Will PND/Panic Disorder go without medication ?

[BustyDeLaGhetto]

(I have posted previously under the houndsoflove moniker but too lazy to name change.)

I have always been anxious but since birth of DD have developed panic disorder which I am gradually managing under CBT. Doc prescribed me Beta Blockers (which I haven't tried) and Setraline (which I did, took one dose and hated it. I don't respond well to drugs at all).

I feel the CBT is helping and after having a bit of a breakdown on Saturday (by which I mean a huge cry and a sense of hopeless despondency) I began to feel much, much better - better than I had in a good six months. I could feel the CBT 'clicking' into place IYSWIM and I suddenly felt more capable and more confident, and even DP remarked on how happy I seemed. I felt like my old self again.

Three days later (today) and I've woken up with a cold and a foggy head, and bubbling anxiety beneath the surface. I was due to go to my penultimate CBT appointment this arrvo but cancelled it - partly because I feel unwell, MAINLY because I had a massive panic attack at the thought of making my way all the way across town and having to sit and talk about myself for an hour.

I'm upset partly because of the dent in my confidence, partly because I didn't make it to my CBT (as it always makes me feel a bit better) but mainly because the force of the panic attack made me cringe. It was horrible - I had thoughts of harming myself and DD, was afraid to be in the house on my own with her, I felt as if I was going mad and kept thinking 'theres a chemical imbalance in my brain'. It was soul destroying, especially as I feel as though I have tackled my previous panic attack trigger (fear of losing control in public), only to have it replaced with something as stupidly dramatic and frightening as thoughts of hurting DD. I was actually considering taking her to a neighbours for them to look after until DP came home :(

Of course I wouldn't hurt her, or myself. But all my CBT 'training' seems to go out the window sometimes and the fear engulfs me. Will this go away in time without medication ? I really dont like the thought of taking ADs. What are the alternatives ?

You could try the diet and exercise route but honestly there's no shame in taking ad's, they lift the fog & help you cope

Thanks Gumby I have given up cigarettes and booze since January - ugh, it is SO boring - and it hasn't made any difference to my mental state. I've also stopped breastfeeding at Christmas but am still co-sleeping to maximise sleep. Its worth noting that DD is nearly two and hasn't ever slept longer than three or four hours at night so my sleep is constantly interupted so I know this could be a factor. I'm eating well and starting meditation soon. I wish I could see more positive results, its so frustrating.

I have no shame about ADs, and actually got the prescription after receiving some very wise advice on MN - I just hate the IDEA of taking them, and the way that first one made me feel was crippling.

Sounds like you are doing all the right things, hopefully you will recover without the ads. But fwiw, sertraline has been really helpful to me in the past. It doesn't change who I am, but it does stop the anxiety spiralling out of control. BUT... the side effects are horrible to begin with. I'm about to start a new course of them after 3 years off and I'm bricking it! i know I'm going to be a complete space cadet for rhe next week or so but then afterwards I'll be in a much better state than I am now. It's gotta be worth it!

I suffered with crippling panic & anxiety for 8 years (prior to becoming pregnant). I was taking the contraceptive pill, & within 6-8 weeks of coming off of that, my problems disappeared. All through my pregnancy & early months after my baby was born I felt amazing. I then decided to have the implant put in. Within 5 days of that going in, I was a panic stricken, crying wreck. I asked the Dr to take it out. After arguing with her that I did not have PND, & that it was the hormones that was making me feel this way, it was removed. It took a good month to return to normal, but I'm back to feeling good again. I now believe that for all those years & many AD's later, it was all hormonal. This may be worth looking into?
There is no shame in using medication, but I am a big advocate for talking therapies. I have also done hypnotherapy & that has helped my thought processes along the way & has had a great impact.
Stay positive & I really hope you feel better soon. You are not alone in feeling this way

Thanks for your replies, it is always helpful that someone knows what you're wanging on about, especially as panic is so insular sometimes. I'd like to reply to your posts in a bit more detail if thats okay, and will try to do so tomorrow as DD just awakened.

Loulabelle83 I have often wondered if it may be hormonally driven - I seem to worsen before my period is due, and one of the reasons I stopped Breastfeeding was so that I could regulate my hormones again. I had very much the same reaction to the contraceptive pill as you did, when I was taking it years ago. I think it was Micro-bloody-Gynon. I became angry, embittered and completely irrational. It was only when I stopped taking it that I began to feel better again. I wonder if this is something the doctor could test for ? Not sure how it can be treated though, if there is found to be an imbalance. May call GP, you've certainly given me something to think about, thank you!

KeithLemonsBackDoors I actually read your thread on the MH board the other day and can really, really relate to your situation - I used to be terrified of being sick in public and this broadened into 'losing control' in a range of other ways from pooing myself to fainting to going mad. I still carry this with me, and it manifests in pretty much 99% of my bastard panic attacks. Like you, I had a lot of safety behaviours (I used to carry a plastic bag in my handbag in case I needed to be sick) and its taken me a long time to stop doing these things. Part of the CBT I'm doing forces you to break all these safety behaviours and it is very, very difficult. You just need to know you'll manage without them. WHen she told me I had to take my GIGANTIC FAMILY SIZED bottle of Rescue Remedy out of my bag I nearly had a cardiac arrest.

I just don't think I will manage well on AD's, but will obviously try it if I don't seem to be improving. My pupils dilated to big black pools and I felt like I had a head full of cotton wool and candy floss. It frightened me, and I don't think I need any more fear in my life. You wouldn't think I'd once travelled the world and appear on stage would you ? I can barely scrape myself together to get to the local park. It is improving - the 'whats the worst that can happen' mantra seems to work for me unless I'm exhausted - but I feel like I'm constantly battling against the onset of panic and it is KNACKERING.

my dr has just given me pregabalin for anxiety and panic and its really helping, im still having to work hard to dig myself out and i have times of despair, but meds deffo helping me along. Also on fluoxetine, if this info helps.

Loula - I was CONVINCED my [massive] anxiety problems were initially kicked off by hormones. It all started on the day my milk came in with a huge panic attack. It had very slowly we'd over the course of DC's first year but every time I dropped a feed or prior to coming on a period it would all get worse.

FWIW I haven't had any ADs as, being convinced it was hormonal, I didn't want to mix my system up any further.

• it has very slowly eased over the course

Just reading this and wondering how you are feeling now bustydelaghetto? I went through something very similar recently, 14 weeks after my second baby was born. It was the most horrific frightening experience of my life. I had at least one panic attack a day, felt foggy headed for days on end, felt disconnected from the real world. became phobic about the weather of all things, if very cloudy or very sunny I felt a horrible sense of claustrophobia. At my worst I thought I would have to have myself admitted. I am 39yrs old and a trained counsellor with no previous mental health problems. I tried hypnosis and psychotherapy. After two months though I decided to take AD's as although I was making some progress it was just too exhausting. I took citalopram first and hated it. Felt completely spaced out and was terrified at thought of second dose. I then tried Prozac 20mg and have been on it for 8 weeks now and am 100% better, started to feel significantly better after 3weeks. I don't have any side effects except an increased appetite, so have put on a few pounds. Couldn't care less though as I feel I am sane again. I am now convinced post natal anxiety is a chemical imbalance, and this from a counsellor. Please please do reconsider the meds, I highly recommend Prozac. My dr said the only reason they stopped prescribing Prozac as a first line treatment was because citalopram is cheaper. I do hope things work out for you.

Mumcity - it's a living hell isn't it? I know exactly what you mean re. the weather too! I can't actually believe I've [hopefully] survived it. At its worst I was convinced none of my loved ones were real. Horrendous. Very interesting that you're a counsellor. When I had any contact with mental health professionals they would look at me in a sad way when I rambled on about it being hormonal, and then say that it's categorically an 'adjustment' period from becoming a new mum. But seeing as though it's your second baby...

Yes I can see why people would talk about an adjustment period, I would have said the same before I went through it. Yes I am sure our personal psychology plays some part. My husband was diagnosed with ME around the time our 2nd was born. So I had extra stresses going on. However my symptoms were SO extreme and just plain wierd that there is absolutely no way there is not a strong chemical element. Similar to you my first physical panicky feelings (butterflies in my tummy) started during first few minutes of starting to breast feed. And once I stopped breastfeeding symptoms did ease.
So good to be able to share wierd thoughts I had with people as that's one thing I could not share with family and friends as I know they could not have related at all and it would have freaked them out as i am normally so grounded. Had something similar to you where looked at husband one day and felt I did not know who he was and that the whole experience was part of a plot by him and my family to make me think i was mad. NUTS!!! NUTS!! NUTS!!!

My DH was a rock throughout but everytime I tried to open up in a mum's group situation I was met with blank looks - but then again trying to explain how i'd suddenly become obsessed with what happens after you die does sound a bit strange when everyone else is chatting about their baby's poo colous and consistency. Luckily (though not for her I suppose) I had a friend who had been through it with her first who was a real lifeline.