Do you know about anxiety, Beta Blockers, CBT or PND ?

[houndsoflove]

Because I need advice on all these things I think.

Went to see my GP today to discuss my stupid bastard panic attacks. I don't want to start taking anti depressants so he has prescribed me Beta Blockers (Propranolol) for the symptoms.

Brief background;

My previous doctor diagnosed me as having PND but I remained convinced it was just Panic Disorder & Anxiety. I have had panic attaks for 15 years but have always been able to 'manage' them (by using a lot of safety behaviours and avoidance, mainly). Since the birth of DD they have increased markedly in both frequency and veracity, and I started to exhibit horrible signs of developing severe agoraphobia. I am 'managing' this, but it is a daily struggle against myself, and I am starting to become depressed because of the anxiety, not in spite of it IYSWIM ?

I am due to complete CBT in the next fortnight - it has been helpful and the therapist is wonderful, but I am not seeing results fast or dramatic enough for my liking. She has told me to lower my expectations.

I feel trapped, fearful and my confidence has taken a mighty blow. I dread the feeling of blooming terror which preceeds a panic atack now, and spend much of my time engaged in conversation with myself (internally) or self-sabotaging all my efforts at self-help (again, internal voice). I am thinking of leaving my partner (I am storing up resentments) and when I look back at old photos of myself (pre DC) I do not recognise the happy girl in them. Its like another lifetime. I have near constant episodes of unreality and dis-association, and feel like a cartoon some days. Its very frightening and tiring. I am aware I think too much, and wonder if I ought to go back to work (am SAHM often alone with DD all day) in order to 'normalise' myself.

However, I do not feel useless or exhausted and unable to go on. I am not unhappy, other than at my failure to cope with the anxiety, and am not angry other than with my resentment toward it. I do not feel like a failure or suicidal or tearful, nor all the other boxes I didn't tick on the 'Depression' list I have to look at each week for CBT.

My GP today said that if the BBs don't work they will try me on ADs and that I have 'suffered long enough to be proud about it'. I can see what he means but I don't think I am depressed, just very, very anxious.

Has anyone used BBs to successfully cope with panic symptoms ?

If I can take the BBs and utilise the CBT methods as well I think I may well allieviate a lot of my misery. The practioner told me not to expect significant change until six months AFTER the course finishes. Has anyone with experience of CBT had the same effect ?

If I do nothing about PND does it go away eventually or am I doomed to this forever ? I miss me an awful lot.

I was given Propranolol when my DD had serious health issues. The Dr said it would take away the physical signs of anxiety straight away, which it did.

But I was also given 20mg of Citalopram as well. I wouldn't have been described as depressed but incredibly anxious. The Citalopram has worked incredibly well for me.

hth

Beta Blockers don't do anything for anxiety as such - all they do is stop your heart from racing in a panic attack.

It's a shame you are dismissing ADs out of hand. It is a popular misconception that you need to be depressed to use them. Well no, maybe the stuff needs renaming. Anyway, modern ADs, usually of a type called SSRI can work very well on anxiety, unlike beta blockers they do actually make you feel less anxious. It is well possible that once you are stabilised on some ADs you can work better on strategies to help with your anxiety.

On the other hand you may indeed have too high expectations. Entrenched safety and avoidance behaviours do not simply disappear with a short course of CBT. It will take ongoing work and possibly psychotherapy or counselling if the underlying causes need addressing.

Finally PND might need renaming as well, as in some women it manfests itself mainly or completely in anxiety.

Coco thanks, I did a quick search on the Talk archives for Beta Blockers and I saw Citalopram came up a lot on Anxiety threads, all with mostly good responses about how helpful people found it.

I may look into it if the BBs don't have any effect - I think I'm unsure mainly because I think of the nature of my panic as being quite specific and I think of ADs as a mood enhancer and being quite general.

Will speak to my GP more in-depth and will google Citalopram now.

madmouse speaks sense .

A lot of ADs are mainly used for anxiety disorders and can work very well indeed. Think of them as simple another tool in the toolbox - they can be incredibly helpful in improving anxiety and panic attacks to the point where you are better able to actually use the techniques taught during CBT and allow you NOT use avoidance behaviour etc.

BB work on the physical symptoms of anxiety, like heart rate, breathing rate, sweating, stomach churning etc. Some people do find that their anxiety improves by not feeling the symptoms of it so much IYKWIM.

Hi madmouse I remember you from my other thread (where you were incidentally very helpful).

I'm certainly not dismissing ADs out of hand - I would drink the Thames through a straw if I thought I could go into town and get a coffee without feeling like the End was Nigh. However my CBT practitioner did say that it would be best to see how far I could get with CBT methods before embarking on any AD medication, and I agree with her, at least for now. I feel like the BBs are a bit of a placebo in that respect and am hoping not to have to take them too often.

As I've always had anxiety issues it is hard for me to know whether or not it has worsened as a result of the pregnancy, motherhood, sleep deprevation, hormones, chemical imbalance, previous alcohol abuse or all of the above. If I thought I had PND I would certainly seek to address it properly, although I am still aiming to finish the CBT and try to help myself down that route too.

That's true Pacific BB can work well for people who are afraid of the panic attacks themselves.

OP you may also want to google Mindfulness. That helped me a lot with panics.

Oh hi Hounds! Answered the thread without looking at the nickname

Pacific You see, that was what I thought. When I mentioned asking my GP for ADs to the CBT lady (ACRONYMS ahoy!) I was thinking that if I could use them to get on an even keel I would be better prepared to use the CBT methods.

What I am hoping for is that the BB will remove the physical (as you said) and then I just need to work on the mental. However one of my main fears is passing out or having a seizure when out with DD and one of the BB side effects is light headedness so will see how that goes. It may work in a crazy kind of 'facing the fear way'.

Fluoexetine is an antidepressant (SSRI) that is also used for anxiety. You might find it helpful to view your anxiety as treatable by altering your brain chemisty with the drug, and treatable by altering your thinking patterns with CBT, and treatable by altering your environmental circumstances, because being a SAHM alone with the DC and no adult company is enough to tax the least anxious of us.

Another option is psychoanalytic psychotherapy, which might be useful if AD, CBT and change of circumtance don't work.

Fortune favours the brave :)

I never had any side affects with the BBs, in fact they helped with my regular headaches

madmouse

When CBT finishes she is going to try to get me on a course of Mindfulness meditation which I am really looking forward to as I really think it will help ground me and prevent me overthinking. I am also considering going back to Hypnotherapy as I found it very calming.

I think I am getting frustrated by my own limitations, and its making me resentful. Interestingly the GP said to me that I need to stop over-analysing WHY I have started feeling this way as the main concern is that I do.

reading One of the reasons I am a leetle bit scard of ADs is that initially they can make your anxiety worse, and if that happens I think my eyes will fall off with fear

Citalopram didn't make my anxiety worse.

cocolepew I might go back to GP again and see. I think the CBT is working - at least I can see signs of improvement, slowly, slowly - but perhaps I just need to give my brain a bit of nudge too, so it catches up.

Sometimes ADs can make anxiety worse before it gets better, that is true. Usually that effect wears off after a few days, very rarely 2 weeks. Starting at a low dose and building up after a week or 2 can avoid this, or a tiny dose of Diazepam for the first few days.

I take your CBT practitioners point re trying out the full effect of CBT techniques in the first instance, but IME ADs do have their place and often meds AND therapy of whatever description together are most effective.

I am a GP and I hate to tell you, I agree with your GP regarding the 'stop overanalysing the reasons': if you had indigestion would you drive yourself around the bend asking 'why?' and beating yourself up about it? Probably not. I don't mean to be flippant, but it can be helpful to just accept anxiety as your Achilles Heel, just like other people get migraines or piles, and concentrate on what works for you to get it better.

Your eyes will never fall off with fear btw, they are well attached .

Pacific annoyingly, I agreed with him too. Even as I heard myself listing all the possible causes for my anxiety ("And DD is nearly two and has never slept a whole night through,") I thought I sounded like a worrier. Actually my main thought was;

"Oh God, I'm turning into my mum."

Genes can be a right fucker !

I have high hopes for your recovery as you sound like you have preserved a healthy sense of humour and the ability to laugh about yourself .

On a more serious note, of course sleep deprivation makes everything worse (DS1 almost finished me off) - it's not used as a form of torture for nothing.

Just keep putting one foot in front of the other - it really sounds like you are on quite a good track for getting better. And be patient with yourself and your CBT.

I used Fluoexetine years ago to help with anxiety and depression, although I didn't realise it at the time , it really helped me regain an "even keel" for a while before I was able to learn how to recognise my moods, triggers and was able to head any problems off at the pass.

This was about 10 years ago and I was on it for about 18 months, had no issue stopping taking it.

Hello all, quick update.

Went back to GP this morning and he has prescribed me Setraline (sic) at 50mg which he assures me is quite low. He is prescribing it for Panic Disorder and totally agrees that I need to get back on an even keel. I took my first one this morning, then went to meet DP in the park with DD (he is off work as we both have colds)

When I told him about the ADs he said;
"I'm not happy about this" and proceeded to tell me that I hadn't yet given everything a chance, that the CBT needed time to work, that I had a tendancy to over-exaggerate etc etc.

I am fucking FUMING. Not only is he being completely unsupportive at a time when I most need it he is completey discounting all the good work I have tried to do prior to the GP appt. this morning i.e hypnotherapy, St John's Wort, meditation etc.

SO pissed off.

Yes 50mg of sertraline is a starting dose, like 10mg of citalopram.

Tell your DP coolly that you have considered all options and that you are taking responsibility for your health in this way.

It's not up to him what you need to feel better.

Thanks, madmouse I just feel like he sees me as a bit of a failure for having to take this route, and I have worked bloody hard on myself recently to try to overcome the anxiety.

I also feel that he thinks ADs will turn me into a Stepford Wife type zombie, and while I appreciate his concerns I don't want to be made to feel as though I need to Man Up (his response to EVERYTHING emotional).

Agh. Well, I am going to continue, persue the CBT to the end and try the Mindfulness too, and maybe yoga. Probably not the Yoga though, to be honest as am quite lazy at heart.

Good for you for going to the Dr, I hope it works.

Give your DH a poke in the eye from me.

Ah well, hounds, your DH is a man, isn't he - he deserves our support and understanding. Seeking help for this kind of thing is not easy for men (one of the reasons for high suicide rate in young men ) and is often seen as 'weakness'.
It is crap that he cannot support you in this though; you just stick to your guns and keep going.

ADs do NOT change your personality, they do NOT turn you into somebody you are not and they are NOT happy pills.

FWIW, Sertraline is less likely to make your anxiety flare before it gets better, so I really hope you feel a bit more settled soon.

I take propranolol, I find it helps the anxiety in that I don't feel like my heart is about to pump out ofmy chest constantly, but the emotional feelings are still there.

It sounds to me like you are very much on the right track, most importantly because you are taking steps to put yourself in control of the way you feel. I try to use mindfulness stuff too, and it definitely helps me if I stick at it. Sometimes finding the motivation to do it is hard though, which seems silly because who should need motivation to sit and do nothing!? But it's not that easy when there's so much else to do.

I'm sorry your dh is not being as supportive as you would like. Mine tries, but he doesn't really get it. The way I try to see it is that I can't expect all the support I ever need to come from the one person just because I married him. If I wanted support with a course I was doing I'd go to a tutor or someone who was in my position. If I wanted support to buy the right outfit I'd go to a friend who is good at fashion stuff. So it figures that if I want support for my anxiety I go to people that understand it or have first hand experience of it. All I can expect from my husband is that he respects what I'm going through and what I am trying to do. I think you need to point out to your dh that he needs to respect what you are trying to do, even if he has no way of understanding it. A lack of understanding is no reason to make you feel weak over it.

I think unless you have first hand experience of what a panic attack actually feels like, it is very hard to comprehend how something that is basically in your mind can have such strong physical symptoms. That shocks me still, especially how it can literally come out of nowhere, so I think it's understandable that someone who has never felt it struggles to understand it.

Even without your DHs understanding, you aren't alone in this.

Thanks all for messages, I really do value your support.

Ack I feel like shit. Its been 24 hours since I took my first dose and I am having nausea, palpatations, waves of panic and anxiety and my pupils look massive. I slept really badly too. It reminds me of the time I took my first and only 'e' in Newquay when I was nineteen, that was a horrible experience too. Except I talked bollocks for hours and here I am mostly silent (or also talking bollocks ?)

DP had to go to work today, and I nearly burst into tears when he left, feeling so unable to cope with just DD alone today, in this foggy weird world. I am too scared to take second dose - any idea if it would be safe to halve it and just take it this evening so I can sleep through worst of it. Alternatively DP has ten days off in April so could start course then instead when I will have more practical support. I explained to him that I needed his support and he seems a bit less angery now - Pacific you are right about the 'sign of weakness thing'. He doesn't understand anxiety really, and is a bit of an emotional Sahara.

Outraged I'm curious, how much ARE Freddos ? Are they not 10p