also use pregablin for acute anxiety and it has been a lifesaver. I also tried CBT for panic disorder and anxiety and it made me worse. It took a long time for my meds to be adjusted by the psychiatrist to a good working dose. I take venlafaxine as well for depression and although I have dips sometimes, I am ok.

I do hope you get something that works for you soon OP, I know the struggle x

Propranolol is for your physical symptoms (heart rate) it’s not an antidepressant, when you say sertraline didn’t work while it does get worse before it gets better (2-3 weeks) rather than changing the medication it might be the dosage which is an issue, you can (when prescribed) take up to 250mg a day is it possible you started on 50mg and then didn’t speak to your GP about titrating up to find the dose that works for you. Clonazepam is an addictive short term medication while sertraline is a long term depression/anxiety medication

I’m glad you had the 24hr ECG so they could rule out any cardiac issues.
Also glad to see that they figured out it was hormonal and HRT has helped you.

They were very thorough - I had an 8 hour operation a few months before so figured anything bad would have shown on that anyway! Also increased my levo as my thyroid TSH had increased a bit

I would ask the crisis team what they can recommend to get you through this crisis period and then what could help longer-term. Diazepam (Valium) is sometimes used for only 1-2 weeks to help very short term now and is more likely to be prescribed than Clonazepam.

In terms of SSRIs and SRNI's there are quite a few which act on anxiety as well as depression, and people have listed these. Another option is venlafaxine for anxiety/depression, and although it has a not great withdrawal syndrome, it's very effective and you can taper off when you no longer need it. I would take the advice of the team as there are many shorter term (e.g. increase propranolol; short-term diazepam) and longer term (try at least one or two anxiety decreasing meds) to try.

Once you get through this period, it will be easier to work on the whole thing but I get right now that would be very difficult. I'm sorry about your mum, OP, this does seem a very difficult time for you.

As these drugs aren’t helping, one option might be to try Magnesium and also vitamin D3. Make sure if possible to get exercise too.

All the best with your mental health team. I hope everything works out for you.

I already take those, and exercise regularly.

At 41 could be the start of perimenopause

@PinkLemonadee

Here's a simple technique to calm you within minutes. Take a small object – a bottle of water or a bunch of keys, for example and gently throw it from hand to hand, concentrating only on it pass back and forth. This requires the two hemispheres of your brain, the logical and the emotional, to coordination so that you don't drop the object. It's a tried and trusted method from Howard Cooper, who was the lead psychological presenter on Virgin Atlantic's 'Flying Without Fear' course.

In the longer term it's very possible to reduce the frequency and severity of panic attacks until they simply stop. You don't have to live with them.

Thank you. I'll give that a try.