Where are you?

Dr. Mahteme Selassie, MD, is in Bethesda. He is fantastic and takes insurance

OP here again. Thank you again for all the wonderful advice and tips. It's helpful to know I am not alone. I realize I need a good psychiatrist to work with, but I cannot afford $250-$350/half hour for sessions, especially when the psychs want you to go in for twice-a-week appointments at first. That would just add to my stress. Are there any good psychiatrists out there in DC or NoVA who take insurance? All of the ones I tried to reach aren't accepting new patients.

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.

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.

Capital Institute is great. However, they don't take any insurance and are pretty expensive.

I have severe anxiety with frequent panic attacks. I am on disability. I can work no more than 12 hours per week. My official diagnosis is severe generalized anxiety disorder and PTSD.

You need to see a psychiatrist, not a GP to manage your meds. You should also be seeing a therapist.

What helped me -

celexa
Valium
Blood pressure meds- Labatatol (mine spiked to 225/150 at one point)
Tramadol

And most helpful of all, mindfulness practice and yoga. I hate taking medication and am working towards decreasing the amount. I very rarely need the Valium these days. Mindfulness Meditation has been a huge help.

Anxiety disorders and panic are tough to live with. I ended up having to step back and accept that I just could not manage a full time job. All of my student loans were discharged, thankfully. And I easily qualified for disability. It's not what I wanted, but it's better than forcing my family to live with me the way I was.

There is help out there. See a psychiatrist and a therapist. And start a mindfulness practice. Sending love, light,prayer, and peace your way. You will find your way through this

OP, I haven't read all the other posts so I apologize if this has been mentioned.

I have anxiety, depression, and panic attacks. I started taking fish oil, Vitamin D supplements. After a few weeks, I noticed an improvement. I was less edgy, less of a glass is half full person. I heard vigorous exercise helps too but I haven't found a way to incorporate this into my daily routine yet.

I did also hear ashwaganda helps.

You may want to call Village Green Apothecary and they have nutritionists on staff to help suggest different supplements.

I take 500 mg of magnesium before bed and it helps my chronic, lifetime anxiety.

OP, even if it will mean you have to pay some out of pocket, you really should see a good psychiatrist. When my anxiety attacks were debilitating, I saw a psychiatrist who helped me find the right meds and worked with me to taper the dose upward very slowly. Like you, I was sensitive to SSRIs; they made my anxiety worse at first. This is normal when you start an SSRI. He prescribed me a liquid form of Zoloft so that I could start at tiny doses (like 1/8 tablet equivalent) and work my way up. He also prescribed me Klonopin, and for me, that worked better than anything.

Eventually I stabilized and then after a while I stopped taking all of that stuff, and now I just take magnesium.

This was Dr. Portillo at Potomac Psychiatry in Rockville. He is wonderful.

not OP, but have had a lot of anxiety. how much magnesium are people taking?

Anonymous wrote:OP here. Thanks to all for the referrals, tips and advice.

I need to do something and soon. Last night was terrible. I am mid cycle and am ovulating and perhaps that is why the flare-up is happening. I woke up with my heart flip-flopping and then the panic attacks started. Every 2 hours from 12 am - 6 am. I took a beta blocker that helped but still kept waking up anxious as all hell.

I'm tired, upset, and now have to get my kids up and ready for camp and then get myself to work. No idea how I will function. I wonder if my last pregnancy permanently destroyed my hormones and body. I miss the old me and don't think I will ever get her back. Instead I am left with trembming, shaky, anxious me.

Did you go to bed at 12am? That is too late. Constantly going to bed late makes my panic attacks flare up and as others said you really should look into magnesium. Low magensium weakens your muscles and causes them to spasm, this includes the heart. Make sure your vitamin D is adequate as well because your body can't absorb magnesium without it.

How's your spiritual Live? maybe that is the most important thing!!! Seek God, he is faithful!!! Also, I recommend to see a holistic doctor. They will treat your whole being. They will help you to get rid of so many medication little by little and replaced them with natural herbs. My mom had severe depression and anxiety and she is 80% better after she started taking natural herbs.

Anonymous wrote:OP here. Thanks to all for the referrals, tips and advice.

I need to do something and soon. Last night was terrible. I am mid cycle and am ovulating and perhaps that is why the flare-up is happening. I woke up with my heart flip-flopping and then the panic attacks started. Every 2 hours from 12 am - 6 am. I took a beta blocker that helped but still kept waking up anxious as all hell.

I'm tired, upset, and now have to get my kids up and ready for camp and then get myself to work. No idea how I will function. I wonder if my last pregnancy permanently destroyed my hormones and body. I miss the old me and don't think I will ever get her back. Instead I am left with trembming, shaky, anxious me.

I think that your sense of responsibility and your level of concern for addiction is a good sign that you'd do just fine on benzos. I'm a pp who used to take Xanax. I was reluctant because I was so concerned about becoming addicted, but because of that fear, I followed the doctor's orders exactly. Once I was to a point where I took it as-needed (I did eventually switch to Klonopin, which I'd forgotten about), I truly only took it as-needed. Like PPs have said, it was really helpful just knowing I had a fast-acting pill available to me, if needed. Sometimes in the midst of a panic attack, you become so fearful or worried about the symptoms, that they ramp up even more. Being able to tell myself "OK, my heart is racing and I have that sick adrenaline feeling in my stomach right now, but that's ok because if it gets any worse, I'll take a pill" helped so much that sometimes I didn't even need to take the pill. If you don't have to worry about whether you'll end up awake all night long, or worse, in the ER, well...that's one less thing to worry about which is one less thing to ramp up that anxiety.

I guess I'm pushing Xanax or Klonopin because I remember how absolutely awful it was to have those anxiety attacks (and mine weren't even as severe as yours), and how I put off taking medications for so long, and just the utter RELIEF I felt once I finally started taking it. I feel for you, OP.

Anonymous wrote:

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.

Original CBT poster here. I did CBT in another state, but my experience was the same. Afterwards I didn't even need my "emergency" Ativan anymore.

Agree with PPs about getting enough sleep and magnesium, too -- CBT is wonderful but you need sleep and the right minerals in your body as a foundation!

Op if you are looking for a nonSSRI solution try Ashwagandha capsules. Works for me.

OP, I'm so sorry. It's so scary to feel like someone other than yourself.

I'm not sure if you've responded about the magnesium deficiency - - have you tried that? Pregnancy really does strip you of magnesium stores. It could help.

A dear friend of mine had crippling anxiety attacks out of nowhere starting almost two years ago. They got so bad that she had to be hospitalized numerous times and ended up going on disability. The hospital put her on some pretty scary doses of benzos just to keep her from losing her mind entirely, but they made her a total zombie. After many, many trials and errors of med combos, the one that has worked magic is old fashioned tried and true lithium. A really low dose. Nothing else. She's off all benzos now.

Lithium is not as scary as it sounds. You can even get really low doses that are found naturally in water in some areas of the country -- areas that report fewer violent crimes, fewer suicides, etc...probably because most people are happier with a tiny dose of natural mood stabilizer in their systems. Here's a thing in the NYT about it:

http://www.nytimes.com/2014/09/14/opinion/sunday/should-we-all-take-a-bit-of-lithium.html?_r=0

OP here. Thanks to all for the referrals, tips and advice.

I need to do something and soon. Last night was terrible. I am mid cycle and am ovulating and perhaps that is why the flare-up is happening. I woke up with my heart flip-flopping and then the panic attacks started. Every 2 hours from 12 am - 6 am. I took a beta blocker that helped but still kept waking up anxious as all hell.

I'm tired, upset, and now have to get my kids up and ready for camp and then get myself to work. No idea how I will function. I wonder if my last pregnancy permanently destroyed my hormones and body. I miss the old me and don't think I will ever get her back. Instead I am left with trembming, shaky, anxious me.

I've been interested in nutrition and psychiatric disorders for a long time, and finally mainstream medicine is starting to realize that all these expensive drugs don't work as well as does nutrition.
http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366%2814%2900051-0/abstract

OP, what is your diet like? Have you seen a nutritionist? Use one certified by the American College of Nutrition
http://www.americancollegeofnutrition.org/

Their next conference is all about Optimizing Brain Health. All science-based.

Nutrition is tough medicine, though, because food is so linked to emotion, social and cultural norms, upbringing, etc. It's very difficult to change your diet permanently, but you may need to.

The other "problem" with nutrition is that it takes a long time to see results. Take Welbutrin, and you'll see results almost immediately. Change your diet, and you'll see results in 2-3 months. Most Americans don't have the patience for that, and most studies of diet and nutrition don't last longer than 6 weeks, so they often conclude that dietary changes don't work.

All these meds suggested by PPs are a Band-Aid, OP. They do not address the underlying problems that are causing your anxiety, OP. Perhaps they can help in the interim, but you need a long-term solution.