Severe anxiety and panic. Help.

[AllAboutTheGin]

I came off sertraline 5 ish months ago. Was on it for pnd/pna for 2 years and 2 more 2 year stints between each of 3 kids.
Since coming off I have had severe anxiety and panic attacks for an intense period of a week befor and during my period. So I was pretty sure it’s hormonal.
This month, I have been trapped in 3 days of sheer terror, middle of the night panic attacks, utter, deep fear constantly and I am totally desperate.
Three nights ago I was woken by the worst panic attack ever. Palpitations etc and lasted 6 hours before I could sleep, then lingering achy chest and churning stomach/butterflies the next day. I went to A&e and ecg was clear.
Two nights ago I had a massive panic attack in the evening with DH, I was sobbing and begging him to take me to hospital (I didnt think it was going to Kill me, but I felt so SO afraid that it was never going to end and I wanted to be sedated or monitored or something - just be somewhere safe) it went on about an hour. Eventually a relative came over with 5mg of Valium and it worked and I slept it all off.
Saw GP the next morning (yesterday) and she gave me propanolol 40mg 3x per day, and 5mg Valium for desperate nights. (It always peaks in evening) I was reluctant to go back on sertraline as I basically haven’t had sex for 6 years apart from on the times I’ve been off it - to conceive! Totally destroys my libido. But that’s the only side effect.
Yesterday I was fine and I thought the propanolol was helping. I was kept busy with toddler DD3 which helped. Last night even then Valium didn’t really help. I was so anxious and fearful and convinced I was going to feel panic for ever and would end up sectioning myself to stay safe. Really believed I would never come out of this. eventually I slept, obviously from the Valium.
Today still feeling that creeping up feeling of dread from the pit of my stomach. Butterflies and my mind fixating on the ‘fact’ that it will never go away. The last 3 months this has happened it has gone on day 3-4 of my period but I’m still waiting for my period to arrive and I amd now completely convinced this time will be different and it will never end. The only ray of hope I have is that if it doesn’t end when my period does, I can go back in the sertraline, but I even have some doubt there that it will work this time. I’m just so stuck in this fear. My worst case thought is that it will never stop and I’ll be forced to kill myself, although I don’t feel suicidal. I just feel terror. And I can imagine myself as that person rocking and crying and sobbing in a mental institution for the rest of time.
What do I do? I am desperate and I am counting down the house till the kids are in bed and that’s when it all starts to kick off.

Anyone? Please

That sounds awful! If you think it’s hormone related would it be worth trying a contraception which completely stops your periods to see if that helps?
Have you had other blood tests done such as iron levels? Anemia can cause bad anxiety and panic attacks around your period.
When I had bad anxiety I used to take lavender tablets before bed and it would calm me down a little bit. I also listened to the mindfulness guys on YouTube as their guided meditations and breathing techniques used to calm me down a bit when I was having a bad panic attack

I’m worried about taking the contraceptive pill because I had never experienced any kind of anxiety in my life until I first took yasmin in my 20s. It definitely started my relationship with anxiety.
The actual panic attacks are hideous, but equally bad is this constant low level panic that never leaves me. Once the panic attack is over I don’t feel normal again. I haven’t felt normal since Saturday. Friday maybe.
My GP wants to fix this episode before doing too much testing I think. No bloods yet. I didn’t know about anemia and anxiety - must be the one thing I haven’t googled. I’m a meat eater and I don’t think have any symptoms of anemia but I will definitely look into that. Although as I said my period hasn’t even started yet!
Thank you for replying. I’m still feeling desperate. I am imagining the feeling of a full blown attack and planning my a&e trip tonight already. I can’t convince myself it’s not going to happen.

I think there are some low dose hormone contraceptive pills out now which might suit you better.
If you have low level panic that never leaves then you definitely need to do things to bring your stress levels down and be able to relax more. A magnesium spray at night can help relax nerve function. Kalms tablets might help take the edge off it and so might relaxing breathing techniques, eating a good diet and drinking plenty of water etc. Oh and things like yoga can help to relax your mind (I do YouTube workouts at home such as Cat Meffan).
Ask to be referred for some CBT therapy which will help retrain your brain to stop overthinking and overanalysing all the time.
Definitely ask for some bloods to be taken to check for deficiencies etc like iron, b12 and vit d as these can all cause anxiety and neurological issues if they get low enough.
Beta blockers might be a good option for you to be prescribed too. You can take one when you’re having a panic attack and they will really help.

The propanolol I was prescribed yesterday is a beta blocker. I take it 3 times a day. I find it helps with most of the symptoms but not the worry or the butterflies. The low level panic I am experiencing is like just waiting for the next full on attack. I know I will have one once the kids are down tonight, it’s like I’m holding it in but could let it out at any moment. I’m doing everything I can to keep busy and my mind off it while the kids are here.
When it kicks in in the evenings I just have Tf is desperate urge to take myself to a&e and declare mental health crisis and let them take over. I don’t even know what that means or what would happen but I feel that I’m totally out of control and I don’t know what’s going to happen to me if it doesn’t stop. Rationally (or so I am told) I think a panic attack actually can’t last forever, but I can’t quite believe that.

I’m just about getting through the afternoon by cooking. Absolutely dreading the next episode 😢

I just have Tf is desperate urge to take myself to a&e and declare mental health crisis and let them take over. I don’t even know what that means or what would happen

If you go to AandE they won't do much at all, most likely just send you back to your gp. People who've attempted suicide often get sent home after a few hours with nothing, can't imagine them being very much concerned with panic attacks tbh.

Self refer to IAPT for CBT or stress control course, try other medication.

I’m not in UK so it might be different here but maybe you’re right. I just have this intense need for a dr to tell me I’m going to be ok. I want to see a mental health professional. I don’t know why or how.
I am seeing my therapist tomorrow who I haven’t seen for a couple of months, but he’s more emdr than cbt. Everything is too intense for me to consider doing emdr at the moment but it might feel good to just talk to him.
What’s IAPT?
Everyone in real life keeps saying I need to do things like yoga and mindfulness to help my stress, and I get that, and I am going through a bit of a stressful time, but I don’t actually worry about those things. I worry about my health, my kids health and my panic never coming to an end. That’s it. I’m not consciously worrying about moving house or juggling home life with 3 kids. The panic has just Totally come out of the blue. All I can think about is the impending evening when it is going to blow up again.

The point of the mindfulness stuff is it would calm your nervous system down which would lower your cortisol levels (stress hormone) and stop you having any panic attacks x

Ok. I’ll try it. I don’t know if you have ever felt this but I don’t feel like I can focus on anything like mindfulness, it feels so trite. But I know it’s meant to help. I will try it. Any time, or in the middle of an episode?
Also I feel quite tearful but I’m scared of crying in case it triggers a whole rollercoaster of panic. I’m not a crier. That sounds weird. Can’t explain it.
I think I need to go back on the sertraline and give up on any idea of having a sex life.

I used to get really pissed off when people suggested mindfulness as I felt SO unwell from the panic attacks and physical symptoms. It just seemed like a load of nonsense that wouldn’t help. It’s the only thing that ended up curing me but you have to put effort into it doing it regularly and learning to relax your body and mind properly.
Could you try a different anxiety med if sertraline was giving you a low libido? There are about 50 of them so there would probably be one that would suit you. It’s a minefield though and can take a long time trying to make it work

Ignore the IAPT suggestion if not in uk.

The panic has just Totally come out of the blue

Well, it may have come on all of a sudden at first but now you are sort of setting yourself up for a panic attack. You say you know you'll have one this evening- it might not happen but you've already started getting your body into panic mode by obsessing about it so naturally thats going to cause an attack this evening. Self perpetuating cycle you're trapped in.

There are some online CBT courses or books you could try, it does sound like you'd benefit.

What will you be doing this evening or most evenings while waitng for your attack? What's your panic routine?

I need to make sure I don’t have one tonight, don’t I. I have been repeating the mantra ‘this is not nice but I’m surviving and it will pass’. Usually the panic starts to creep in while I’m putting the kids down and then fully kicks in as soon as the last one goes to bed. I could maybe go out for a walk? Or do a 9pm supermarket shop?!
I have to say that right now I feel ok physically, it’s just the thought processes i’m struggling with and the dread.
As for trying a different ssri, I’m frankly terrified of trying something unknown and I know that sertraline works for me. I have heard so many stories of people reacting badly that I can’t risk that right now.
Like I said, last night even Valium didn’t prevent a panic attack coming on while I was watching tv - the only difference was that I felt all the thoughts and the dread in my stomach but I was too tired and drowsy from the Valium that The attack didn’t go full blown. I have to say I felt quite trapped by the meds. On the other hand, I slept well so 🤷🏼‍♀️ Which is worse?

Also, I woke up feeling the heart racing thing, felt the dread creep in, then went straight back to sleep in a druggy haze. I suppose it’s good that I slept through it but I remember feeling quite frightened by that.
That said, the GP told me to do one more night (tonight) with the 5 mg of Valium to try break the cycle so I suppose I will do so again.

So can you recommend me a mindfulness thing or relaxation to try once the kids are in bed?

I rate Calm app.
There are daily mindfulness sessions and sessions that help panic. I also listen to the sleep stories.
I understand that it all sounds so 'tame' when you are feeling like you're climbing the ceiling. I've been there and it's horrendous. Indescribable.

Thank you all for replying. Yes, it is indescribable. I can’t imagine feeling normal again now that I know how horrendous I can feel.

You can and will feel normal.
You will come through this a stronger person with more empathy, understanding and awareness.
You will be 'you' again albeit an updated 'you' who appreciates 'normal' more than you ever did before!

So sorry to hear of your struggles 😔 I also suffer from anxiety, it really does suck. My brain loves to worry and go on panic mode. About anything. About 5 years ago I was having panic attacks, I went to to doctors to be assured im not dying, (I didn't know what I was experiencing was panic attacks, I genuinely thought I had a heart problem ) and was prescribed sertraline. It helped for a while but I I felt numb, couldn't feel happy, excited or sad. I was just existing. I would spend silly money impulsively on junk to try and make me feel better. I had withdrawals when I came off them. Then after a while I started to feel things again, but I felt happiness! I haven't had a panic attack in a while. I convinced myself to control thoughts and feelings and although sometimes I struggle, most of the time I manage to rationalise things and it takes a weight off my shoulders. Medication didn't work for me but I have seen it help other people!! Being rational and talking about everything that goes on in my head really helps. I make lists to follow, set a routine to follow and adjust it continously keep it easy and fun. If I feel myself panic I just tell myself it's temporary and will pass. Stick to my lists and routine and I have no reason to worry and everything go smoothly. If I miss something on the list, it's a lesson in dealing with change. Each time it gets easier. There are ways of coping it's just different for everyone and harder for some. I surround myself with things that make me happy and inspire me like candles and fluffy blankets. Rearrange furniture every now and then to make the room feel lighter. Force out the negative thoughts with the positive. Getting yourself out of the pit is the beginning of a long road but you will get there all in your own time and I promise things will get easier. 💗

Hi, what might be happening is this.

You begin to experience the physical symptoms of anxiety, sometimes caused by hormonal fluctuations, and your mind goes into overdrive. Your anxious thoughts trigger your bodies adrenaline response because it thinks there is a threat (fight,flight or freeze). Now your mind and body are in full blown panic mode with adrenaline causing the physical symptoms and your thoughts spiralling out of control. It is cyclical.

A suggested therapy route might be CBT to help retrain your mind at the first feelings of anxiety so that you can halt the adrenaline response. There are lots of websites and books that can help you on this journey.

Be kind to yourself. You are not alone.

I've been there and it's horrrendous - I really sympathise. The Calm app is great but you might find it hard to do a mindfulness session when you're panicking - it's something to do during the day, while you have time and feel ok - ie before the panic kicks in.

It will get better and you will not die - the urge to be at a hospital and for medical reassurance is completely understandable but you may find that environment makes you feel worse.

You might benefit from trying mirtazepine which is specifically for anxiety and stopped my panic attacks - it did make me drowsy in the morning but having my sleep back was more important for me and it broke the cycle. Your mind is a powerful thing but it will settle with help and time; and there is help out there. CBT also helped me. Good luck x

I've been there OP, was on sertraline, propranolol (and diazepam when things got really bad). I've been off all meds for over 2 years now so you can and will get through it and come out the other side.

Remind yourself, 'it's 'only' anxiety and it can't hurt me'.

Google 7/11 breathing technique, it really helps calm you down during a panic attack.

That makes total sense emeeno1, and I will try cbt (hasn’t worked for me in the past for depression but I accept this is very different) but what can I do NOW, right now while I’m in the middle of 4 days of panic mode? That’s what I need to know. How do I get out of it.

Thank you everyone so much. Will look up mirtazepine.
I’ve been on and off sertraline for 8 years. Ow since my first child and it’s so sad to think that’s my life, for good. I can’t function without it, clearly.