Crippling Anxiety and Panic but can't tolerate SSRIs - need advice.

[Anonymous]

Magnesium, Klonopin, Sunshine and Regular Exercise - In the short run Klonopin will do wonders, in the long run the rest 3 will keep anxiety at bay. Also, practice deep breathing.

[Anonymous]

How much sleep are you getting? After my first I developed severe panic attacks. It was bad to the point that I went to the ER a few times over it. Cogntive therapy helped immensely along with breathing expercies, vitamin D supplements, and magnesium. Yoga is great too because it involves a lot of stretching and deep breathing which helps to relax the body.

I also did a low dose beta blocker for a while but they made my blood pressure to low so I had to come off of them. During that time I had zero panic attacks and felt great but then started getting too many dizzy spells.

Another thing that helps me is drinking St. John Warts tea.

[Anonymous]

Anonymous wrote:OP here. Thank you everyone who wrote in and offered advice. I think maybe clonadine is worth asking my GP about. I did see a psych for a while, but she didn't take my insurance and basically prescribed the same stuff the GP prescribes. I didn't find it helpful for the cost.

I am nervous about benzos because of the dependency risk. But these anxiety attacks are so extreme that it might be worth trying temporarily. I have been warned to not even attempt wellbutrin, as uppers are the last thing I need. I had bad reactions to some of the more calming ssris, which ramped up my panic. Wellbutrin would probably put me in the ER for days!

Would like any further thoughts on clonadine or Someone mentioned gabapentin. Anyone have experience with those?

I am still sure this is somehow hormonal. But just odd that it came on during/after my third child. Had nothing like this prior with the other two. The BP spikes and pounding heart are thr worst. I have tried meditation, hypnotherapy, talk therapy, and even tapping. No luck.

Okay, but have you tried CBT?

Research has shown it to be more effective than medicating.

Other types of therapy, meditation, etc are not effective for anxiety, CBT is.

[Anonymous]

OP here. Have not tried CBT with a counselor but have tried some on my own and haven't found it helpful especially in the throes of an attack. Same for yoga and mindfulness. Great when I feel calm. But when the panic comes on nothing helps.

Where does one find a CBT counselor? It took me forever to find just a regular therapist who was accepting new patients and took my insurance.

[Anonymous]

You really might want to consider Hyperadrenergic POTS as the source of your problems, especially since a beta blocker seems to help you. POTS (postural orthostatic tachycardia syndrome) is a disorder of the autonomic nervous system. Hyperadrenergic POTS is a subtype characterized by increased blood pressure upon standing, severe anxiety, and other symptoms caused by very high norepinephrine levels. It is often treated with beta blockers. I would really encourage you to do a google search and see if the symptoms describe you.

In my experience, most people in the medical community - including cardiologists - are not familiar with POTS and tend to dismiss it (to put it mildly). You need to see a doctor who specializes in this problem (there aren't many). There is no point in treating an anxiety disorder if you have an underlying medical problem.

[Anonymous]

Anonymous wrote:OP here. Have not tried CBT with a counselor but have tried some on my own and haven't found it helpful especially in the throes of an attack. Same for yoga and mindfulness. Great when I feel calm. But when the panic comes on nothing helps.

Where does one find a CBT counselor? It took me forever to find just a regular therapist who was accepting new patients and took my insurance.

If you are in the District, I can recommend the Capital Institute for Cognitive Therapy. I called them earlier today, explained the situation, and they matched up with a counselor who has worked out well. Didn't need to wait long either.

http://cognitivetherapydc.com/

If your anxiety attacks are as bad as you describe, an emergency med like Ativan is called for. I also second a more thorough investigation for POTS given beta blockers are working for you.

[Anonymous]

What type of doctor treats or diagnoses POTS?

[Anonymous]

Anonymous wrote:OP here. Have not tried CBT with a counselor but have tried some on my own and haven't found it helpful especially in the throes of an attack. Same for yoga and mindfulness. Great when I feel calm. But when the panic comes on nothing helps.

Where does one find a CBT counselor? It took me forever to find just a regular therapist who was accepting new patients and took my insurance.

You need to do CBT with a counselor when you are calm and can focus on what you are doing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here. Have not tried CBT with a counselor but have tried some on my own and haven't found it helpful especially in the throes of an attack. Same for yoga and mindfulness. Great when I feel calm. But when the panic comes on nothing helps.

Where does one find a CBT counselor? It took me forever to find just a regular therapist who was accepting new patients and took my insurance.

You need to do CBT with a counselor when you are calm and can focus on what you are doing.

This, but also benzo's are really not a bad option for panic attacks like this. Just knowing you have access to them if needed often helps, without even taking them.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Wellbutrin did not help me with anxiety at all. I think it made it worse. It did help with depression though.

Are you seeing a psychiatrist or a GP for meds?

Wellburtirn is not an anti-anxiety drug. It is an anti-depressant. It improves mood and energy level. It is a mild stimulant. In patients that are already anxious, it can ramp their anxiety through the ceiling. It's counter-indicated for patients who have anxiety as their primary problem.

PP who Wellbutrin helped here. Looks like it can have paradoxical effects in patients with anxiety, which must be what I experienced. It did help me - but it was literally the last thing I tried after lots of SSRIs and SNRIs... Would not recommend going straight there.

[Anonymous]

Anonymous wrote:What type of doctor treats or diagnoses POTS?

Cardiologist. Not all of them do it or on the look out for it. One I know who does is Dr. Ramin Oskui in DC.

[Anonymous]

Anonymous wrote:What type of doctor treats or diagnoses POTS?

Generally a cardiologist who specializes in dysautonomia. Dr. Peter Rowe of Johns Hopkins is one of the best known. You can find other doctors online. You can do basic blood pressure testing at home to see if you might be a candidate for further screening. Again, research online. Testing for POTS generally includes a tilt table test with cardiac monitoring and something called the valsava maneuver. More extensive testing is also available. This is a good summary of POTS:

http://www.dysautonomiainternational.org/page.php?ID=180

[Anonymous]

Check your magnesium and vit d levels.

[Anonymous]

OP, I can't tolerate SSRIs for my anxiety/panic either. Make me feel like im going crazy.

Buspar was like god-send.

I'm telling you, it really works, and there's NO side effects. Just reduced anxiety, more carefree. It's not even narcotic. You do have to take it twice daily though - I'd do 1/3 tablet 2x/day (its broken into thirds).

A lot of clinicians are surprised to hear me say it works. I think they were all trained years ago to believe oh, it's outdated and doesn't really work, so why bother. But it does so much for me.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here. Have not tried CBT with a counselor but have tried some on my own and haven't found it helpful especially in the throes of an attack. Same for yoga and mindfulness. Great when I feel calm. But when the panic comes on nothing helps.

Where does one find a CBT counselor? It took me forever to find just a regular therapist who was accepting new patients and took my insurance.

You need to do CBT with a counselor when you are calm and can focus on what you are doing.

Im the buspar lady lol - I saw Dr Laura Primakoff - and then quit Buspar - didnt need it anymore. She was just that good. No insurance though. But very worth the $$ to be free.