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Wednesday, September 22, 2010

Panic Attacks!

                                                                                Mood:Freaking Out!!
I haven't eaten anything today..
Had three cups of tea only.
I am super dizzy, then comes the headache..
Time ticks by and the dizziness gets stronger, the panic is setting in. I haven't had one since my trip to the hospital last week, why now? I hate this.
I'm a prisoner in my own skin. I want to cry.
My breathing gets shallow and the thoughts start at 100 mph. Food, food, food.
A buffet at the Festival tonight, what am I going to wear? I still have to dress my kid, I have to shower. So many small trivial things suddenly seem like obstacles. The headache is intense, the breathing gets slower, am I even breathing?
I need air, a cigarette..Outside it doesn't help?
Now come the tremors inside and out. I'm cold.
I'm having a panic attack. Its strangling my life. I just have to breathe and stay put. I wish I had something to take to help me calm down, but I don't. I don't even have a therapist! How am I going to overcome this.
I start thinking about the huge crowds, all those strangers. I don't know a single soul there.
I hate this!! I can't calm down, how can I make this go away. No chest pains yet but it will come. I need to be strong tonight, I have to go. The b/p concern me but its in the back of my mind, not up front and center like I thought earlier. I can't focus on anything right now, feel so paralyzed.
I wish I could just be normal, why is everything a thousand times harder for me than others?
This is becoming a huge trigger for me. Makes me just want to say Fuck it! You win! Go ahead and destroy me!
I'm so irritable right now, here comes the chest pains. I just want to fall asleep, just keel over. I hate that I'm going through this alone. No one understands how hard this is for me. I can't even fathom it at times. Triggers all around now, my daughter back from school, my husband and his parenting. I have the weight of the world on my shoulders, such a load I cannot carry. I pray for broader shoulders.
I can't catch a breath, I can't calm down. I want to just scream!
I'm so dizzy, wish I would just pass out already, at least then I would have a moment of peace and disconnected from feeling anything.
I'm tired of being at war with myself..I'm my own enemy.
I have to cry now. I feel so defeated.
Am I slowly going crazy?
Just have to breathe.............in-out-in-out- exhale.
The writing is helping some, feels like I'm channeling the panic elsewhere.
Dear God, please let me be okay tonight, for my daughter's sake. Let me not embarrass her with this phobia.
Breathe.
I have to lie down and try to find the quiet..
Breathe.....


                             Panic attacks and panic disorder
                                                
A panic attack is a sudden episode of intense fear that develops for no apparent reason and that triggers severe physical reactions. Panic attacks can be very frightening. When panic attacks occur, you might think you're losing control, having a heart attack or even dying.
You may have only one or two panic attacks in your lifetime. But if you have had several panic attacks and have spent long periods in constant fear of another attack, you may have a chronic condition called panic disorder.
Panic attacks were once dismissed as nerves or stress, but they're now recognized as a real medical condition. Although panic attacks can significantly affect your quality of life, treatment is very effective
                                          Symptoms
Panic attack symptoms can make your heart pound and cause you to feel short of breath, dizzy, nauseated and flushed. Because panic attack symptoms can resemble life-threatening conditions, it's important to seek an accurate diagnosis and treatment.
Panic attacks typically include a few or many of these symptoms:
  • A sense of impending doom or death
  • Rapid heart rate
  • Sweating
  • Trembling
  • Shortness of breath
  • Hyperventilation
  • Chills
  • Hot flashes
  • Nausea
  • Abdominal cramping
  • Chest pain
  • Headache
  • Dizziness
  • Faintness
  • Tightness in your throat
  • Trouble swallowing
Panic attacks typically begin suddenly, without warning. They can strike at almost any time — when you're driving the school car pool, at the mall, sound asleep or in the middle of a business meeting. Panic attacks have many variations, but symptoms usually peak within 10 minutes and last about half an hour. You may feel fatigued and worn out after a panic attack subsides.
One of the worst things about panic attacks is the intense fear that you'll have another panic attack. If you have had four or more panic attacks and have spent a month or more in constant fear of another attack, you may have a condition called panic disorder, a type of chronic anxiety disorder.
                                        Risk factors
Symptoms of panic disorder often start either in late adolescence or early adulthood and affect more women than men.
Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends.
Factors that may increase the risk of developing panic attacks or panic disorder include:
  • A family history of panic attacks or panic disorder
  • Significant stress
  • The death or serious illness of a loved one
  • Big changes in your life, such as the addition of a baby
  • A history of childhood physical or sexual abuse
  • Undergoing a traumatic event, such as an accident or rape
                                        Complications   
Left untreated, panic attacks and panic disorder can result in severe complications that affect almost every area of your life. You may be so afraid of having more panic attacks that you live in a constant state of fear, ruining your quality of life.
Complications that panic attacks may cause or be associated with include:
  • Development of specific phobias, such as fear of driving or leaving your home
  • Avoidance of social situations
  • Problems at work or school
  • Depression
  • Increased risk of suicide or suicidal thoughts
  • Alcohol or substance abuse
  • Financial problems

           
                                    Treatments and drugs
The goal of treatment is to eliminate all of your panic attack symptoms. With effective treatment, most people are eventually able to resume everyday activities.
The main treatment options for panic attacks are medications and psychotherapy. Both are effective. Your doctor likely will recommend starting with just one type of treatment, depending on your preference and whether there are therapists with special training in panic disorders in your area.
Your doctor may recommend a combination of medication and psychotherapy if you:
  • Have severe panic disorder
  • Have panic disorder along with another major mental health diagnosis, such as depression or post-traumatic stress disorder
  • Have already tried one type of treatment and haven't improved
                                         Medications
Medications can help reduce symptoms associated with panic attacks, as well as depression if that's an issue for you. Several types of medication have been shown to be effective in managing symptoms of panic attacks, including:
  • Selective serotonin reuptake inhibitors (SSRIs). Because these antidepressant medications are generally safe and have a low risk of causing serious side effects, SSRIs are typically recommended as the first choice in medication options to treat panic attacks. Drugs in this class that have been approved by the Food and Drug Administration (FDA) for the treatment of panic disorder include fluoxetine (Prozac, Prozac Weekly), paroxetine (Paxil, Paxil CR, Pexeva) and sertraline (Zoloft).
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications are another class of antidepressants. The SNRI drug called venlafaxine (Effexor XR) is FDA-approved for the treatment of panic disorder.
  • Tricyclic antidepressants (TCAs). While effective, these antidepressants pose a risk of serious side effects, including heart and blood sugar problems. No TCAs are FDA-approved specifically for the treatment of panic disorder.
  • Benzodiazpines. These medications are mild sedatives. They belong to the group of medicines called central nervous system (CNS) depressants. Benzodiazepines may be habit-forming (causing mental or physical dependence), especially when taken for a long time or in high doses. Benzodiazepines that have been FDA-approved for the treatment of panic disorder include alprazolam (Xanax) and clonazepam (Klonopin). If you seek care in an emergency room for signs and symptoms of a panic attack, you may be given a benzodiazepine to help stop the attack.
  • Monoamine oxidase inhibitors (MAOIs). Because these antidepressants can cause life-threatening side effects and require strict dietary restrictions, they're not commonly prescribed. No MAOIs are FDA-approved specifically for the treatment of panic disorder.
If one medication doesn't work well for you, your doctor may recommend switching to another or combining certain medications to boost their effectiveness. Keep in mind that it can take several weeks after first starting a medication to notice an improvement in your symptoms. All medications have a risk of side effects, and some may not be recommended in certain situations, such as pregnancy. Be sure to talk to your doctor about the possible side effects and risks.
                                       Psychotherapy
Psychotherapy, also called counseling or talk therapy, can help you understand panic attacks and panic disorder and how to cope with them. The main type of psychotherapy used to treat panic attacks and panic disorder is cognitive behavioral therapy. Your doctor also may recommend a type of psychotherapy called psycho dynamic psychotherapy.
  • Cognitive behavioral therapy. Cognitive behavioral therapy can help you change thinking (cognitive) patterns that trigger your fears and panic attacks. It can also help you change the way you react (behave) to anxious or fearful situations. During therapy sessions, you learn to recognize things that trigger your panic attacks or make them worse, such as specific thoughts or situations. You also learn ways to cope with the anxiety and physical symptoms associated with panic attacks.
    These may include breathing and relaxation techniques. In addition, working carefully with your therapist, you may re-create the symptoms of panic attacks in the safety of his or her office. This is an important step because it can help you learn to control and master the symptoms so that they don't continue to be a source of intense fear. Doing this can also help you overcome fear of certain situations that you may avoid, such as crowded malls or driving.
  • Psycho dynamic psychotherapy. Psycho dynamic psychotherapy focuses on increasing your awareness of your unconscious thoughts and behaviors. Unlike cognitive behavioral therapy, this approach doesn't intentionally re-create panic symptoms. Instead, your therapist helps you investigate your mind to identify internal emotional conflict that may play a role in your panic and avoidance reactions.
    Based on your findings, your therapist will help you develop healthier ways to respond to conflict. Early study results suggest that psycho dynamic psychotherapy focused on panic reactions may be an effective short-term treatment option for panic disorder. More research is needed to fully understand how this type of therapy compares with other treatments for panic disorder.
Your therapist may suggest weekly meetings when you begin psychotherapy. You may start to see improvements in panic attack symptoms within several weeks, and often symptoms go away within several months.
As your symptoms improve, you and your therapist will develop a plan to taper off therapy. You may agree to schedule occasional maintenance visits to help ensure that your panic attacks remain under control.

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